'I've Got Some Bad News'
How well does medical school prepare physicians to handle the difficult task of delivering bad news, or managing the spectrum of patients' psychosocial needs that follow? Not very well, say some young physicians. Here's some advice to make it easier.

A Better Office, By Design
Good design can make or break physician efficiency. Here's how one physician came to recognize the limits of his own design ability and learned more about how to make a practice run right.

A Better Way To Practice
Results from a three-year-old initiative by the Institute for Healthcare Improvement (IHI) on the way care is delivered at the practice level indicate that embracing change and encouraging innovation are not only possible but, ultimately, profitable.

A Tangled Web
A growing number of states, medical organizations, physician practice groups, and for-profit organizations are peppering the Internet with physician profiles. There is general agreement that these profiles can be helpful tools for consumers. But some physicians may find they are on the receiving end of just the kind of advertising they don't need, and some in the medical field question the content of these sites.

Are You Prepared?
It's hard to estimate how many physician offices are sufficiently prepared for patients presenting with sudden medical emergencies, such as a heart attack, seizure, or severe asthma attack. Here's how to handle it.

Boost Your Bottom Line
A growing number of physicians have expanded their traditional practices to include additional services, from alternative medicine to MRIs to executive physicals. While the primary motive for some physicians is to produce more revenue, others see their expanded service lines as a natural extension of their practices, an opportunity to provide one-stop shopping as well as to give their incomes a shot in the arm.

Building Your Business
How one expert approaches facilty design

Handle Patients With Care
"You have cancer." These three little words can make a big difference to a patient. No physician can guarantee everything will be all right; even coercing the illness into remission may be out of reach. But one oncology practice in Memphis is bound and determined to at least make the experience of cancer treatment as positive as it can be.

It's Your Call
Is your call coverage a harmonious arrangement or an issue that leads to verbal sparring between you and your partners? Although the variation in call arrangements is broad, two things are clear: call coverage is less onerous in practices that take the time to delineate and negotiate an arrangement that is considered fair by everyone, and managed-care contract language plays a role in how you structure the arrangement.

The Coding Conundrum
Like it or not, today's physicians no longer have the option of throwing up their hands and saying: "I'm a doctor, not a businessperson. I don't want to have anything to do with coding." The ultimate responsibility, if an error is made, is always the physician's. And it is the physician who can get audited — not the billing person or the certified coder. Despite shouldering the burden, physicians' involvement in the coding process varies across practices. Thus, the debate remains: who should code? Ideally, most experts say, coding should be a shared responsibility.

The Message Is Quality
There are few practices that mention marketing as a primary strength, but at Cardiovascular Associates (CVA), of Birmingham, Ala., the practice's image and ability to differentiate itself in the market are sources of pride. Now in its 55th year, CVA is one of the largest private adult cardiology practices in the country. "And we are successful in part because of the way we market," says practice administrator William F. Cockrell.