2017 03 15 Practice Management Training Morning Report By Melissa Nilan 0 Making Practice Management Training a Priority: Update from RDoC By Dr. Melanie Bechard, PGY-2 Pediatrics, University of Toronto Co-Chair, Practice Committee, Resident Doctors of Canada Canadian resident doctors have spoken. They say training in Practice Management is necessary yet under-provided. Here’s what we’re doing about it – and what you can do about it, too. Do you feel ready to leave residency and enter independent practice? While we’re all focused on acquiring medical and / or procedural skills and knowledge, the non-clinical aspects of entering practice – things like negotiating a contract, billing, purchasing capital, hiring staff – are just as important for being able to serve patients throughout our medical careers. These non-clinical aspects of practice are called Practice Management (PM). They include legal, administrative, and financial matters. Did You Know… PM skills are listed as a key component of CanMEDS and CanMEDS-FM, and PM is included in resident program accreditation. There are currently no published studies describing Practice Management training within the Canadian context. Practice Management training in the U.S.A. and other jurisdictions is delivered in a variety of formats: retreats, workshops, longitudinal courses, or mentorship. Over the past 18 months, Resident Doctors of Canada (RDoC) has examined how Canadian resident doctors are taught these skills. This has included a literature review and a 2015 National Resident Survey. Survey Says… PM training in Canada is inconsistent and sometimes non-existent: Access to Practice Management training appears to be varied and disparate across disciplines 85% of family medicine residents reported receiving some form of PM training during residency Less than 60% of residents in medical, surgical, and laboratory / diagnostic specialties received such training. Approximately one third of respondents reported receiving no Practice Management training. This improved with time; only 14% of final-year residents reported not having received any PM training compared to 30% of first year residents. Residents WANT Practice Management Training In the survey, residents expressed great dissatisfaction towards current methods of Practice Management Training. Only 10% of residents overall were satisfied with their training in these non-clinical skills. When asked about the ideal format for learning these non-clinical skills, residents preferred didactic and experiential learning over “self-selected online resources”. This most likely reflects a preference for protected time. Residents expressed a particular need for training in financial planning, physical remuneration, setting up a medical or clinical office, and accounting/taxation. What RDoC is Doing to Make PM Training a Priority Given the importance of learning how to manage one’s practice as we transition from residency to an independent environment, RDoC is active in advocating for enhanced training. Our Principles document for Practice Management training calls for training that is Universal, Comprehensive, Evidence-Based, and Collaborative. We’ll be sharing these principles with our members, national medical organizations, and social media in a coordinated dissemination campaign in Spring 2017. (Follow @residentdoctors to keep up to date.) What YOU Can Do to Make PM Training a Priority As your national voice, RDoC will ensure that PM training becomes a priority with educators. But don’t underestimate the power of your individual voice! Here are some suggestions for how you can start improving PM training today: Speak with recent graduates: Contact your senior colleagues who have recently transitioned into practice and ask what they wish they had known during their training. Better yet, invite them to speak with your current resident cohort to share some of the valuable wisdom they have gained through experience. Organize workshops: My own program has recently created workshops to help us compile curriculum vitae and teaching dossiers to give us a head start with our future job applications. For financial matters, inviting accountants and representatives from financial management companies to speak with residents can be beneficial. For example, MD Financial is a subsidiary of the Canadian Medical Association and has branches in provinces across Canada. Make it discipline-specific: We recognize that Practice Management training might look very different for a Paediatrician versus a Pathologist. Focusing on the key skills and knowledge needed for running a practice in your discipline is likely to have the greatest impact. Don’t wait – collaborate: Speak with your Program Director, senior / chief residents, and other potential faculty champions to help find support for your ideas. Explore available modules: Practice Management modules have been created for residents by the Canadian Medication Association. Take advantage of these available Canadian resources to help guide your questions. https://www.cma.ca/En/Pages/pmc-modules.aspx Practice makes perfect! By honing our Practice Management skills during residency, we’ll gain the skills needed to one day manage our own practices well. Our vision is that every final-year resident will answer the question, “Do you feel comfortable to leave residency and enter practice” with a resounding “Yes!”. Thank-you to the RDoC Practice Committee, a national committee of residents from different specialties across Canada, for their leadership on Practice Management and review of this piece. Watch for future updates from RDoC – the national voice of resident doctors in Canada.