Customer Reviews

The Business of Medical Practice: Advanced Profit Maximization Techniques for Savvy Doctors, 2nd Edition

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This comprehensive multi-authored text contains over 450 pages of highly specific and well-documented information that will be interest to physicians in private practice, academics, and in medical management. The previous edition has been updated and significantly expanded.

The book is organized into three sections: Qualitative Aspects of Medical Practice, Quantitative Aspects of Medical Practice, and Contemporary Aspects of Medical Practice. Appendices include sample management service agreements, and information on medical unions and public perception of physician salaries. A particularly useful feature is a brief biosketch of each contributor, complete with contact information.

I read with particular interest the chapters entitled "Medical Office Business Plan", "Insurance Coding Guidelines", "The Case for Concierge Medicine", and "Dissecting a Medical Malpractice Trial". Like the rest of the book, these were readable, concise yet complete, and well developed.

I could have used a book like this in the past, I will certainly refer to it frequently now.

Reviewed by Carol EH Scott-Conner, MD, PhD, MBA

Based on the other reviews, I was expecting a lot from this book but was disappointed after finishing it. The book's collection of papers provides a good introduction to the general concepts found in other books, but I found that it lacks many of the specific implementation details and calculations that I have seen elsewhere.

In the past, only major practices and hospitals could afford expensive management consulting and technology offered by the big accounting firms. Dr. Marcinko's book extends high-quality advice equally well to both large and small doctor practices. Together with a new generation of billing companies, e.g., Affinity Billing or Billing Precision, that leverage new technologies, his book is an indispensable tool for today's smaller practices.

Doctors running their own practices will find Dr. Marcinko's advice extremely useful because of his pragmatic approach to the complicated subject of practice profitability. Medical practice is a business and doctors need to make strategic decisions about adding equipment, hiring other doctors, addressing specific kinds of patients, selection of referrals, marketing, etc. Dr. Marcinko's book teaches doctors how to use quantitative data to make such decisions.

One major theme is the need for gathering centralized practice management information, which makes the business case for adopting robust technology platforms. Ideally, technology platforms should combine front office and back office information systems, providing physicians with the strategic practice management information they need, and of course, be affordable.

The book has ambitious scope: business plan, practice valuation, ROI, coding, billing, econometrics, cash flow analysis, compliance, technology, and various legal aspects. But Dr. Marcinko and an exceptional array of contributing experts do a remarkable job of exploring each topic with sufficient detail and meaningful examples. In summary, a doctor building a profitable medical practice must read this book and return to it often for reference.

Yuval Lirov, Medical Billing Networks and Processes - Profitable and Compliant Revenue Cycle Management in the Internet Age

Editor Dr. David Edward Marcinko, MBA, CFP®, CMP(tm)
Publisher: Springer Publishing Company
ISBN: 0-8261-2375-9
Format: Hardcover 494 pp
Review Date: August 4, 2008

This book was written to assist doctors, advisors and professional administrators help
manage medical offices in these tumultuous times. The multi-authored text contains information
on a broad range of topics affecting the medical practice. If its goal was to help maximize
medical practice efficiency and profitability, then it was achieved.

The book itself encompasses many topics - from healthcare economics, ethics and
CRM - to business planning, cash flow analysis, revenue enhancement and concierge medical services.
In addition, it offers actionable information on specific topics like linear-regression cost accounting,
IT systems, insurance claims, health-law, compliance and CPT coding, etc.
And, it is organized into three parts for easy reference; Qualitative, Quantitative and Contemporary
medical practice.

I found the book interesting, informative, precise and well written. Dr. Marcinko, and his team,
drives a dagger into the heart of medical management - first dissecting it - and then resuscitating it
for modernity.

As a CERTIFIED FINANCIAL PLANNER (tm) looking forward to improving my understanding of the
healthcare space, I found this book more comprehensive than its peers. This extensive knowledge
helped me understand what really affects a medical practice. It is a fine read for the physician
and administrative professional interested in improving the profitability of any medical practice specialty.

