JOB LOSSES, FORECLOSURES AND YOUR PRACTICE

"We are about to have a big problem...Foreclosures were bad last year? Its going to get worse, " says Morris A. Davis, a real estate expert at the University of Wisconsin. Davis isn't the only pundit talking about this. Mark Zandi, the brilliant author and chief economist at Moody's Economy.com is saying: "... loss of jobs and loss of overtime hours and being forced from a full-time to part-time job is resulting in [mortgage] defaults." All over the US, doctors are having to deal with individuals who cannot cover deductibles, co-pays, and are less reluctant to see the doctor. Where elective type treatment is involved, patients are just not accepting treatment as readily as they have in the past.

Silkin research in over 50 practices in the past 3 months indicates that doctors in every category of health care are having a much more difficult time getting patients to comply with treatment plans. Let's face it. The general public is scared when it comes to spending money, and the doctor and staff have to know how to deal with this. Otherwise, their practices go the same direction as the economy!

Allen Jackson, one of Silkin's senior analysts and consultant for over 20 years made this observation recently: "When credit was lax, and everyone was getting 0% credit card offers in the mail, it didn't require any skill to get a patient to comply with a treatment plan. If a practice was not growing during that period at a solid 15-20% then something was wrong. Now, its a different world; management skills like, "selling" treatment, keeping staff motivated and efficient, and increasing profitability in a private practice take expertise and knowing what to do. Doctors need to start managing and they need staff who are on their toes and know their jobs cold. During those "good times" lack of management expertise in a practice was hidden by the fact that patients had an abundance of credit available. The danger of that time period, Jackson says, "led to complacency and not being as alert as possible to the signs of downturns practices."

We recently did a survey on about 150 of our clients and found that they have continued to grow at a solid rate over the past 12 to 18 months, while revenue in private practices nationally continues to decline. We asked these clients if they felt things had slowed down for them with the economy being so poor. Over 90% said no, that they were continuing to grow.

Some of the comments were:

"We're in control of our new patients, so it's not a problem."

"It (the economy) hasn't been a problem with the things I've learned from you."

"I'm still moving up, last month was the best month of my entire practice." "We've actually grown. March growth was 7% and April was 20%."

Learning basic practice management skills puts one in control of the growth and profitability of any practice. As a philosopher once said, "knowledge is power" and that holds true whether referring to running a country, a business or a health care office. Get yourself trained in practice management, whether you use Silkin or another practice management program. It will help you be pro-active during these tougher economic times.

We also invite your feedback to this blog or previous blogs by participating in our Discussion Forum at the Silkin Facebook Page BY CLICKING HERE.

Larry Silver
President, Silkin

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Solutions Magazine

An Argument for developing a Web Presence

An impressive web presence is generally not a high priority for most private practice health care owners. Although many practices now have website, the importance and use of them is often not taken to seriously.

I am not a computer genius nor do I know the first thing about HTML (Hyper Text Markup Language - used for creating web sites) formatting. I use a computer at work and like many people, I have a computer at home that I use for email and more importantly, to "Google."

By "Google" I am of course referring to the massively popular activity of searching for information on the web to find a restaurant, a vacation spot or a doctor's practice that I am considering going to.

Over the past three years, it has become more and more obvious that Americans are more and more using the World Wide Web to find out about companies that they wish to do business with. The days of looking up a doctor's phone number in the bulky, yellow, phone book are gone. I am not implying that paper phone books are no longer useful, they most certainly are. I use mine at home to shore up a short leg on my basement desk. However, if I am interested in finding a good doctor to visit, I am just a mouse click away from the largest resource of information of doctors in my area ever known.

For example, my Veterinarian's site provides directions to her practice so that I can easily refer my friends to her. Her site also lets me know about new services for my pet, background information on her new employees and emergency hours. I even discovered that her office is starting a grooming service! (Hmm, good idea, I am scheduling an appointment for my dog "Bo" next week.)

