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Business education’s role in preventing physician practice decline

Mon, 03 Jun 2024 19:37:03 GMT

Physicians, particularly those who haven’t received business education, must address the frequently circulated question among their ranks: “Can you practice medicine without money?” Medical history unveils an era when most physicians were compensated through non-monetary means for their medical services and often went unpaid.

During that time, the choice to pursue a medical career was grounded in the personal belief that treating patients was the foremost aspiration for most physicians. Few made this decision, and the majority anticipated fulfillment from it. Physicians resided within the lower middle class due to the unavailability of business education.

At present, most physicians still reside in the middle class of society. However, the medical landscape in which they practice has undergone a complete transformation. These changes have led to a significant loss of physicians for various reasons. Surveys indicate that about 65 percent of privately practicing medical doctors contemplate leaving medical practice. They find their medical practices inadequately profitable to sustain or achieve their objectives, thus joining the “burnout club.”

Private medical practices are collapsing because these physicians cannot generate the income required to sustain their practice or meet their obligations and goals.

Currently, we find ourselves in a situation similar to that of physicians in the 1700s—struggling to earn a livable income and compelled to tap into their creative capabilities to survive financially. This predicament remains despite their unique professional education and status, with a lack of business knowledge to pull them out of the quagmire.

Renowned author Nicholas Erik points out our failure to revert to the fundamental principles that have held true for centuries. These are the factors that remain relatively constant. Drawing from his AI experience, he believes in the potential to align our work and knowledge with the pace of technological advancement, building a sturdy career foundation.

Recognizing the significance of fundamentals highlights how often we overlook and neglect them. Many of us tend to bypass them, hoping that new tactics or tricks will miraculously yield improved outcomes. This phenomenon has indeed seeped into the medical education system.

I still find it astonishing that I spent four years in a top medical school in our nation, progressed through internships, residency training, and several years in private medical practice before realizing the necessity of a business education to achieve my goals. It’s astounding that I endured all of that without once comprehending the fundamental aspect of medical practice—managing a medical practice as a business.

Moreover, and more crucially, I committed the same oversight as the majority of medical students and young physicians still do today. Even as a more seasoned practicing physician, struggling with the realization that I had neglected the “other” critical fundamentals essential for a successful medical practice. I had never worried about or considered making a profit until it became an issue.

During the initial five years of private solo medical practice, as my income gradually increased, I never received any form of business education. The progress I made was more like a “placebo miracle” experienced by every physician in the early stages. “Hey, things are going great.”

Certainly, another business-savvy physician in my specialty required someone to handle the overflow of patients, and I can’t express enough gratitude for that opportunity. The presence of a new physician in the area is also a draw. Medical patients often seek out a new medical doctor to determine if they align with their treatment criteria, leading to an influx of new patients beyond the natural flow. This phase is exhilarating for both patients and physicians.

The issue arises when this excitement dwindles after five years. Income levels off, especially during certain holiday months. Patients depart from your practice, and the influx of new patients diminishes. However, you remain oblivious to this since you haven’t maintained records of new patients versus those leaving your practice each month. You believe you’re “doing great,” yet the attrition remains unnoticed. Why do we fail to perceive this? I certainly did.

Most private practice physicians receive monthly financial statements or printouts from their CPAs or accountants. Unfortunately, these summaries often seem of minimal value because, if the income figure surpasses the expenses, “all is well.” Few pay heed to the subtle messages scattered across the pages that hint at potential problems. Most physicians lack comprehension of financial statements, myself included. Despite being a proficient medical doctor, this doesn’t translate to improved financial outcomes.

Only when the office manager mentions that the practice’s income barely covers overhead expenses do you start to suspect something is amiss. Consequently, you review the last six to eight monthly financial statements from your CPA. A gradual decline in practice income becomes evident. You dismiss this as a temporary issue, believing that income will inevitably rebound. When this dwindling income persists for half a year, a significant concern arises, demanding action.

What no one informs you about, and what you’ve never questioned, is the deficiency in your office management. Unfortunately, your CPA, attorney, or office manager never raises a red flag. This predicament is yours to address, not theirs.

Once your practice’s income has decreased for six consecutive months, the likelihood of its total failure reaches 100 percent, unless you possess marketing knowledge to resolve the issue. Do you possess such knowledge? Unfortunately, most physicians don’t and have never grasped its significance. It’s one of the fundamental aspects of a prosperous business. Yet, even then, you might not have the resources to hire a business expert capable of resolving your practice’s business and financial challenges.

During my tenure in private medical practice from 1973 to 1994, I’m ashamed to admit that my lack of business acumen ultimately led to the demise of my medical practice. Only after retiring did I commit to understanding why my private medical practice career concluded in such a disappointing manner. My self-assessment of “I believe I performed well in my private medical practice” despite my business ignorance came to an abrupt halt upon retirement. Several attempts at online businesses failed, yet I did establish that anyone aspiring to substantial business success must possess foundational business education, either before or early in their business venture. The cornerstones of business success lie in business management and business marketing.

After dedicating fifteen years of retirement to studying and absorbing business principles, I finally found the answers I sought. I comprehended why, over the past century, countless physicians lost their private practices due to financial reasons. The absence of business knowledge and the utilization of business tools were the culprits.

The ultimate consequence of inadequate business education for physicians is a predetermined likelihood of failure to some extent in their medical practices. This is a truth medical schools inexplicably omit. Consequently, thousands of medical doctors have either forfeited their private practices over the course of a century or have struggled to subsist on an income comparable to that of blue-collar workers, rather than reflecting their value as elite professionals.

The current surge in physician attrition is evident. Men are deterred from pursuing medical careers. Documentation reveals stagnant physician incomes coupled with government-imposed fee limitations and financially unfeasible practice mandates.

Medical schools must integrate business education into their curricula to ensure the viability of our profession. Failing to do so will likely result in the assimilation of our profession into a socialized health care system. This compromise would undoubtedly erode physician quality and trigger the deterioration of health care nationwide.

I’m resolved to champion the inclusion of business education in all medical schools until my last breath. What about you?

Curtis G. Graham is a physician.h

25% of low-income older Americans lack health insurance

Mon, 03 Jun 2024 19:35:30 GMT

Researchers from Oregon Health & Science University found that a high number of older Americans lack health insurance.

The study found that about 25% of low-income patients receiving care at community health centers remain uninsured when they turn 65, even though most would become eligible for Medicare coverage. The results were published in the Journal of the American Board of Family Medicine.

Researchers note that its more difficult to manage health conditions without insurance, and that older uninsured patients may face costly hospital stays and avoidable illnesses that require expensive health care services.

The researchers examined electronic health record data for more than 45,000 patients who became eligible for Medicare between 2014 and 2019. The data was from patients seeking care at community health centers, which provide care regardless of ability to pay.

The results showed that it was more common for Hispanic Americans to lose insurance coverage at 65. Medicare requires participants to be U.S. citizens or permanent legal residents, meaning undocumented immigrants cannot access the government-provided program. Also, patients with low incomes may not be able to afford the Medicare premiums.

Researchers found that patients tend to be diagnosed with new chronic conditions as they become eligible for Medicare. For example, about 86% of the study’s patients had two or more chronic conditions after they turned 65, compared to 77% beforehand. Those who were uninsured prior to enrolling in Medicare were diagnosed with more new chronic conditions than patients who had insurance prior to enrolling. Researchers noted this was most likely because the patients were not aware of the conditions because of a lack of health care access.

A message of hope for physicians

Mon, 03 Jun 2024 18:51:43 GMT

Physicians are struggling with challenges navigating the health care system while trying to provide the best possible care for their patients. Sometimes, struggles at work are compounded by struggles at home as we all face stressors during our travel through life; doctors are no exception.

Many physicians who went through a period of burnout have sought and are seeking help. They are feeling hope for the future. I asked three physicians how burnout manifested in them, how they are doing now, what brings them joy, and a best tip to share with their colleagues. Here’s what they had to say:

Diana Londoño, MD

Before coaching, when I was in full-blown burnout (x 2), I was a ball of negativity and cynicism. I was definitely not a joy to be around. My body also suffered from chronic unmanaged stress, including symptoms leading to teeth grinding, which destroyed my molars, leading to root canal and abscess, new onset GERD, asthma at 42 years old, debilitating chest pain with “normal” echo, and Holter monitor, and joint pain with elevation in rheumatoid factor seen in autoimmune disease.

Once I began coaching and had a spiritual awakening, I began a daily spiritual practice, and all symptoms resolved. It is daily work, but I am more calm, joyful, less reactive, and more compassionate and curious than before. I have a bigger space from reaction to action, and I take things that bothered me before now more lightly. I also started writing to process my emotions and reading daily to keep my mind and creativity active. I have a daily routine to quiet my mind as well as continue to learn as much as I can to share with others. My burnout/ spiritual crisis was the impetus to create Physiciancoachsupport to help colleagues in a free and confidential manner and realize we are never alone and there is always hope!

Every day, I wake up and realize all the blessings we have that bring me joy, including giggles and laughs from my kids. Knowing I have stopped many cycles of generational trauma also brings me joy.

Best tip: Be yourself.

See what brings Dr. Londoño joy .

Jillian Rigert, DMD, MD

We often wait until we need a change to give ourselves permission to pause, ask for help, and possibly pivot. I know … I am guilty of it.

It took a few close calls with a slow death from starvation for me to realize- no one was going to be able to save me but me — and I needed to pivot.

Letting go of the guilt and shame after the career pivot that saved my life took five years, and it started with an article on KevinMD (thank you, Dr. Pho!). Some people say I was brave, but quite frankly, I didn’t know if I could keep going- and I knew I couldn’t leave this Earth without speaking the words that may save others.

Sharing my story has brought a community of friends into my life who taught me what it really means to be seen and supported holistically. Through our shared humanity, struggles, and triumphs, we find community and belonging. Connection, a sense of belonging, and a mission-driven life have brought peace, love, and optimism back into my life.

Coaching taught me how to get back into the driver’s seat and discover, or rediscover, what it truly means to live a life true to myself. Helping others to do the same has expanded my world and filled my heart with a sense of purpose, meaning, and fulfillment.

“What do you really want for your life?” – a question I’ll leave you with. And one we often don’t stop long enough to consider.

Learn more: Jillian Rigert, DMD, MD – A Life True to You

Best tip: Create a life in alignment with your core values and grounded in your why- break free from societal pressures that often lead you astray.

Strength through Resilience and Accountability

Mon, 03 Jun 2024 18:50:14 GMT

Resilience and accountability go hand in hand. In order to bounce back from adversity, we need to be willing to take responsibility for our actions. We need to acknowledge the mistakes we’ve made and the damage we’ve caused. But we also need to have the strength to keep going, even when things seem impossible. We need to be able to pick ourselves up and move forward—no matter what.

Of course, this is easier said than done. It can be incredibly difficult to take accountability for our actions, especially when those actions have caused harm to others. It can also be challenging to stay resilient in the face of adversity, especially when the odds are stacked against us. But as this week’s podcast guest shows, it is possible.

Molly Bloom, the real-life titular character of the Oscar-nominated film Molly’s Game, shares her unconventional journey through the highest of highs and lowest of lows in her life.

Her story began with the dream of becoming an Olympic skier. When a devastating injury put an end to that dream, Molly was forced to find a new path in life. But as her success grew, so did the risks. Molly soon found herself mixed up in a world of drugs, violence, and corruption. And when the FBI finally caught her, she was forced to confront the consequences of her actions.

Throughout it all, Molly Bloom demonstrated a remarkable level of resilience. Despite the many obstacles she faced, she never gave up. And even when things seemed impossible, she found a way to keep going. That’s evident in the way she handled her arrest, her trial, and her time in prison. Despite the many challenges, she never lost hope or succumbed to despair.

At the same time, she also took full accountability for her actions. She acknowledged the mistakes she made and the harm she caused to others. She didn’t make excuses or try to shift the blame onto anyone else. Instead, she assumed responsibility and worked to make amends.

Maximizing care amidst provider shortages: the power of measurement-based care

Mon, 03 Jun 2024 18:42:17 GMT

Since the pandemic, the shortage of behavioral health professionals has become more dire as the need for more comprehensive mental health care has increased. As of March 2023, 160 million Americans lived in areas with mental health professional shortages . 55% of counties in the U.S. have no psychiatrists, and 77% report a severe shortage.

In some states, such as Maine, there was a 50% drop in the number of psychiatrists from 2015 to 2020, leading to wait times of up to 18 months to access psychiatric care. Moreover, 70% of psychiatrists are 50 years old or older. By 2025, demand for psychiatrists will outstrip supply by 25%.

The toll that psychiatric illness takes is substantial. Depression is the leading cause of disability in the world. Medical costs for treating patients with chronic medical disorders and co-occurring psychiatric disorders such as depression are two to four times higher than in those without psychiatric disorders.

Nearly half the population in the U.S. report recent symptoms of anxiety and depression. The annual number of deaths by suicide is 48,000, and overdose deaths exceed 100,000. Among the 20% of the U.S. population that are the highest utilizers of medical care – accounting for 80% of all health care costs – 60% to 80% have an underlying psychiatric disorder that drives increased utilization. Despite the high prevalence of psychiatric illness and costs associated with untreated psychiatric illness, 60% of those with a psychiatric disorder and 90% of those with substance use do not receive any psychiatric treatment. It’s not only the stigma of receiving treatment or a lack of resources available but an unreliable intake system to identify and support those who need the most help.

We live in an era where physical health providers are overwhelmed with requests from patients, lacking many of the tools and training needed to address the surge. And simply collecting written questionnaires on a patient’s mental health is not enough. Integrated behavioral health care models, where behavioral and physical health providers work together to treat patients, can address this growing issue. But with limited resources and high demand, delivering effective, integrated behavioral health care at such a large scale is challenging.

In response to this growing need, measurement-based, population-focused models of care combined with the thoughtful utilization of digital solutions has emerged as an effective approach that can help deliver integrated care at scale despite limited resources.

What is measurement-based, population-focused care?

Measurement-based and population-focused care, a critical part of integrated care models like collaborative care , is an evidence-based health care approach where treatment decisions are guided by systematic measurement of patient-reported symptoms, functioning, and overall well-being.

Typically, measurement-based care (MBC) includes standardized questionnaires (to assess symptom severity, progress, etc.), data collection, and provider analysis of the data to make informed treatment decisions and continuously adjust a treatment plan based on the patient’s evolving needs. This health care approach allows providers to offer more effective and personalized care based on objective information collection and assessment.

MBC, traditionally used to collect and assess physical health metrics (blood sugar, weight, etc.), is essential for treating patients holistically — taking into account both their physical and behavioral health. For patients needing behavioral health support, MBC can help objectively track and assess a patient’s symptoms, which can often be subjective and highly variable over long periods. With MBC, health care providers can monitor a patient’s mental health status — whether it’s stable, improving, or declining — and address it accordingly.

Aside from the efficiency that MBC can provide, this type of clinical approach can also help bridge other, more interpersonal gaps in the health care system. If executed well, ongoing patient monitoring can inform highly personalized treatment plans and improve patient and provider communication, allowing patients a structured channel for sharing their experiences with mental health without stigma or shame. Likewise, MBC can be used to help bolster patient engagement. The self-reported methods of MBC can encourage patients to take a more active role in their treatment plan and diagnosis, which can be empowering.

Integrated care models are focused on treating large populations while relying on fewer resources. Psychiatrists that participate in these integrated care models will not consult with patients directly. Instead, they provide oversight of large caseloads of patients managed by behavioral health clinicians working in the practices alongside the non-psychiatric attending physicians (e.g., primary care physicians).

MBC and population-focused integrated care models can bring an actionable, data-driven approach to supporting behavioral health while substantially increasing access to behavioral care holistically interwoven with patients’ overarching medical needs. However, it’s incredibly challenging to execute this strategy successfully without the right technology.

How can technology advance measurement-based care?

One of the biggest hurdles to using measurement-based care is having the right technology to deploy and scale it. Without technology, health care providers can struggle with administering routine assessments, or receiving unbiased patient information (due to the lessened but still present stigma around mental health) among other administrative burdens. With technology, health care providers can work more efficiently and more cost-effectively by sending remote questionnaires – clinical assessments like PHQ-9 and GAD-7 – via desktop or mobile, so providers and patients aren’t limited to in-person assessments, which can take up valuable appointment time.

Providers can set up custom notifications that alert health care providers, directly in the EHR, when a patient’s data indicates a significant change or deterioration to help ensure timely intervention if necessary. Technology helps health providers make the most out of MBC — helping to risk-stratify populations, deliver timely interventions, and even allow health care providers to be proactive in their care, saving costs and preventing behavioral health crises.

Measurement-based care — with the help of technology — embodies a commitment to evidence-based, patient-centered care, and it holds the potential to revolutionize how we understand, manage, and treat behavioral health conditions. The deployment of MBC using robust, secure technology has the power to create a brighter, healthier future for everyone.

Tom Zaubler is a psychiatrist and physician executive.

3 myths sabotaging healthcare innovation

Mon, 03 Jun 2024 18:39:37 GMT

Myth #1: Innovation depends on technology.

Reality check: Innovation doesn’t have to be technical at all. It’s about reinventing as much as it is about inventing.

Start by empowering your teams to address process or service challenges they deal with every day. Clinicians are hungry to remove barriers to quality care. They need to be empowered to think outside the box and act.

Consider how a simple process redesign can greatly impact efficiency, cost, and patient and clinician experience. For example, reducing the average ED boarding time by just one hour can add up to millions in additional revenue each year.

