Session

12-13

How to prepare a clinical

practice for family
physician?

When students graduate from

professional schools, they are not
stopping just right here

Working

Further
education

for what?

Two basic options for

employment
A self employed
person (alone/group)

Working for someone

else

Bussinessman

Bussiness owner

Bussiness with other

people

To understand that,
clinical practice as a
system

CLINICAL PRACTICE AS A SYSTEM

Manpower
Market

Money
GOAL

Method
SOP

PROCES
S
P-O-A-CE
Materials

Input of clinical
practice

Output : good
health services

WHAT ARE THE

DOCTOR
PREPARING OF ?
HOW TO DO
THAT ?

THE MANAGEMENT PROCESS

1
2

Definition of practice population

Assessment of needs, demands and

resources

4
5
6

Allocation of priorities (scarcity of

resources)

Formulation of objective

Formulation of policies/health care

Evaluation of performance

1 FORMULATION OF OBJECTIVE
Values of the
physician
Accessibility of the
doctor
Availabilty of the service
Personal care
Continuity of care
Preservation of the
doctor-patient
relationship
The expectations of
the patients

Objective

Personal
values
(satisfying
personal and
family life for
the
physician)

More specifically to
prevention and
management of disease

Definition of practice population

Prepaid system
The List is
compiled by going
through the
practice records
and entering all
patients who have
need the practice
regularly.
Fee for - service

member

Complete picture
of population you
served
Complete picture
of population at
risk
Catchment area

To describe how to
select a community for
practice

Community selection for a practice

General factor :
climate,
demographic,
economic, social and
cultural
characteristics
Do/ make research in
three major areas :
Personal
consideration
(where do you
and your family
want to live)

Business factors
(what is the local
economy and does
community need
another practitioner)

Profesional
consideration
(among another
health care facilities
and specialists)

Assessment of unmet
need
needs

to do : Assessment of
demands

Assessment of
resources

needs of which the patient

is unaware
needs that the patient feels
have not been met by the
health care system
patient generated demand
physician generated
demand

the resources include the

physical plan, communication
system, physician, staff, the
attached personel, hospital and
community resources

ALLOCATION OF PRIORITIES
Scarcity of resources : priorities in input

Formulation of policies/health care

Various of health care according to the need and
demand of the population and scarcity of
resources (prevention, promotion, curative and
rehabilitation )

WHAT TYPE OF PRACTICE

SOLO PRACTICE

GROUP PRACTICE

ADVANTAGES

Freedom To Work,
To share of knowledge &
Without Responsibility To
expertise
Another Party
Quality control through peer
Independence
review, peer support
Have Greater Privacy

DISATVANTAGES

Greater expenses and

lower income
Overwork
To solve managerials
problem as well as to
care the patients

Absent of individuals
freedom
Sharing of income
Group control of invested
capital
Equal responsibility for
expenses, incured debt and
bankrupt
Potential conflicts

6 EVALUATION OF PERFORMANCE
What kind evaluation tools you need to evaluate
performance ?
Inputs
: resources
Processes : POAC
Outputs :
-

Finance : Claim, balance sheet, income statement,

expenditures, cost analysis
total patients : who come for prevention, promotion, curative
and rehabilitation
disease patterns
practice (managerial) procedures: time spent in waiting
room, delay appointments,
audit of records
patient satisfaction etc