The idea for this blog was created from an incident that occurred just recently. In the normal course of doing business, I was invited to speak with a Veterinarian in Colorado. Prior to my call, I decided to look up the doctor's practice on the web to find out more about the doctor himself and his practice. As a professional, I find it helpful knowing something about a client before meeting them. I was surprised that I could not find any information regarding the doctor on-line. I attempted to find him on several search engines; I even varied my search. I tried his name, I tried his name plus DVM in "City Name," CO. I even did a search just for Veterinarians in his town. Finally, I was able to find the doctor's name in the web site of his competitor in the same town! His competitor's site was very beautiful with plenty of information about his practice, the staff, his facilities, etc. If I were a resident with a pet in this beautiful town in Colorado, I would now know exactly which practice to go to, and it wasn't his. And yes, I did call the doctor as scheduled and made the doctor very aware of what was happening in his neighborhood. Interestingly enough, the doctor was wondering why his practice was contracting in a community that was expanding quite rapidly.

Unfortunately this is not only a true story it is also very common.

Developing a web presence now is more important than ever. Home computer use is not going to slack off in the years to come. More than ever, Mr. and Mrs. Patient and Client are going to go to the World Wide Web to find information regarding the doctor or practice that they are going to visit.

And yes, word of mouth is still the number one draw of new patients and clients to your practice. But know this - after I hear your name and how wonderful your practice is from my best friend, I promise you, I will Google you. What happens after that is up to you.

We also invite your feedback to this blog or previous blogs by participating in our
Discussion Forum at the Silkin Facebook Page BY CLICKING HERE.

Larry Silver
President, Silkin Management Group

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The U.S. Dollar

In our last two blogs, I presented a two part article from Mr. Bruce Wiseman about the international financial crisis and the "Big Brother" controls that are being implemented.

Mr. Wiseman also predicted the potential fall of the dollar as the world's reserve currency. Well, lo and behold, the NY Times op-ed pieces for Thursday, May 14 had not one, but two pieces on the fall of the dollar. I thought it would be of interest to pass these articles along to anyone interested in following this situation.

The first article is by a professor of economics at the New York University Stern School of Business, and the second article is by an executive director of the Beijing Private Equity Association who is also a director of the China National Association of International Studies. Click on the links below to read the articles. I think you will find them interesting in light of the two previous articles by Mr. Wiseman.

The Almighty Renminbi?

China’s Heart of Gold

We also invite your feedback to this blog or previous blogs by participating in our Discussion Forum at the Silkin Facebook Page BY CLICKING HERE.

Larry Silver
President, Silkin Management Group

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THE REAL SITUATION

Here is Part 2 of the latest article by Mr. Bruce Wiseman regarding the sources of the worldwide financial crisis.  Part 1 can be seen in our previous Blog below. If you haven't read Part 1, please do so before reading Part 2, below.

Larry Silver
President Silkin Management Group

THE REAL SITUATION
More to the point, you may have noticed that you weren’t consulted on this setup. Neither was Congress. In other words, the command channel for implementing global financial strategies goes from the FSB leadership to its central banker members and from them to the world’s financial institutions. You don’t get a peek, neither does Congress, nor, for that matter, does the White House.

And while there may be some accountability in some of the member countries, by and large these central bankers have the authority to implement these regulations and strategies. And they are held responsible by the FSB to do so.

In short, on April 2, 2009, the President signed a communiqué that essentially turns over financial control of the country, and the planet, to a handful of central bankers, who, besides dictating policy covering everything from your retirement income to shareholder rights, will additionally have access to your health and education records. There is also this troubling little line about “clear specification of the structure and functions of government.” What the hell is that suppose to mean? There is no oversight here. Not by you, not by Congress, not by anybody. No oversight over a handful of central bankers who operate out of a clandestine organization that is above the law and is responsible for having implemented and enforced the “standards” that froze world credit markets and precipitated the worst financial crisis in the planet’s history (see “The Financial Crisis: A Look Behind the Wizard’s Curtain”).

I haven’t heard word one out of Congress about this, but I’m afraid they are a few clowns short of a circus up there. Which begs the question, what do we do about this?
                                
