Rebecca Fox, MD

It’s inevitable. Every practice will have patients with unpaid balances. While it is unpleasant to ask people to pay you what is owed, it is critical to collect this revenue.

Here are some of the strategies my practice has put in place to improve patient payment collections:

Collecting past-due patient balances

We all work very hard each day and our practice also has bills to pay in a timely manner. Make sure you work those patient responsibility accounts receivable regularly, and collect the money due to your practice.

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Every medical practice will have patients with unpaid balances, but those that have smart collection strategies in place will be better off.

New year resolutions for private practice

7 ideas to get you started on your new year resolutions, whether you’re a practicing physician or a practice manager.

’s blog features contributions from members of the medical community. These blogs are an opportunity for professionals to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions are that of the writers and do not necessarily reflect the opinions of 

If you were to see a little blue square with a white lower case “f,” you would immediately recognize it asFacebook. How about the little flying blue bird? Does it make you think of Twitter? And everyone knows the golden arches means McDonald’s.

Take a look at your phone apps. The shorthand on your screen consists of symbols, usually the logo for the company. These visual representations are a powerful and fast way to identify a business. So what about the logo for your practice? Do you even have one? If you do, is it unique and memorable? How
about the name of your practice: does it evoke what your practice does or stands for?

When I was forming my new practice, I spent many hours thinking about all of these things. A good logo and brand appeal don’t happen by accident.

I had some very specific ideas in mind with respect to my practice’s name and logo. First, I wanted my surname (Fox) prominently featured in the practice name. I most certainly wanted something more creative than “Fox Clinic” or “Fox Medical Practice.” It took me a few weeks to come up with an appropriate name. Obviously, anything with vixen in the title wouldn’t do. I finally came up with the name “FoxCare” as it really conveys the idea that my new integrative medical practice would truly care for patients and their families. I know it seems obvious, but that’s what marketing is all about: emphasizing the obvious.

As for my logo, I wanted to keep with the theme of caring. Since I take care of children (and thus families too) I wanted a logo that suggested the same. My logo depicts a smiling mama fox curled around her sleeping baby fox kit. I wanted to send the message that I care for little ones just like a mom would do.

I also took great care selecting the color scheme for my logo (which also was incorporated into my practice’s decorating scheme). I am a hand-weaver and have written a weaving book that focuses on color theory. Because I know how much color affects a person’s emotions, I wanted a color that conveyed a peaceful but confident mood. The colors of water, aqua, and teal blue are perceived to be clean as well as calming, so I chose a vibrant teal/aqua color for the background of my logo.

If you want to create a logo that advertises the unique qualities of your practice, keep the following ideas in mind:

1. Do you have a logo? Is it contemporary and does it visually represent your practice goals? Does your logo need a facelift? My advice is to hire a graphic artist as they have access to all the latest design software and can produce a logo in every conceivable medium. You are going to need to provide your logo in many different digital forms (for various usage). Hire an expert. It will be more than worth the cost!

2. Your logo should be simple, easy to identify, and hopefully send a message about your medical practice. Think deeply about what you want the public to think about your medical group. If you, a staff member, or a loved one has artistic ability, that’s a great place to start. Sketch out some ideas but refer back to my first suggestion to produce the actual logo.

3. Consider rebranding your practice by adjusting your practice name. Many practices simply use the last names of the senior physicians. While that is an established tradition, does it really send a message about what your medical practice stands for? For example: Smith, Smith and Smith Orthopedic Group doesn’t create the same emotions as “The Bee’s Knees Orthopedic Group.” I know that is a silly example, but you get the point. Which one is more memorable and evokes positive emotions to you?

4. Play to your strengths. As I wrote above, my practice name, FoxCare plays with my last name, Fox. If you have a memorable name, feel free to use it. A brand is nothing more than something that people associate with certain ideas and feelings.

