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CURRENT CIRCULATION: 7,894 DATE: 15th March, 2012 ISSUE NO: 189

Welcome to Health & Life’s free email newsletter service. Tell a friend that we would be happy to add their email address to the distribution list. This service is to provide Health and Life’s clients and those who attended our presentations with up to date information on key financial and practice management issues that may affect your practice. Please do not use this as a substitute to seeking professional advice. Writer in charge: Mr David Dahm BA.Acc, FCPA, FTIA, Ffin, FAAPM, FGLF.

Efficient and Effective Decision Making!


It’s a baby gir!! Nurses Low Wage Pay Claim 2012 Update DHS Launches Email MBS Interpretation Service New Health and Life Facebook Fan Page

1. Effective and Efficient Decision Making – Practice and Clinical Governance Matters! 2. NSW, QLD & SA March to October 2012 Seminars and One to One Meetings

3. Catching up with David Dahm and the Team 4. Where to from here?


It is a baby girl!

Congratulations to Kylee, one of our long serving senior consulting accountants. She, has had a little baby girl on Tuesday morning, a little earlier than we thought! Zaylia was 8.1 pounds and 53 cm. Mum and baby are all doing well. We look forward to seeing Kylee and Zaylia back at Health and Life. In the meantime may your family and friends all have a wonderful time in this new chapter in your life. Congratulations Kylee!

Nurses Low Wage Pay Claim 2012 Update

The Australian Nurses Federation December 2011 low wage enterprise bargaining claim is gaining some questionable momentum in Victoria, NSW and Tasmania. As you all may be aware in our past editions we have reported that we have been representing practices that have purchased our employment kit at no charge if they have followed the kit instructions to the letter. By the end of February 2012 the union was supposed to provide overwhelming evidence that nurses are underpaid. 800 practices in Victoria were served notices, less than 100 sought representation. Unless a practice seeks representation or represents itself then any default order for a pay increase may apply to those practices. It is interesting note only 18 nurses have made a complaint in Victoria. This matter is set to be heard by June 2012. Employers now have to prove that they are paying above the Award entitlements. This does not mean paying a higher hourly rate is enough, you must have individual signed employment contracts that address all award issues e.g. overtime, leave etc signed by each staff member you employ. Fines up to $33,000 per breach are applicable. We note the union have been writing unsolicited emails to practice nursing staff requesting payslips and details of employment contracts. Let us hope this information is not used against a practice in the negotiation process. Contact us should you wish to purchase our employment kit if you wish to keep out expensive employer and employee union enterprise bargaining arrangements and not have to re-invent the wheel by having a lawyer create new employment agreements for your practice. We are providing at no charge free representation for clients who have bought and used the kit correctly. David Dahm is presenting on this issue to practices. See below for NSW & QLD, SA seminars. •

DHS Launches Email MBS Interpretation Service

The AAPM welcomes the decision of the Department of Human Services to introduce a Medicare Benefits Schedule (MBS) item enquiry email service to assist practice managers

and doctors with complex interpretations in the use of MBS item numbers. Practice Managers can now send queries to a dedicated email address and receive a rapid written response to specific questions about the correct MBS item for a particular medical service. The service is available to practice managers or doctors and can be accessed by either: email MBS item questions directly to; or use the online enquiry form available at Contacts for providers. Source: The Australian Association of Practice Managers •

New Health and Life Facebook Fan Page – “Like” us!

On a less serious note we have a new facebook fan page and we loved to see you there visit. What we really want you to do is to “like” us we are going for 100 likes by the end of March. There is a free Ipad offer if you can help us.

Efficient and Effective Decision Making!

1. Introduction

Recently David Dahm has been visiting practices all around Australia. We have a few more in the Eastern states to go. See below for more information. From owners, management and staff we have received the following comments and these are from very successful practices. The objective for most practices is to not just be good at what they do but great at what they do. This means making light work of a heavy load and just to do things better then how we did them yesterday takes out the daily stress of working in a practice. There is no point doing the same thing yesterday and hoping for a different result. Nothing will change. Albert Einstein once said… “An intellectual solves problems, a genius prevents them” We all share the same problems you may be feeling. Believe it or not, as night is to day these problems can be solved overnight if we have the right thinking tools! Some common comments we here are: Recruitment and Retention • • • •

“We cannot recruit or retain any doctors or providers it is time to sell to a corporate” “We try and get providers to sign and agreement and then they threaten to leave” “The other practices are offering ridiculous incentives. We can’t compete” “We keep offering a percentage but they really want a future we can’t offer”

Owners • • • •

“We are spinning wheels. We are going through change management burnout” “It’s a benevolent dictatorship. I can’t let go. I have been burnt before” “ I just don’t have time, I need to see the next patient” “We do have a good practice manager , don’t we? So why do we feel the way we do?”