THE SOLUTION
There are two critical things that need to be done. The first lies in the fact that the communiqué signed by the President is an agreement that is binding on the United States and, as such, requires approval by Congress. If classed as a Treaty, it requires approval by two-thirds of the Senate. At the very least, approval should be by Congressional Executive Agreement, which requires a majority of both houses of Congress. The agreement signed in London on April 2 has been called a New Bretton Woods (Bretton Woods being the location of a meeting of world leaders toward the end of the Second World War, which gave birth to the international financial organizations the World Bank and the International Monetary Fund). The original Bretton Woods agreement was put in place as a Congressional Executive Agreement. So this “new Bretton Woods” should at least do the same. But this step is just to get Congress to recognize their responsibility here. The Federal Reserve Act, the bill that established the Federal Reserve System, was passed in 1913 two nights before Christmas by a sparsely attended Congress. People have been complaining about this ever since. What do you say we don’t let this happen again? Not on our watch. Congress needs to understand that it has a responsibility to approve any agreement signed by the President that is binding on this nation. But the point is not to get Congress to approve what has been done. It is to first get them to recognize that agreements have been made that affect our entire financial system and that it is their responsibility to shape these agreements in a way that is beneficial to our Republic AND to provide a mechanism for real oversight of this international body. Central bankers should not be making decisions about international finance without oversight and a system of checks and balances that are reflective of those provided by a republican form of government. I am, of course, not talking about a political party here. No, no. I’m talking about the American form of government where citizens elect others to represent them. 

A republican form of government is one that is operated by representatives chosen by the people. Congress must step up to the plate. They must insist that the Financial Stability Board be ratified either by Treaty or Congressional Executive Agreement. And that ratification must include the creation of a body with oversight and corrective powers that is comprised of representatives of all the nations involved who are chosen from each country’s elected officials. There is nothing inherently evil about an international financial organization. As much as we might protest it, it is a global world today, and a body that oversees the smooth flow and interchange of currencies and other financial instruments is needed in today’s world. But the organization cannot be controlled by international bankers who are not answerable to the citizens of the countries in which they operate. It should be overseen by a senior level group which itself is organized as a liberal republic, following the original model of the United States. Why? Because the system of government originally created by the United States has been the most successful form of government in man’s history. Any problems with the system have come about as a result of deviations from the original structure—a representative form of government with adequate checks and balances. Such a body could help create an international economic system in which those that want to be successful can be so. It would also allow them to take an active role in controlling their futures by effectively participating in the legislative process. ACT!

Let your Representatives and Senators know: the Financial Stability Board must be approved by Congress and must be subject to oversight by elected officials of the
countries involved. Personal visits, followed by calls and faxes to both Washington and local offices, are the most effective. Don’t be surprised if they don’t know what you’re talking about. Politely insist they find out and take action. And understand this when dealing with legislators or their staffs: they are focused almost exclusively on legislation that has already been introduced—a bill with a number on it.

That is not the case here. You want them to take action on this matter by introducing legislation that brings the approval and structure of the Financial Stability Board under congressional control. This can be accomplished.  

“All tyranny needs to gain a foothold is for people of good conscience to remain silent.” —Thomas Jefferson
 
Find your elected officials here:
http://www.visi.com/juan/congress/

Bruce Wiseman
bdwiseman@earthlink.net
www.Brucewiseman.net
Copyright © 2009 Bruce Wiseman

About a month ago, I presented a 3 part article from Bruce Wiseman concerning his research on the "whys and wherefores" of the global financial crisis. I followed his article with another piece I found in my research by Dick Morris, former Clinton advisor and political strategist, that echoed some of the information that Wiseman wrote about. I just got a follow up piece by Wiseman that I thought was very, very interesting and worth sharing with anyone reading this blog. His data seems factual and, from what I can tell, accurate although I certainly haven't gone and attempted to verify every piece of it. I invite you to read it and share any thoughts through our Discussion Forum at the the Silkin Facebook Page BY CLICKING HERE.

Larry Silver,
President Silkin Management Group

Here is Part 1.

HITLER’S BANK GOES GLOBAL

THE PURPOSE OF THE FINANCIAL CRISIS

By Bruce Wiseman

A towering citadel housing what is essentially a sovereign state known as the Bank for International Settlements is located in Basel, Switzerland. The bank now controls the financial affairs of planet Earth.

If you think this is an exaggeration or the conspiratorial ramblings of the author . . . or not, I invite you to read on.

I wrote the first installment of this article—“The Financial Crisis: A Look Behind the Wizard’s Curtain”—in mid-March of this year. The article included the following statement: “The purpose of this financial crisis is to take down the United States and the U.S. dollar as the stable datum of planetary finance and, in the midst of the resulting confusion, put in its place a Global Monetary Authority—a planetary financial control organization “to ensure this never happens again.”

