How to prepare a clinical practice for family physician?

1. How to prepare a clinical practice for family physician?

2. Session 13

3. When students graduate from professional schools, they are not stopping just right here Working Further education for what?

5. Two basic options for employment A self employed person (alone/group) Working for someone else Bussinessman Bussiness owner Bussiness with other people

6. It’s very important to know that, a family doctor effectiveness depends not only on clinical skills, but also on managerial ability or managing ( to run their business) …… to be a manager poor practice management can lead to poor patient care, public dissatisfaction, and demoralization on the doctor and her/ his staff Every family doctor must be involved in the process of assessing needs and demands for care, establishing priorities and allocating resources

7. MANAGING IS : • To get work done through the efforts of others • Producing an output (technical care and patient satisfaction) from input (manpower, money, materials, methode and market) and processes (operational work, developmental work and organizational work - POAC)

8. BASIC FUNCTION, SKILLS SET AND ROLES OF MANAGER BASIC FUNCTION : • PLANNING • ORGANISING • LEADING • CONTROLLING THE DOCTOR IS OFTEN THE MANAGER OF THE PRACTICE • ROLES OF MANAGER: • LEADERSHIP ROLES • INFORMATIONAL ROLES • DECISIONAL ROLES • SKILL SETS OF THE MANAGER : • CONCEPTUAL SKILLS • HUMAN SKILLS • TECHNICAL SKILLS

9. BASIC FUNCTIONS OF MANAGER IN DETAIL: • PLANNING : IS A PROCESS OF SETTING OBJECTIVE AND FORMULATING THE STEPS WHICH WILL BE NECESSARY TO ATTAIN THESE OBJECTIVE. • ORGANISING : IS A PROCESS OF GETTING ACTIVITIES, PEOPLE, MATERIALS STRUCTURE TO MEET ORGANIZATIONAL OBJECTIVE, INCLUDES SETTING OF JOB DEFINITION, AUTHORITY TO ACT AND DEPARTEMENTALIZATION • LEADING : IS THE PROCESS OF INFLUENCING STAFF TO MEET PREDETERMINE OBJECTIVE. THE EFFECTIVE SKILL ARE COMMUNICATION & FEEDBACK, MOTIVATION OF STAFF AND USE OF APPROPRIATE STYLE TO SPECIFIC SITUATION • CONTROL : IS A PROCESS OF ENSURING THAT THINGS HAPPEN ACCORDING TO PLAN AND TAKING CORRECTIVE ACTION WHERE NECESSARY. IS A THREE-STEP PROCESS : SETTING STANDARDS, COMPARING PERFORMANCE AGAINST STANDARD AND CORRECTING DEVIATIONS.

10. ROLES OF MANAGER LEADERSHIP ROLES : FIGUREHEAD, LEADER AND LIAISON PERSON. IN THESE ROLES, THE MANAGER INTERACTS WITH OUTSIDE ORGANIZATION INFORMATIONAL ROLES : MONITOR, DISSEMINATOR AND SPOKESMAN. IN THESE ROLES, THE MANAGER HANDLES INFORMATION DECISIONAL ROLES : ENTREPRENEUR, DISTURBANCE HANDLER, RESOURCE ALLOCATOR AND NEGOTIATOR. IN THESE ROLES THE MANAGER MAKE DECISIONS

11. EFFECTIVE LEADERS SIMULTANEOUSLY SATISFY THESE THREE SET OF INTERDEPENDENT NEEDS (TASK NEED, GROUP NEEDS, INDIVIDUAL NEEDS) AND INTERCONNECT EACH OTHERS. LEADERSHIP : IS THE PROCESS WHEREBY ONE PERSON INFLUENCES THE THOUGHTS AND BEHAVIOURS OF OTHERS • PERSONAL LEADERSHIP STYLE : • AUTOCRATIC OR PERMISSIVE • THEORY X OR THEORY Y

12. PERSONAL EFFECTIVENESS IS ABILITY TO EXERT A POSITIVE INFLUENCE ON THE TASKS OF MANAGEMENT. MAKE YOURSELF LOOK GOOD MANAGING PAPER MANAGING MEETING