Management • • • •

“We can never seem to finish what we started and they just don’t listen” “I just need a decision from the doctors, they are like herding sheep” “Some of the principals keep micro managing me in the corridor” “What if I get hit by a bus tomorrow - what will the practice do?”

Staff • • • •

“I don’t get any feedback and it is frustrating” “If the boss just said thanks once I would be much happier” “We are being bullied and intimidated” “I no longer enjoy what I do. It is a prison and I am counting down the days”

Advisers • • •

“The training program gives different and conflicting advice and it is putting off our doctors” “Our advisers are great but charge every time we call we don’t know when to call them?” “Do we really follow the advice, if not we are wasting everyone’s time”

After 21 years we found it is not uncommon that many practices make important decision’s and mistakes based on fear, egos or ignorance. It only takes one moment to make a bad decision such as a bad hire or signing the wrong type of finance lease that results in a very expensive and stressful solution. So having the right thinking tools and processes in place to avoid such problems and to take advantage of such opportunities is a no brainer. The panacea to building a stronger and better practice is quite simple, it is called Governance. This is now part of the 4th Edition Royal Australian College of General Practice Accreditation Standards. What is Governance? They are the rules, processes, or laws by which a practice is operated, regulated, and controlled to meet the organisation’s shared vision. How do you do it: 1. Establish and ensure your owners and people live your governance structure Use an appropriate governance structure to address both clinical and non clinical governance problems and/ or opportunities that a practice may face. This means define what is the etiquette i.e.

social work rules that determine how the owners relate to management staff and external stakeholders such as suppliers and government that is efficient and effective. 2. Establish intuitive key high level thinking and operating systems that sets the tone on how we do things here It is impossible for any practice to have a solution or policy for every problem that they encounter. So practical systems such as template delegation authorities such as when matters need to be referred to the Board of the CEO/Practice Manager need to be established .Why have 5 doctors billing at $2,500 (5 principals x $500 per hour per principal) per hour to decided whether to take advantage of a $200 discount on a photocopier is a waste of time. This decision could easily be left to a practice manager. The point is to clearly determine the lines of authority, so people know how to solve problems on their own by following a set range of policies and procedures that are flexible and clear and not tedious to apply but self empowers them to find the right decision efficiently and effectively. Little things like providing instant feedback without fear or favour and 6 monthly performance reviews are critical and they should be the norm. Everyone loves constructive feedback and the opportunity to learn and grow. 3. A great work culture is the end game! It is people who enforce policy, not policy manuals or a whole list of tasks. For example if at a board meeting the owners agree that coming to work in professional attire is an action, then a policy can be set. Given people come to work with right professional look, soon this becomes a habit that everyone by default follows because they follow others. This sets what is and should be a “normal� standard and this means you have a great work culture. Your practice culture is the most important risk management tool not insurance companies or lawyers or supervisors banging on what you should or should not do. If your peers tell you and not your boss you have a great work culture which improves morale and your bottom line. We have a number of on-line tools to measure staff productivity and Board or owner productivity. Contact us for more information or visit our website. We are also proud to announce we have a new presentation off the press called Practice and Clinical Governance Matters which also addresses the Royal Australian College of General Practice new 4th Edition Standards. Practice and Clinical Governance Matters (new presentation) We developed this presentation for practice principals and practice mangers and CEO’s with Ms Kate Costello. Kate Costello has a video series and was responsible for writing the national Australian Company Institute of Directors course which these clinical standards refer to. The presentation which we will be presenting interstate will cover: Practical ways on:

• • • • •

How to run a practice How to create and efficient and effective decision making processes Role of a Board of Directors/Owners – you don’t know what you should know Directors/Owners Performance – yes owners need to perform or they should leave! CEO/Practice Manager performance - what is reasonable and what is not

This will allows owners to work on and not in the business and to delegate effectively as well as monitor outcomes without having to get personally involved. It will also free up personal and clinical time. It will also show owners how you get doctors to buy into your practice and not be overwhelmed as it is a simple and well structured process that will not frighted potential owners away. Finally it will allow practice managers and CEO’s to manage and not be micro managed in the corridor by principals

2. NSW, QLD & SA March to October 2012 Seminars and One to One Meetings Below is a summary of dates for our practice visits and seminars across Australia. There is an opportunity to meet with us face to face for a no-obligation discussion of any practice issues you may have at each seminar or by personal appointment. Email us at to pre-book an appointment. If you would like your local medical organisation to host a seminar, forward them this email with our seminar details and copy us at We will contact them directly about presenting in your local area. We thank you in advance for your interest and support. You would be surprised how it only takes one person to make things happen! New confirmed programs are detailed below. Please contact the organisations directly for details about the course program, content and costs. It is free to Medicare Locals and Associations if it is part of the program detailed below. Please email your expression of interest to us or email your local association and we can do a presentation at no cost to them. See where David will be visiting! Click on the link to the map: MAP

Host and Location


Contact Name

Contact Email



19th March, 2012

Ashley Moore 08 8415 5400

*One on one meetings Contact us if you would like a complimentary

meeting Note a couple of spots left strictly first in first served. Wollongong Grand Pacific Health Medicare Local

20th and 21st March, 2012

Kathy Lymbery


22nd March, 2012

Ashley Moore 02 4220 7600 08 8415 5400

PRESENTATION Question and Answers Sessions: Topic: Practice and Clinical Governance. Nursing Federation Australia *One on one meetings Contact us if you would like a complimentary meeting Note a couple of spots left strictly first in first served.

