BUSINESS OF PRACTICE: MANAGING ACCOUNTS RECEIVABLE
Wright, would you likeme to clip this wound for you?” is a nice reminder of what needs to be done when the new practitionermay be feeling overwhelmed. A senior clinician checking over medical records
and billing upon case completion will help train the new graduate in practice billing policies, as well as medical record style, and expedite confidence in these tasks. University-setting medical records are often
longer andmore detailed than what is practical in the field. This also provides the opportunity for case dis- cussion, and a chance to dissect how the appointment went outside of earshot of the clients.
Scheduling
Setting realistic time management expectations of the new doctor is integral for success in practice, especially when it comes to the length of time itmay take for case workups at the start of a career. This is relevant for both staff who schedule time for appointments, as well as the new doctor for working within the designated time frame. Allotting more time for appointments at the start of employment will ensure the new doctorwill not feel rushedor unabletocompletetheir desiredcase work up. This also decreases the chances of being late to other scheduled appointments, which can start a relationshipwith a newclient in a stressfulmanner. In the author’s experience, an additional fifteen minutes per routine appointment provides an adequate buffer. By giving the new graduate time to sharpen their examroutine, basic technical skills, and client commu- nication including history taking, treatment recom- mendations, and expectations, their chances of success on future “fire-engine days.” will be increased. The author’s practice has successfully used a
graduated appointment schedule for a new doctor, accounting for both appointment type and time requirements. This allows for the growth of both skills and confidence. Using the phased approach gives the doctor time to establish relationships with minimal on-site hiccups, which will increase the ac- ceptance of the doctor by the clients. The timing of each phase listed below is practice-dependent and should be modified to best suit the needs of your practice. An example for a graduated schedule of appointments is below.
• Phase 1: Shadow other doctors for both routine and emergency cases, meet clients, learn farm locations, practice using software, write medical records and billing for cases seenwith senior clini- cian; senior clinician to revise/edit for complete- ness of record and accuracy of charges.
• Phase 2: Schedule solo basic wellness and simple appointments; these provide opportunity for direct client interaction and communication in a non-stressful environment with a high likelihood for success and confidence-building. Examples of these appointments include vaccines, routine dentals, bandage changes, lasers, shockwaves.
118 2022 / Vol. 68 / AAEP PROCEEDINGS
A senior clinician still double-checks records/ billing for completeness.
Emergency coverage can be added once all parties feel comfortable and the new doctor
has appropriate back up if needed.
In the author’s practice, the new doctor accom- panies senior clinicians on emergencies for six
months and then begins to take primary emer- gency coverage; during this time, a senior cli- nician is available by phone and able to meet on the farmif needed for assistance.
• Phase 3: Continue to schedule complex cases/ equipment with senior clinicians (lameness, gas- troscope, etc.) even as the new doctor increases the frequency of seeing their own appointments. Joint appointments with a senior clinician will provide increased exposure to difficult cases and examples of client communication while simulta- neously building skillset and confidence.
The newer doctor is responsible for writing medical records while the senior clinician pro-
vides a final review.
The newer doctor should take charge as much as possible in these appointments with the
senior clinician present for advice and support as needed.
Communications
Fostering effective client communication skills should begin with the opportunity to practice callbacks on routine cases. This allows the new doctor to become comfortable speaking with clients while simultane- ously reducing the pressure of communicating a diag- nosis and treatment plan. Ensure that when they are working with other clinicians that they are present for the entire workup and conversation and not distracted by cleaning or putting away equipment. Remember that a new doctor is not a technician. Witnessing another clinician’s client communication is where theywill pick up case-related communication skills. Triaging ER phone calls is often stressful for newdoctors. Doing so succinctly and successfully takes time, experience, and practice. Answering the daytime emergency calls for the practice is an opportunity to have these types of conversations while still having the support staff and other clinicians available for questions and assistance.
Case Outcome/Expectations
Helping the doctor navigate the gray area of case workups will help them form new roadmaps to case resolutions in the context of general practice as opposed to the university setting. Limitations of equipment in the field, client budget, and practicality of treatments are all topics that can cause stress and insecurity to a new graduate coming from the
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