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Q Do you have any information or checklists that might be helpful as we close a practice? I want to be sure we cover all of our bases regarding patient records, legal concerns, and so on.

A I am very sorry to hear this news. Take a look at the checklist the Texas Medical Association offers at www.texmed.org/Template.aspx?id=2198. Here are some other standard considerations:

To close, you need to review all the logistics based on your practice’s situation. For example, what will you do with your building? Do you rent, lease, or own it? If you rent, you need to notify your landlord of your intentions. If you own, do you plan to sell? Find a real estate agent, and start your preparations.

Also determine what you need to do to move your equipment, files, and furniture — and where you will put them. If you lease your equipment, notify your leaser. If you want to sell the equipment you own, find a seller, have a yard sale, put your equipment up for sale on eBay, or find another way to locate a buyer.

Give your staff adequate notification. You’ll want to retain at least one staff member for 30 to 60 days after the close to follow up on your final outstanding accounts. Most physicians find a part-timer for 60 days to be adequate, but it depends upon the volume of your outstanding accounts.

Remember that a physician has an ethical obligation to notify patients when he/she moves or closes the practice to allow them to obtain copies of their medical records or have their records transferred to another practice. Ideally, a physician should notify each patient by letter at least 60 days in advance of closing. Often, a physician supplements these letters with a published notice in the local newspaper scheduled to appear on three or more occasions.

The American Medical Association’s Ethics Opinion 7.03, Records of Physicians Upon Retirement or Departure From a Group, states in part: “A patient’s records may be necessary to the patient in the future not only for medical care but also for employment, insurance, litigation, or other reasons. When a physician retires or dies, patients should be notified and urged to find a new physician and should be informed that upon authorization, records will be sent to the new physician. Records which may be of value to a patient and which are not forwarded to a new physician should be retained, either by the treating physician, another physician, or such other person lawfully permitted to act as a custodian of the records.”

Finally, if you have admitting privileges at a hospital — and especially if you take emergency call — you’ll want to give that hospital at least 90 days notice, if not more.

Q I would like to be able to tie staff bonuses to quantifiable staff performance. Any suggestions?

A Here’s a model I saw recently that I really like. It’s a two-part system:

Staff members receive a revenue bonus if the practice collects a preset dollar amount, which goes up over time. Twelve percent of any amount over the goal goes back to the employees. Of that 12 percent, half is divided equally among staff, and the other half is distributed based on staff members’ evaluations of their co-workers. You can see how this approach keeps your staff focused on revenue collection and encourages a team environment.

The second part is based on patient satisfaction survey results. Each staff member receives $50 if all patients surveyed say they would recommend the practice to others. I like this because it also builds teamwork.

Other programs are geared to reward the success of specific staff members. For example, billers may receive extra cash or a profit share if collections are up.

Some general words of advice:

You will get what you pay for, so be careful. I’ve seen practices give their billers incentives to work faster. As a result, more claims went out, but there were also more errors in those claims. So total accounts receivable actually dropped.

Reward your employees only for what they can control. For example, in the profit-sharing program mentioned above, the practice divides its top-line revenues or collections. The staff has little control over costs, so the practice doesn’t base the bonus program on net revenue.

Keep it as simple as possible, and keep it as public as possible. Competition works.

Set the rules clearly, and then stick to them. You don’t want to change your plan halfway through the year. Although you can establish temporary programs for defined periods, don’t give your staff a goal and then move the goal line.

Q I work for a disabled physician who is looking for ways to communicate with other disabled physicians or retired doctors. Can you suggest anything for him?

AThere is a Canadian Association for Physicians with Disabilities. Its Web site has some nice links (www.capd.ca).

You may also want to try the American Society of Handicapped Physicians. The director is William Lambert, and the society’s address is 3424 South Culpepper Court, Springfield, Missouri 65804.

A similar group in the United Kingdom can be found at www.adp.org.uk.

These groups should be able to help your boss get in touch with others who share his concerns.

For more information, try searching www.PhysiciansPractice.com for EMR.