13. CONCEPT & HISTORICAL DEVELOPMENT DECISION PROCESS INTRAPRENEURSHIP ENTREPRENEURSHIP ETHIC & RACIAL RESPONSIBILITY BASIC START-UP TYPES THE ROLE IN ECONOMIC DEVELOPMENT

14. INTRAPRENEURSHIP IS ENTREPRENEURSHIP WITHIN AN EXISTING BUSINESS STRUCTURE AND ALSO BRIDGE THE GAP BETWEEN SCIENCE AND MARKET PLACE • CREATIVITY • INNOVATIVE • SPIRIT

15. CONCEPT & HISTORICAL DEVELOPMENT EARLIEST PERIOD : MARCO POLO ESTABLISHED TRADE ROUTES TO THE FAR EAST. LOTS OF RISKS WITH MONEY PERSON MIDDLE AGES : DIDN’T TAKE RISKS AND MANAGED PROJECTS WITH RESOURCES PROVIDED 17th – 20 th CENTURY : • MOVED FROM GOV’T CONTRACTUAL ARRANGEMENTS TO INDIVIDUALIZED WORK • WAS DISTINGUISH FROM THE CAPITAL PROVIDER • ORGANIZED AND OPERATED FOR PERSONAL GAIN THE MIDDLE OF 20th CENTURY : ENTREPRENEUR AS AN INNOVATOR ( AN INDIVIDUAL DEVELOPING SOMETHING UNIQUE/ INVENTION)

16. DEFINITION OF ENTREPRENEURTODAY IS THE PROCESS OF: • CREATING SOMETHING NEW WITH VALUE BY DEVOTING THE NECESSARY TIME AND EFFORT • ASSUMING THE ACCOMPANYING FINANCIAL, PSYCHIC AND SOCIAL RISKS. • RECEIVING THE RESULTING REWARDS OF MONETARY AND PERSONAL SATISFACTION AND INDEPENDENCE.

17. ENTREPRENEURIAL DECISION PROCESS IS DECIDING TO BECOME AN ENTREPRENEUR BY LEAVING PRESENT ACTIVITY OR MOVEMENT FROM A PRESENT LIFESTYLE TO FORMING AN ENTERPRISE. • FORM NEW ENTERPRISE • DESIRABLE (ASPECTS OF SITUATION THAT MAKE IT DESIRABLE TO START A NEW COMPANY: CULTURE, SUBCULTURAL, FAMILY, TEACHERS, PEERS) • POSSIBLE (FACTORS MAKING IT POSSIBLE TO CREATE A NEW VENTURE : GOVERNMENT BACKGROUND MARKETING, FINANCING AND ROLE MODELS) • CHANGE FROM PRESENT LIFESTYLE • WORK ENVIRONTMENT • DISRUPTIONS

18. CHANGE FROM GP TO FAMILY PHYCISIAN • IS NOT AN EASY ONE • TAKES GREAT ENERGY & EFFORT • RESEARCH DEVELOPMENT & MARKETING CHANGE INDIVIDUAL FAMILY PRESENT LIFESTYLE NEW VENTURE FORMATION

19. TYPES OF START-UPS LIFESTYLE FIRM : A SMALL VENTURE THAT SUPPORTS THE OWNERS AND USUALLY DOESN’T GROW GAZELLES : VERY HIGH GROWTH VENTURES HIGH-POTENTIAL VENTURE : A VENTURE THAT HAS HIGH GROWTH POTENTIAL AND THEREFORE RECEIVES GREAT INVESTOR INTEREST FOUNDATION COMPANY : A TYPE OF COMPANY FORMED FROM RESEARCH AND DEVELOPMENT THAT USUALLY DOESN’T GO PUBLIC

20. ETHIC & SOCIAL RESPONSIBILITY • MUST TAKE RISKS • EXPENDING GREATER ENERGY • IN ORDER TO INNOVATE • FACED WITH DAILY STRESSFUL SITUATION & DIFFICULTIES • ETHICAL EXIGENCIES • ECONOMIC EXPEDIENCY • SOCIAL RESPONSIBILITY BALANCE • USUALLY DEVELOP IN INTERNAL ETHICAL CODE • TEND TO DEPEND ON THEIR OWN PERSONAL VALUE SYSTEM WHEN DETERMINING ETHICALLY ACTION • SENSITIVE TO PEER PRESSURE AND GENERAL SOCIAL NORM IN THE COMMUNITY • SENSITIVE TO PRESSURE FROM THEIR COMPETITORS.