Coffs Harbour

23rd March, 24th March and 25th March, 2012

Ashley Moore 08 8415 5400

*One on one meetings Contact us if you would like a complimentary meeting Note a couple of spots left strictly first in first served.

Mid North Coast Division of General Practice

24th March, 2012

Karen Plumbe

26th March, 2012

Kyra Moss PRESENTATION 02 6651 5774

Coffs Harboour Armidale New England Division of General Practice 02 6771 1146

Topic: The World’s Best Practice Presentation PRESENTATION Question and Answers Sessions: Topic: Practice and Clinical Governance. Nursing Federation Australia


28th March and 29th

Ashley Moore

*One on one meetings

March, 2012

08 8415 5400

Contact us if you would like a complimentary meeting Note a couple of spots left strictly first in first served.


30th March, 2012

Ashley Moore 08 8415 5400

*One on one meetings Contact us if you would like a complimentary meeting Note a couple of spots left strictly first in first served.


2nd April, 2012

Ashley Moore 08 8415 5400

*One on one meetings Contact us if you would like a complimentary meeting Note a couple of spots left strictly first in first served




20th June, 2012

Ashley Moore 08 8415 5400

10th August, 2012

Ashley Moore

12th October 2012

Ashley Moore 08 8415 5400 08 8415 5400

PRESENTATION CPA Week “Great People” PRESENTATION Dental Practice Update – 2 sessions PRESENTATION Tafe SA – Dental ”Strategy & Legal”

*So you are looking for that competitive advantage – why not catch up with David Dahm and the Team. See below.

3. Catching up with David Dahm and the Team We can talk about succession planning, business structures, effective tax planning, employee vs contractor agreements, benchmarking and many more topics. We are using this time to catch up with existing clients. If you are not an existing client, this may be a good opportunity to tell us what is on your mind. Ask yourself the following questions: • • • • •

What new challenges am I facing? What new opportunities do I anticipate? What kind of support or expertise would be most helpful to me now? What changes do I anticipate over the next year or so? What more can Health and Life do for you, if anything?

We are planning trips and one to one to meetings as detailed above. Please note that this is on a first come first serve basis. In the meantime, please feel free to contact us to arrange a no obligation teleconference to get you started on any significant issues. Email us at

4. Where to from here?


Consult your professional adviser in relation to any advice suggested;


If you require any back issues of our news alerts please email us;


If you are not sure about any issues raised in this broadcast, contact David Dahm on 1800 077 222 for an initial no obligation consult or email us at Health and Life provides comprehensive Practice consulting, accounting, taxation and financial planning advice for group Practices and individuals. Email us for information about our Employment Template kits for providers and support staff and our Doctors pay Calculator.

Which topics would you like to be covered? If there is a particular topic that you would like covered in one of our future News Alerts, please email and let us know what it is. We will then endeavour to cover your requested topic.

Do we have your email address? It is apparent in feedback we are receiving that there are persons receiving this regular email who are not on our email list. If you are receiving this email ‘second-hand’ from another source, we would be delighted to receive your email address and we will add you to our database so that you can receive it first-hand on the day it is sent. This invitation is open to all Medical Practices. Please send your email address to Do you wish to unsubscribe from our list? Please email if you wish to be removed from our distribution list. Copyright Notice 2012 This email, including any attachments, is for the personal use of the recipient(s) only. Republication and re-dissemination, including posting to news groups or web pages, is strictly prohibited without the express prior consent of Health & Life Pty Ltd. Disclaimer Notice Health & Life Pty Ltd’s Best Practice News Alert is designed as a comprehensive and up-to-date Accounting, Practice Management and Healthcare news service to alert readers to the latest in Practice and related developments affecting the medical, dental and allied health professions as they happen. It is published when there is news to report. No responsibility can be accepted for those who act on its content without first consulting us or obtaining specific advice.

Efficient and Effective Decision Making  

This article covers an update of the Nurses Low Wage Claim, DHS Launches Email MBS interpretation service, practice and clinical governance...

Efficient and Effective Decision Making  

This article covers an update of the Nurses Low Wage Claim, DHS Launches Email MBS interpretation service, practice and clinical governance...