Also, imagine how education might transform an existing service. Vituity’s award-winning Emergency Psychiatric Intervention (EPI) initiative is a great example. Behavioral health patients often wait many hours in the emergency room because clinicians aren’t sure how to assess and treat them. Vituity physicians created EPI to close this gap through education and care standardization.

Myth #2: We don’t have the resources.

Truth bomb: Is innovation costly? Sometimes. But given the level of disruption moving through our industry, health systems can’t afford not to invest in innovation.

The good news is that meaningful innovation doesn’t have to start with big, expensive projects. Instead, offer whatever support you can to small, well-defined initiatives. As each small win demonstrates a return on investment, you can justify a bigger innovation spend.

Care transformation can also start from within your own teams. One of our practice sites is currently trialing an abdominal palpation device invented by one of our front-line physicians. This technology could inform the need for abdominal imaging without an in-person examination.

It’s important not to underestimate the innovation potential coming from the front lines. Carve out protected hours for individuals to innovate, and you’ll be surprised what they can accomplish with little else.

Myth #3: We don’t know where to start.

Straight talk: Start thinking of innovation as “everything can be done better,” and you’ll easily spot opportunities for business, operational, and clinical improvement across your organization.

One key to successful innovation is to start with a well-defined problem. For example, let’s say you want to improve inpatient length of stay. You might work with your clinical teams to map your current processes and set realistic goals for change.

Another winning strategy is starting small with an agile, iterative approach. Test and validate solutions in real-world settings, gather feedback, and make necessary adjustments along the way. Many of Vituity’s signature solutions (including EPI and virtual navigation) were developed in a single health system before they were adopted across the organization.

Finally, when choosing projects to invest in, consider their long-term scalability. Solutions that can be used by multiple departments, hospitals, or systems will reach more patients and have a more meaningful impact. A standout example is Vituity’s Rapid Medical Evaluation (RME)® solution, which was created by a single emergency physician in the early 2000s. RME has since been adopted by almost all Vituity EDs—and is used in some form by almost every ED in the country.

Bringing Change to Life

In our highly disruptive healthcare environment, innovation is a survival imperative. However, it’s hard to get executive leadership buy-in for innovative projects when it’s believed they’ll be highly technical, expensive, or time-consuming.

Survey shows need for better IT and physician alignment to improve outcomes and reduce burnout

Mon, 03 Jun 2024 18:38:22 GMT

A survey from symplr , a health care software company, shows that chief information officers recognize the burden that inefficient technology systems place on physicians and other care providers.

The survey, conducted among members of the College of Healthcare Information Management Executives (CHIME), encompassed CIOs, IT leaders, and clinicians from top U.S. health systems. The findings are detailed in the 2023 symplr Compass Report, "From Imminent to Urgent: Aligning Clinicians & IT is Critical to Streamlining Healthcare Operations."

The data illustrates the formidable challenges facing health care leaders, with 80% of respondents highlighting the complexities arising from working with disparate IT systems , and 84% concur that bringing together health care operations software on a single platform could enable clinicians to redirect substantial time back to patient care, potentially reducing burnout and enhancing the management of technology.

"The 2023 symplr Compass Survey data indicates a huge opportunity to consolidate health care operations solutions and give clinicians time back for patient care , which could greatly reduce burnout and make technology easier to manage," said B.J. Schaknowski, chief executive officer, symplr, in a statement.

Key survey findings also include the shift in concerns, as clinician burnout and workforce challenges (41%) surpassed financial pressures (39%) as the foremost threats anticipated by organizations in 2024. Furthermore, 55% of health care organizations currently rely on more than 50 individual point solutions to drive their health care operations.

Clinicians expressed distinct priorities compared to their IT and CIO counterparts. Concerns such as nurse retention, the overall well-being of nurses, technology optimization, and workflow streamlining were identified as more pressing issues by clinicians.

Additionally, the survey highlighted a disparity in user experience perceptions, with 67% of clinicians and 48% of IT/CIOs concurring that their organizations provide a challenging user experience for individuals working across health care operations software, particularly in administrative and non-clinical tasks essential to hospital and health system management.

Schaknowski emphasized the need for alignment, stating, "To do so, health systems must align the right stakeholders and partners to remove barriers between IT and clinicians to stop attrition of health care talent."

The survey findings echo industry trends. McKinsey & Company, for instance, has identified potential time savings of 10-20% for nurses through digital automation to address workforce gaps. The 2023 KLAS Healthcare Operations Report revealed that over 90% of health care workers prioritize technology consolidation for operational efficiency, while Bain & Co.'s 2023 Healthcare Provider IT Report highlighted continued investments in Health Information Technology (HIT), with 75% of respondents anticipating increased software and technology investments in the coming year.

DEA, HHS announce second extension of telehealth flexibilities that started in pandemic

Mon, 03 Jun 2024 18:37:21 GMT

Telehealth flexibilities for prescribing controlled substances will continue through 2024.

On Oct. 6, the U.S. Department of Health and Human Services (HHS) and the U.S. Drug Enforcement Administration (DEA) in the U.S. Department of Justice announced the continuation of a rule that started during the COVID-19 pandemic . Starting in March 2020, physicians were permitted to prescribe some controlled substances via telehealth without seeing patients in person.

That allowance was to end with the COVID-19 public health emergency (PHE) in May, but the federal regulators continued it until Nov. 11, six months after the end of the PHE. The Oct. 6 announcement extends the exception again through Dec. 31, 2024.

“In order to prevent lapses in care, these exceptions allowed for the prescribing of controlled medications via telemedicine encounters even when the prescribing practitioner had not conducted an in-person medical evaluation of the patient,” said the notice from HHS and DEA.

The provision actually consists of two exceptions, one dealing with controlled substances and on covering buprenorphine. The federal regulators had a public comment period that prompted 38,369 comments before it ended in March this year.

DEA hosted public listening sessions, scheduled for last month, and the announcement said leaders would carefully evaluate all the public comments before promulgating new standards or safeguards by fall 2024.

DEA listed a number of formal reasons for the most current extension. They include addressing “the urgent public health need for continued access to the initiation of buprenorphine as medication for opioid use disorder in the context of the continuing opioid public health crisis,” the announcement said.

If the existing telemedicine flexibilities ended on Nov. 11, there is a chance “it could lead to potential patient harm – due to an inability to access appropriate care – in some instances,” the announcement said.

The American Telemedicine Association (ATA) and its ATA Action committee praised the DEA and HHS for the action.

“We are thrilled that the DEA is taking such a thoughtful and thorough approach to creating the right rules around the prescription of controlled substances. This is a critical issue for millions of individuals and their families, as well as clinicians wanting to provide care to their patients, wherever and whenever they need it,” ATA Senior Vice President Kyle Zebley said in a statement . He also is executive director of ATA Action.

“We have served as the guardians we promised to be for patients benefitting from these services and will continue to work on their behalf to ensure that the final rules do not restrict access to needed telehealth and virtual care services and do not create undue burdens for providers, while preventing diversion,” Zebley said.

Next year could be a “Super Bowl for telehealth,” with other flexibilities first granted to deal with COVID-19, also set to expire. Examples include tax provisions for high deductible health plans and health savings accounts, and in-person or telehealth rules for Medicare, hospice care and the Acute Hospital Care at Home Program, the ATA statement said.

“This is a historic opportunity to make crucial changes to our healthcare system that will appropriately expand access to urgently needed care to some of our most challenged and underserved patient populations,” Zebley said. “This is not rhetoric, it’s real opportunity that we must not squander.”

How other doctors are using social media to benefit their practice

Mon, 03 Jun 2024 18:36:13 GMT

In the early days of social media, many doctors did not see a use for it at their medical practice. Now, with social media becoming the dominant way that many people – including their patients – prefer to communicate, doctors have found ways to leverage it to benefit their practices.

Research from Software Advice revealed many insights into how doctors are using social media. Here are the key findings.

Study examines health and other factors in happiest states

Mon, 03 Jun 2024 18:35:00 GMT

You work hard to help your patients stay healthy.

What factors are making them happy – or not?

Primary care physicians are looking for ways to assist patients dealing with difficulties in drivers of health , also called social drivers or social determinants of health. Those issues include food security, housing stability, transportation, utilities, and interpersonal safety.

There are other stressors that physicians may never be able to cure. For example, in the national economy, high inflation remains a threat to patients’ mental health, said the study, “2023’s Happiest States in America.” More than 75% of Americans who have experienced price increases where they live reported feeling “very” or “moderately” stressed by those.

The findings were published by online personal finance company WalletHub.

“Happiness comes from a combination of internal and external factors,” WalletHub financial writer Adam McCann said in the report. “We can influence it somewhat by approaching situations positively or choosing to spend time with people we love, doing activities we enjoy. It’s harder to be happy in some years than in others, though.”

WalletHub examined 30 metrics around the 50 states to determine the happiest states, and states where joy may be more limited. Data come from a variety of government, academic and private business sources, including the U.S. Census Bureau, Bureau of Labor Statistics, and Centers for Disease Control and Prevention.

The health care disruptors are not coming. They are here.

Mon, 03 Jun 2024 18:34:02 GMT

Plenty has been written and said about how health care in the United States is too convoluted to be disrupted by new entrants. Dan Munro, health care author, and Forbes contributor compiles most of the rationales provided by thought leaders in his 2018 article titled “ 10 Reasons Healthcare Won’t Be Disrupted .” While traditional health care systems carried on with some air of certainty, would-be disruptors continued to make advances, and five years later, they have solidly taken over health care’s low-end market. They are coming for the upmarket, and traditional health care systems must set up their command centers now.

Clayton Christensen, professor of business administration at Harvard Business School, laid out the tenets of disruptive innovation: First, the entrants would enter the low end of the market, claim the least profitable portion of the market as its own, and because the incumbent owns the most profitable market segments, they most likely won’t fight the entrants for that market share. Second, the entrants will improve their offerings and move upmarket with increasing profitability. Finally, disruption will occur once the incumbents’ customers have widely adopted the entrants’ offerings in the mainstream market.

So, how have these tenets unfolded in health care in the last five years? And how should health system executives and business leaders prepare for the next ten years?

The would-be disruptors have entered the low end of the market, where they’ve begun to revolutionize preventive care, primary care, prescription benefits management, and medication dispensing. Upon transforming it, they will march upmarket for the profits of high acuity specialty, subspecialty, and surgical care.

In March 2023, Amazon officially closed on its $3.9 billion acquisition of primary care provider One Medical to establish a nationwide brick-and-mortar presence and deliver fully integrated primary care in the comfort of people’s homes. With annual memberships starting at under $200, patients are promised access to on-demand virtual care and in-app messaging, same and next-day in-office and remote medical appointments, walk-in laboratory services, and prompt prescription requests and renewals. And with access to One Medical’s network of more than 180 offices across the United States, consumers will also have increased options for community-based retail care. Amazon is making health care more accessible, faster, personal, and convenient by integrating pharmacy, telehealth, and primary care into a comprehensive and attractive model.

CVS Health purchased Oak Street Health to expand its primary care footprint. Walmart, which operates 32 health centers delivering primary and urgent care, plans to double that number by 2024. Best Buy struck a deal with Atrium Health to bring certain aspects of hospital care to people’s homes with wearable devices that enable care teams to monitor patient’s vital signs remotely.

In June 2023, Uber launched same-day, over-the-counter medication delivery directly to patient homes, adding to its transportation of enrolled patients to their doctor’s offices and other medical appointments through Uber Health. Uber’s platform streamlines coordination across multiple benefits- non-emergency medical transportation, prescription delivery, food, and over-the-counter medication delivery.

Google has assembled the blocks to build the next-generation clinic. With Onduo, Google has created a virtual diabetes clinic to control insulin performance backed by data from its Fitbit wearable technology. OneFifteen is Google’s data-driven physical campus dedicated to all facets of opioid misuse, treatment, and recovery. Calico is Google’s biotechnology company, which develops therapies for health and longevity. With Apigee, Google reduces risks during care transitions and empowers collaboration between patients, physicians, and health care providers. Google’s G-Suite provides clinical workflow tools and patient data storage in a HIPAA-compliant repository. Google for Retail offers accurate pharmaceutical product information, price, and availability. This array of health care services assembled through in-house start-ups, acquisitions, and strategic partnerships will operate seamlessly across Google’s integrated platforms.

What Google, Amazon, CVS, Walmart, Uber, and Best Buy (hereafter referred to as the Big Six) bring to the market is equivalent to fiber-optic internet, ultra high-definition television, or 5G coverage on a mobile network carrier. Consumers ultimately accede to these game-changing features. Once health care consumers assent to the offerings of the Big Six, the upmarket path into high-acuity specialty, subspecialty, and surgical care becomes inevitable.

Google, for example, has its sights on health care’s upmarket already. The tech giant now has specialty and surgical care infrastructures in the works. Through OneBraveIdea, Google uses genomics and phenotyping in clinical care to solve coronary heart disease. With its Verb Surgical platform, Google combines robotics, advanced visualization and instrumentation, data analytics, and connectivity for digital surgery. Google’s DeepMind and Google Ventures focus on developing tools and devices to collect, organize, and activate health data.

Google is determined to get the health care business model of the future right. When Google and other powerful entrants like Amazon succeed, and customers and patients become accustomed to their health brands, traditional health systems will see their market share and profitability erode quickly.

A survey by Wolters Kluwer shows that American health care consumers are eager to see the health care landscape and structures dramatically transformed. There’ll be no more barriers to the data and information we need to coordinate care and access services on time. With novel technology and business models, these would-be disruptors will ensure we no longer need to test more, treat more, and make patients consume more health services.

The wind of change is blowing, and while not every disruptive path leads to success, and not every successful entrant follows one, health system executives must accelerate innovations to align with the trajectory of health care delivery. The Big Six and other entrants promise better patient health, convenience and ease of care navigation, more fulfilling work for doctors, healthier communities, and less financial strain on health care consumers and taxpayers. So, how should health system executives approach the next ten years?

While traditional health systems entrench their teams in routine internal processes to cut expenses and grow revenue, system executives must also, for the next five years or more, stand up an operational apparatus designed solely to explore models, processes, partnerships, people, and tools that allow traditional health systems to evolve or symbiotically coexist with the Big Six and other entrants: (a) Set up a situation room at the V- and D-suite to closely monitor the Big Six and other entrants in the market to inform, interpret, and recommend actions for formulating and implementing operational responses that defend market shares for traditional health systems. (b) Create an innovation lab at the B-Suite for stakeholders from across the organization to ideate, create, and develop novel ideas, models, workflows, processes, tools, and mechanisms to help traditional health systems move fast and match the Big Six and other entrants. (c) Empower clinical and administrative leaders to identify opportunities, showcase strengths, exploit weaknesses, and address threats up and down the market under the command center’s knowledge, coordination, and decision-making authority.

In 10 years, our traditional health systems could become obsolete when health care consumers have widely adopted the offerings of the Big Six and other entrants in the mainstream health care market. Borders, Blockbuster, and Sears were defenseless when Amazon, Netflix, and e-commerce disrupted them. Taking our chances and hoping to fare better than Borders, Blockbuster, or Sears is no longer a safe bet. Health system chief executives must now set up their command centers and prioritize their defenses. As the adage goes, the best defense is a good offense.

Konye Ori is a health care finance professional.

Sleep doctors call for a sunset to daylight saving time

Mon, 03 Jun 2024 18:30:01 GMT

When the clock “falls back” to standard time (ST) early Sunday, that should be the last seasonal time change for the United States, say physician experts on sleep.

Daylight saving time (DST) will end at 2 a.m. Nov. 5, when clock time falls back one hour for the winter. This week, the American Academy of Sleep Medicine (AASM) reaffirmed its position that DST desynchronizes day, night, and people’s internal clocks , creating potential health risks .

“It is the position of the AASM that the United States should eliminate seasonal time changes in favor of permanent standard time (ST), which aligns best with human circadian biology,” AASM said. “Permanent standard time is the optimal choice for health and safety: an American Academy of Sleep Medicine position statement” was published in the Journal of Clinical Sleep Medicine.

On the clock

AASM said three clocks affect human activities. The Society for Research on Biological Rhythms also explained the time measures in “Why Should We Abolish Daylight Saving Time?” in the Journal of Biological Rhythms.

The internal biological rhythm is the circadian clock. Earth revolving and orbiting the sun creates the solar clock. The social clock dictates times for activities such as school and work.

When the three clocks don’t match up, bad things can happen.

“Springing ahead,” moving clocks ahead by an hour in the spring, causes people to lose sleep. That can lead to health issues ranging from higher heart rates and blood pressure, to atrial fibrillation, to increased risk of pregnancy loss following in-vitro fertilization, to more car crashes, according to AASM, which cited a number of studies on various health conditions and effects.

Likewise, “falling back” in November also causes sleep disruption that can lead to adverse health effects, even though it is “commonly thought to be beneficial because it is associated with ‘an extra hour of sleep,’” AASM said.

“Evidence indicates that the body clock does not adjust to DST even after several months, so that ongoing sleep debt and circadian misalignment continue to persist,” AASM said.

This week’s position paper reiterated arguments from a 2020 AASM position paper that acknowledged “there is little direct evidence regarding the chronic effects of DST.” There may be some benefits, such as decreases in crime rates and motor vehicle crashes due to more daylight in the evenings.

Up for debate

Seasonal time changes have prompted debate for decades.

