p atien t care which so o ften tends to fall by th e w ay in this busy w orld o f ours. R eferences K han, A ., H ow royd, H . A . (1976). P hysiotherapy care audit and peer review. Physiother. Can. 28, 163. Weed, L. (1968). M edical records th a t guide and teach. JUNE 1980 43 N e w Eng. Jnl. M ed. 278, 593. Weed, L. (1971). Q uality control an d the m edical record. A rch. Int. M ed. 127, 101. A cknow ledgem ents D r. D. J. van Schalkwyk, D ep artm en t fo r B iostatis­ tics, S outh A frican M edical R esearch C ouncil. p h y s i o t h e r a p y PRACTICE MANAGEMENT P A U L SULCAS, B.Com., B.A. (Hons.), T h is article is based on a presentation by the author at the A n n u a l General M eeting o f the Private Practi­ tioners Association o f the So u th A frica n Society o f Physiotherapy held in Cape T ow n during February 1979. V arious aspects o f practice m anagem ent are dealt with, and suggestionsjrecom m endations m ade as to pos­ sible courses o f action w hich could overcom e actual (or potential) areas o f concern. IN T R O D U C T IO N F o r m any years I have h ad dealings w ith physiothera­ pists. A s to professional com petence in preventative and rem edial treatm en t there can be no doubt. H owever, when it comes to general adm inistrative m atters there can be n o do u b t th a t m uch can be im proved. W ith this fu ndam ental prem ise in m ind the aspects w hich follow are intended to provide guidelines in two directions, viz. potential areas of im provem ent, a n d /o r confirm ation th a t (if you believe it) y o u r practice is well m anaged and controlled. A SPEC T S O F C O N C E R N 8^ # T h e w aiting room reflects the im age o f y o u r prac- ce. T ry to ensure th a t it is easily accessible an d well laid out; fu rn itu re to be fun ctionally co m fortable and in good condition; the walls, curtains and carpets colourful and m atching; p o tted plants a re always eye­ catching; periodicals should be o f interest to patients an d up-to-date; and d o be punctual w ith y o u r ap p o in t­ ments! # ‘A dm inistrative’ activities are relatively easy to h an d le provided you do n o t perm it a backlog to build up. C onsiderable attention should be given to th e size, content, durability and layout o f th e p atien t record card which, in m any instances, also functions as p atien t’s account card. E n su re th a t all patients are charged, and a t th e correct ra te — double check all additions and subtractions. Rules fo r alphabetical filing of these cards should be devised in o rder to facilitate easy location. T h e handling of paym ents from patients is always a potential problem area and m ust be closely m onitored. T ry to p rep are y o u r m o nthly accounts to patients tim eously to reach the patient, if possible, as near to A ssociate P rofessor, D epartm ent of A ccounting U n i­ versity o f C ape Town. Received 12 F e b ru a ry 1980. M .C om ., D .C om ., C.A.(S.A.), A .C.I.S., A .T .D .P.M .* O P S O M M IN G D ie artikel is gebaseer op ’n voordrag deur die skryw er tydens die A lgem ene Jaarvergadering van die Privaat Praktisynsassosiasie van die Suid-A frikaanse Fisioterapie Vereniging gehou te K aapstad gedurende Februarie 1979. A sp ekte van p ra ktyksb estu u r word bes- preek en voorstellelaanbevelings w ord gem aak ten op- sigte van aksie w at w erklike (o f potensiele) probleem areas kan bemeester. m onth-end as possible (Sulcas, 1976). D elin q u en t payers can b e encouraged to pay by using stickers on accounts, o r th ro u g h personal telephonic contact, o r by w riting a letter. R em em ber th a t if y o u r inflow o f cash is bad because of lack o f y o u r attention/interest, you could have problem s in settling your own outstanding accounts as well as keeping th e Receiver o f R evenue satisfied! # Security considerations are frequently overlooked. H e re specific reference is m ade to keeping y o u r records locked u p in a fire-proof safe during h o u rs when the practice is closed. In addition, equipm ent can be stolen relatively easily and you should have serial num bers readily available fo r th e police. Finally, check the phy­ sical security o f your prem ises fo r ease of unauthorised entry, o r fo r p o ten tial fire h a z a rd circum stances, e.g. your air-conditioning unit. # T h e m ethod o f financing equipm ent acquisition can be problem atic