Editor's note: This article is the first in a two-part series about improving patient perception of your medical practice. This month, we focus on how to implement a caller-friendly voice mail system and streamline appointment scheduling. Next month's article will focus on billing practices, patient paperwork, and structuring a productive workspace. The old saying "You never get a second chance to make a first impression" is true in every aspect of life, including your medical practice. In fact, in many cases your first impression might be your only impression.

Most physicians still identify diabetes as either noninsulin-dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM), rather than Type I or Type II, according to survey results revealed during the recent audioconference "Diabetes coding:Understand the disease and its documentation requirements." The audioconference was sponsored by HCPro, Inc., in Marblehead, MA, the parent company of HealthLeaders Media. Shannon McCall, RHIA, CCS, CPC, director of HIM/ coding for HCPro, said those results were surprising, considering CMS removed the NIDDM and IDDM definitions of diabetes from the ICD-9-CM coding manual in 2004, replacing them with Type I for juvenile onset and Type II for adult onset.

Behind every great medical practice is a motivated staff. And behind every motivated staff is a great supervisor. "Staff motivation begins with the supervisor and trickles uphill to the administrator and to the physicians and so on . . . to the owner," says Jacqueline Coates, MA, practice administrator at Apple Hill Eye Center in York, PA. A practice's weak or solid foundation is built upon the supervisor's direct leadership, she adds. Following are six key elements that make up the framework for employee motivation and performance

Small physician practices face many unique challenges when it comes to creating an effective time-off policy for their employees. In fact, many small practices choose not to have a time-off policy at all, because they lack the necessary staff to fill positions when employees are out. To complicate the matter further, "very few practices are large enough to fit under [the Family and Medical Leave Act or 1993] unless they're associated with a hospital, in which case they're usually under totally different guidelines," says Marge McQuade, an experienced practice manager and professional development coordinator for the Professional Association of Healthcare Coding Specialists in Brooksville, FL.