Your medical practice has an ethos, a mission, and a practice culture that keeps patients coming back to your group. Do not underestimate the power of your logo. You need to recognize what is special about your medical practice and then broadcast that message to potential new patients.

A good logo doesn’t happen by accident. Here are some tips to help you create a logo that advertises the unique qualities of your practice.

Creating your practice logo

Let’s say you are a general pediatrician. Would you be doing a cardiac catheterization for an adult?

What about if you were an orthopedic surgeon; would you manage a child’s seizure medication?

Or if you were a neurologist, would you prescribe chemotherapy for a breast cancer patient?

Of course, the answer to all the above questions is an emphatic “No!” but so many physicians are indeed working outside their scope of expertise when it comes to managing the business side of their medical practice.

A friend of mine works in a practice in which the new physician owners (the seniors having recently retired) are doing just what I described. They have disregarded the very seasoned office manager and are making business decisions on their own. And wouldn’t you know it, their practice is floundering.

As doctors, we are specialists in managing medical conditions of our patients within our chosen specialties. So why do we think we are business geniuses too?

I’m not making a blanket statement that all physicians have poor business skills. But the most prudent medical practices assess their business prowess and hire the best specialists to fill in the deficiencies. Consider the following suggestions if you think you might need a second opinion about your medical practice.

Look at workflow at all levels of the practice (front desk to nursing to practitioners) and streamline inefficient practices.

Analyze scheduling carefully. Are there too many gaps in the number of patients seen in a day? Are your providers seeing enough patients to cover their part of the overhead plus extra for practice profit?

Audit the coding done by providers. Are they capturing all the revenue that you are due?

Look at your inventory, both medical and non-medical. Do you have excess items sitting on shelves?

Look at your food budget. Are you buying lunch or dinners for the practice often? Perhaps you should cut back if your bottom line is suffering.

2. Employ a good practice manager. The ideal practice manager will have management education and relevant experience. If you already have a trusted and capable office administration, offer educational opportunities to improve their skills. The Medical Group Management Association has lots of courses, books, and meetings that will give your practice manager loads of extra information and training.

3. Hire a new accountant to go over the books as a second opinion. A fresh set of eyes can pinpoint problems more quickly. And don’t just hire them, listen to them.

4. Consider hiring a business consultant. Similar to an accountant, the consultant can help you analyze your business operations and provide you with additional insight. Think of this as an investment, not as an expense.

The most important thing for a medical practice is for it to remain profitable. Yes, you must give the best care to your patients, but if you are not making money, you won’t be in practice to take care of those patients. And you won’t be able to hire the best talent nor purchase the latest new medical technology in the future.

Lastly, don’t wait until you are already in debt. Take a look at your practice today to spot areas that need improvement. Don’t be like my friend’s practice and suddenly find yourself in trouble. Preventive care applies to practices as well as patients.

Physicians are specialists in medical care, but they sometimes need help with the business side of medical practice.

When physicians need a second opinion

Last weekend, we started Daylight Saving Time again.

Daylight Saving Time is good time to check on things at the office, such as the batteries to your smoke alarm. Make files concerning each of these items so you won’t have so much work to do the next time you run your list (when we leave Daylight Saving Time in November). Here's a list of items that, like changing the batteries in a smoke alarm at your office (or home), need continuous monitoring.

1: Check and change all equipment that has batteries. Thermometers, portal blood pressure cuffs, clocks, and timers. If you don’t want to actually replace all the batteries,  make sure you have an adequate stock of replacement batteries ready to go.

2: Check for replacement items such as specialty light bulbs for otoscopes and ophthalmoscopes.  Make sure you have spare parts for other equipment that is vital for your practice.

3: Don’t forget to check your AED and crash carts. Make sure they have not expired and replace items that are close or past dates.

4: Look at your medicine cabinet and lab supplies for expired items.

5: Do you have spare oxygen tanks? Are all your tanks full and operational?

6: Testing kits (strep test, flu test) also have expirations dates. Make sure to check those.

