Observations during your Private Practice Experience

This is a guide for your observations while you are at your private clinician's office. Please print a copy of this page to take with you to your preceptor's practice. Spend time with the office manager and staff to ask some of these questions.

At our final Wednesday session, we will discuss some of these questions from one of the sections below.

1. Patient Flow:

• How frequently are patients scheduled? Would this doctor benefit from "advanced access" patient scheduling?
  • Murray M, Bodenheimer T, Rittenhouse D, Grumbach K. Related Articles, Books, LinkOut
    Improving timely access to primary care: case studies of the advanced access model.
    JAMA. 2003;289:1042-6.
    PMID: 12597761
  • Murray M, Berwick DM. Related Articles, Cited in PMC, Books, LinkOut
    Advanced access: reducing waiting and delays in primary care.
    JAMA. 2003;289:1035-40.
    PMID: 12597760
    
• How long is wait for follow-up and new patient appointment?
• How long do patients wait to be seen?
• What preparation (by whom) is done before MD sees patient?
• How are the rooms set up (i.e., what's stocked)?
• How are multiple rooms used?
• How are patients dismissed?
• Labs and x-rays:
• What labs are done in-house versus sent out?
• Follow-up of lab results?

2. Medical records:

• How are office records made (written, dictated)?
• How stored?
• Computerized records?

3. Nursing personnel:

• How many?
• What degrees?
• What responsibilities (and procedures)?
• Phone calls?

4. Additional staff:

• What additional staff?
• What responsibilities?
• Office manager?

5. Finances:

• What did it take on MD's part to start (or join) this practice?
• What benefits were provided (insurance, retirement, etc)?
• Who handles business finances?
• Who handles personnel issues?
• How are insurance forms handled?
• How are fees collected?
• Is this a fee for service setting or prepaid?
• Does MD participate in any PPOs?

6. Other MD responsiblities:

• Does MD ever do house-calls
• Is he the doctor for a nursing home, sports team, or job-site?

7. Please ask your doctor to comment on:

• What functions well in this practice?
• What could function better?
• What changes would he/she recommend?

Last update 2004-06-17

Badgett@uthscsa.edu