21. BUSINESS ETHICS 1. PEDAGOGICALLY ORIENTED INQUIRY INCLUDING THEORY & EMPIRICAL STUDIES THE STUDY OF BEHAVIOR AND MORALS IN A BUSINESS SITUATION • RELATED WITH THE CONCEPT OF CULTURE • INDIVIDUAL MORALITY AND BEHAVIORAL HABITS ARE RELATED AND IDENTIFIED AS AN ESSENTIAL QUALITY OF EXISTENCE 2. THEORY – BUILDING WITHOUT EMPIRICAL TESTING 3. EMPIRICAL RESEARCH, MEASURING THE ATTITUDES & ETHICAL BELIEFS OF STUDENT & ACADEMIC FACULTY 4. EMPIRICAL RESEARCH WITHIN BUSSINESS ENVIRONTMENTS

22. THE FUTURE OF ENTREPRENEUSHIP ENTREPRENEURSHIP EDUCATION THROUGHOUT THE WORLD IS ALSO GROWING DIFFERENT THINGS TO DIFFERENT PEOPLE AND DIFFERENT CONCEPTUAL PERSPECTIVE BUT ARE SAME ASPECT : RISK TAKING, CREATIVITY, INDEPENDENCE AND REWARD SUPPORT AN INCREASE IN ACADEMIC RESEARCH GOVERNMENT ARE TAKING AN INCREASED INTEREST IN PROMOTING THE GROWTH OF ENTREPRENEURSHIP SOCIETY’S SUPPORT IS CRITICAL IN PROVIDING MOTIVATION AND PUBLIC SUPPORT AND WILL CONTINUE

23. SKILLS SETS OF THE MANAGER CONCEPTUAL SKILLS : ARE SKILLS OF PERCEIVING HOW THE PARTS OF THE ORGANIZATION LINK TOGETHER IN STRUCTURE AND PROCESS. HUMAN SKILLS : THESE ARE SKILLS INVOLVED IN WORKING WITH PEOPLE, OFTEN AS A MEMBER OF A GROUP. THE ABILITY TO CONSIDER THE INTERESTS OF SUBORDINATES AND CO-WORKERS, TO MOTIVATE THEM TO CONTRIBUTE THEIR BEST AND INVOLVE THEM IN DECISION MAKING ARE IMPORTANT TO GET WORK DONE THROUGH THE EFFORTS OF OTHERS. TECHNICAL SKILLS : THESE ARE SKILLS IN MANAGING THINGS RATHER THAN PEOPLE AND ARE OFTEN LEARNED THROUGH ON THE JOB TRAINING PROGRAMMES.

24. Session 14

25. WHAT ARE THE DOCTOR PREPARING OF ? HOW TO DO THAT ?

26. 1 2 3 4 5 6 THE MANAGEMENT PROCESS FORMULATION OF OBJECTIVE DEFINITION OF PRACTICE POPULATION ASSESSMENT OF NEEDS, DEMANDS AND RESOURCES ALLOCATION OF PRIORITIES (SCARCITY OF RESOURCES) FORMULATION OF POLICIES/HEALTH CARE EVALUATION OF PERFORMANCE

27. 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 PERSONAL VALUES (SATISFYING PERSONAL AND FAMILY LIFE FOR THE PHYSICIAN) OBJECTIVE THE EXPECTATIONS OF THE PATIENTS MORE SPECIFICALLY TO PREVENTION AND MANAGEMENT OF DISEASE

28. To understand that, clinical practice as a system

29. CLINICAL PRACTICE AS A SYSTEM MANPOWER MONEY MARKET GOAL METHOD PROCESS P-O-A-C-E SOP MATERIALS OUTPUT : GOOD HEALTH SERVICES INPUT OF CLINICAL PRACTICE

