You know your practice needs protocols and spent time developing them, but now these valuable protocols are not being followed? WHY? These are the biggest reasons:

1. Your protocols are not hanging on the wall.

You developed the protocols together as a clinic, but guess what? No one is going to remember them. Laminate your protocols, make sure you have added clinical pictures, and HANG THEM UP!

Post them in a location your staff can see the practice protocols and reference them often. Put them in the supply room where they gather their supplies or hang them by their workstation.

2. Your protocols were never written down in the first place.

Protocols must be written down. There is no excuse for this! Do it!

Those of you that have heard me speak, had me work in your office, or have known me longer than two minutes, understand that this is a requirement. Your staff cannot read your mind. You must write your protocols down. Then…hang them up!

3. You never review your protocols.

You must review the protocols with your staff. Train your staff on them; test your staff on them. Even doctors can forget what was on each protocol. Review them, and review them often.

4. Your protocols are never enforced.

Just because you develop protocols, does not mean they will magically be followed. No one likes change. No one willingly jumps up and down at the chance to change their daily routine. Change is hard and needs to be reinforced by constant reminders and praise.

5. Your supplies are not out in plain sight.

Yes, your office may stock what you need in a room but are the needed supplies completely set out for the doctor at each appointment? The whole reason for a tray set-up is to be a constant reminder to the medical assistant and the physician at what must be done. It saves an enormous amount of time instead of searching for and retrieving an item that should be in the room but it is not.

6. The Doctors don’t follow the established protocols.

This is a major reason protocols fail. Many doctors will say it is their staff, but the real culprit usually lies with the physician. They do not change. They do not follow their own protocols. The doctors must lead if they want their staff to follow.


(1) A medical assistant always gets x-rays on a patient, but the doctor never looks at them.

(2) The medical assistant brings in wound care supplies that should be dispensed, but the doctor doesn’t prescribe it.

Examples such as these frustrate the staff, confuse the patient, and cause a documentation nightmare. Develop your protocols and follow them. Yes, you will have patients that don’t fit the mold, but your protocols will work 95% of the time.

Finally, don’t waste your time developing protocols if you are not going to implement them. If you want to run a successful practice; write them down, make them accessible, review them, and follow them. No excuses!

Comprehensive, complete wound care protocols by AMERX Health Care are now available for your office. These protocols are available to all physicians who purchase wound care products, ensuring that they are easily implemented into the practice. Simply ask your AMERX Account Manager to include protocols for in-office dispensing, at-home delivery, and/or nail avulsion with your next order.

Holly Burkman
Holly Burkman, MBA

Holly is a recognized international speaker and author. Working with her husband to build a medical practice from the ground up, she has handled all aspects of the podiatry field from medical assisting to billing and practice management. Currently, she spends her time as a practice management consultant helping physicians learn how to run successful medical practices by implementing protocols. Holly holds numerous degrees and certificates that give her the credibility to help practices; however, it is the years of personal in-office experience that allow her to offer customized solutions that make practices profitable again.