This purpose has now been accomplished.

The dollar, the former king of currencies, now goes begging in the pant-suited persona of Hillary Clinton to our creditors at the Chinese Communist Party. Almost unthinkable a few short years ago, the U.S. dollar is fast losing its status as the world reserve currency, and any thought of saving it is being nuked by the Larry, Moe and Curly of U.S. economic policy - Bernanke, Geithner and Summers - and their Alice in Wonderland trillion-dollar budget deficits. I would not be surprised to see central banks start using the renminbi (the currency of the newly awakened People’s Republic of China—also called the yuan) for international trade and reserves in the not too distant future. This prediction will likely be scoffed at by global economists, but then they have about as much credibility as pharmaceutical salesmen these days. A more generally discussed alternative is the International Monetary Fund’s SDR (which stands for Special Drawing Rights). There is no production or property behind the SDR. It is one of those clown currencies that are made up out of thin air—a magic trick central bankers like to do. Intoxicated by the power of the purse, they think of themselves as fiscal alchemists. But the dollar has seen its glory. It can return one day, if Washington ever finds its financial backbone. But let’s be real, with the exception of a very few, like Ron Paul in the House and Tom Coburn in the Senate, these folks are addicted to spending like junkies on horse.
More importantly, the other shoe has dropped. Like some ghoulish predator from another Alien sequel, a Global Monetary Authority has been born. It lives.

THE FINANCIAL STABILITY BOARD

On April 2, 2009, the members of the G-20 (a loose-knit organization of the central bankers and finance ministers of the 20 major industrialized nations) issued a communiqué that gave birth to what is no less than Big Brother in a three-piece suit.

Which means? . . .

The communiqué announced the creation of the all too Soviet sounding Financial Stability Board (FSB)—and no, I’m not going to make a crack about the fact that this acronym is the same as that of the Russian intelligence service that replaced the KGB. The Financial Stability Board. Remember that name well, because they now have control of the planet’s finances . . . and, when one peels the onion of the communiqué, control of much, much more. The FSB morphed into existence from an earlier incarnation called the Financial Stability Forum. The Financial Stability Forum (FSF) was established in 1999 to promote international financial stability through co-operation in financial supervision and surveillance. Since it had done such a wonderful job, the central bankers decided to expand its powers and give it a new name.

A board sounds like it has more authority than a forum. But the name change isn’t the problem. The FSB’s broadened mandate includes under point 5, “As obligations of membership, member countries and territories commit to pursue the maintenance of financial stability, maintain the openness and transparency of the financial sector, implement international financial standards (including the 12 key International Standards and Codes), and agree to undergo periodic peer reviews, using among other evidence IMF/World Bank public Financial Sector Assessment Program reports.” Rather a mouthful of elitist banker-speak. But, as a friend of mine is fond of saying, “The Devil is in the details.”

THE 12 INTERNATIONAL STANDARDS AND CODES

While several press releases from the G-20’s London conclave reference these codes as though they were handed down from a fiscal Mount Sinai, finding the specifics takes some digging. But then the Bank for International Settlements (BIS), out of which the FSB operates, has never seen transparency as one of its core values. In fact, given its fascist pedigree, transparency hasn’t been a value at all. Known as Hitler’s bank, the Bank for International Settlements worked arm in arm with the Nazis, facilitating the transfer of gold from Nazi-occupied countries to the Reichsbank, and kept their lines open to the international financial community during the Second World War.

As noted in the first article, the BIS is completely above the law. It is like a sovereign state. Its personnel have diplomatic immunity for their persons and papers. No taxes are levied on the bank or the personnel’s salaries. The grounds are sovereign, as are the buildings and offices. The Swiss government has no legal jurisdiction over the bank and no government agency or authority has oversight over its operations. In a 2003 article titled “Controlling the World’s Monetary System the Bank for International Settlements,” Joan Veon wrote: “The BIS is where all of the world’s central banks meet to analyze the global economy and determine what course of action they will take next to put more money in their pockets, since they control the amount of money in circulation and how much interest they are going to charge governments and banks for borrowing from them. . . .“When you understand that the BIS pulls the strings of the world’s monetary system, you then understand that they have the ability to create a financial boom or bust in a country. If that country is not doing what the money lenders want, then all they have to do is sell its currency.”