30. 2 DEFINITION OF PRACTICE POPULATION Prepaid system member The List is compiled by going through the practice records and entering all patients who have need the practice regularly. Complete picture of population you served Complete picture of population at risk Fee – for - service Catchment area

31. To describe how to select a community for practice

32. 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) PROFESIONAL CONSIDERATION (AMONG ANOTHER HEALTH CARE FACILITIES AND SPECIALISTS) BUSINESS FACTORS (WHAT IS THE LOCAL ECONOMY AND DOES COMMUNITY NEED ANOTHER PRACTITIONER )

33. ASSESSMENT OF NEEDS Needs of which the patient is unaware Unmet need Needs that the patient feels have not been met by the health care system Patient generated demand 3 ASSESSMENT OF DEMANDS To do : Physician generated demand The resources include the physical plan, communication system, physician, staff, the attached personel, hospital and community resources ASSESSMENT OF RESOURCES

34. ALLOCATION OF PRIORITIES 4 Scarcity of resources : priorities in input FORMULATION OF POLICIES/HEALTH CARE 5 Various of health care according to the need and demand of the population and scarcity of resources (prevention, promotion, curative and rehabilitation )

35. WHAT TYPE OF PRACTICE

36. Finance : Balance sheet, income statement, expenditures 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 EVALUATION OF PERFORMANCE 6 • What kind evaluation tools you need to evaluate performance ? Inputs : resources Processes : POAC Outputs :

37. MANAGING INPUT MANPOWER MARKET MONEY METHODE G.P/ F.P SOP MATERIALS INPUT OF CLINICAL PRACTICE

38. MANAGING PEOPLE AND RESOURCES

39. PEOPLES/ HUMAN RESOURCES WORKING TOGETHER TO ACHIEVE THE GOAL PLANNING, ORGANIZING, ACTUATING, CONTROLLING, EVALUATING ENTRY EXIT MOTIVATION REWARD AND PUNISHMENT RECRUITMENT & SELECTION PEOPLE HANDLING: CONFLICT, ABSENTEEISM JOB DISCRIPTION STAFF DEVELOPMENT JOB QUALIFICATION SEPARATION TRAINING AND EDUCATION LEADERSHIP PROMOTION FOLLOWERSHIP PLACEMENT

40. MANAGING FACILITIES AND UTILITIES

41. BUILDING SELECTION RELATIVE COST : BUY/ RENT OR BUILD ? PROXIMITY TO MEDICAL FACILITIES, COLLEAGUES IMMEDIATE ENVIRONMENT TRANSPORTATION & PARKING BUILDING SERVICES POSSIBILITIES FOR REMODELLING OR EXPANSION

42. MANAGING INFORMATION SYSTEM - MEDICAL COMPUTER SYSTEMS • HARDWARE : • COMPUTERS • PRINTERS • TERMINALS • SOFTWARE : • PATIENT REGISTER • MEDICAL RECORD • APPOINTMENT • ACCOUNTING • BILLING SYSTEM , ETC BRAINWARE : HUMAN RESOURCES, LEGAL ASPECT

43. MANAGING FINANCES

44. FINANCIAL MANAGEMENT IS : • Keeping proper records of income, expenditure/expenses and profit • Preparing financial statements at the end of accounting period : income (profit and loss) statement and balance sheet • Analyzing financial statements and taking the necessary actions • Implementing inventory and stock control processes • Acting on discrepancies • Ensuring that financial records are audited • Developing financial plans (capital, operational) ….> budgeting • Taxes

45. MONEY • PATIENTS/ CLIENTS • INSURANCE • CORPORATES • SALARY • OPERATIONAL • MAINTENANCE • INVEST • “ MARKETING” • EXPANSION • UNIT COST & PRICE • RULES REVENUE EXPENDS BALANCED

46. PLANNING: INPUT, PROSES, OUTPUT EVALUATION CONTROLLING ORGANIZING ACTUATING MANAGING PROCESS

47. MANAGING OUTPUT/ QUALITY OF HEATH SERVICES STANDARDS/ PROTOCOLS QUALITY OF CARE PROFESIONAL PATIENTS/ CLIENTS SATISFACTION

48. Thank you…….