For many, the making and breaking of New Year’s resolutions has become a humorless cliché. Still, the beginning of a new year is as good a time as any for reflection and inspiration; and if you restrict your fix-it list to a few realistic promises that can actually be kept, resolution time does not have to be such an exercise in futility.

I can’t presume to know what needs improving in your practice, much less your life; but I do know the office issues I get the most questions about. Perhaps the following examples will provide inspiration for assembling a realistic list of your own:

Dr. Joseph S. Eastern

Dr. Joseph S. Eastern

1. Review your October, November, and December claim payments. That is, all payments since ICD-10 launched. Overall, the transition has been surprisingly smooth; the Centers for Medicare & Medicaid Services says the claim denial rate has not increased significantly, and very few rejections are due to incorrect diagnosis coding. But each private payer has its own procedure, so make sure that none of your payers has dropped the ball. The most common problem so far seems to be inconsistent handling of “Z” codes, such as skin cancer screening (Z12.83), so pay particular attention to those.

2. Do a HIPAA risk assessment. The new HIPAA rules have been in effect for more than a year. Is your office up to speed? Review every procedure that involves confidential information; make sure there are no violations. Penalties for carelessness are a lot stiffer now.

3. Encrypt your mobile devices. This is really a subset of No. 2. The biggest HIPAA vulnerability in many practices is laptops and tablets carrying confidential patient information; losing one could be a disaster. Encryption software is cheap and readily available, and a lost or stolen mobile device will probably not be treated as a HIPAA breach if it is properly encrypted.

4. Reduce your accounts receivable by keeping a credit card number on file for each patient, and charging patient-owed balances as they come in. A series of my past columns in the archive at explains exactly how to do this. Every hotel in the world does it; you should too.

5. Clear your “horizontal file cabinet.” That’s the mess on your desk, all the paperwork you never seem to get to (probably because you’re tweeting or answering e-mail). Set aside an hour or two and get it all done. You’ll find some interesting stuff in there. Then, for every piece of paper that arrives on your desk from now on, follow the DDD Rule: Do it, Delegate it, or Destroy it. Don’t start a new mess.

6. Keep a closer eye on your office finances. Most physicians delegate the bookkeeping, and that’s fine. But ignoring the financial side creates an atmosphere that facilitates embezzlement. Set aside a couple of hours each month to review the books personally. And make sure your employees know you’re doing it.

7. Make sure your long range financial planning is on track. This is another task physicians tend to “set and forget,” but the Great Recession was an eye opener for many of us. Once a year, sit down with your accountant and planner and make sure your investments are well diversified and all other aspects of your finances – budgets, credit ratings, insurance coverage, tax situations, college savings, estate plans, retirement accounts – are in the best shape possible. January is a good time.

8. Back up your data. Now is also an excellent time to verify that the information on your office and personal computers is being backed up – locally and online – on a regular schedule. Don’t wait until something crashes.

9. Take more vacations. Remember Eastern’s First Law: Your last words will NOT be, “I wish I had spent more time in the office.” This is the year to start spending more time enjoying your life, your friends and family, and the world. As John Lennon said, “Life is what happens to you while you’re busy making other plans.”

10. Look at yourself. A private practice lives or dies on the personalities of its physicians, and your staff copies your personality and style. Take a hard, honest look at yourself. Identify your negative personality traits and work to eliminate them. If you have any difficulty finding habits that need changing … ask your spouse. He or she will be happy to explain them in excruciating detail.

Dr. Eastern practices dermatology and dermatologic surgery in Belleville, N.J. He is the author of numerous articles and textbook chapters, and is a longtime monthly columnist for Dermatology News. Write to him at

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