AASM noted in 1973, Congress established permanent DST due to the oil embargo of the Organization of the Petroleum Exporting Countries. The assumption was “that more evening light would lead to energy savings,” but actual energy savings were minimal. Permanent DST was “highly unpopular,” likely because people had more days of dark mornings, and Congress repealed it a year later.

Last year, the Senate approved a bill proposing year-round DST, but the House of Representatives did not act on it.

States may exempt themselves from DST, and Hawaii, Arizona, and U.S. territories do so. AASM cited the Congressional Research Service , which found various states had proposals to eliminate time changes – but they were split on using DST or ST. As of March this year, the National Conference of State Legislatures reported 19 states had enacted year-round daylight saving time.

Mexico eliminated DST last year, and in 2021 the European Parliament voted to eliminate mandatory DST.

Rising nurse practitioner burnout: charting and work-life balance

Mon, 03 Jun 2024 18:28:30 GMT

Nurse practitioner (NP) burnout is at an all-time high. Many nurse practitioners (and health care providers in general) are struggling right now, feeling mentally, physically, and emotionally exhausted. Many are contemplating leaving health care altogether. The factors contributing to nurse practitioner burnout are multifactorial, stemming from various personal and work-related causes. However, for APRNs, there is a leading cause of burnout.

Signs and symptoms of nurse practitioner burnout:

Before we delve into the top cause of nurse practitioner burnout, let’s explore how burnout can present, focusing on its signs and symptoms.

The main difference between stress and burnout for nurse practitioners is reaching the level of depletion. Many burned-out nurse practitioners begin to feel detached from their work and personal lives. They no longer find passion or purpose in caring for patients and feel completely empty, like they have nothing else to give.

Here are some common signs and symptoms of nurse practitioner burnout. What would you add to the list?

Mental, physical, and emotional exhaustion
Mental: poor clinical judgment, brain fog affecting productivity
Physical factors: poor sleep, chronic fatigue, headaches
Emotional: chronic stress, anxiety, depression
Detachment from work
Feeling detached from loved ones or your own life
Feeling numb, loss of passion
Lack of purpose
Lack of empathy and understanding
Negative thoughts
Imposter syndrome or limiting beliefs
Difficulty processing trauma or challenging work experiences

The #1 cause of nurse practitioner burnout

Let me provide some background on how I discovered the #1 cause of nurse practitioner burnout. After conquering health care burnout myself, I help overwhelmed APRNs create a better work-life balance and overcome burnout. While coaching and talking with nurse practitioners, I discovered the leading contributor to nurse practitioner burnout.

Surprisingly, it’s not what I expected. I figured the recent pandemic and added stress were the primary causes of burnout. I thought the modern health care system played a significant role in nurse practitioner burnout. I would have guessed that the lack of boundaries or a toxic work environment contributed to it.

However, after working with nurse practitioners, I discovered that the #1 cause of burnout is a lack of work-life balance.

And the #1 cause of work-life imbalance is charting.

So many nurse practitioners are staying late at the office and bringing their charts home. This increase in time, energy, and stress disrupts their work-life balance.

Instead of having the energy to cook a healthy meal and eat with their families, nurse practitioners are depleted from a busy workday. Instead of having the time to enjoy the company of their children, nurse practitioners are thinking about how many open charts they need to finish. Rather than relaxing and engaging in self-care activities, nurse practitioners have a pile of charts to sign (not to mention reviewing medical documentation, analyzing diagnostic data, responding to patient messages, etc.).

The amount of charting and tasks nurse practitioners need to catch up on is insurmountable. Many nurse practitioners spend an extra 10-15 hours of unpaid time just trying to stay caught up with charting. After a long workday, the only time to finish their tasks is at home. Talk about a work-life imbalance!

Yes, charting at home is the #1 culprit of work-life imbalance and is a strong indicator of developing nurse practitioner burnout. The good news is that nurse practitioners can improve their time management and documentation in many ways so they can stop charting at home.

Resources for nurse practitioner burnout

While there is no easy solution to overcome the #1 cause of nurse practitioner burnout (after all, we still have to chart), there are many things we can do. For example, improving our charting and time management skills, setting boundaries with patients, ensuring we learn and utilize the electronic health record, and so much more!

But before implementing any of these charting and time management tips, we need to step back. We should focus on the personal and work-related factors contributing to our burnout and be honest with ourselves. It will be different for each nurse practitioner, but we must focus on our challenges and struggles.

The next tip I want to share is to find support. So many nurse practitioners and health care providers are struggling with burnout. We should be open and honest about our struggles, have hard conversations, bring awareness to the topic, and rally together during our burnout journey.

Acknowledging and addressing nurse practitioner burnout is so important. If you realize you struggle with the #1 cause of nurse practitioner burnout, work on improving charting. If you realize that your burnout is caused by toxic personal relationships, then focus on improving those. If you have completely lost your passion for health care, take a break to give you the opportunity to catch your breath. Going through nurse practitioner burnout is not easy.

Erica Dorn is a nurse practitioner.

We all make mistakes. Don’t let them define you.

Mon, 03 Jun 2024 18:27:07 GMT

We are human and we all make mistakes. It’s an inherent part of our nature. It’s easy to get caught up in the belief that our mistakes define us or determine our worth; however, this couldn’t be further from the truth.

As physicians, mistakes often serve as the uninvited guests in our otherwise meticulously planned professional lives. Yet, it is crucial to recognize that these errors are not stamps of incompetence but rather intricate threads woven into the fabric of our growth and wisdom.

In health care, there is a small margin for error, which can lead to devastating consequences. It is in this understanding where we can share in our humanity. While none of us wants to cause harm, we are faced with the reality of dealing with situations where not all is known and time hasn’t fully taken its course. Inherent to that is the possibility for mistakes to happen.

They are not necessarily a reflection of who we are as individuals or professionals but rather an opportunity for growth. They may provide us with key information as to the areas in which we need to improve and guide us to becoming better physicians and healers.

Mistakes present us with invaluable learning experiences, and it is in these moments that we have a choice. We can either allow ourselves to get stuck in the weight of our mistakes, burdened by self-doubt and regret, or we can embrace them as stepping stones on our path of improvement.

To learn from our mistakes, we must remain true to ourselves and stay committed to our journey of growth. It’s what we are all doing anyway, always growing and trying to get better. Approaching our patients (and ourselves) with a sense of humility keeps our minds open for this to happen. We’ll never know it all; we can just do the best we can at any given moment.

Obviously, we want to prevent mistakes from happening, and we can do that by keeping an open mind, asking for help from others, and recognizing the limitations of our intellect. We can prepare for all sorts of scenarios, but when the rubber meets the road, we don’t always know what we will encounter. With our best judgment, we set out on a path and need to be willing to course correct.

We can do that by taking an honest look at our thoughts and decisions and reevaluating the path we’re on. There are always ways to enhance our skills, knowledge, and our approach to care. With humility, open-mindedness, and a willingness to accept feedback we can make the necessary changes. Further, we can share with others, enabling them to learn from our experiences.

As physicians, we serve others, and to do so in the best capacity, we can approach our mistakes not with fear and self-doubt but with curiosity and the chance to do it differently next time. Each mistake is an opportunity to refine our skills, deepen our understanding, and enhance the world around us through our commitment to growth and improvement.

As we navigate the challenges of our profession, let us embrace our mistakes with grace and gratitude. Let us learn from them, integrate the lessons into our practice, and move ahead with renewed determination and wisdom. This is how we create a culture that fosters resilience, learning, and excellence.

Josh Schwarzbaum is an emergency physician.

CPT codes for 2024 unveiled

Mon, 03 Jun 2024 18:16:49 GMT

Consolidated codes for reporting current COVID-19 immunizations , provisional codes for forthcoming monovalent vaccines, and codes for Respiratory Syncytial Virus (RSV) immunizations are among the features of the American Medical Association’s 2024 Current Procedural Terminology (CPT) code set unveiled today.

In all, the 2024 code set includes 230 additions, 49 deletions and 70 revisions among its 11,163 codes according to an AMA news release.

The 2024 version will also be the first to offer Spanish language descriptors for medical procedures and services. “Providing approximately 41 million Spanish speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive health care environment, where language is no longer a barrier and patients can actively engage in their own care,” Lori Prestesater, AMA senior vice president of health solutions said in the release.

To streamline the COVID-19 immunization reporting process, the 2024 code set consolidates more than 50 previous immunization reporting codes into 17 (91300-91317), and a new code (90480) for reporting the administration of any COVID-19 vaccine for any patient. The latter replaces all previously approved specific vaccine administration codes.

In addition, it includes provisional codes (91318-91322) for monovalent Moderna and Pfizer COVID-19 vaccines for when they are approved by the U.S. Food and Drug Administration.

The 2024 code set contains five new codes (90380, 90381, 90683, 90679 and 90678) developed in response to product-specific RSV immunizations . The codes will enable better tracking, reporting and analysis for planning and allocation purposes, the AMA said.

Responding to requests from the Centers for Medicare and Medicaid Services, some evaluation and management (E/M) reporting codes have been revised for greater clarification. The revisions include:

Removing time ranges from office or other outpatient visit codes (99202-99205, 99212-99215) and aligning the format with other E/M codes,
Defining the “substantive portion” of a split/shared E/M visit in which a physician and a non-physician practitioner work jointly to furnish all the work related to the visit, and
Instructions for reporting hospital inpatient or observation care services and admission and discharge services for the use of codes 99234-99236 when the patient stay crosses over two calendar dates.

Patients warm to billing reminders via text messages

Mon, 03 Jun 2024 18:15:36 GMT

Consumers say they’re more

open to getting digital reminders about health care bills and want providers to pay attention to their preferences, a recent survey suggests.

Patients say they’re increasingly interested in getting bill reminders by text, according to a recent survey of more than 1,300 people conducted by Salucro Healthcare Solutions , a health care payment technology company.

Well over half of the participants (62%) said they would prefer to pay their bills via an online patient portal, the survey found.

The survey found 59% of patients would prefer a text notification over a phone call or email. Last year, 45% said they’d prefer a text message. A slight majority of respondents (51%) said a text message reminder would prompt them to pay their bills more quickly.

More health care systems have been looking at ways of improving convenience for consumers , including in areas such as scheduling appointments and paying bills.

More hospitals are offering digital options to pay bills, but plenty of patients say they’re not seeing different payment options from their health care providers.

About a third of consumers (32%) said their health system offered an online payment option , up from 27% a year ago. And 11% of those surveyed said they had a text-to-pay option this year, up from 8% last year.

At the same time, 53% of those surveyed said their health care provider had not updated their payment communication options over the past year.

Many providers aren’t asking patients about their preferred method of getting billing reminders. Nearly half of the survey’s respondents (45%) said their providers didn’t inquire about the way they’d like to get billing reminders.

No quick and easy answers for health care workforce shortages

Mon, 03 Jun 2024 18:14:32 GMT

Workforce shortages are evident , but experts said there are no easy remedies to current employment issues across the U.S. health care system.

On Nov. 16, KFF hosted “The Health Care Workforce Under Pressure: Strikes, Shortages, and Staffing Requirements,” as part of its regular Health Wonk Shop webinars with panels to discuss current issues in health care.

Is there a workforce shortage in health care? The answer is not a simple yes or no, said Bianca Frogner, director of the University of Washington Center for Health Workforce Studies, and professor in UW’s Department of Family Medicine.

“I think generally, there is a broad perception among employers that we have a shortage but we really have to ask, where? For whom? But what purpose are we having a health workforce shortage?” she said. “I think we certainly feel a lot of stress in the primary care space. I think we're feeling a lot of stress in the behavioral health space, as well as the long-term care space. So, we have many sectors of the health care industry that are certainly feeling a crunch of trying to find workers to fill the slots. As well as, then we have like a maldistribution problem of different areas of the country also struggling to find workers to fill the slots that they need, particularly in rural areas and underserved communities.”

Nurses in need

McKinsey & Co. and the American Nurses Foundation conducted a survey this year that found 56% of nurses are experiencing symptoms of burnout – “an unacceptable state,” said Gretchen Berlin, a registered nurse and McKinsey senior partner.

Among other findings:

About 20% of nurses indicated they changed positions in the past six months
About 39% of nurses indicated they were likely to leave their current positions in the next six months. That was up to about 41% of nurses who provide direct care to patients.

In earlier surveys, figures of 25% to 30% of nurses wanting to leave were shocking; but that has remained consistent and now industry watchers have gotten used to it, Berlin said.

American employers cannot expect an influx of foreign-born workers to fill in gaps. Burnout has become a global issue, with health care workers in other developed countries having similar feelings as those in the United States, Berlin said.

“And at the end of the day, what we're seeing folks say they want, is a safe work environment, some work life balance, a workload that they feel they can successfully deliver on a daily basis, and that's been consistent across time as well as across geographies,” Berlin said.

Long-term care

The COVID-19 pandemic disproportionately affected the long-term care workforce, said Alice Burns, PhD, associate director of KFF’s Program on Medicaid and the Uninsured.

The job requires skills from changing catheters to preparing food. Medicare and private health insurance generally don’t pay for long-term care, so payment comes from Medicaid and people paying out of pocket, Burns said. That pushes down payment rates, which in turn pushes down wages, so long-term care workers may be earning $15 an hour, the say pay they could make at a much less physically and mentally demanding job at a department store or coffee shop, Burns said.

Meanwhile, the administration of President Joe Biden has proposed minimum requirements for registered nurses and nurse’s aides. Facilities would have three to five years to comply, and there would be broad hardship exemptions, Burns said.

Based on those requirements, currently fewer than one in five facilities would meet the minimums, Burns said.

“Nurse facilities might need to pay more, to certainly have more staff and to attract more staff,” said KFF Executive Vice President for Health Policy Larry Levitt, the webinar moderator. “You know, where would the money come from to pay for that?”

“So, that is the question, right?” Burns said. States have been using COVID-19 pandemic funding to develop innovative strategies to help. Increasing pay is part of it, but workers also have responded to newly created career ladders and opportunities for advancement.

“You know, making these jobs a place people want to be,” Burns said.

Competing for workers

Hospitals also have looked at staff-to-patient ratios, with an eye toward quality, and those do help to make sure patients get high-quality care, Frogner said.

“But the problem is, where’s the supply of workers when you put those ratios into play?” Frogner said. The three panelists noted hospitals, nursing homes, ambulatory settings all compete for workers.

It is possible that more people could enter training programs for nursing. Pay is a factor, Berlin said, but it also is important to have meaningful work in a positive environment. The trauma of the COVID-19 pandemic, and more current reports about workplace violence in emergency departments and other care settings, may be deterrents to new workers, she said.

Why physicians need financial independence and how to achieve it

Mon, 03 Jun 2024 18:13:30 GMT

In the modern world, physicians are respected and highly regarded for their compassion, dedication, skill, and knowledge. People value the effort physicians put into taking care of others often before taking care of themselves. While this noble profession was once lucrative, many now find it challenging to make ends meet, given falling reimbursements, lack of independence, and exorbitant student loans. Achieving financial independence is not just a personal goal; it is a vital pursuit for physicians that can positively impact their well-being, patient care, and overall professional satisfaction.

For many physicians, student loans are a significant financial burden. Achieving financial independence allows them to break free from the cycle of debt, reducing stress, and improving their overall quality of life. By managing and eventually eliminating their debt, physicians can redirect their income towards investments and savings, setting the foundation for financial security for themselves and their family.

Physician burnout is a real and pressing issue in the medical field. Financial stress is a major contributor to burnout. Many physicians feel enslaved to their employers, fearing the loss of income or large gaps in income. They have forgotten that they are in high demand. When physicians achieve financial independence, they can work in positions of their choosing rather than out of necessity. This provides an environment where they are satisfied and can achieve work-life balance. This financial safety net can significantly reduce stress, allowing doctors to focus on their patients and prevent burnout.

Financial independence provides physicians with the freedom to make career choices based on passion rather than financial necessity. They can pursue specialties or areas of medicine that truly inspire them, even if those fields or practice settings are less financially lucrative. This freedom can lead to a more fulfilling and satisfying career. Even more importantly, financially independent physicians can work on their terms and not be dictated to by administrators and practice managers.

Most people are not aware that doctors don’t receive a pension. Doctors retire when they have accumulated enough savings that they no longer need to work. The burden of school debt, falling reimbursements, and the demanding nature of the medical profession often leads physicians to delay retirement. Achieving financial independence early in their careers enables doctors to retire comfortably when they choose, without worrying about financial constraints.

Financially independent physicians can invest in continuing education, innovative treatments, and advanced technologies. They can also take time off for personal well-being and outside interests without worrying about lost income. This results in enhanced skills, improved patient care, and better overall outcomes. A content and relaxed physician is less likely to rush through patient interactions and more likely to establish effective therapeutic relationships.

Physicians are influential figures in society. By achieving financial independence, they set a positive example for their colleagues, patients, and the community. They can educate others about financial literacy and responsible financial planning, promoting a culture of financial well-being in the medical community.

Principles to achieve financial independence

Now that we’ve explored why physicians should achieve financial independence, let’s discuss some basic principles for doing so.

1. Financial responsibility and planning. Financial responsibility means living below your means. While the temptation of luxury items may be strong, it’s important to consider your financial plan. Do you even have a financial plan? Many physicians believe they can handle their investments independently or through online services without understanding their financial goals. Seeking assistance from financial advisors is crucial, as they can provide a holistic view of your finances and help you make informed decisions.