Dr. Marcinko's other clinical publications are archived in the Library of Congress, the Library of Medicine
and the National Institute of Health. In addition, this book has been referenced by multiple magazines
and associations, such as investment Medical Group Management Association (MGMA) and the
American Collage of Physicians Executive's (ACPE).

Amaury Cifuentes
CERTIFIED FINANCIAL PLANNER(tm)
Certified Medical Planner(tm) candidate
3878 Sheridan Street
Hollywood Fl 33021
954-986-0633

This book should be on the "required reading" list for all physicians who are starting a new practice or looking for ways to improve the profitability or efficiency of an existing practice. Dr. Marcinko covers a wide array of important topics, including formulation of a business plan, coding, use of information technology, and cash flow analysis. I found the chapter on Medical Practice Financial Benchmarking to be particularly insightful and pertinent to my own practice.

ABOUT THE FIRST EDITION
A Classic!

This book is destined to become the classic practice management textbook for all physicians, and is a must-read for the nation's more than two million, independent healthcare providers and their related business and financial advisors.

Antonio Silva, MD, MBA
Emory University
Goizueta School of Business
Atlanta, Georgia

Also recommended: 1] Financial Planning for Physicians and Advisors. 2] Risk Management and Insurance Planning for Physicians and Advisors, by the same Editor/Author.

ABOUT THE SECOND EDITION
More Praise!

(...)

It¡¦s never been easy to be a physician, and in many ways the pressures on practitioners are only getting worse. This is why I¡¦ve been a longtime admirer of what David Edward Marcinko does with his writing and knowledge of medicine and medical practice. Dr. Marcinko¡¦s books provide guidance for physicians ¡V helping them to survive organizationally, administratively, and financially so that they can continue to serve their patients.

Helping fellow physicians in one way or another often figures into the motivations of those who have left the joys of a medical practice to pursue healthcare from a different vector. Some are called into research, giving up the rewards of helping individuals with the hope that they might contribute insights that can lead to the helping of many.

After medical school, my own path took me to the University of Pittsburgh and a doctorate in medical informatics, with visions of helping physicians help their patients through better management of data. Fortunately, I see that vision coming true, especially as I work with my colleagues at Microsoft to create a secure informational infrastructure that gives physicians the information they need at any time, and at any place ¡V including over a wireless device as they attend to a patient at bed side. We call this initiative to provide seamless, yet secure, access to data on an anytime, anywhere, basis Healthcare Without Boundaries.

Though we are proud of our proud of our work, the great wonders, come from what we see after we release our products, as physicians do things with our software that we never envisioned. Physicians, by nature ¡V or through selection and training ¡V have a scientific mind and a driving curiosity. Over and again my colleagues and I are dazzled by what physicians are creating by using our technology in unexpected ways. And often the work is done by private practitioners looking for ways to create their own solution because they either couldn¡¦t afford a pre-packaged one, or couldn¡¦t find a solution that answered their creative visions.

Physicians, especially those in private or small group practice, are under great stress today. But they are buoyed by a passion for their work and dedication to their patients, and they are extremely resourceful with the brilliance and ingenuity that comes from the curiosity of the scientific mind.

Medical Economics magazine recently ran a story about Robert Novich, a New Rochelle, New York internist who needed an electronic medical records system for his solo practice. Suffering from sticker shock and the inflexibility of the commercial EMRs he looked at, he decided to create his own ¡V using Microsoftµ Word and a fax machine. Lab reports and other documents received by fax are directly imported into the computer for digital storage. Working with his son Jeff, who was a college student at the time, Dr. Novich created a system that uses Word templates to simplify creation of medical records; and Explorer to provide instant file access; slashing time from pulling information out of file cabinets. The system also creates and manages electronic prescriptions.

