In order to be a successful organization or business...

...health care team members must know how to present themselves and lead even when they are not in charge. Health care team members must be leaders as individuals. This is best referred to as self-development and is divided into seven key areas...

Keep an eye on your pharmacy

We all know that the pharmacy can and should be a major profit center for your practice. It makes no sense to me to farm this profit center out. As you know, there are companies that are offering to take over your pharmacy for you. You call in, e-mail or fax them the prescription and they will send it to the client. You tell them what prescription fee you want and they rebate that to you. It is their position that your pharmacy is not profitable and you will make more money this way. It is my position that the pharmacy is one of the most profitable aspects of your practice and, on a square foot basis, is probably THE most profitable. Why would you want to give up this profit center? Another concern would be that you are giving away precious information in the form of your client data. That information is gold in the internet world.

I would ask that you review your pharmacy markups and dispensing fee. The normal markups in our profession have not changed. It is customary to markup your inventory items at 150% unless they are shopped and exposed or expensive items, in which case the markup might be 100%. It is also time to look at your dispensing fee. As your costs go up you must adjust this fee accordingly. Fixed costs and support staff costs have increased substantially in many areas, when was the last time you increased your dispensing fee?

One last note of advice—I have been in several hospitals that thought their inventory markup system was working just fine. In some software programs there is a “switch” that says “auto markup.” If that switch is set at “off” your computer will not automatically increase the cost of medications when the purchase price has increased. I would suggest that you put a phantom new product into your software program at a price of $10.00 and see what comes out on the client receipt. Make sure your software is doing what you think it should be. Your pharmacy should be a major profit center for your practice. Make sure it is!

Dogs and Work, They go together.

At the dog-oriented website, dogster.com, a survey was done that showed pet owners would be willing to stay at a job they disliked, work longer hours and even take a pay cut if they were able to bring their dog to work with them.

Here is what the survey respondents said:

• 11% would take a 10% pay reduction, 32% would take a 5% pay reduction
• 49% would change jobs for the privilege
• 66% would be willing to work longer hours
• 70% believe that a pet friendly workplace is an important benefit

The Top Ten Tips to Preventing Fraud in Your Hospital

Most are trusting and many give away to much control over the financial activity in their hospitals without understand the possible ramifications. It is only when it is to late and someone has a gruesome story to tell do you understand why these top ten tips to prevent fraud in your hospital are so important.

Here they are. (In Order of Effectiveness)

1. Send Bank and Credit Card Statements to a Separate Address. Do not send your bank statements to your business address. Have your bank statement sent to your home or PO Box. Review each check both front and back for payee, signature, and endorsement. Even if you don’t allow your employees to use your credit card, make sure those statements are sent to an alternate address, too. Examine each statement carefully. Review each and every line item of both payments and charges.
2. Do Not Let Anyone Misrepresent Themselves as You. Do not let them use your password, sign your name, or use your credit card, ever. Never let an employee sign your name, use your credit card, or misrepresent themselves to your bank or credit card company. Reimburse their expense. Don’t reveal sensitive passwords. If you allow your employee to sign your name even on credit card purchases, it could compromise your legal recourse in case of fraud or embezzlement.
3. Reconcile Bank Accounts and Review Statements. Review every statement. Make sure all bank accounts and credit cards are reconciled. Afterwards, take time to review every reconciliation report. Notice stale checks or deposits that have not cleared the bank. Check for missing deposits. An increase in the number of reconciled items may also reveal mischief.
4. Assign Administrative Rights Effectively. Use the Administrative rights in QuickBooks and your veterinary software to protect your data. The first person to set up QuickBooks is by default assigned as Administrator. This role has unique permissions. So the administrator should be designated to either an outside party, i.e., a CPA, Consultant, or the savvy owner. Make sure that every user is set up separately and that passwords are used. Lock down permissions to change or delete transactions. Especially important: Use passwords for closing dates.
5. Use the Audit Trail in QuickBooks. If you don’t have the latest version of QuickBooks, make sure you turn on the Audit Trail. Go to Preferences > Accounting and click on the box "Audit Trail". Caution: the Audit Trail won’t tell you if a vendor name has been changed or merged. It is wise to maintain a strict paper trail. Supporting documents need to be readily accessible in your files and then archived according to the type of document.
6. Use the Voided/Deleted Transaction Report. After you have turned on the Audit Trail, and made its review part of your routine, periodically review the Voided/Deleted Transaction Report to see which entries have been modified.
7. Establish Accounting Controls. The principle of countervailing power is the fundamental reason to use checks and balances in accounting. Split the responsibilities between staff members or outside accounting professionals. Warning Sign: If only one person writes the checks and reconciles the account, there is no double check. Separate the duties. Consider another person to do reconciliations so it is done by a person other than the staffer generating the checks.
8. Adhere to a Numerical Sequence. Use a numerical sequence for all transactions. Invoices, bills, and checks which are numbered fall in a logical and chronological order. The reason: To identify missing documents. Look at the bank statement for large gaps. Secure paper checks. If you keep voided paper checks, remember to tear off the signature area to keep it from being misused. If your bank sends paper checks, sort them numerically.
9. Review Receivables and Payables. Look for adjustments to Receivables or Payables. Such adjustments could indicate subverted payments or vendor checks.
10. Back up Your Data. Repeat after me – Back up, back up, back up. Think redundant backups as a contingency plan for disasters of all sorts. Make scheduled copies. Rotate the media (tape drive or portable storage). If you use CDs, better buy the read-only variety. Store your backups at another location. Such diligence can come in especially handy if there is a disaster. In some fraud cases, the bookkeeper may delete all of the QuickBooks files to avoid detection. In such cases the business has to pay a large sum for data retrieval in hopes of capturing any shred of evidence. Be smart; back up. It only takes a few minutes.