2. Debt management. Pay off high-interest loans like student loans and car loans before indulging in luxuries. Work with your financial advisor to engineer a strategy for paying off these loans efficiently. Always strive to pay more than the minimum required payment to save on interest.

3. Diversify investments. Diversify your investment portfolio. Avoid putting all your assets into a single stock or investment. A diversified approach can mitigate risks and provide stability.

4. The three-legged stool. Consider a “three-legged stool” investment strategy. Allocate one-third of your assets to the stock market, one-third to passive real estate investments (preferably in commercial real estate), and one-third to active business ventures that do not require your physical presence for generating income.

5. Real estate investments. Real estate investments, whether in commercial or residential properties, offer steady rental income. Seek guidance from experienced real estate agents and investors to make informed decisions in this area.

6. Emergency funds. Instead of traditional emergency funds, consider utilizing a home equity line of credit or a margin account with a financial institution. These can provide substantial funds at reasonable interest rates for unforeseen expenses.

Summary

Achieving financial independence is not just a personal financial goal but a professional responsibility for physicians. It enables them to provide the best care for their patients, reduce stress, and make a positive impact on the health care system and society as a whole. By adhering to sound financial principles and making prudent decisions, physicians can secure their financial future and enjoy a more balanced, fulfilling life.

Brian Hudes is a gastroenterologist.

Risk management: What medical practices need to consider before adding revenue streams

Mon, 03 Jun 2024 18:12:05 GMT

Practices are always looking to boost their income, and adding new revenue-generating services are a great way to do it. But before you take the leap, make sure you have considered all the risks and prepared accordingly.

Committee sends 19 health care bills for full House consideration

Mon, 03 Jun 2024 17:15:48 GMT

The House of Representatives will consider 19 bills that affect various aspects of the U.S. health care system.

The House Energy & Commerce Committee this week voted to advance various draft legislation for consideration by the full chamber. The actions came this week in a committee meeting involving 44 bills dealing with energy and technology, along with health care.

Medicare pay for doctors

The batch of bills included House Resolution (HR) 6545, known as the “Physician Fee Schedule Update and Improvements Act,” which would affect pay for physicians treating Medicare recipients. Sponsors include physicians in the House.

“The current structure of the physician fee schedule does not provide sustainable, reliable and consistent payment rates for physicians who see Medicare beneficiaries,” Rep. Marianette Miller-Meeks, MD (R-Iowa), said in a news release . “These cuts, especially when the costs to practice have markedly increased, further strain our nation’s doctors, limiting patient access to care. Each year, doctors routinely face harmful payment cuts making it increasingly difficult to remain in practice and accept Medicare patients, which is worsened in rural areas like Southeastern Iowa. I am proud to introduce the ‘Physician Fee Schedule Update and Improvements Act’ and will continue to work to stabilize adequate payment rates to keep providers in practice and increase access to quality care that seniors can afford.”

The legislation would increase Medicare budget neutrality from $20 million to $53 million, allowing greater flexibility in calculating pricing adjustments for services without payment cuts for doctors, said a legislative summary from Miller-Meeks’ office.

That summary noted the U.S. Centers for Medicare and Medicaid Services (CMS) did not update supply and equipment prices from 2005 to 2019 and froze clinical staff wage rates from 2002 to 2022.

“While CMS did eventually update payment rates, incremental increases would have allowed doctors to plan better,” Miller-Meeks’ summary said. “This bill brings needed stabilization to reimbursement and updates the formula to reflect accurate costs of running a medical practice.”

Health in the House

The health care legislation is among a number of bills pending in the House and Senate.

In her prepared remarks, committee Chair Rep. Cathy McMorris Rodgers (R-Washington) noted the United States “has the unfortunate distinction of spending more on health care as a percentage of our economy than any other developed nation, and for our money, we have not become healthier.”

“Instead, life expectancy in the United States has declined in recent years,” she said. “We will report out legislation that will make the American people healthier and better equipped to make health care decisions.”

Committee Ranking Member Rep. Frank Pallone Jr. (D-New Jersey) noted at least some of the legislation has bipartisan support to “address the critical needs of both Medicare patients and providers, and lower costs for patients.”

The bipartisan bills include new rules to rein in practices of pharmacy benefit managers (PBMs), such as improving transparency in Medicare Part D, Pallone said. He noted he would not support any policies that increase out-of-pocket costs for Medicare beneficiaries, or any policies that the U.S. Centers for Medicare & Medicaid Services cannot implement.

Full House consideration

The list of bills sent for full House consideration, as published by the Committee:

HR 5372 , “Expanding Seniors’ Access to Lower Cost Medicines Act of 2023.”

HR 2880 , “Protecting Patients Against PBM Abuses Act.”

HR 5393 , To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D.

HR 5385 , “Medicare PBM Accountability Act.”

HR 5386 , “Cutting Copays Act.”

HR 4881 , To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program.

HR 5389 , “National Coverage Determination Transparency Act.”

HR 133 , “Mandating Exclusive Review of Individual Treatments (MERIT) Act.”

HR 5396 , “Coverage Determination Clarity Act of 2023.”

HR 5371 , “Choices for Increased Mobility Act of 2023.”

HR 5388 , “Supporting Innovation for Seniors Act.”

HR 5380 , To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.

HR 3842 , “Expanding Access to Diabetes Self-Management Training Act of 2023.”

HR 5397 , “Joe Fiandra Access to Home Infusion Act of 2023.”

HR 5555 , “DMEPOS Relief Act of 2023.”

HR 2365 , “National Plan to End Parkinson’s Act.”

HR 6364 , “Medicare Telehealth Privacy Act of 2023.”

HR 1352 , “Increasing Access to Biosimilars Act of 2023.”

Four health technology trends to watch for in 2024 (and a look back at 2023)

Mon, 03 Jun 2024 17:14:37 GMT

The traditionally conservative health care landscape has undergone massive and rapid technological disruption in the past decade. The explosion of generative AI and Large Language Models (LLMs) outpaced any wave of innovation that we’ve seen.

While these innovations are being hailed as potential solutions to many of the challenges plaguing health care, the digital health industry faces a harsh reality check. The once-soaring sector is grappling with market corrections, leading to the shutdown of unicorn startups and raising questions about its future.

How does this situation resolve? Where do the market corrections stop? Here’s what I think we can expect to see from the intersection of tech and health care in the upcoming year:

All about AI

Let's take a minute to acknowledge how generative AI has stealthily become a part of our daily lives. From autocomplete suggestions to voice assistants, we interact with these models regularly without giving them a second thought. It's a testament to the seamless integration of technology into our routines, and a sign that the world of science fiction is now firmly our reality.

In health care, the integration of LLM and LMMs (Large Medical Models) holds promise, but safety concerns are a major obstacle. No regulatory body or model monitors AI implementation similar to the FDA, FCC, or FTC, posing challenges to the legitimate use of these powerful tools in a sector where privacy is paramount. Where there are guidelines, they fall short of enforceable protections for patients and consumers. Further, experts in the space speculate that the rapid pace of AI innovation makes regulation impossible, which would severely limit its benefits for health care if not killing the technology on arrival.

On the health plan side, the adjudication of reimbursement is ripe for disruption, having previously benefited from the adoption of digital tools. As an example, plans could use AI to automate administrative pieces of the lengthy manual claims evaluation process. In the long term, applications of generative AI for payers could lower costs through conclusions based on data analysis.

It’s almost guaranteed that we will see more AI adoption in health care in 2024. While some optimists envision AI-powered predictive clinical models in the near future, it’s a more realistic bet that non-clinical applications, like documentation and education, will make the first inroads into a cautious sector.

Consolidation and vertical integration

In the face of a challenging financial landscape, mergers and consolidations have become survival strategies for health care players. Payers are becoming providers, health systems are expanding their roles, and employers are stepping into the health care arena. Even Venture capitalists are joining the game, contributing to the creation of large, fully integrated health care systems.

As these health care giants emerge, digital health companies will be forced to rethink their strategies and attempt to carve out a role for themselves in the brave new world among a small group of healthcare behemoths.

Macro meets micro

With AI taking up all the oxygen in the room, it’s hard to make space to address the financial and structural challenges that plague the American health care system like reimbursement, alternative payment models, and the larger economic duress of health care as a whole. As the largest sector of the economy and significantly service-oriented, health care cannot escape the broader angst Americans feel toward the state of the economy. Unlike Big Tech, which can ride the innovative AI boom to harness growth, health care transformation will follow a slow, winding road. Add in the end of government assistance for COVID-related expenses, halting Medicaid expansion in several states, and an unpredictable economy showing no signs of stabilizing in an election year, and it figures that financial barriers to adoption will be front and center for innovators in 2024.

Expect to see a continued focus on cost-effectiveness and proving return on investment as the industry cuts down on vendor sprawl. Value-based care will remain a hot topic of discussion as providers try to optimize their financial models, but unless reimbursement structures change dramatically, its feasibility remains questionable.

Don’t sleep on AR/VR

While AI has dominated the narrative of 2023, augmented and virtual reality technology has been quietly but rapidly making inroads into the health care industry. Meta recently rolled out its Oculus III, a more accessible and budget-friendly version of its revolutionary AR/VR headset, and Apple introduced Apple Vision Pro, a similar product with a higher threshold to entry.

Both of these companies have actively promoted health care use cases. With their massive user bases and existing infrastructure, they have the potential to completely revolutionize medical training ― potentially clinical and surgical care, too. While still in its nascent stages, and coming up against the same privacy and safety concerns surrounding AI adoption, AR/VR technology could be the sleeper hit of 2024 that outlasts the hype of volatile stars like generative AI.

The theme of 2024 will be tension: between the sweeping innovations of the tech sector and the hard realities of complex reimbursement structures, shifting infrastructure, and safety concerns in health care that threaten to slow progress. How will these tensions resolve? The answer might need more than a year to reveal itself.

Anish Sebastian is the co-founder and CEO of Babyscripts , an innovative maternal health care company focused on reinventing the standard of prenatal and postpartum care through the delivery of digital education and remote patient monitoring experiences.

5 days, 5 minutes: life-changing daily habits for health care professionals

Mon, 03 Jun 2024 17:13:05 GMT

It’s no secret that health care workers are some of the most stressed and burned-out professionals in the workforce. Health care was a tough job even before we had to bear the brunt of the worst of the pandemic. Even now that we’re nearly four years out from the initial outbreak of COVID-19, we’re still contending with a myriad of challenges, such as mental health disorders and ever-diminishing staff.

Amidst these ongoing struggles, there are dedicated individuals and groups tirelessly working behind the scenes to enforce safe staffing ratios or push for federal legislation to address workplace violence . But as they say, “Bureaucracy moves at the speed of molasses in January.” In the meantime, stepping into the new year is the perfect time to shift focus and prioritize your well-being—especially in a field where taking care of others comes first, and self-care inevitably falls by the wayside.

For those of us on the front lines, here are five evidence-based strategies that can improve your life—and all it takes is five minutes or less for five days straight.

Before your inner critic chimes in with, “I’m busy!” Or, “You don’t know how much overtime I just picked up!” consider this: there are 86,400 seconds in a day, and all five of these things take less than 1,500 seconds. That’s less than 1.7 percent of your day for strategies that are proven to have a massive impact on reaching your goals, feeling less stressed, and boosting your happiness.

Bad habits are hard to break, and good habits are hard to develop, but it can start today with these five habits:

1. Practice mindfulness or meditation. Embracing the habit of mindfulness or meditation has been shown to significantly transform the stress response. Regular meditation reduces the body’s inflammatory response to stress and elicits changes in brain function and structure that allow us to more rapidly recover from stressful events. Additionally, those who practice mindfulness respond less to negative stimuli and show a heightened positive response to positive images, effectively rebalancing the natural tendency to focus on life’s negatives.

2. Take a cold shower. Taking a cold shower can offer surprising health benefits. The shock of cold water on the body has been shown to stimulate the production of mood-boosting neurotransmitters, providing a natural lift in mood and potentially easing symptoms of depression. Additionally, cold showers have been shown to enhance the immune response , which is particularly beneficial for those in high-stress environments like health care, where chronic stress can often compromise the body’s immune defenses.

3. Eat two servings of fruits or vegetables. Incorporating just two pieces of fruit or vegetables into your daily diet can have profound benefits for your physical and mental health. These natural foods are rich in fiber and essential nutrients, which nourish your body and gut microbiome, a key player in the production and function of neurotransmitters. Daily avocado consumption, for example, has been shown in studies to improve cognitive function and reduce visceral fat .

4. Start a gratitude journal. Writing down five things you’re grateful for every day has been shown to improve well-being, lower diastolic blood pressure , and potentially decrease the incidence of depression . Engaging in this simple practice helps shift the focus from negative or overwhelming thoughts to positive aspects of life, fostering a sense of contentment and peace. Over time, this habit can enhance mental resilience, improve mood, and even lead to a more optimistic outlook on life as you regularly acknowledge and appreciate the good around you.

5. Stretch. Health care workers have physically demanding jobs with high rates of injury. Regular stretching can not only help prevent these injuries by increasing flexibility and reducing muscle tension but also enhance overall physical well-being. Interestingly, stretching exercises have also been linked to mental health benefits. Just like more intense forms of exercise, stretching can influence serotonin levels , offering a dual benefit of maintaining physical fitness while also contributing to mental wellness.

While not an exhaustive list, these five things can jumpstart a happier and healthier year. By spending less than 2 percent of your day, you can be more productive at work and home, feel better physically and mentally, prevent chronic disease, and enhance your relationships with loved ones and colleagues—all it takes is five days to develop a new routine with an improved mindset and better quality of life.

Scott Ellner has been a general surgeon for over 20 years, and can be reached at PEAK Health . He has transitioned into health care executive roles due to his passion for patient safety, quality, and value-based care delivery. His authentic leadership style inspires team members to navigate challenging situations, such as resistance to change and innovation, in order to bring about meaningful transformation. Most recently, he served as the CEO of Billings Clinic, the largest health system in Montana. During his tenure, Forbes recognized the clinic as the best place to work in the state. It was also at that time that he formulated a strategic growth plan that included the development of a level 1 trauma network and a rural-based clinically integrated network.

Top trends in medical technology for 2024 - a slideshow

Mon, 03 Jun 2024 17:11:56 GMT

Medical office software company AdvancedMD has released its six top health care technology trends for 2024.

These technological advancements, including artificial intelligence (AI) and the growing internet of things (IoT) will have the biggest effects on physicians, their patients and practices, said company President Amanda Hansen.

“Every single aspect of health care will be impacted – and improved,” Hansen said. “Clinical and diagnostic processes, back-office workflows, patient engagement, and billing capabilities will all see major enhancements. The integration of AI, generative AI, and IoT is ushering in a truly new era of health care technology. Private practices will be able to provide more equitable care to all patient populations, care delivery models will be more effective and provide better outcomes, and payors and vendors will have more seamless workflows that improve the overall healthcare experience.”

This slideshow presents AdvancedMD’s top six technology trends to follow this year.

Predictions abound for health care policy as presidential election year begins

Mon, 03 Jun 2024 17:11:06 GMT

Inflation and the economy are the top concern of voters heading into the 2024 presidential election cycle, but health care remains among the top worrisome issues nationally.

On Jan. 17, 2024, the Bipartisan Policy Center and The Commonwealth Fund hosted the online forum “Health Care Policy in the Election Year.” Four policy analysts offered their interpretations of recent poll data about voters’ feelings, along with forecasts on what that will mean in November and beyond as the nation votes on the president.

Discussion lasted almost an hour with Robert Blendon, professor emeritus at Harvard University’s T.H. Chan School of Public Health; Jarrett Lewis, partner at Public Opinion Strategies; Chris Jennings, founder of Jennings Policy Strategies; and Sheila Burke, a strategic adviser for Baker Donelson.

Blendon and Lewis began with a presentation on polling data – some of it pessimistic or showing great partisan divisions. Jennings and Burke said they hoped to inject some optimism, while recognizing key issues in health care at the state and national levels.

Personal concerns

People right now are pessimistic about the future and thinking short-term. They have little interest in President Joe Biden’s policies that go into effect in 2026 or 2028, but great interest in what’s happening to their families, Blendon said.

Under health care, about 28% to 30% of voters define abortion as a personal issue, meaning they cannot vote for a candidate who does not share their views, he said. Opioids and fentanyl overdoses are a top concern in health care, surpassing cancer, Blendon said.

In the last five years, the country has moved further apart and become incredibly polarized, with sets of values setting apart the Republican and Democratic parties, Blendon said. For example, Republican voters think the federal government is overspending, contributing to inflation, but Democratic voters think the federal government needs to spend more to solve inflation.

Public health and epidemics long were generally were nonpolitical, but now public trust in public health institutions is rock bottom for Republican voters, while Democratic voters still have confidence in public health. Republican voters don’t want to repeal the Affordable Care Act , but they do want to repeal it, while Democratic voters want to enlarge it, Blendon said.

A pandemic of pessimism

American voters are living in the longest sustained period of pessimism that’s been measured. The last time a plurality or majority of Americans thought things were going in the right direction in the country was in January 2004, Lewis said. Now, 66% of Americans have a pessimistic view of the economy, a figure worse than in the Great Recession, he said.

For health care, voters are “exasperated” by costs. Almost 40% of Americans have skipped or delayed care in the last year because of costs, and more than 40% say they are extremely or very worried that one illness, accident or medical event will pull them into bankruptcy, Lewis said.