7: This is a good time to take a look at your office's service contracts. Make a chart for renewal dates and if there is an advance time period in which you would need to make changes. Such contracts can include: telephone service, IT services, cell phone contracts, copy machine, EHR services, office cleaning and even the service that manages your waiting room fish tanks. It’s always a good idea to look around for new services providers and the possibility of better pricing.

8: Waiting room magazines: Re-evaluate whether the magazines you order are a good fit for your patient population. Make a list of resubscription dates and adjust accordingly.

9: Regular delivery of medical and office supplies: if you have a regular recurring delivery of these items, make sure to evaluate whether you have excess stockpiles of certain items. Inventory on the shelf is money that you have spent but that investment isn’t doing much for your bottom line. You need just enough inventory to replace items as you use them up but not so much that you are wasting money.

10: Plan a brain storming meeting with providers and with staff members. Ask them in advance to think about any ideas for new services or items that might be helpful for the office. You might be surprised what they can come up with.

11: It’s a good idea to review dates for all personnel contracts (with providers and staff alike). Make sure you know when you need to have the yearly review with everyone.

12:  Find a time to do a deep spring cleaning of the office. Take everyone out of drawers and shelves and discard items that are no longer useful. Pull furniture away from walls and clean behind it. Assess your dÃ©cor and replace any that is faded, dirty, or out of date.  Get rid of live plants that are scraggly, dead or unhealthy looking then buy some new ones. Time to ask the office cleaning crew to wash windows and blinds, wax the floors and clean the carpets. A clean and well-maintained office gives the right first impression to everyone.

Spring is about to appear all across the country soon (despite what that ground hog told us!). Hopefully these tips will get your spring off to a good start.

Daylight Saving Time is good time to check on things at the office, such as batteries and old equipment that need replacing.

Spring Awakens: 12 Steps to Maintaining Your Practice 

I have many new patients express frustration with my office about our strict adherence to HIPAA policies; some of the stories I’m hearing are truly jaw dropping.

One new parent (with a medically complex child) was incredibly irritated that we don’t communicate via email. He told my front-desk staff that “he communicates this way with many other physicians all the time!” He is in the IT industry and was surprised to know that email is not considered medically secure.

We have a practice email where patients can contact us. I primarily use this email account to notify parents that I have sent them a portal message (many of my patients get themselves locked out and I have no way to know if they received my messages). We fully let patients know that if they choose to send records via email, it not considered secure enough for private medical information, but most patients prefer to send their records to us this way.

It’s also a bit surprising to me that most patients do not have access to fax machines. Their reaction to the news that fax is considered secure is comical.

What worries me is the reports I get from patients about communications they have had via email and even Facebook messenger with physicians that live in other states. Some have even had Skype consults with out-of-state providers. Not only is this not secure, these medical professionals are essentially practicing without a license if they are not licensed in the same state as the patient.

Texting private medical advice is also not considered secure. About a month ago, I had a family with a child in psychologic crisis over a weekend. He was not so severe that he needed to go to the ER, but the mother desperately needed support while they went through the day. She and I were texting each other, however I was very careful to not put any medical information in my texts. If anything needed that sort of information exchange I called her.

Mostly I was checking in to ask how he was doing and whether things had improved. The mother told me afterwards how grateful she was to have ongoing live contact with a physician for support.

And of course, I have had Facebook friends (parents of my patients) ask me advice on that platform. I simply inform them that I cannot answer as it is risky for private medical information. Most are understanding (and a bit embarrassed to have asked).

We all know that medicine is slow to adopt new technology and states are glacial in their ability to aid reciprocity between states. But rather than complain about the fact of the matter, physician MUST be extremely careful to uphold HIPAA protections. Anyone can report a physician to the government. With hefty fines, not carefully protecting medical privacy is an extremely expensive gamble to take.

If you have any comments on this article email 

Texting, Facebook, Skype - these technologies can all put you in the crosshairs of the government for failing to comply with HIPAA.