Medical Practice Policies and Procedures and Why You Need Them

Article Written By: Carlos H. Arce, Esq.

During your time in medical school you never imagined that managing your own medical practice would have little to do with the practice of medicine. Medical school likely did not prepare you for the legal consequences that come with the modern-day business of medicine. Many physicians are forced to sell their practices, or worse, due to the legal liabilities that may come with owning a medical practice.

A medical practice is typically composed of these essential elements: physicians, patients, medical records, exam rooms, medications, computers, administrative and support staff. However, many medical practices lack another essential component: the proper written policies and procedures necessary to govern the moving elements listed above.

These policies and procedures should be used as a governing organizational plan for the day-to-day operations of the practice. What should be included in these policies and procedures? Pretty much everything. The written policies and procedures should include but not be limited to all the operating policies to be enforced by the practice administration, employee’s rights, employee protocols, patient protocols, emergency protocols, management protocols, billing protocols, HIPAA policies, overview of important requirements and prohibitions of federal and state health care laws, regulations and third-party payer requirements, etc.

The rules and protocols within your policies and procedures should be a guide for you and for the members of your practice when you are not present to direct them. Healthcare providers live a busy life; on-call, tending to hospital visits, emergency phone calls, along with daily responsibilities. Why juggle the day-to-day tasks with unforeseen auxiliary issues? You might drop the ball.

Without adequate policies and procedures in place, or failure to follow them, severe detrimental issues can arise.Some of these potential issues include the following: employee payroll and benefits problems, improper use or disclosure of patient medical records, medical malpractice lawsuits, disciplinary action against your medical license, federal and state government investigations, loss of healthcare insurance contracts, government fines and many other forms of sanctions and penalties.

You may be thinking that the generic manual you received from your payroll company is sufficient, but unfortunately that is not enough. Every practice is different: the number of employees, the medical specialty, the type of patients, the insurance or government payment source, etc. These distinct variations create specific needs which require specialized compliance with state and federal laws.

Like any business, a medical practice has its benefits and burdens. One of these benefits is the treatment you render to your patients. One of the necessary burdens is implementing an administrative structure for your practice to keep it running smoothly and legally. As a physician, you entered this industry to help your patients. Why not have a plan in place that may save your patients, your practice and you one day.

To receive more information regarding a policy and procedure manual for your practice and the benefits it can provide, contact me at our Fort Lauderdale location 954-880-9500.

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