Belief in excellent or good health care quality is at 48%, the first time below 50% in 20 year of tracking; historically it was in the 50s or low 60s for percentage points. A full 55% of people disagree with the statement that the U.S. health care system offers good value for the costs, and more than 75% say the U.S. health care system is in a state of crisis or has major problems, Lewis said.

Agreeing to agree

Blendon and Lewis noted two areas of agreement about national issues.

Medicare is the second most popular program among Republican and Democratic voters. The program has financial problems that need addressing, but candidates who speak up about cutting it must confront an “incredibly popular issue,” Blendon said.

There is strong bipartisan agreement on a mental health crisis in the nation, “and something needs to be done in a dramatic way,” Lewis said. The opioid crisis is part of the mental and behavioral health crisis, and both parties agree they must act on that, he said.

Voter motivation

In health care and other issues, voters become motivated when they think something they value is going to be taken away from them. “That’s why abortion has become a very motivating issue,” Jennings said. He predicted it will be “front and center” on the campaign trail this year.

The cost and complexity of health care is a huge issue across the board. The Biden administration has promoted prescription drug price reforms and voters can expect more of that from his campaign, Jennings said.

Former President Donald J. Trump has suggested repealing and replacing Obamacare, so expect Democrats to use that in campaigns to motivate voters, Jennings said.

“There are very, very significant motivating issues that will drive voters and I think in the end of the day, when you really compare the two candidates and their threat of taking away things that people value, Joe Biden will do very well,” he said.

Jennings suggested Medicaid spending could become a target if Washington is split or dominated by Republicans.

Government’s role in health care

Right now, voters deal with personal issues in health care – cost, complexity, inability to navigate the system, time and ability to access care. There are unique issues affecting rural areas, Burke said.

There also is a huge national issue: the distribution of responsibility between the federal government and state government in terms of the provision of services, and quality and access, she said. An example was states choosing not to expand Medicaid services.

Another issue is the increasing maternal death rate and risk of mortality, particularly among communities of color, and that has state-level implications, Burke said. And another issue is the Trump administration raising questions about the role of government in dealing with a public health emergency, with diminishing support for public health activities at the state level, she said.

“I think we can look at health care as just the obvious programs, public health service programs, Medicare, Medicaid. We need to look across the board and the government’s responsibility for lots of elements that have an impact,” Burke said.

The discussion included introductions by Marilyn Serafini, executive director of the Bipartisan Policy Center, and Rachel Nuzum, senior vice president of The Commonwealth Fund, and was moderated by Alice Ollstein, health care reporter for Politico .

Nursing homes: How they impact the dignity of older adults

Mon, 03 Jun 2024 17:09:27 GMT

Doctors are continuing to abandon private practice in favor of direct or indirect hospital employment, according to an American Medical Association (AMA) study of physician practice arrangements.

The association’s biennial Physician Practice Benchmark Survey found that in 2022 46.7% of doctors worked in wholly-owned physician practices, down from 49% in 2020 and 60% in 2012, the first year of the survey.

Conversely, 31.3% of doctors worked in practices that were wholly or partially hospital-owned, up from 30.5% in 2020 and 23.4% in 2012. The percentage of doctors employed directly by hospitals or working as contractors increased to 9.6% from 9.3% in 2020 and 5.6%
in 2012.

Respondents cited the ability to negotiate higher payment rates as the biggest reason for joining a hospital, with 79.5% calling it “important” or “very important.” That was followed by the need to better manage payers’ regulatory and administrative requirements (71.4%) and wanting to obtain better access to costly resources (69%).

“The AMA analysis shows that the shift away from independent practices is emblematic of the fiscal uncertainty and economic stress many physicians face due to statutory payment cuts in Medicare, rising practice costs, and intrusive administrative burdens,” AMA President Jesse M. Ehrenfeld, M.D., M.P.H., said in an accompanying news release.

The survey also revealed significant differences between private and hospital-owned practices in their incorporation of primary care. Among physicians in hospital-owned practices, 61% were affiliated with practices that include primary care, compared to 44.9% of those in private practice.

Among hospital-owned practices, 39% of physicians were in multispecialty groups that offer primary care services. By contrast, primary care in private practice is more often offered in solo or single specialty practices. About 31% of private practice physicians work in a solo or single specialty primary care practice, and 13.7% are part of a multispecialty practice that includes primary care.

The study also found:

An ongoing migration from smaller to larger practices, with the percentage of doctors in practices with five or fewer physicians declining from 40% to 32.8% between 2012 and 2022, while the percentage in practices with 50 or more physicians grew from 12.2% to 18.3%
A decline in the number of self-employed physicians and corresponding growth in employed physicians. In 2012 53.2% of doctors were self-employed, compared to 41.8% who were employed. In 2022, the percentages were 44.0% and 49.7%, respectively.

While practice ownership has declined among physicians of all ages, the sharpest drop — from 44.3% to 31.7% -— occurred among doctors under age 45.

The consequences of administrative burdens: Doctors in private practice continues to dwindle

Mon, 03 Jun 2024 17:08:20 GMT

Doctors are continuing to abandon private practice in favor of direct or indirect hospital employment, according to an American Medical Association (AMA) study of physician practice arrangements.

The study also found:

An ongoing migration from smaller to larger practices, with the percentage of doctors in practices with five or fewer physicians declining from 40% to 32.8% between 2012 and 2022, while the percentage in practices with 50 or more physicians grew from 12.2% to 18.3%
A decline in the number of self-employed physicians and corresponding growth in employed physicians. In 2012 53.2% of doctors were self-employed, compared to 41.8% who were employed. In 2022, the percentages were 44.0% and 49.7%, respectively.

While practice ownership has declined among physicians of all ages, the sharpest drop — from 44.3% to 31.7% -— occurred among doctors under age 45.

Why private practice doctors are vital

Mon, 03 Jun 2024 17:07:18 GMT

“The sustenance of private practice doctors, like the survival of small bakeries amidst the sprawling dominion of retail giants, nurtures a tapestry of diverse health care providers, ensuring that patients have access to a symphony of medical options in close proximity to their communities.”

– Dr. Clarissa Meadowsong, patient advocate and champion of health care diversity.

As physicians and related health care providers, we all remember the golden days of private practice. It’s not hard to look back at because the true cannibalization of private doctors by the hospitals started in the last twenty years. In the not-so-distant past, there was a pride in puffing your chest as you proclaimed to people that you were “independent.” As if the opposite, being dependent on a health care system, was a weakness, an anathema that the short-sighted brought upon themselves. A Faustian bargain that would only lead down the path of darkness and eventual crushing of your soul and will.

Fast forward a few years, and the last few still stand against the juggernaut of consolidation, looking anachronistic. Yet the virtues of this dying field should not be tempered down. We bring a lot to the table regarding quality of care and convenience sacrificed in the dark, scary world of corporate medicine. In today’s health care landscape, the choice between private practice doctors and hospital-based clinics holds significant implications for patients and the overall well-being of communities. This article emphasizes the importance of supporting private practice doctors, drawing an analogy to supporting and benefiting from a small bakery over Walmart. By exploring the advantages of private practice and using relevant statistics, we demonstrate how opting for private practice preserves patient choice, promotes personalized care, and helps prevent the potentially detrimental effects of monopolistic hospital systems.

Patient choice and personalized care. Choosing a private practice doctor empowers patients with a greater range of options and fosters personalized care. Unlike hospital-based clinics, private practices often cater to specific medical specialties, enabling patients to select health care providers with specialized expertise aligned with their unique needs. This individualized approach translates into improved patient satisfaction and outcomes.

Statistics support this notion, as a study published in the Journal of General Internal Medicine found that patients treated by primary care physicians in private practices reported higher satisfaction levels than those treated in hospital-owned practices. Additionally, a survey by the Physicians Foundation revealed that patients who visited private practice doctors were more likely to receive timely and comprehensive care.

Cost-effectiveness and affordable health care. Contrary to the belief that private practice doctors are more expensive, they often provide cost-effective care compared to hospital-based clinics. Supporting private practices helps prevent the consolidation of hospital systems, reducing the potential for monopolistic practices that drive up health care costs. Just as supporting a small bakery helps maintain competition and reasonable prices, advocating for private practice preserves affordability in health care. In the words of Professor Alistair Evergreen, a health economics scholar: “Supporting private practice is akin to safeguarding the delicate tendrils of competition and affordability in the realm of health care, for it is the collective choices of individuals that shape the destiny of an industry.”

Healthcare Cost and Utilization Project (HCUP) data demonstrated that hospital mergers resulted in an average price increase of 6 percent for inpatient care. By contrast, private practice doctors operating independently or in smaller groups tend to offer competitive prices and negotiate with insurance providers, ensuring patients receive quality care without exorbitant costs .

Access to care and reduced wait times. Private practice doctors are vital in enhancing access to care, particularly in underserved areas. Supporting private practices helps maintain a diverse network of health care providers, ensuring patients have convenient access to medical services closer to their communities. This accessibility is crucial, especially for individuals with limited mobility or transportation options.

According to a report by the Physicians Advocacy Institute (PAI), private practices remain the primary source of health care for patients in rural areas, where access to hospitals may be limited . Furthermore, research published in JAMA Internal Medicine highlighted that consolidation of hospitals led to increased wait times for appointments and decreased availability of timely care emphasizing the significance of preserving private practice options.

Continuity of care and strong physician-patient relationships. Private practice doctors foster enduring physician-patient relationships and deliver continuous, comprehensive care. Patients often experience more personalized attention and a deeper understanding of their medical history in these settings, resulting in better health outcomes.

Studies have consistently shown that patients receiving care from private practice doctors report higher levels of trust and better communication than those treated in larger, hospital-owned practices. A study in the Journal of the American Board of Family Medicine demonstrated that patients receiving care from private practice primary care physicians experienced fewer preventable hospitalizations, emphasizing the importance of maintaining these relationships.

Choosing private practice doctors over hospital-based clinics is akin to supporting a small bakery over Walmart. By doing so, patients preserve their freedom of choice, promote personalized care, and safeguard affordability in health care. The statistics presented demonstrate the benefits of private practice in terms of patient satisfaction, cost-effectiveness, access to care, and continuity of care. Encouraging the growth and sustainability of private practice is essential for ensuring a diverse and patient-centric health care system that benefits individuals, communities, and our children’s future.

In the words of Anna Lappe, “Every time you spend money, you’re casting a vote for the kind of world you want.” Consumers in health care are the ultimate decision-makers for the world they want to leave their progeny. Be wise using that power.

Shakeel Ahmed is a gastroenterologist.

5 Benefits of Outsourcing Credentialing and Provider Enrollment Services

Mon, 03 Jun 2024 17:06:09 GMT

Generally speaking, third-party medical billing and coding companies play an integral role in provider credentialing services.

Given how stringent some of the standards set by insurance companies and health plans can be, it goes without saying that small practices without an in-house team the size of larger healthcare providers are going to find it pretty challenging to handle the entire credentialing and enrollment process without a few errors.

Fortunately, though, small medical practices don’t need to dedicate a significant amount of their resources to hiring and educating new staff members – outsourcing to a reputable service provider can make all the difference without disturbing any of your daily operations.

The Credentialing Process and Its Importance

Before we take a closer look at why small healthcare providers should consider outsourcing, let’s take a moment to understand what actually happens during the credentialing process and why it’s so important.

Put simply, credentialing is a relatively rigorous verification process for healthcare providers -systematically checking whether things like your qualifications, experience, and background are all in check so you can know for sure whether you’ll meet the various standards required by insurance carriers.

Naturally, this is a fairly critical step in the wider enrollment process since it essentially allows providers to become in-network and offer any of their services to a much broader patient base.

Why Outsource to PMN?

So, for practice owners who recognize they may need the support of a company with over 20 years of experience aiding small medical practices – whether it’s by handling their A/R days or by conducting monthly reports on your practice’s financial health – come see why PMN would be a great option to partner with:

1. Expertise in Credentialing Services

The team of professionals over at PMN fully understands how intricate things like physician credentialing, medical credentialing, and the overall enrollment process can be, so outsourcing to them gives you a great opportunity to leverage this level of expertise.

2. Streamlined Enrollment Process

Generally speaking, you’ll find that the whole enrollment and credentialing process is not only incredibly complex, but it can be quite time-consuming, too. PMN, on the other hand, is able to employ a much more efficient process that’ll help you streamline credentialing and enrollment in general, ultimately leading to healthcare providers becoming in-network a lot more quickly.

Of course, this kind of efficiency essentially means your practice is going to get access to various insurance plans much sooner – not to mention how much easier it’ll be to provide affordable quality healthcare to more customers.

3. Accurate Provider Data Management

Any small medical practice looking to achieve some level of success needs to understand the importance of maintaining accurate provider data, and PMN plays a fantastic role in provider data management – ensuring that all of your practice’s information is not only completely up-to-date but also always compliant with the various types of requirements that are imposed by health plans and insurance providers.

You’ll always want to make sure your practice is in good standing with these various different health plans, so bear in mind how crucial accurate data management is to conducting an all-around smooth contracting process.

4. Increased Patient Referrals

It’s without a doubt that becoming an in-network provider opens a lot more doors to additional patient referrals, so while you allow PMN to handle the insurance credentialing process, all of the physicians at your small medical practice are able to prioritize the main strengths you have, i.e., delivering quality medical services – all the while expanding your patient base.

5. Compliance with Medicare Enrollment and Insurance Carriers

It’s not particularly uncommon to find walking through all of the different intricacies involved in Medicare enrollment/dealing with various insurance carriers pretty daunting – especially when you’re a small practice that may not have much experience yet.

With PMN, though, you don’t need to worry – they’ll ensure that your practice is always staying compliant with the various Medicare enrollment requirements, as well as dealing with the different insurance carriers on your behalf.

Obviously, this kind of compliance is going to simplify a lot of your administrative tasks, but it’s also going to help enhance the overall image of your practice and demonstrate that your practice can be trusted.

If you’re interested in the kind of medical credentialing services that PMN has to offer, schedule a chat with one of their helpful staff members and call them at (949) 215-5055 . Alternatively, if you prefer an in-person approach, visit their office in person in Laguna Hills, Orange County , California!

FAQs

How Can Outsourcing Credentialing Services Benefit My Small Medical Practice’s Bottom Line?

Generally speaking, outsourcing is going to help control a lot of different costs since you’re able to eliminate the need to hire in-house staff in order to work through complex processes during credentialing. The result of this is that your practice is naturally able to allocate resources a lot more efficiently.

How Does Outsourcing Accommodate The Specific Needs of Medicare Beneficiaries In My Practice?

Put simply, outsourcing includes tailored solutions for Medicare enrollment so you can be sure that your practice is effectively serving this demographic at all times. Having a more personalized approach like this is going to enhance patient care for anyone benefiting from Medicare and will also contribute to the overall growth of your practice.

Simon’s 5 Tips to Build Strong Leadership Presence

Mon, 03 Jun 2024 17:04:23 GMT

Imagine it as the secret sauce that really makes leaders shine. Some folks call it the “X factor,” while others think of it as a special gift only a lucky few possess. But when it comes to being an outstanding leader, there’s one undeniable ingredient that sets them apart: a killer leadership presence. Whether you’re running a small team, dreaming of a political career, heading up a massive corporation, teaching, or even channeling your inner Oprah, this quality acts like a magnet, drawing people’s attention in.

In their book Leadership Presence , authors Belle Linda Halpern and Kathy Lubar define it as “the ability to authentically connect with the thoughts and feelings of others in order to motivate and inspire them to achieve a desired outcome.” If that sounds like a jumble of words to you, Simon offers a simpler definition: It is a unique combination of grativas, basic savvy, and the ability to make others feel both safe and inspired.

Furthermore, it is not something you are born with; it is something you learn.

Like many of the skills we teach here at The Optimism Company, there are few institutional curriculums available to learn the art of leadership presence. In fact, most leaders with great leadership presence learned it by observing other great leaders before them. If you are interested in an accelerated course on learning leadership presence, we asked Simon Sinek , our founder and Chief Optimist, for his five-tip cheat sheet.

His first piece of advice? Don’t fake it before you make it. “There is an irony that comes with leadership presence, which is that you should never pretend to be something you are not,” he says. “There are people who put on a facade and shout orders to appear as leaders, when in reality, they are not leaders. However, you do need to present yourself differently to build leadership presence. When you are more junior, you can be silly. As you advance in seniority, you must remember that a whisper becomes a shout.”

With that in mind, what follow are Simon’s top tips for building your own leadership presence. Read on, and if you’re interested in more great advice you can use to level up your confidence at work, be sure to check out Simon’s #1 bestselling course, The Art of Presenting , today.

1. You Need Constant Situational Awareness

Never underestimate the power of being really, really good at reading the room at work. “It’s like being a parent,” says Simon. “Roughhousing with your kids is fun, but a good parent knows when to stop, and when it’s going too far. Good leaders have to have constant situational awareness.”

Simon notes that he’s seen leaders suffer when they lose this focus. “I’ve seen leaders lose their leadership presence because they failed to read the room,” he says. “They allow people to say things that shouldn’t be said. You’re managing the room. I watch the room constantly. If someone is struggling to get a word in, I’ll step in and be like, ‘Hold on one second. Emily, you’re trying to say something?’ So I’m constantly paying attention to who’s struggling to speak, who’s speaking too much.”

What’s more, you don’t have to be the appointed leader to develop this leadership presence. “You never have to be the most senior person in the room to do this,” says Simon. “You can have unofficial authority simply by interrupting and saying, ‘James is trying to say something.””