The results? Dr. Novich said, ¡§I feel like a brand new doctor.¡¨

This book is filled with a wealth of information on how to survive the financial, administrative, and regulatory pressures that could otherwise draw down on the time you want to spend with your patients. Dr. Marcinko and his contributors cover the spectrum from developing a medical office business plan for the new practitioner, to placing a value on a practice for the retiring physician preparing to sell. A sampling of topics includes: human resource management and physician recruitment, marketing, insurance coding and health-law compliance, process improvement and medical care outcomes tracking, cash flow analysis, office expense modeling, cost accounting, practice benchmarking, financial and ratio analysis, ROI calculations, CRM, six sigma initiatives, concierge medicine and medical ethics.

Throughout this book a common denominator is the need for acquiring and managing information. Fortunately we live in a time when information technology is providing ever more benefits with an ever lower threshold ¡V both financially and technically.

For less than $500 you can buy a computer today that has a more powerful central processing unit and more memory than the multi-million dollar mainframes and super computers that were enshrined in regional banks and university research centers in the 1980s. And the advent of point-and-click interfaces and drag-and-drop development environments mean that everyday doctors can do extraordinary things.

Microsoft recently sponsored a contest looking for innovative ways in which our Office suite of applications had been used by healthcare workers. The response was overwhelming -- not because of the technology, but because of the innovative ways it was being deployed to solve real-world problems.

Cecil Lynch, an M.D. and medical informaticist who teaches at the University of California at Davis is using Microsoft Access to help the U.S. Center for Disease Control (CDC) enhance the efficiency of its disease surveillance system.

Dr. Duke Cameron of the Division of Cardiac Surgery, Johns Hopkins Hospital, came up with the idea of using the Outlookµ Calendar to schedule operating rooms, to help assure the OR is properly setup with specific implant devices and other special equipment or supplies before the surgical team arrives.

Nick Hoda, a psychologist-in-training at Mississippi State University, uses Microsoft Excel charts and graphs to show his elementary school clients coping with learning and behavioral problems ¡V that their behavior really is getting better. He uses the same charts with teachers and administrators to win his young clients another chance at the classroom.

My favorite story, came from Dr. Thomas Schwieterman, a fourth-generation physician working in the same medical office his great grandfather established in 1896 in the town of Mariastein, Ohio. From those same historic environs, Schwieterman has used Microsoft Access to create his own physician assistant application.

The Schwieterman Family Physicians practice kept him so busy that he was wondering how he could keep up with his patient caseload. Schwieterman wanted a faster way to handle prescriptions, provide medical information, and record data for his patient records.

He walked into a MacDonald¡¦s restaurant one day and had an idea.

¡§I ordered a cheeseburger and fries and watched the person at the counter touch the screen of the cash register a few times, and realized the order was getting transferred back to the food preparation area, and that by the time I paid, my order was ready,¡¨ he said. ¡§I thought to myself: ¡ĄThat¡¦s what I need!¡¦¡¨

He searched for commercially available solutions, but when he couldn¡¦t find an exact match for his needs, and when he found prices steep for a small private practice, he decided to create his own ¡V using Access. He also called upon a friend with a Master¡¦s Degree in electrical engineering to help on the coding. His creation boosted his income by 20 percent ¡V ¡§Which was important because we pay more than $60,000 a year for malpractice insurance even though our clinic has never been sued since it was founded 107 years ago.¡¨

What my friends at Microsoft especially like about this story is that when Dr. Schwieterman¡¦s colleagues tried his program, liked it, and suggested he try to sell it, he put together a PowerPointµ presentation ¡V and landed a partnership agreement with a major healthcare supply and services corporation to market his ChartScribe solution.

So, the pressures facing physicians are great, but so are their resources. Information technology is one resource, this book is another, but the greatest of all is the innate curiosity and drive to discover and create that seems to be so much a part of those who are drawn to this noble profession.

Ahmad Hashem, M.D., Ph.D.
Global Healthcare Productivity Manager
Microsoft¡¦s Healthcare Industry Solutions Group
Microsoft Corporation
Redmond, Washington