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Tuesday 5 March 2013

Private Practice: A Patient File Numbering System

When you work for a large organization, the way that client files are managed is already determined for you. When you open a private practice, it’s up to you. What kind of system should you use?

One option, of course, is the client’s name. How about just calling Abraham Lincoln's file “Abraham Lincoln” and leaving it at that?

Not bad, and indeed “Abraham L" or “Abraham Lincoln” will probably appear on the file header.  But in the course of seeing any client, you will gather all kinds of information about them and you will want to maintain strict security and confidentiality.

For example, Abraham will pay you sooner or later and you’ll need to record the payment. But your accountant shouldn’t see that Abraham is one of your clients. You’ll probably have computer files for different things, like a blank for Abraham’s payment receipts, or goal lists, or session notes, or letters to his physician. And you don’t want his name on all those files, even though you will practice excellent data security using encryption and so on (more about that another time).

As well, you’ll want to track some elements of your practice.  You’ll want a simple way to know how many different clients you saw last year compared to the year before, or how many referrals you get each month.

For these reasons and more, it’s helpful to assign each client a number, and then use the number for the file and any computer information you hold. There are lots of systems for this, but I settled on one for Changeways Clinic years ago and we’ve found it simple, useful, and easy for everyone to understand.

Our client numbers begin with the year that the client was first booked into an appointment at the clinic. Then we have a dash, then a 3-digit number assigned in sequence as new clients are seen. Then the client’s initials. So the first client booked in 2013, let’s say Marie Curie, would be 2013-001MC.

Except that when I started out, I only saw a few private clients. Client numbers are mostly in the background; clients don’t usually see them. But if they did I wondered if someone would say “Hey, I started seeing you in February and my number is 1999-001. Am I your only client?” So I started each year with 101 instead of 001. To this day, our first client of the year is 101.

This enables us to record client payments with a number that we can easily match up with a client’s file, but that doesn’t tell the accountant the names of people we see. It also allows us to have computer files labeled 2013-101MC that don’t reveal anyone’s identity.

Different types of files have different endings.  So 2013-101MCbill.doc is for receipts, 2013-101MCgoals.doc is for the goals the client set in session, 2013-101MClet.doc is for any notes that Marie has requested I send to her physician, and so on. Again, all files are also encrypted. Marie would keep the same number no matter how many years she sees us.

Blank client files are made up months ahead. We include intake forms and other documents that we use with almost everyone we see, and the file is prelabeled with the numbers in sequence. When a new referral calls to book, we just take the next blank file in the drawer and add the person’s first name and last initial.

The file numbers are in a Word document formatted for Avery labels and printed out as we create more blank files. Each year the clinic assistant simply opens the file and does a find/replace/ALL, changing 2012-101 to 2013-101, then printing sheets of new numbers for the coming year.

This system makes tracking the number of referrals quite easy. At the end of the year you can simply look at the number of the last client booked. If it was 2013-400, then you know (given that you started with 101) that you had 300 new bookings that year.

Also, your assistant can glance at the blank files on the first day of each month. If last month the next one in line was 2013-301 and this month it’s 2013-353, then you know you had 52 referrals last month.

Keeping a record of these over time can show month-to-month referral trends. If the numbers for the past 4 months were 52, 47, 31, 28, then it’s time to focus on clinic promotion. You can also look at (or graph) monthly referrals year by year, revealing that August is always slow for you, or that fall is when you are popular.

It's useful to decide on a system early in your practice and keep to it. Although it may save you only a second or two each time you deal with a file, over time the benefits can add up. Just think of it as a kind of behavioural compound interest.

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Want more information on operating a private psychotherapy practice? 

Check out my book Private Practice Made Simple.  It contains information on starting a practice, creating a space, designing a website, getting referrals, managing finances, avoiding burnout, and much more.

The book is available at bookstores, from the Changeways Clinic website, and through Amazon here.

Vancouver Workshop November 29 2013

Click here for information and registration for the one-day workshop Private Practice Made Simple being held in Vancouver Canada Friday November 29. 

1 comment:

  1. I also number clients, based on the date they became a client. However, I don't see the point of including "20" since neither they nor I will be around by 2100! And for any successors, it will be safe to have destroyed the file LONG before then!

    I do, however, include the month. Since this is at least 01, there's no need to number from 101, I just add two more digits, starting at 00 (rather than 01, to give me 100 available client numbers per month, not 99 - it's no biggie either way!).

    For example, my first client in February 2014 was 140200, the next 140201, but the first in March was 140300.