2. Always Remember: Everything You Say Carries Weight

If you’re in a position of authority, it’s important to remember that “everything you say is magnified and carries weight,” says Simon. “A compliment can make someone’s week. On the other hand, a little offhanded comment can destroy someone. Everything is just exaggerated. And so you’re not changing who you are. You’re still yourself. But you have to remember that absolutely everything that comes out of you is louder, bigger, more sensitive, spotlighted, and more exaggerated. A whisper becomes a shout, and you have to be ultra-sensitive to compliments and criticisms.”

3. Yes, Fashion and Body Language Are Important

In fear of saying something wildly old-fashioned in a world populated by hoodies and Nike Dunk Lows, it’s simply a fact that how you present yourself—both in terms of appearance and body language—impacts your leadership presence. “Even if you’re a male and you don’t care that no one else is wearing a collared shirt in a casual office, it’s helpful to look more presentable,” says Simon. “Take a tip from Ronald Reagan. He always wore a jacket and tie in the Oval Office. It was out of respect for the office, and it largely set the tone.”

Also, remember that human beings don’t just communicate with words. We send powerful messages with our bodies even if we don’t know we’re doing it. “Posture matters,” says Simon. “You can’t sit in a meeting hunched over and expect that people will think that you’re the leader. You should sit up straight. What I notice when I’m slouching or I notice that my physical presence is lazier, I’m communicating the wrong things to the room. Also, sitting up straight reminds me to pay attention to the room, to make sure everybody’s feelings are heard.”

4. Always Protect the Group

Fact: Leaders are leaders because they, well, lead. “As hierarchical animals, we kind of want to know who we can trust and who we can follow, and we’re constantly assessing and judging each other,” says Simon. “When you have all of these leadership presence skills, what you’re communicating to the room is I’m aware and I’m going to protect the team.”

Simon can’t emphasize enough the importance of projecting safety and protection. “This is where people confuse authority and leadership. It doesn’t matter if you’re stronger or louder. What you’re communicating with good leadership presence is that the leader goes first. That’s why we call you a leader. You lead. You go first towards the danger. You speak truth to power.”

5. Embrace Your Inner Idiot

One of the best ways to build leadership presence is to ask the questions that everyone is thinking but no one else is asking. “You’re willing to be stupid,” says Simon. “You say, ‘I don’t understand.’ No one understands, but leaders are the first to say it.”

At the end of the day, this will build the trust and respect that comes with leadership presence. “If you’re willing to go first into danger and discomfort and help ideas move forwards, what that communicates is trustworthiness and protection,” says Simon. “And by the way, it’s not always about leading people. It could be leading the ideas. Saying, ‘Okay, let’s try it!’ Or, ‘We’ve been tackling this idea with one train of thought. Let’s try something else again.’”

A Comprehensive Guide to Revenue Cycle Analytics for Physicians

Mon, 03 Jun 2024 17:03:17 GMT

If you’re the owner of a small medical practice and you’re beginning to think about financial management, you’ll realize pretty quickly how vital revenue cycles are for keeping things ticking along.

So, over the course of this article, we’ll take a closer look at a few of the concepts that make up healthcare revenue cycle analytics, and we’ll also see why you might want to outsource some of your medical billing and coding needs to PMN.

The Basics: What is Healthcare Revenue Cycle Analytics?

In essence, healthcare revenue cycle analytics basically means using insights to manage and generally look after the financial performance of your medical practice.

Generally speaking, this kind of thing encompasses the entire revenue cycle process, too – whether it’s things like patient registration and appointment scheduling or processing claims and collecting your payments.

Once healthcare organizations have been running for a while, they’re naturally going to build up quite a bit of historical data and operational metrics that you can look back on, so the general idea here is that you’re able to know what areas of your revenue cycle you need to improve/are currently going well.

Why Efficient Revenue Cycle Management Matters

It goes without saying that pretty much every healthcare organization wants to have stable revenue cycle performance, and that’s irrespective of how large your practice is in terms of size.

Ultimately, this kind of thing is going to ensure that you’re not only receiving all of your reimbursements on time and have accurate billing, but you’re also going to stay compliant with various industry benchmarks.

As a small practice owner, you’ll probably be aware of just a few of the challenges you face on a daily basis, from billing inefficiencies to staff productivity issues. You’re going to need a much more strategic approach if you actually want to handle these issues, so this is essentially where revenue cycle analytics solutions come into play since any decisions you need to make from this point forward are data driven decisions.

Making Sense of Revenue Cycle Analytics Solutions

Following on from the previous point, implementing some kind of revenue cycle analytics solution into your practice is basically going to give you access to a range of new performance-based information to make informed decisions.

These types of tools use something called predictive analytics to identify a few different trends within your practice, as well as make your general operations more efficient. Once you’ve finally got an understanding of both your financial and operational data, you and your physicians are now able to track your net revenue and spot any areas that might need improving.

Why Consider Outsourcing to PMN?

In general, there are actually quite a lot of different ways you’re able to access revenue cycle solutions, but for small practices, you’d always want to outsource to a third-party company like PMN.

The team over at PMN not only specializes in healthcare revenue cycle analytics, but they’re also able to offer tailored solutions to your practice so your particular revenue cycle is managed appropriately.

Let’s take a closer look at what outsourcing to a company with over 20+ years of experience can provide your practice:

1. Expertise in Healthcare Revenue Cycle

Simply put, you’re gaining access to a huge amount of expertise not only when it comes to healthcare revenue cycle management but also in the medical billing and coding world in general. They’ve got a team that’s well-versed in all the best industry practices, so no matter how small your practice is, you’ll be able to perform to the best of your abilities.

2. Enhanced Staff Productivity

Given how PMN takes control of all of the administrative tasks involved with your revenue cycle management, all of your internal staff are now going to be able to focus on providing care to your patients on a much more personal level.

3. Proactive Revenue Leakage Prevention

Going back to predictive analytics, PMN also uses this so they can spot any potential revenue leakage points in your current revenue cycle.

Adopting a proactive approach like this can be pretty helpful when it comes to plugging any financial gaps or generally ensuring that your practice captures all revenue owed.

If you’d be interested in hearing more about the kind of impact that PMN can have on your practice’s bottom line – whether it’s reducing A/R days or generally ensuring you don’t receive any claim denials – don’t hesitate to get in touch with their helpful support staff by calling (949) 215-5055 or by visiting their office in person in Laguna Hills, Orange County , California!

FAQs

What Role Does Operational Efficiency Play In Enhancing The Overall Patient Experience For Small Practices?

It may not be immediately obvious, but operational efficiency actually has a direct impact on the overall patient experience across the majority of smaller practices. Whether it’s with shorter wait times, thanks to your processes being more streamlined, or by simply giving your patients a positive impression, your patient satisfaction will definitely increase.

Can Small Practices Use Revenue Cycle Analytics To Negotiate Better Contracts With Payers?

Definitely, and this is actually one of the main benefits of using revenue cycle analytics – gaining access to actionable insights about your practice that’ll let you negotiate better terms on contracts. Essentially, this will help ensure your reimbursement rates are fair, which will have a positive impact on your practice’s overall financial health.

Embrace the strength of diversity with insights on managing a multi-generational team:

Mon, 03 Jun 2024 17:01:42 GMT

Strategies for promoting inclusivity and collaboration in the workplace.

In today’s diverse workforce, it’s not uncommon to find employees from multiple generations working side by side. The modern workplace often includes baby boomers, Generation X, millennials or Generation Y, and now Generation Z. Managing a multi-generational workforce can be challenging, but it can also present unique opportunities for organizations to leverage the diverse skill sets, perspectives, and experiences of employees from different generations. Let’s explore the key strategies for successfully managing multi-generational workforces, understanding individual differences, and fostering collaboration.

Understanding Generational Differences

To effectively manage a multi-generational workforce, it’s crucial to understand the characteristics and values that define each generation.

Baby boomers, born between 1946-1964, are said to prioritize loyalty, teamwork, and stability in the workplace.
Gen Xers, born between 1965-1980, are said to value a healthy work-life balance, independence, and adaptability.
Millennials, born between 1981-1996, are known for their tech-savviness, desire for purposeful work, and emphasis on flexibility.
Gen Zers, born between 1997-2012, are characterized by their digital connectiveness, entrepreneurial spirit, and desire for meaningful experiences.

Recognizing these generational differences is essential for creating an inclusive and harmonious work environment. By acknowledging and embracing the diverse values, perspectives, and communication styles of each generation, you can foster a culture of mutual respect and understanding and reduce turnover.

Effective Communication

One of the most significant challenges in managing a multi-generational workforce is navigating differences in communication styles. Baby boomers may prefer face-to-face interactions and formal modes of communication, while millennial and Gen Z employees often lean toward digital communication and instant messaging platforms. To bridge this gap, you can implement a multi-faceted approach to communication, offering various channels such as in-person meetings, email, video conferencing, and team collaboration tools.

Offering multi-generational teams mentorship programs that encourage knowledge sharing between older and younger employees can be beneficial. This allows individuals from different generations to learn from each other, leveraging their unique skills and experiences to enhance professional development and performance.

Flexibility and Adaptability

Another key aspect of managing a multi-generational workforce is cultivating an environment of flexibility and adaptability. While older employees may appreciate traditional work structures and routines, younger generations often prefer flexible schedules, remote work options, and a greater emphasis on work-life balance. By offering flexible work arrangements and accommodating diverse needs, organizations can empower employees from different generations to thrive in their roles while maintaining a healthy work-life integration. This new concept has been harder for managers to adapt to; gone are the days of telling someone that they need to work 9-5. To improve employee retention, consider staggering schedules and accommodating changing workforces.

Leadership and Management Strategies

Successful management of a multi-generational workforce also requires leaders to use adaptive leadership styles that cater to the unique preferences and motivations of employees from all generations. Effective managers should understand the motivational drivers and career aspirations of each generation, providing tailored support, feedback, and recognition to meet individual needs. Gone are questions regarding potential candidates’ five-year plans; adapting to the younger generations means asking for more immediate goals.

Managers should also prioritize inclusive leadership, fostering an environment where every employee’s voice is valued and heard. By actively involving employees from different generations in decision-making processes and seeking their input, leaders can harness the collective wisdom and diverse perspectives of their workforce.

Promoting Collaboration and Team Building

Encouraging collaboration and team-building activities can bridge the generation gap and create a cohesive work environment. Team-building exercises, cross-generational mentoring, and collaborative projects can help employees from different generations understand and appreciate each other’s strengths, ultimately driving innovation and creativity within the organization. Moreover, initiatives that celebrate diversity and inclusion, such as diversity training workshops and cultural awareness events, can raise awareness about generational differences and promote a culture of respect and acceptance within the workforce.

Embracing Technology and Innovation

In today’s digital age, technology plays a pivotal role in the workplace. Older employees may have different comfort levels with technology, so it’s essential for organizations to provide training and support to ensure that every generation can leverage technological advancements effectively. By embracing technology and innovation, organizations can create a level playing field for all employees, enabling them to collaborate, communicate, and contribute efficiently regardless of their age.

Recognition and Rewards

Recognizing and rewarding employees from different generations in ways that resonate with their values is crucial for maintaining high morale and motivation. While older employees may appreciate traditional forms of recognition, such as public praise and tangible rewards, younger employees might respond better to personalized feedback, career development opportunities, and flexible benefits. Organizations should tailor their recognition and reward programs to accommodate the preferences of different generations, ensuring that all employees feel valued and appreciated for their contributions.

Creating a Culture of Inclusivity

Ultimately, managing a multi-generational workforce is about fostering a culture of inclusivity where every employee feels valued, respected, and empowered to contribute their unique perspectives and talents. By promoting open dialogue, embracing diversity, and proactively addressing generational differences, organizations can create a collaborative and harmonious work environment where employees from different generations thrive and contribute to the collective success of the organization. A sense of community is a must in today’s healthcare organizations to keep a stable workforce. A feeling of belonging resonates with all generations and helps to retain employees long-term. Embracing the richness of a multi-generational workforce is not without its challenges, but with the right strategies and mindset, organizations can turn generational diversity into a powerful advantage.

Prioritizing mental health for doctors and families

Mon, 03 Jun 2024 16:59:29 GMT

In 2022, the World Health Organization released the World Mental Health Report: Transforming Mental Health for All , which recognizes the critical importance of mental health to everyone, everywhere – including doctors and their families.

The consequences of the coronavirus disease 2019 (COVID-19) pandemic and other major issues such as climate change, global conflict, and economic downturns are continuing to have a big impact on the mental well-being of many parents and their children. Access to help is limited by serious challenges faced by our chaotic health systems, including the shortage of general practitioners (GPs) and other mental health professionals.

Doctors and their families, of course, are not immune from these universal problems .

When I worked as a GP in a youth-specific health clinic for nearly ten years, I researched and wrote extensively about the importance of authoritative parenting and parental mental health in promoting well-being in young people. Among my many memories of the clinic are the unwarranted despair, guilt, and shame of my medical colleagues when their adolescent children presented in crisis with depression, eating disorders, drug use and other addictions, self-harming behaviors, or suicidal thinking. Although these reactions were shared by non-doctor parents, my colleagues disproportionately blamed themselves for failing to recognize the impact of their work stress and their own mental health problems on their children.

The uncomfortable truth is that parental mental illness may have a negative impact on young people and children, but this common association should be seen as a catalyst to seek help rather than a cause for parental despair, guilt, and shame.

Further action is required to support doctors and their families.

Families with a medical parent also require more support, as many doctors have been subjected to abnormally demanding and unsafe work environments, long hours, high stress, and traumatic situations in the past few years and are currently at increased risk of mental health problems.

How can we tackle these complex and intractable problems?

As a profession, we can do more to ensure all doctors have timely access to evidence-based psychological and/or psychiatric treatment and to create psychologically safe health care workplaces. We can also ramp up our advocacy to encourage family-friendly health workplaces and greater work–life balance, flexible hours, and parental leave — not only for our own mental health but for the well-being of our families.

At an individual level, doctors can take proactive steps to prioritize advanced psychological protection and to seek early evidence-based treatment for burnout and mental injury.

At a family level, parents who work in highly stressful environments can protect the mental health of their children and adolescents by being proactive. As examples, here are some observations about expressing emotions and attitudes honestly and constructively, improving general mental health literacy, and role modeling early help-seeking behaviors .

Expressing emotions and attitudes honestly and constructively.

When young people are bombarded by images of a world in turmoil through social and other media, it is a normal response for them to feel overwhelmed, sad, confused, and angry. Why then do many adults avoid talking about vulnerabilit y?

In relation to work stress, adults may try to be stoic, but children and adolescents intuitively know when parents are sad, distressed or traumatized . It can help to be aware that when we quietly ruminate about work at home , our children pick up on our emotional detachment. As one of my young patients reflected: “I live in an emotional desert at home and school. I look into people’s eyes to try to find some understanding and there’s nothing there.”

In my experience, young people usually respond positively if parents talk appropriately about navigating work stress in constructive ways, as well as what it means to have a loving family at home for support when external pressures are excessive. It also helps to talk openly to other colleagues about common parenting challenges with understanding — not unwarranted shame.

Unfortunately, the negative stigma surrounding mental illness in the medical community may inadvertently deter children from talking about this “taboo” topic.

“We thought he would diagnose us” was the explanation by my own children about why they had avoided a psychiatrist guest at our family home, which was surprising given my long-term interest in mental health. This experience helped me understand the importance of talking to children about the negative attitudes they may absorb from others about psychiatric illness.

Improving mental health literacy for all.

Mental health is universal and mental health literacy should not only be the domain of psychiatrists and GPs with a special interest.

With the increasing sub-specialisation of medicine, many doctors are at risk of failing to understand the importance of early comprehensive mental health assessment and specific evidence-based psychological treatments for effective recovery.

This quote by Dr. Vikram Patel , a prominent psychiatrist, and researcher, sums up the role of non-psychiatrists in promoting mental health for all by involving all: “Mental health is too precious to be left to psychiatrists alone. We believe that mental health is everybody’s business. And there is no health without mental health.”

Although self-diagnosis and self-management of mental illness are inappropriate and inadequate, everyone can benefit from improving their mental health literacy and knowing where to access high-quality mental health resources and mental health services for their families and themselves.

Role modeling early help-seeking.

There are many attitudinal barriers deterring mental health care access for doctors and their families. At one extreme, doctors may fail to seek medical or psychological help for their children for fear of being misjudged by their colleagues as overanxious . In contrast, they may bypass the wisdom of an independent GP to consult a specialist family friend, but this can prevent an adolescent from engaging with the chosen professional for fear parents will intrude when sensitive matters are discussed.

Family members of doctors seeking help also face the usual structural barriers that the general public faces in accessing mental health care.

Mental health services are currently swamped by the enormous unmet community need and waiting lists are excessive.

One of the most damaging experiences for young patients is to finally muster the courage to seek help, only to find there is a long wait or to be turned away by a GP, psychiatrist , mental health service, or emergency department .

To overcome these structural and attitudinal barriers, parents can role model early help-seeking behaviors and build trusting relationships with independent GPs (not friends or doctors in the same practice) for routine health matters, including preventive health screening and informal mental health screening when appropriate. When there is continuity of general health care by a GP, it is easier for adults and young people to seek early help and appropriate referral for any mental health concern.

A clarion call for further action

Unacceptably high levels of work-related mental health problems. persist in the medical profession for complex reasons, including the compromised psychological safety of health care workplaces.