And if you don’t find that troubling, a close reading of the new powers of the FSB are chilling. The 12 key International Standards and Codes, which are minimum requirements, contain such things as

• clear specification of the structure and functions of government;


• statistical and data gathering from ministries of education, health, finance and other agencies;


• corporate governance principles;


• shareholder rights;


• personal savings;


• secure retirement incomes;


• international accounting standards to be observed in the preparation of financial statements;


• international standards of auditing;


• securities settlement;


• foreign exchange settlement;


• minimal capital adequacy for banks;


• risk management;


• ratification and implementation of UN instruments; and


• criminalizing the financing of terrorism.

“Sounds oppressive,” you say; “but I don’t really care what a bunch of bankers do in Basel, Switzerland. It’s got nothing to do with me.” But I am writing this to tell you that it has everything to do with you, your family, your business, your country, and—if you’re up to it—your planet. Because as currently structured, the dictates of the Financial Stability Board will impact your life without any say-so on your part whatsoever.

Here’s one example from an article written by former Clinton advisor and political strategist Dick Morris in an article for The Bulletin on April 6, 2009. “The FSB is also charged with ‘implementing . . . tough new principles on pay and compensation and to support sustainable compensation schemes and the corporate social responsibility of all firms.’ “That means that the FSB will regulate how much executives are to be paid and will enforce its idea of corporate social responsibility at ‘all firms.’”

You begin to see what’s involved here.

You see, these standards and codes are commitments, obligations and requirements, not merely advice. The strategy, policies and regulations of the FSB are worked out at the senior levels of the bank. They are approved by the plenary and implemented through the national representatives.

THE STRUCTURE

The plenary, in this sense, is the complete membership body of the FSB. And the membership, my friends—the national representatives who implement these policies—just happen to be the heads of the planet’s more powerful central banks. And in case it slipped your mind, most central banks are private institutions and answerable to no one. Take our central bank, the Federal Reserve Bank. Yes, the chairman is appointed by the President and often testifies before Congress, but there is virtually no public control over the institution. It can’t be audited nor can Congress tell it what to do. It is not really accountable to anyone. The idea that the Fed is a government agency subject to the control of Congress is a PR line. It is simply not true. Among other things, central banks govern a country’s monetary policy and create (print) the country’s money. They make income by charging interest on the money they loan to the government.

Watch this, because if you blink, you’ll miss it.

Governments are perpetually in debt. They are always borrowing money. They have a mental disorder that prevents them from spending less than they collect in taxes—BDD, Budget Deficit Disorder. And if it looks like they might balance the books some year, why, someone can always start a war.

Here’s an example.

Let’s say the annual budget calls for the U.S. government to spend $2.5 trillion. But the income will only be $2 trillion. They’re going to be a little short. But no worries, they have the ultimate credit card—a debt limit that they themselves control. If they borrow up to the established limit, they can just vote it higher —which they have done to the tune of a cool $11.2 trillion dollars.

The Fed loves this.

Listen as the Secretary of the Treasury calls the Chairman of the Fed.

“Ben. It’s Tim.”

“Dude. What’s happening?”

“I need a little bread. Friggin’ Taliban again.”

“No problem, Timbo. How much you looking for?”

“Five hundred big ones.”

Ben licks his lips. “Anything for you, big guy. Send me the notes and I’m down with the five hundred. Five percent work for you?”

“Whatever.”

So the Treasury prints up $500 billion dollars’ worth of IOUs—they are called Treasury bills (short term), notes (medium term) or bonds (long term)—and sends them over to the Fed with a fifth of Chivas.

In the old days, the Fed would print the cash. These days, they click a mouse.

Now here’s the part where you aren’t allowed to blink.

When the Fed prints the money or clicks the mouse, they have no money themselves. They are just creating it out of thin air. They just print it, or send it digitally. And then they charge interest on the money they lent to the Treasury. A hundred-dollar bill costs $0.04 to print. But the interest is charged on the $100. Go ahead: read it again; the words won’t change.

The interest on the national debt last year was $451,154,049,950.63. That’s $1.23 billion a day. These are the same people that are now running our banks, insurance companies and automobile manufacturers.

Reason weeps.

