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Our response to the skyrocketing cost and nonuniform delivery of medical care has been a call for the rationalizing of medical practice through decision-support techniques. These tools, which include protocols, decision analysis, and expert systems, have generated much debate. Advocates argue that they will make medical practice more rational, more uniform, and more efficient and that they will transform the "art" of medical work into a "science." Critics argue that formal tools cannot and should not supplant humans in most real-life tasks. Marc Berg takes the issues raised by advocates and critics as points of departure for investigation, rather than as positions to choose from. Drawing on insights and methodologies from science and technology studies, he attempts to understand what "rationalizing medical practices" means: what these tools do and how they work in concrete medical practices. Rather than take a stand for or against decision-support techniques, he shows how they transform medical practices and discusses what is gained and what is lost. Berg investigates how new discourses on medical work and its problems are linked to the development of decision-support tools. Studying the construction of several individual technologies, he looks at what medical work consists of and how the new technologies figure in and transform it. Although he focuses on decision-support techniques in the field of medicine, the issues he raises are relevant wherever rationalizing techniques are being debated or constructed. Touching upon broader issues of standardization, universality, localization, and the politics of technology, Berg addresses problems that are central to medical sociology, technology studies, and tool design.

What is a medical practice worth? The answer depends, in part, on whom you ask. Purchasers would say value is based on what they plan to bring to the table; sellers assume it’ s simply a matter of formula applied uniformly across the board. In actuality, both are correct— to a degree. While there are basic guidelines used to ascertain values, valuation must be determined on a case-by-case basis, as each has a unique set of circumstances that ultimately affects final outcome. Covering the specific issues that impact valuation, Valuation of a Medical Practice takes you through the entire process, highlighting pitfalls and mistakes that are commonly made and that should be avoided. Written by Reed Tinsley, Rhonda Sides, and Gregory D. Anderson, leading experts in the field, this comprehensive resource clears up the ambiguous question of what exactly constitutes the value of a medical practice. As the authors stress, there are two main points to keep in mind: The strength of the practice’ s income stream and what it produces for the owner(s) is what creates true valueThe key to a successful valuation is deciding whether or not the practice’ s future income stream will mirror its present income streamAlong with case examples, sample valuation letters, and checklists for gathering data, as well as an exhaustive appendix and glossary of terms, Valuation of a Medical Practice has complete details on: Regulatory issues— Medicare fraud and abuse, private benefit/private inurement, the Stark LawSpecial issues— gross revenues, referral patterns, payer mix, practice efficiencies and transition, productivityGetting started— engagement preplanning and planning,requesting pertinent dataOn-site inspection and owner interview— fixed assets, personnel, accounting system, supply inventory, marketing, physician and management issuesCompleting the process— reporting, reviews, reconciling valuation methods.

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