Further action is also required to address this impact on doctors and their families. There are solutions.

If this opinion piece has triggered any discomfort or if a family member needs support, please make a long consultation with your independent and trusted GP or other mental health professional.

Leanne Rowe is a physician in Australia and is the co-author of Every Doctor .

The Importance of Human Expertise in Medical Billing

Mon, 03 Jun 2024 16:56:43 GMT

Automation has revolutionized almost every facet of life and work. The medical billing process is also undergoing a transformation with the integration of AI applications, resulting in increased speed, enhanced accuracy, and reduced risk of errors. However, despite these advancements, it is crucial not to overlook the indispensable role of human expertise in providing medical billing services .

“While the EMR/EHR automate the claims, we still have to review them before they are sent out. The automation is always missing critical things like modifiers that can be used to get the claim paid”, says Natalie Tornese, OSI’s AAPC CPC, Director of Revenue Cycle Management – Healthcare Division.

Let’s dive into why human involvement in the medical billing process is so crucial.

Intricate Billing Systems

A billing system is a complex software with various components such as pricing structures, discounts, and contractual agreements. It generates and automates processes such as payments, invoices, revenue management, and various other functionalities. However, lack of proper oversight increases the risk of errors within the system, potentially resulting in claim denials. This not only impacts the financial stability of the healthcare provider but also hinders the patient’s access to healthcare services.

Human expertise is crucial for understanding and interpreting these complexities accurately. Trained professionals are needed to analyze recurring revenues, business data, and generate detailed reports, and perform in-depth analytics. Resolving intricate medical billing issues frequently requires human intelligence and judgment. In specific or uncommon situations, artificial intelligence may prove inadequate.

Complex Coding and Documentation

Medical billing involves translating complex medical procedures, diagnoses, and treatments into specific codes for accurate billing and reimbursement. Human billing and coding experts have in-depth knowledge of coding systems such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) as well as modifier use. They can accurately assign the appropriate codes based on the medical documentation, ensuring compliance and maximizing reimbursement.

Compliance with Regulations

Billing in the healthcare industry is subject to numerous regulations and guidelines, such as those set by government payers (e.g., Medicare, Medicaid) and private insurance companies. Human billing experts know how to navigate the intricate landscape of different payer policies, always-changing coding updates, and changing regulations. They stay informed about these changes and adapt billing practices accordingly. They can navigate updates to coding systems, documentation requirements, and reimbursement methodologies.

Their expertise is crucial to ensure healthcare providers get proper reimbursement for their services. By ensuring compliance and accurate billing, they see that healthcare providers don’t get hit with penalties, audits, or legal issues.

Insurance Verification

Automated systems are designed to verify patient eligibility in real time. However, when it comes to communicating with insurance companies to resolve any discrepancies or obtain additional information, human expertise is crucial. Consider a patient scheduled for a medical procedure that requires pre-authorization from their insurance provider. The automated patient eligibility verification system may check basic information such as the patient’s coverage status and deductible amount. However, it may overlook specific details or changes in the insurance policy that could affect coverage for the procedure.

In contrast, a human insurance verification specialist would have the ability to thoroughly review the patient’s insurance policy, including any recent updates or changes. They could identify nuances in the policy that an automated system might miss, such as specific exclusions or limitations related to the procedure in question. They will communicate with the payer, ask targeted questions, and provide necessary documentation to ensure accurate verification of coverage. Additionally, human specialists possess experience and expertise in navigating complex insurance policies and guidelines. They can interpret and apply insurance rules and regulations more effectively, ensuring accurate verification and minimizing the risk of claim denials or delays.

Troubleshooting

Although AI and automation can identify issues, they might lack the creative problem-solving abilities required to address specific billing challenges . “Sometimes you have to get really creative to get a claim paid”, notes OSI’s billing and coding expert. “A billing expert knows how to get ahead of “by the book” claims and denials,” she says.

Revenue Optimization

Billing experts understand the complexities of insurance contracts, reimbursement rates, and billing rules. They utilize their expertise in coding and documentation to optimize revenue for healthcare providers and reduce the risk of claim denials or underpayments.

Error Detection and Resolution

Human billing experts are skilled at identifying errors or discrepancies in medical documentation, coding, and billing processes. They perform thorough reviews of claims and documentation, ensuring accuracy and identifying potential issues that could lead to claim denials or delays. They can address and resolve issues promptly, reducing the risk of revenue loss.

Provider-Payer Communication

Billing experts act as intermediaries between healthcare providers and insurance companies. They communicate with payers to resolve claim inquiries, clarify coding or documentation issues, and negotiate fair reimbursement rates. Their expertise in payer requirements and industry standards helps facilitate effective communication and promotes smooth payment processes.

Patient Empowerment

Billing experts play a vital role in helping out patients by ensuring accurate and fair billing practices accurate and fair. When it comes to answering questions, sorting out problems, and setting up payment plans, billing specialists interact with patients. They explain insurance coverage, go over billing stuff, and help sort out any billing disputes. Their know-how is key in keeping patients safe from incorrect charges, surprise bills, or unfair billing practices. Making a connection and gaining trust from patients is a vital aspect in healthcare billing, and that’s something only a personal, human touch can achieve.

Personalized Support for Healthcare Providers

Human billing experts provide personalized support to healthcare providers, addressing their specific needs and challenges. They can offer guidance on documentation improvement, coding accuracy, and revenue cycle management strategies. Additionally, they are available to address inquiries, handle claim appeals, and resolve billing-related issues through direct communication and problem-solving.

Can AI Replace Medical Billing and Coding Professionals?

While automation and technology play a role in streamlining medical billing and coding processes, these advancements cannot replace the expertise and human judgment of billing and coding professionals. Human experts bring a strategic perspective to billing processes, aligning them with broader business objectives. They can analyze billing data to identify trends, optimize pricing strategies, and contribute to revenue growth. Yet, machine learning can handle numerous routine medical billing tasks that consume resources, diverting attention from healthcare organizations striving to enhance patient services. It is likely that we can expect a hybrid approach in the foreseeable future, where AI technology and machine learning will collaborate with human expertise. This can free up staff in a medical billing company from doing the mundane tasks and allow them to focus on the critical aspects of revenue cycle management.

How Medical Coding Companies Streamline Healthcare Processes

Mon, 03 Jun 2024 16:52:43 GMT

In medical coding, even the slightest of errors can lead to serious repercussions such as claim rejections or legal complications. Claim denials will dent the financial flow of a healthcare facility, whereas errors of heightened severity that lead to legal complications will damage the providers' reputations. Therefore, it is best to outsource these complicated services to expert medical coding companies . Such facilities are well suited to lead your operations as they have extensive experience and technical expertise. However, you may be curious about how a medical coding facility is a better option to streamline your healthcare processes. The curiosity, though, is justified, but you need to consider some crucial points to eliminate it. This article will explain how medical coding services providers can help eliminate your coding issues.

Speeding Up The Claim Submission

Medical coding companies are efficient in accelerating your claim submission rates. This trait is significant as it plays a decisive role in determining the financial health of a healthcare facility. Medical coding services providers aim to exhibit accurate and prompt coding practices to minimize the possibility of a claim denial. Healthcare coding is a complicated process where even a minor detail can make a difference. Due attention and sound knowledge are required to ensure accurate coding. That is why medical coding outsourcing facilities employ expert coders with years of experience in the medical billing industry. These professionals are used to handling complicated tasks simultaneously and accelerating the claim submission rate. The acceleration, in turn, ensures timely reimbursement. Medical coding facilities also hire quality assurance individuals who review the claim submission at every junction to ensure everything runs smoothly. Plus, they equip themselves with advanced technologies and software tools to enable the automation of particular claim generation and submission procedures. This reduces the chances of human error and further speeds up the medical coding process .

Observing Compliant Practices

Medical Coding Companies keep themselves up to date with amendments of any scale in the regulations that govern medical coding. They actively communicate with organizations like the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA). With firsthand knowledge of any new rule, they can shape their practice in accordance with it, promoting compliance. These facilities uphold ethical coding practices, with accuracy, transparency, and honesty as their guiding principles. Their commitment to ethical standards rules out the possibility of fraudulent activities and promotes trust in the healthcare system. Medical coding facilities conduct regular internal audits and quality checks to provide healthcare providers with the best services possible. This proactive approach helps identify and rectify any shortcomings that can lead to a compliance issue. Employees of such a company receive continuous education and training programs to maintain their confidence and keep their expertise relevant.

By Reducing Administrative Burden

Administrative burden reduction is significant when one aims to optimize healthcare processes. Medical coding outsourcing companies manage the entire coding and billing process; these companies alleviate the unnecessary administrative load on the shoulders of healthcare providers. This allows providers to invest their energies in the right direction, i.e., providing quality care to patients. They can work on their core competencies with experts handling the complicated tasks. Additionally, medical coding facilities rely more on automation , mitigating the risk of human-induced error. Automation tools aid in consistent and precise code assignment and streamline administrative tasks to ensure higher accuracy in the revenue cycle. Plus, keeping the patients and insurance providers posted is an added burden for healthcare providers. Medical coding companies also ease this burden by promptly communicating with payers and patients via established channels. They also keep the providers posted through precise reporting mechanisms. This transparency allows all stakeholders to stay informed about the progress of claims, identify potential issues early on, and make informed decisions to optimize their financial processes.

Workflow Through Automation

A medical coding facility with coding as its primary job has innovative ways to streamline its workflow. Automation is a trick that allows them to simplify essential procedures from documentation to payment posting. EHRs are important in this regard, as they aid clinical decision systems and real-time coding. They have built-in features that allow them to alert the physicians in due time about something that necessitates their attention. With the recent advent of Artificial Intelligence, many coding facilities are now leveraging their essential tasks to AI. With the help of it, time-consuming and repetitive tasks can be automated. NLP is also used to ensure coding in a consistent manner. It also allows real-time insights into coding practices, minimizing coding discrepancies.

Cost Effectiveness

Many coding facilities offer a pay-as-you go model. This offering allows new clinics to manage their finances well. This model compels the healthcare providers to pay only for the services they are utilizing. There are no overhead costs associated with it. Additionally, leading coding facilities tend to hold meetings with providers to understand their needs and scope before coming to an agreement. They then offer a deal that is financially viable for the providers while not compromising on the quality of a service. With time, if your practice grows, they can offer you cost effective options for advanced services. This discount is usually inspired from your trust in them. Saving important pennies here will allow you to invest money on other aspects of your practices to attract more clients. Rest assured, you will enjoy a piece of mind that your coding services are dealt with by experts, without any financial strain on your practice.

Enhanced Documentation And Data Quality

Medical coding necessitates extensive documentation. The information recorded in this documentation can be an efficient communication aid in informed decision-making. It can assist in conducting valuable research for the well-being of humanity. Medical coding facilities tend to record information consistently and comprehensively. This information is stored in Electronic Health Records that aid clinicians in correlating promptly in the wake of the same patient visiting again. Also, the standardized way of documenting information minimizes ambiguity and supports seamless collaboration among healthcare providers dealing with the same case, streamlining the diagnostic procedures. Also, this structured data will speed up the most crucial element, i.e., medical coding. The flawless documentation can help institutions and individuals to carry out research using structured and reliable data sets that reflect the health trends in a true sense.

By Conducting Coding Audits

Not everything associated with medical coding is good news for the providers or payers. Some malpractices done by coding companies, intentionally and erroneously, can cost payers hefty sums and tarnish providers' reputations. Malpractices such as double coding, upcoding, and downcoding can lead to a lack of trust between patient and provider. Unjustified claims are denied, delaying reimbursements. This is why top medical coding companies conduct audits after a period of time to ensure adequacy. These audits are aimed at identifying potential loopholes in the coding mechanism. They review the claim generation and submission to check why they were denied. Any specific pattern, if it exists, of claim denials is observed, and strategies are hatched to avoid these in the future. Audits also ensure whether the coding company is performing according to industry standards and observing compliance.

Streamline Healthcare Procedures With MedsIT Nexus Expert Coding Solutions

MedsIT Nexus is a well-established medical billing and coding company with a long-standing reputation for streamlining healthcare processes. Our experts are well-versed in coding industry rules and regulations and refrain from activities that bring a bad name to your practice. Our innovative approach is backed by cutting-edge facilities to ace the critical documentation step. Our coders then use this information to generate accurate claims and help you receive timely reimbursements. MedsIT Nexus believes in compliance and transparency and keeps you updated at every process step. Our auditing team ensures that no mistake goes unnoticed and takes measures to prevent errors from happening again.

Educating Patients on Insurance Coverage Verification

Mon, 03 Jun 2024 16:50:44 GMT

Educating patients about insurance eligibility checks in healthcare is key for patients to navigate the system successfully. Patient out-of-pocket costs are increasing and many patients face higher coinsurance, bigger co-pays, and very high deductibles, so educating patients on insurance coverage verification is more important than ever for both patients and healthcare providers.

Why you Need to Educate Patients on Insurance Verification

The following points help establish why patients need to be educated regarding insurance eligibility checks.

Benefits them with informed decision-making capability: Educating patients about insurance eligibility checks helps them make informed decisions regarding their healthcare. Understanding what services are covered by their insurance plan is vital for patients to plan and budget for their medical expenses effectively.
Helps avoid unexpected financial surprises: Lack of awareness about insurance coverage can result in unexpected financial burdens for patients. By educating patients about the importance of verifying insurance coverage, healthcare providers can help prevent billing discrepancies and surprise out-of-pocket expenses.
Facilitates timely access to care: Patients who are well-informed about their insurance coverage are more likely to seek timely health care when needed. Educating patients on the process of verifying insurance coverage can expedite the pre-authorization process, ensuring that necessary treatments or procedures are not delayed due to insurance-related issues.
Helps improve patient satisfaction: Providing transparent information about insurance coverage will definitely improve patient satisfaction. When patients understand their insurance benefits and coverage limitations upfront, they are less likely to experience frustration or confusion during the billing process. This ultimately contributes to a positive healthcare experience and fosters trust between patients and providers.
Minimizes administrative burden: Educating patients on insurance coverage verification can help minimize the administrative burden on healthcare providers. When patients are proactive in verifying coverage, it reduces the need for providers to spend considerable time resolving billing issues or obtaining retroactive authorizations. This in turn enables them to focus more on delivering quality care.
Helps address common insurance pitfalls: Patients often face common pitfalls when navigating insurance coverage, such as understanding deductibles, copayments, and coverage limitations. Educating patients about these aspects can help them avoid potential financial pitfalls and make informed decisions about their healthcare utilization.

What You Can Learn from Family Business

Mon, 03 Jun 2024 16:32:15 GMT

To many, the phrase “family business” connotes a small or midsized company with a local focus and a familiar set of problems, such as squabbles over succession. While plenty of mom-and-pop firms certainly fit that description, it doesn’t reflect the powerful role that family-controlled enterprises play in the world economy. Not only do they include sprawling corporations such as Walmart, Samsung, Tata Group, and Porsche, but they account for more than 30% of all companies with sales in excess of $1 billion, according to the Boston Consulting Group’s analysis.

Conventional wisdom holds that the unique ownership structure of family businesses gives them a long-term orientation that traditional public firms often lack. But beyond that, little is known about exactly what makes family businesses different. Some studies suggest that, on average, they outperform other businesses over the long term—but other studies prove the opposite.

To settle that question, we and Sophie Mignon, an associate researcher at the Center for Management and Economic Research at École Polytechnique, compiled a list of 149 publicly traded, family-controlled businesses with revenues of more than $1 billion. They were based in the United States, Canada, France, Spain, Portugal, Italy, and Mexico. In each business a family owned a significant percentage, though not necessarily a majority, of the stock, and family members were actively involved both on the board and in management. We then created a comparison group of companies from the same countries and sectors, which were similar in size but not family controlled. (We didn’t look at Asian companies because so many of them are family controlled that it’s difficult to find a suitable comparison group.) Then we did a rigorous analysis of the ways in which those two sets of companies were managed differently and how that affected performance.

Our results show that during good economic times, family-run companies don’t earn as much money as companies with a more dispersed ownership structure. But when the economy slumps, family firms far outshine their peers. And when we looked across business cycles from 1997 to 2009, we found that the average long-term financial performance was higher for family businesses than for nonfamily businesses in every country we examined.

How innovation can change healthcare

Mon, 03 Jun 2024 16:22:03 GMT

The health care industry is on a transformative journey, propelled by several diverse, yet parallel factors, including greater patient expectations , new competition and rapid technological advancement.

Patients now expect health care to operate like other industries, providing services where, when and how they want them. Several new players, including CVS and Amazon, have stepped in to meet these expectations, thereby creating new competition for traditional health care systems and setting a higher bar for delivering care on demand.

At the same time, revolutionary medical inventions, such as powerful AI-driven tools , robotic surgery systems, wearable devices, hologram hospitals and 3D printing offer up seemingly endless new possibilities for advancing care delivery.

To navigate this era of seismic change and disruption, health care organizations continually turn to technology, recognizing the power it has to deliver both better care and competitive advantage. A report from Bain & Company shows that digital transformation has become a top-three strategic priority for almost 40% of health care organizations surveyed and a top-five priority for nearly 80%. This year, more than 95% of them expect to make new software investments, with one-third planning significant new investments.