Sure, I oversimplified it. The Fed doesn’t own all the debt and they do some other things. But these are the basics. That is how a central bank works. It is the heads of the planet’s central banks and some finance ministers that make up the membership of the FSB.

In brief, here’s how it works: the Board’s leadership provides strategies, policies and regulations to the membership. The members vote on the matters and then see to their implementation in their respective countries.

FSB leadership is in the hands of the chairman, Mario Draghi. Mr. Draghi is also the governor of Italy’s central bank. He is a former executive director of the World Bank and like his comrade in international finance, Henry Paulson—the former U.S. Secretary of the Treasury who bludgeoned Congress out of the first $700 billion bailout package—Draghi was a managing director of Goldman Sachs until 2006. Like Paulson, he left Goldman in 2006, a year before the financial crisis exploded: Paulson went to Washington to run the U.S. Treasury; Draghi went to Rome to run Italy’s financial system as well as the Financial Stability Forum (forerunner to the Financial Stability Board).

Let’s call it government by Goldman, shall we?

END PART 1

Are You Getting Enough Compliance to your Treatment Plans?

Are You Getting Enough Compliance to your Treatment Plans?

We have found over the years that one of the most rapid ways to increase practice production is to increase patient compliance to recommended treatment plans. This increase in production can be done without increasing the number of new patients. A minor 10% increase in compliance can result in tens of thousands of dollars of additional production and income with no change in overhead. The biggest single factor in increasing patient compliance is the doctor's ability to properly present treatment plans to the patient. Below you will find some helpful tips along this line.

Treatment Presentation Tips

A sale is an exchange whereby all parties involved receive something of value. In health care professions, a patient/client receives care to remedy a health problem and/or to maintain good health. In exchange for the work done, the staff and doctor are paid. A successful practice has doctors and staff members in it who care enough to sell patients exactly what they need.

The doctor's role in the sale cycle is to diagnose and plan treatment for the correct care. Without that, there would be nothing to sell. Does this sound easier than it actually is? Most doctors would say "yes".

From working with doctors for over 25 years, we've isolated many common mistakes doctors make when presenting treatment plans. Three of those are covered below.

Convincing vs. Selling

Convincing people they need to buy something is different than selling them on an idea, service or product. Selling is really nothing more than obtaining agreement. A patient/client who understands the treatment needed, agrees that it needs to be done and commits to doing it is the result of a successful treatment plan presentation. In an attempt to convince a patient/client to accept a plan, doctors often talk too much which, in most cases, works against them. Don't overwhelm your patients/clients with information or with too much communication.

Plan A vs. Plan B vs. Plan C

Do you give your patients/clients too many choices? Your patients/clients don't know what's best for them. They rely on you to tell them what they need. If you don't do that, but give them a choice between Plan A, Plan B or Plan C, the patient/client will naturally ask the cost of the different plans and select the least expensive one. Asking someone to make a choice between a $600 plan, a $350 plan and a $195 plan can even cause suspicion. The patient/client may wonder why you would do a $600 plan if a $195 plan will suffice. Don't let the patient/client decide what he/she needs or what is best for them. That's your job. You are the professional and should give your professional opinion as to what is the right thing for them to do.

"Maybe" vs. "You Need"

As mentioned, you know what your patients/clients need in order to be in good health now and in the future. You spent years and years and years in school learning this. However, when discussing treatment with patients/clients, doctors will often "water down" the presentation. Phrases such as "I think" or "Maybe it's a good idea" instead of "You need" create uncertainty in the patient's/client's mind. If a patient/client needs a specific treatment that may be costly, and this is presented to them with obvious hesitation, they will follow your lead and get the idea that it's an optional treatment. They may not understand that it's vital to their well-being. When you have confidence in the treatment you're providing, you don't need to back off from stating it with certainty. Your patients/clients will appreciate your sincerity, honesty and competence. A very successful application of this concept is to say, "If it was my situation, I would do....". As long as that is the truth, and you say it with sincerity and certainty, the patient/client will follow your lead.

Try following the above tips and I think you'll find an increase in your patient compliance to the treatment plan you present.

We invite your feedback to this blog or previous blogs by participating in our Discussion Forum at the Silkin Facebook Page BY CLICKING HERE.

Larry Silver
President, Silkin Management Group

What Criteria Do You Use For Evaluating Your Staff's Performance?

