Practice Management

  • 1.  Reading lists

    Posted 04-01-2018 12:17
    I would like to start a reading list of books that people here have read that have helped them to move their skills in practice management or other venues forward.  But before doing that I want to put a plug in for  This is a resource where you pay to get webinars on self help topics that can assist with things such as HR or leadership.  It also comes with 6-8 page summaries of self help/management books that you can read and then if you like the summary, buy the book through another source.  I have found it very helpful.

    Currently I am almost done with the book "Execution".  This is a book that goes thru the things needed for you to get implementation of things done.  It focuses on people (evaluation, coaching, and development), strategy, and operations and is a really good book.

    Brian Iriye

  • 2.  RE: Reading lists

    Posted 04-10-2018 20:03
    The best one for a MFM practice will be the new practice management book that Dr Iriye has done that will be coming out in the next couple of weeks.This is chuck full of great info on how to run a practice . You all will get an email on it . Read it it will help you all tremendously.

    Daniel OKeeffe

  • 3.  RE: Reading lists

    Posted 05-31-2018 09:20
    Other books:

    Impromptu- gives a guideline on how to speak in difficult scenarios

    Zero to One- Peter Thiel book on his views on corporations that succeed- gives ideas on how to make your practice different and grow and the type of business you should be

    Brian Iriye

  • 4.  RE: Reading lists

    Posted 06-05-2018 17:22

    I also would add Drive by Daniel Pink. We have the motivation thing all wrong in medicine . Thinking RVU payments will motivate is wrong . His book and videos on you tube show the right way to motivate . 

    Daniel F. O'Keeffe, MD


    Cell: (602) 791-0176

  • 5.  RE: Reading lists

    Posted 06-06-2018 09:29
      |   view attached
    Here is a great modeling paper on RVU vs. clinical efficiency.  This is using the following methods:

    The following equation was used to calculate the efficiency index (E):

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    The efficiency index was defined as a function of adjusted costs (Ca), adjusted number of patients (Na), and quality (Q). Constant b is an empirically determined adjustment factor so that the value of E remains between the limits of 0 and 1. Constant y was set at a value of 2. Higher values of y will further differentiate practices with low quality from those with higher quality. For example, if 2 practices had Q1 = 0.1 and Q2 = 1, y = 0.5 would result in effective Q values of 0.3 and 1, whereas y = 2 would result in effective Q values of 0.01 and 1. In effect, the higher the value of y, the more the practice with lower quality will be punished. The units of b are such that E is a value without units.

    The adjusted number of patients (Na) was calculated from the numbers of follow-up patients (N1), new patients (N2), and surgical patients (N3). Adjustments for each type of patient (x1, x2, x3) were empirically derived from Medicare relative value units (RVUs) for each ophthalmology subspecialty, which reflect the type of examinations and surgical procedures typically performed on patients:

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    Subspecialties in this study included cornea, comprehensive, glaucoma, neuro-ophthalmology, oculoplastics, pediatrics, surgical retina, medical retina, and uveitis.

    Adjusted cost (Ca) is a variable sensitive to the location of the practice and describes the ratio of the cost of caring for a given group of patients to the value of the care provided as determined by Medicare RVUs:

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    Medicare value of work is a function of the number of patients, RVUs for each category of patients previously mentioned, and geographic practice cost indices. The RVUs and geographic practice cost indices are determined by the Centers for Medicare and Medicaid Services (CMS) for each fiscal year. A more detailed explanation of the calculation for Medicare value of work is available in the eEquation in the Supplement. In total, 7 inputs from the physician's practice were required for the calculation of adjusted costs: (1) subspecialty; (2) location; (3) total number of new patients for a given period; (4) total number of follow-up patients for the same period; (5) total number of surgical patients for the same period; (6) total practice cost for that period (to care for the reported group of patients); and (7) the period under examination.

    Quality (Q) in this study was a metric of medical process, as defined by the Donabedian model, and was scored by independent auditors masked to patient identities.6 For each practice, auditors used 20 randomly selected patient medical records and used patient-oriented quality questionnaires based on American Academy of Ophthalmology Preferred Practice Pattern.7Ten medical records were used to complete a questionnaire pertaining to a comprehensive eye examination evaluation, and the other 10 medical records were used to complete a questionnaire from 1 of 3 diagnostic checklists as chosen by the practice depending on its subspecialty or stated area of interest or expertise. The 3 diagnostic checklists were specific to patients with cataract, patients with glaucoma, or patients with age-related macular degeneration.

    Christopher Robinson


    eoi150042.pdf   416 KB 1 version