title: Practice management education during surgical residency.
abstract: BACKGROUND
  Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management.
  
  
  METHODS
  The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits.
  
  
  RESULTS
  Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period.
  
  
  CONCLUSIONS
  When residents finish their surgical training they need to be ready to enter the world of business. These needs will be present whether pursuing a career in academic medicine or the private sector. A program that focuses on the business aspect of surgery enables the residents to better navigate the future while helping to fulfill the systems-based practice competency.
authors.affiliation: Department of Surgery, Methodist Health System, 221 W. Colorado, Pavilion 1, Suite 100, Dallas, TX 75208, USA.
authors.forename: Kory
authors.initials: K
authors.lastname: Jones
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Lebron
authors.forename: Alicia
authors.initials: A
authors.lastname: Mangram
authors.forename: Ernest
authors.initials: E
authors.lastname: Dunn
mesh_terms: D002983:Clinical Competence; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D020399:Practice Management; D014481:United States