when faced w ith alternative p ro p o ­ sals fo r purchasing, leasing, o r renting. I t is suggested th a t you seek advice fro m som eone w ho n o t only un d er­ stands th e im plications o f these choices, b u t also fully understands y o u r personal circumstances. Y o u r accoun­ ta n t/a u d ito r w ould n o rm ally be ideal. # I f a p artn ersh ip is operational, o r contem plated, ensure th a t a legally d ra fte d agreem ent exists setting o u t th e rights an d obligations o f all parties. Included should be, in te r alia, procedures on dissolution o r adm ission o f a new p a rtn e r, an d on w h at happens if o n e p a rtn e r dies. D espite the friendship of partners, surprising things can (and do!) take place when problem s involving m oney affairs arise. # W ith th e bulk o f y o u r patients being direct referrals from m edical practitioners, it sho u ld be a stan d ard p ro ­ cedure to re p o rt back — this can be done telephonically, b u t it is recom m ended th a t a w ell w ritten re p o rt should be subm itted. N o t only is a p erm an en t reco rd m ade fo r the d o cto r’s files, b u t th e professionalism o f y o u r atti­ tude can n o t fail to create a good im pression. M arketing professionals w ould call this a sound m arketing strategy! # Y o u r p erso n al financial affairs should n o t be neg­ lected, p articu larly when looking to th e future. H ere R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) 44 F I S I O T E R A P I E JUNIE 1980 again y o u r a c co u n tan t/au d ito r should be consulted fo r advice on taxation, estate planning, investm ent possi­ bilities, etc. # T h e area of insurance coverage requires specialist expertise. F in d a reliable and personally recom m ended bro k er to h an d le y o u r w hole insurance portfolio in­ cluding a n office re n te r’s policy f o r all contents and public liability, personal accident/sickness in the event o f m isfortune, p erm an en t disability, an d professional in ­ dem nity cover. O th er insurance such as life, retirem ent annuities, personal all-risks and sim ilar w ould also be han d led by this broker. C onsolidation of your insur­ ances in this m an n er has m any advantages. # Technological progression in equipm ent, coupled with an ever-expanding body o f know ledge in m ethods o f treatm ent, a re of direct relevance to you. Keeping ‘up-to-date’ is incum bent on every professional an d you a re no exception! Subscribe to, and read, local and overseas journals; buy well reviewed books; attend fo r­ m al group discussions an d general meetings of your local o r n atio n al association; get on the m ailing list of equipm ent suppliers in o rder to receive brochures of new releases; etc. T aken together, all could be of tre­ m endous assistance in y o u r developm ent. 9 T he p o ten tial help which your acco u n tan t/au d ito r can offer has already been broached in tex t above. I t is terribly im p o rta n t fo r you to have fu ll confidence in this individual and, if y o u r present choice is not proving adequate, do n o t hesitate to m ove y o u r business else­ w here — the prerogative is yours in th a t you are paying fo r a service. C ONCLUSION T h e aspects covered above are n o t intended to serve as a com prehensive checklist over all y o u r practice acti­ vities. P urposely om itted is any reference to in co rp o ra­ tion as this has been carefully investigated and evaluated by yo u r national association — a th orough and im pres­ sive docum ent has been p rep ared on this subject and w idely debated th roughout South A frica. In addition, p rep aratio n of an n u al financial statem ents was n o t even m entioned as this w ould be th e full responsibility of an ‘outsider’. H owever, it is subm itted th a t th e points above are fu ndam ental to y o u r practice activities, and they are equally relevant to th e ‘one-m an’ show as to a large partnership/association. In the u ltim ate analysis, w hat is required is personaJ- discipline to ensure all these aspects are un d er c o n tr^ an d if fo u n d inadequate, th a t som ething constructive be done fo r im provem ent. This is w hat practice m anage­ m en t is all about. R eference Sulcas, P. (1976): A m anual system fo r p atien ts’ ac­ counting records S .A . M ed. J. 53, 8 5 9 -8 6 2 . 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