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PRACTICE CHECK-UP

Please answer the following questions:

Name:
 
Title:
 
Profession:
 
Address:
 
City:
 
Province:
 
Postal Code:
 
Office Phone:
 
Home Phone:
(optional)
Fax:
(optional)
Email:



For each question below, answer "+" for Yes or mostly Yes. Answer "-" for No or mostly No.
Answer "M" for maybe or uncertain.

1.
I am achieving my financial goals for my practice.
M
+
2.
I have very good success at finding and hiring capable employees.
M
+
3.
Little competition exists in our market.
M
+
4.
I give my accounts receivable/collection staff a rating of 8 out of 10 or better.
M
+
5.
In terms of what we deliver to our patients, we are technically the best.
M
+
6.
I have a regular check on the quality of my product/service.
M
+
7.
We use surveys when going after new patients.
M
+
8.
I often feel guilty about not spending more time with my family.
M
+
9.
Owners and managers should give unexpected bonuses to keep employees on their toes instead of having a routine system of bonuses.
M
+
10.
I believe that people can be helped.
M
+
11.
There has been a downtrend in our profitability over the past 12 months.
M
+
12.
Employees often don't understand how their jobs affect others in the practice.
M
+
13.
The on-going needs of our patients are well-defined and used for increasing the amount of care provided to them.
M
+
14.
Patients often complain about errors in their accounts.
M
+
15.
What we deliver to our patients is normally on time and better than they expected.
M
+
16.
I use patient complaints as a means to improve the practice.
M
+
17.
We keep a record of new patients and know how effective our promotion is.
M
+
18.
There are influences outside my practice that demand my attention right now.
M
+
19.
It is only natural for employees and management to be mistrustful of each other.
M
+
20.
There is something missing in my life.
M
+
21.
We have cash flow problems that need to be resolved.
M
+
22.
Newly hired employees in my practice are quickly trained and soon functioning well at their jobs.
M
+
23.
Our recall/reminder system is effective and produces lots of repeat business.
M
+
24.
I am kept waiting for up-to-date figures on Accounts Receivable.
M
+
25.
If I had better equipment, I could produce a better product/service for my patients.
M
+
26.
My staff know they're good and I don't need to praise them.
M
+
27.
We have effective and proven programs for generating new patients.
M
+
28.
There is quite a bit of stress in my life.
M
+
29.
Trying to define and measure the results produced by each employee would be a waste of time.
M
+
30.
There are other things that I think I should be doing with my life.
M
+
31.
My practice has been involved in disciplinary matters with my licensing board within the past two years.
M
+
32.
I often find myself solving problems that others (managers or employees) should handle.
M
+
33.
We do not have a regular communication (newsletter, etc.) going out to all our patients.
M
+
34.
My practice has an excellent credit rating.
M
+
35.
My patients frequently complain about how long they wait to get an appointment.
M
+
36.
I do not need correction systems for my staff or my service.
M
+
37.
Our practice is getting positive exposure from newspaper articles, free publicity, etc.
M
+
38.
I'm concerned about my health at times.
M
+
39.
Teamwork inhibits creativity.
M
+
40.
There are some problems in my practice for which I have no solutions.
M
+
41.
The amount of debt that my practice is carrying is a problem or a potential problem.
M
+
42.
I could get more work done each day if I had fewer interruptions.
M
+
43.
We do special promotions which are available to our existing patients.
M
+
44.
Payroll is always done on time.
M
+
45.
I haven't yet trained anyone to manage and care for the production/service areas as well as I do it myself.
M
+
46.
We keep and use a staff suggestion box (or a similar system).
M
+
47.
I have at least one employee whose job it is to attract new patients.
M
+
48.
There are too many accidents/mistakes in my life.
M
+
49.
A good policy in business would be to cut every corner possible in order to increase profit margins.
M
+
50.
I intend to find a way to be more effective.
M
+
51.
The long term profitability of my practice is in an uptrend.
M
+
52.
Communication within my practice flows smoothly and quickly to the right person with no misunderstandings.
M
+
53.
Our average amount of service per patient is increasing.
M
+
54.
Tax payments are usually on the late side.
M
+
55.
Quality of service tends to collapse when I am away from the area for any extended period of time.
M
+
56.
Our staff training system is an on-going affair.
M
+
57.
We don't expect much return from our promotional campaigns.
M
+
58.
I have one or more physical problems.
M
+
59.
Most people don't want to work, and do so only because of economic necessity.
M
+
60.
I'm looking for help to improve conditions.
M
+
61.
My gross income has expanded for the last two years.
M
+
62.
I have a reward system for employees who do more than their share.
M
+
63.
We are losing business because of inadequate follow-up of existing patients.
M
+
64.
I can lay my hands on all financial statements at short notice.
M
+
65.
My staff takes pride in pleasing the patients.
M
+
66.
I have sufficient staff in my practice who are cross-trained for other positions.
M
+
67.
Attracting new patients is not an essential part of our income forecasting.
M
+
68.
Others have influenced me in making decisions that I later regretted.
M
+
69.
Expansion isn't always desirable.
M
+
70.
There is something that I need to change or things will worsen.
M
+
71.
There is an external factor which is a threat to the viability of my practice.
M
+
72.
I sometimes wonder how productive some of my employees really are.
M
+
73.
We have a complete database of past and present patients.
M
+
74.
I would like to receive the financial reports more quickly.
M
+
75.
I sometimes cringe and want to hide when my employees are speaking to patients.
M
+
76.
We get along very nicely without any staff training.
M
+
77.
Public Relations is an essential part of our marketing.
M
+
78.
I sometimes experience periods of worry and depression.
M
+
79.
Most problems between people can be resolved with communication.
M
+
80.
Most things that claim to help people actually do more harm than good.
M
+
81.
My practice is dependent on additional external funding (debt or equity) for continued survival.
M
+
82.
I keep graphs of all the key statistics of my practice.
M
+
83.
We have a very loyal and expanding patient base.
M
+
84.
The fixed assets and supplies inventory is complete and up-to-date.
M
+
85.
There is excellent coordination of finance, supplies, personnel logistics, etc. in my practice.
M
+
86.
We apply the principle of quality control to our entire practice.
M
+
87.
I keep separate records of new patients and repeat patients.
M
+
88.
The rewards of operating my practice far outweigh the difficulties.
M
+
89.
A good leader would not hesitate to sacrifice an individual for the good of the group.
M
+
90.
There isn't anything someone else could tell me that would help me run my practice better.
M
+
91.
My practice's cash position is better than it was a year ago.
M
+
92.
Overall morale in my practice is very high.
M
+
93.
A large number of patients have not been presented with full treatment plans.
M
+
94.
I know where the money's going before it gets spent.
M
+
95.
If we did a survey of our patients, at least 90% of them would say that they were satisfied with what we delivered.
M
+
96.
I have a statistic which measures the effectiveness of our Quality Control.
M
+
97.
We get new business from referrals from existing patients.
M
+
98.
Someone or something else is responsible for the condition my practice is in.
M
+
99.
A good executive would rather earn money than borrow it.
M
+
100.
I continually look for ways to improve myself and my practice.
M
+


               
                                                                 
 

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