Continuing our recent theme of how to increase office efficiency, today's blog will discuss some actions you can use to evaluate your staff's performance. If all staff had detailed job descriptions, fully knew them and were doing their jobs properly as well as following office policy (assuming you have basic written office policies), you would most likely have an efficiently running office. This would result in higher production and more net for the doctor. Assuming you have some form of job descriptions and office policies, the steps outlined below will be of assistance in evaluating staff performance. If you don't have job descriptions and office policies, or the ones you have aren't up to date and/or aren't really useful, feel free to contact us as we can help you in that area. We have a 400 plus page manual of job descriptions and office policies that you can put into use in your office on an immediate basis, and you can also easily edit it for your specific office use.

How does one give appropriate performance evaluations?

Below you will find a procedure for evaluating job performance on a regular basis. These performance evaluations are vital for future planning and provide fair, timely and objective measurements of job performance.

It is recommended that you conduct at least two evaluations of a new employee during the first year. The first should be done after approximately 90 days of employment and a second evaluation should be done after 9 to 12 months of employment. Thereafter, each staff member should receive a performance evaluation at least twice per year.

Advise the staff member of the time for their scheduled review at least seven days in advance. This gives both of you an opportunity to prepare so that areas of mutual concern can be addressed.

The evaluation will be based on performance in two broad categories.

• professional responsibilities


• organizational responsibilities

Within these categories, specific areas will be assessed.
In the category of professional responsibility, the following areas will be
assessed:

• quality of care


• effectiveness in patient management


• professional development

In the category of organizational responsibilities, the following areas will
be assessed:

• adherence to office policies


• adherence to the general job duties of a staff member (which you
  should have as part of your employee manual)


• adherence to the job duties of their specific job (which should also
  be clearly elucidated, in writing)


• their handling of communication within the office both with staff
  and patients/clients


• interpersonal relationships


• practice development

The data collection phase of the evaluation process will involve the
gathering of information by the office manager from all sources that he/she
deems appropriate. Generally, input will be received from:

• patient comments


• quality control data


• statistical data observation


• documentation regarding compliance with organizational policies


• any documentation regarding their written job duties for their
  specific job as well as for them as a staff member

Needless to say, in order to have this type of information readily available, the office should have systems in place for proper documentation of these areas. This could mean having, at least, the following systems operational: each staff member having a named product or products they are responsible to produce, a means to measure every staff member's production, having an effective quality control system in place, having a good filing system in place for noting patient comments - both good and bad, having job descriptions and office policies in use, and having proper personnel and other Human Resource files that are kept up for each staff member.

Following information collection, the office manager, the doctor and the staff member will complete the performance review forms and a performance review meeting will be scheduled.

STEPS TO FOLLOW FOR THE EVALUATION PROCEDURE

1. The office manager will give the employee a copy of the job duties for the position the employee holds. The staff member will fill in a rating of each point. The office manager will also provide ratings.
   
   SUGGESTED RATING SYSTEM
   
   
   
   1. Place a check mark ( ) next to any item that is deficient and is in need of improvement.
   
   
   2. Place a star ( ) next to any item that rates excellent in performance.
   
   
   3. Leave blank any item that seems adequate, although the goal would be to work toward excellence in these categories.
   
   

1. The evaluation process begins with the orientation of the new employee. During orientation, the employee is made aware of the organizational goals. The individual's job description (both as a staff member and for the professional position held) is discussed and an understanding of job expectations and standards for evaluation is reached.


2. At this meeting, the performance for the previous period is reviewed and the employee is given an opportunity to comment on any area of the assessment.


3. As the review progresses, both the office manager and the staff member should keep notes with regard to areas to work on and goals that are set. In cases of deficiencies where correction seems achievable and reasonable in terms of practice resources, every attempt will be made to work with the employee to effect change.


4. The employee then signs the document. An understanding is reached concerning past performance and expected future performance and an outline of future performance expectations is drawn up and discussed with the employee.

Salary adjustments are not necessarily made at the time of the performance evaluation.

If you conduct the evaluation as objectively as possible, your staff will appreciate the communication and should strive harder to match expectations.

We also invite your feedback to this blog or previous blogs by participating in our
Discussion Forum at the Silkin Facebook Page BY CLICKING HERE.

Larry Silver
President, Silkin Management Group

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