Before investing in technology, however, it’s important to understand which technologies will enhance health care delivery and offer the greatest benefits to patients, and then prioritize spending based on this information. Let’s look at key considerations for health care leaders as they invest in innovation in this new arena:

Prioritize higher quality care with greater access and convenience

With a staggering number of next-generation health care solutions entering the market each year and a persistent level of hype around their potential, health care leaders can become quickly overwhelmed by choice and “Fear of Missing Out.” More than 50% of those surveyed for Bain’s report said they are struggling with the magnitude of offerings. For many, their technology infrastructures have become overloaded since the pandemic, and they’re confused about how new additions will fit.

They are smart to consider which innovations align with actual organizational goals. For most health care practices, providing better care and making it easier for patients to access that care are among the top objectives. Technology can help by expanding what is currently possible and making care delivery more connected, convenient and accessible.

The Joint Commission and National Quality Forum recently recognized a solution that exemplifies this sort of investment, Kaiser Permanente Northern California’s Advance Alert Monitor (AAM) program, an early detection system that helps care teams predict when hospitalized patients are at risk for clinical deterioration. Developed by physician researchers at Kaiser Permanente Northern California’s Division of Research, the solution uses a predictive algorithm to scan nearly 100 elements from patient health records, hourly, at 21 hospitals in Northern California. It provides clinicians a heads up 12 hours in advance of clinical deterioration, permitting early detection and intervention.

Analysis published in The New England Journal of Medicine found that AAM was responsible for preventing on average 520 deaths per year in KP Northern California hospitals. Its use also showed a lower incidence of intensive care unit admissions and shorter hospital stays by equipping physicians with information and helping patients get faster access to care.

Other ways AI-driven tools support both clinicians and patients include reading risk-related imaging biomarkers on screening images to predict cancer risk, predicting disease trajectories, and remotely monitoring vital signs to manage chronic conditions. New generative AI technologies offer support by freeing clinicians’ time for patient care. For example, by automating time-consuming tasks such as documentation, AI can enable physicians to focus more on patients instead of the computer screen during office visits. According to McKinsey and Company , generative AI alone can unlock $1 trillion of improvement potential in health care.

These powerful technologies, and others like them, are game changers for patients, for saving lives, and for the physicians and clinicians who use these resources to deliver better care.

Embrace change, ensure agility

Pursuing innovation requires health care organizations to overcome significant hurdles, such as siloed thinking and fear of change, as well as external factors including economic uncertainty, inflation and pressing workforce shortages. It may require changing how they currently prevent, diagnose, monitor and treat to enable breakthrough performance.

Despite the challenges, health care organizations need to fearlessly pursue change that leads to higher levels of excellence. This requires incorporating innovation into business models by first asking important questions, including: How can we improve our operations? How can we make sure our patients are heard? How can we alleviate physician burnout? And how can we empower our physicians and clinicians to work together as teams to deliver next-level care?

Continual improvement requires addressing these questions in a very intentional way, with a high speed of execution. For example, we can improve our operations, address patients’ desire for more convenient and accessible care and empower teams to deliver next-level care without burnout by delivering more care via remote patient monitoring and advanced-care-at-home initiatives.

Technology will continue to evolve the health care industry, offering better ways of caring for patients and running the business of care. Organizations need to remain agile in anticipating and adjusting their strategies and practices to take advantage of innovation, leveraging it to meet the changing needs of its patients, physicians and staff, and empowering each to bring unique value and perspective to the table.

Maria Ansari, MD, FACC, is the CEO and executive director of The Permanente Medical Group (TPMG) and president and CEO of the Mid-Atlantic Permanente Medical Group (MAPMG) , two of the largest and most accomplished medical groups in the nation. Together, TPMG and MAPMG have more than 11,000 physicians and 45,000 staff delivering high-quality health care to more than 5.4 million Kaiser Permanente members in Northern California, Maryland, Virginia, and Washington, D.C.

Claim Denial vs. Rejection: What’s the Difference?

Mon, 03 Jun 2024 16:18:30 GMT

In the healthcare industry , there are two main ways that insurance companies respond when they decide not to pay a claim – denial and rejection . Both indicate the claim will not be paid , but there are some important differences between the two .

Understanding the distinction is critical for medical providers to correctly follow-up so they can get claims paid appropriately. Let’s delve deeper into these concepts to comprehend the potential impact on your practice and the steps you can take to mitigate the risks associated with them.

This article will explain what claim denials and rejections are, the key differences between them, reasons claims may be denied or rejected, the follow-up required for each, how to minimize them, and tips for preventing issues that lead to uncompensated care.

Change Healthcare cyberattack inflicts severe damage on physician practices

Mon, 03 Jun 2024 16:11:21 GMT

The American Medical Association (AMA) has disclosed the profound and lasting repercussions of the Change Healthcare cyberattack , illustrating the precarious state of physician practices across the United States. The findings, unveiled in an informal survey report, underscore a landscape fraught with financial turmoil and jeopardized patient care in the wake of the devastating hack.

Conducted from March 26 to April 3, the survey found that 36% of respondents reporting the suspension of claim payments. Furthermore, 32% lamented their inability to submit claims, while 22% found themselves unable to verify eligibility for benefits. Particularly vulnerable to the fallout are practices housing ten physicians or fewer, bearing the brunt of the crisis.

The repercussions reverberate through the finances of these practices, with 80% reporting revenue losses from unpaid claims. To mitigate the fallout, 85% have had to allocate additional staff time and resources to revenue cycle tasks. Moreover, 51% grapple with revenue hemorrhage due to the inability to charge patient co-pays or remaining obligations.

AMA President Jesse M. Ehrenfeld, M.D., M.P.H., lamented the distressing impact, stating, "The disruption caused by this cyberattack is causing tremendous financial strain. These survey data show, in stark terms, that practices will close because of this incident, and patients will lose access to their physicians."

Compounding the crisis are the strains on personal finances, as 55% of respondents resorted to dipping into personal funds to cover practice expenses. Shockingly, 44% were unable to purchase necessary supplies, while 31% grappled with the inability to meet payroll demands. Despite the overwhelming challenges, only 15% of practices have resorted to reducing hours thus far.

In a bid to weather the storm, respondents have sought assistance from various quarters, including advance payments, temporary funding aid, and loans. Notable contributors to relief efforts include the Centers for Medicare & Medicaid Services (12%), UnitedHealth Group/Optum (25%), and other health plans (4.5%). However, the lifelines extended have yet to staunch the bleeding entirely.

The survey, comprising a convenience sample of over 1,400 respondents, serves as a poignant reminder of the fragility of physician practices, especially small-scale ones, according to the AMA. Despite assurances from UnitedHealth Group regarding the resumption of claims processing, disruptions persist, underscoring the far-reaching implications of the cyberattack.

The AMA is calling for concerted efforts to safeguard the integrity of physician practices and ensure uninterrupted access to essential health care services for patients nationwide.

The time to file taxes is almost over. Here’s what to know

Fri, 31 May 2024 23:25:32 GMT

The last day to file your 2023 federal income taxes is April 15, 2024 . If anyone in your household had Marketplace coverage in 2023, you’ll use Form 1095-A, Health Insurance Marketplace® Statement to file. (If you didn’t get Form 1095-A in your Marketplace account or by mail, or if the information on it is wrong, contact the Marketplace Call Center .)

Dr. Kieran Slevin On AI And Its Potential In Pain Detection And Patient Care

Fri, 31 May 2024 23:20:05 GMT

As a pain management specialist and head of North American Pain and Spine, Dr. Kieran Slevin is keeping a close eye on artificial intelligence (AI), a tool not only with myriad applications across the healthcare landscape but one rapidly proving invaluable in delivering optimum patient care levels. Of particular interest to Dr. Slevin are the significant strides AI has made in the areas of pain detection and subsequent pain management.

Dr. Slevin is a board-certified interventional spine specialist from Pennsylvania. The physician co-founded one of the tri-state area's leading spine and pain care providers. The doctor is a recognized thought leader in innovative healthcare models and a global authority on interventional spine care and pain management.

Dr. Slevin is keen to demonstrate AI's potential in significantly benefiting pain detection, management, and overall patient care, both now and in the future. Below, Dr. Slevin offers a closer look at the field and what healthcare professionals and patients can expect in the coming years.

AI and the Future of Pain Management

Artificial intelligence is now widespread in all areas of life. However, there are several key areas where the technology is proving truly transformative – including medicine. AI usage has exploded within the medical sector in recent years. Yielding results across the board, AI is undoubtedly a fundamental tool in the successful future of many areas of healthcare.

Two areas currently seeing impressive advances are pain detection and pain management. Managing chronic pain remains a hot topic for Dr. Kieran Slevin and his peers as they and others around them continue to invest time and resources in effective non-pharmacological methods of pain reduction.

AI is already proving incredibly fruitful in this regard. Doctors increasingly turn to artificially intelligent technologies to help patients manage chronic pain. The results of an ever-growing number of studies point toward an overwhelmingly promising outlook for the technology and sufferers of chronic pain.

Artificially Intelligent Therapy

One area in which the medical field is already successfully using AI to facilitate breakthroughs in pain detection and patient care is cognitive therapy intervention. Cognitive pain therapy presently plays a vital part in helping sufferers of chronic pain.

Dr. Kieran Slevin and his peers know how effective access to cognitive pain therapy can be for chronic pain sufferers. Yet, gaining direct access to specialist therapists can be challenging for various reasons. Such challenges in access to care frequently lead to patients not receiving the valuable forms of therapy most likely to benefit them.

Alternatively, those who have already benefited from a degree of cognitive pain therapy may find themselves unable to finish treatment for similar reasons. But with artificially intelligent therapy—using AI as an alternative to a therapist for cognitive pain intervention—patients face far fewer obstacles in accessing such care.

Studies show similar results in working with therapists and accessing AI assistance. A recent JAMA International study even found that patients receiving AI-powered cognitive behavioral treatment enjoyed superior overall improvement versus physical therapists. As Dr. Slevin has seen, the same AI therapy took around half the time of traditional therapy undertaken with a hands-on professional.

Future Potential of AI-Led Patient Care

Artificial intelligence will likely become vital in optimized patient care in the coming years. Studies show that patients living with physical pain are likely to benefit significantly in this regard. That's because AI therapy is already proving itself a valid option in delivering patient-centered care for sufferers of chronic pain.

Dr. Kieran Slevin believes that, with artificially intelligent therapy, far more patients will gain access to the all-important care they require. The same care should also become more convenient and less costly to access. At the same time, he notes that AI-focused efforts should remain tech-based rather than entirely tech-led for now to ensure optimum patient care.

Either way, with AI underpinning many of today's leading advances in medicine, artificially intelligent therapy represents just one of many invaluable cutting-edge tech-based tools currently emerging as a part of the broader healthcare landscape.

Interventional Spine Specialist Dr. Kieran Slevin

North American Spine and Pain co-founder Dr. Kieran Slevin is a physician and interventional spine specialist from the Delaware Valley in Pennsylvania. The Pennsylvania Medical Society member is a recognized thought leader in innovative healthcare models and is a global authority on interventional spine care and pain management. He is also the Spine Intervention Society's appointed American Medical Association delegate.

Dr. Slevin was born and raised in Donegal, Ireland, and now lives and works in Philadelphia County. In addition to his professional endeavors, he supports various critical charities, nonprofit organizations, and other good causes. These include PHL Cares, a nonprofit addressing homelessness in Philadelphia. Outside his work and charitable efforts, his hobbies and interests include cooking, running, sports, and travel.

Want to learn more? Visit Dr. Slevin and the North American Spine and Pain team today!

The Easiest Ways to Lower Your Stress at Work

Fri, 31 May 2024 23:10:32 GMT

Too often, we forget that some stress in life is a good thing. When you feel the heightened arousal of stress, numerous scientific studies will tell you that it actually does wonderful things: It helps you focus, enhances your memory, gives your body an energy boost, and can even bolster your immune system. (If you’ve ever been stressed about giving a presentation , you can credit some of that stress for helping push you through what you need to do to prepare and get those first words out.)

However, in today’s fast-paced world, it’s simply a fact that far too many of us suffer from excessive or chronic stress. Left uncontrolled and unmanaged , stress reveals its ugly side: you’ll be less likely to control your emotions, it impacts your heart health, it leads to premature aging, and actually weakens your immune system, among other side effects. One of the most common causes of excessive stress? No surprise here: Work.

If you’re feeling overwhelmed by too many Slack messages, an overbearing boss, crazy deadlines, or a combination of them all, Samantha Clarke, author and happiness expert, has some really good advice for you. In her class “Reduce Stress and Anxiety,” which you can find in our Optimism Library, Samantha offers three simple yet effective strategies to de-escalate stress, especially in the workplace. To explore her entire class, feel free to go here , but we’ve taken the liberty of providing just a few of her tips below.

Declutter Your Workspace

Let’s start with your immediate environment—your desk or workspace. Believe it or not, the state of your workspace can significantly impact your stress levels. As Samantha explains, “stress can be triggered even more when we find ourselves working in chaotic environments. Where there’s a lot of clutter and disorganization, our mindset often reflects it.”

A cluttered desk is not just an eyesore; it’s a visual representation of chaos that can hinder your ability to focus and process information efficiently, and science agrees. A study recently showcased in a Harvard Business Review article found that physical clutter in your surroundings competes for your attention, resulting in decreased performance and increased stress.

So, what’s the solution? Take a few minutes each day to tidy up your workspace. File away those papers, organize your supplies, and create a clean, serene environment that encourages focus and calm. The act of decluttering itself can be therapeutic, offering a sense of control and accomplishment amidst the chaos of work.

Practicing Meditation or Tai Chi

If you’re looking for a more introspective approach to stress management, meditation and tai chi are your go-to practices. Both are ancient traditions known for their calming and restorative benefits.

“The practice of meditation or the slow, meditative movement of tai chi are really good starting places for us to think about how we practice being present with ourselves,” explains Samantha. “I’m not saying that you need to move into like a pretzel and do it for hours on end. But just a starting point of even just 5 minutes is great. Take that time to ask yourself ‘how do I come back home to myself and my mind? How do I lean back and take a moment to keep my mind in a place of stillness?’ Just take a moment to close your eyes and just be still when the stress reaction is there or the feeling of deep uncertainty comes up.”

Ultimately, meditative actions help you develop mindfulness, allowing you to observe your thoughts and feelings without judgment. This practice can decrease the body’s response to stress, reducing symptoms of anxiety and depression and make it easier to regulate yourself next time that stress starts to rear its unpleasant head.

Yes, Think Happy Thoughts

We know, it sounds like a terrible cliché, but sometimes the simplest methods are the most powerful. When stress levels start to rise, take a moment to close your eyes and think of a positive memory or the silver linings of your current challenge.

“In moments of stress and difficulty, take a moment and think, ‘what about this challenge could pose something positive?’ Or you can recall some happy memory at the moment of stress to reset your mind. Think about a happy memory or positive thought about the challenge that you’re in and hold that thought for at least 30 seconds. It starts to create more neural pathway recognition to override the negativity.”

This technique is not just about distraction; it’s about reminding ourselves of the joy and positivity that exist in our lives, even when they seem overshadowed by stress. It’s a tool that can be used anywhere, anytime, requiring nothing but a moment of your time and the power of your memory.

A word to the wise, though. As Samantha explains, “when it comes to this particular method, practice actually does make perfect. We need to do this consistently and again through meditation over time when we get stressed. Through repeatedly taking that time to pause, we can start to rewire what’s really happening for us.”

Stress, especially in the workplace, can feel like an inevitable part of life. Whether it’s through decluttering your workspace, incorporating meditation or tai chi into your routine, or simply recalling a joyous moment from your past, each method offers a pathway to greater calm and reduced anxiety.

For more classes like “Reduce Stress and Anxiety”, check out The Optimism Library . Breathe out, dive in, and discover more ways to bring balance into your life.

Simon’s 3 Rules for Answering the Question, “What Do You Do?”

Fri, 31 May 2024 23:08:38 GMT

If you’re an adult, it’s a fact of life that there are certain questions you get asked so often in job interviews , at parties, and on airplanes that you hardly even consider them interesting or put much thought into your response. You know, questions like “How are you?” or “ Tell me about yourself ” or “Where are you from?” Regardless of how you feel about conversation fillers, there’s one seemingly insignificant question we want to address, a question that we believe is actually quite important: “What do you do?”

Now, you might find it slightly irritating or somewhat exciting to have the opportunity to discuss your job. On paper, the answer should be straightforward and formulaic: “I do X at Y company.” However, if that’s all you say, you’re missing out on the chance to truly shine and build better connections.

You see, this seemingly harmless question has the potential to reveal so much more about who you are as a person. It’s an opportunity to showcase your passions, expertise, and unique contributions to the world. Instead of settling for a mundane response, why not seize this chance to captivate your audience and leave a lasting impression?

At The Optimism Company, we believe you should take a swing every time life throws you a question. Our founder and Chief Optimist, Simon Sinek, has shared his insights on how to navigate this common conversational crutch. His advice can help you transform an obligatory question into a golden opportunity.

So keep reading to discover Simon’s three rules for answering this question. And if you’re interested in elevating your communication skills at work, you’ll find classes like “Use Storytelling to Make a Greater Impact,” “The 25-Minute Guide to Better Communication,” and “How to Navigate People, Promotions, and Power Dynamics for Career Success” in our Optimism Library .

Rule #1: Don’t say what you do right away

It might sound counterintuitive, but there are few worse responses to “What do you do?” than outright saying what you do. Instead, you should start with “WHY” (one of Simon’s core tenets ).

“One of the most difficult questions we ever get asked is, ‘What do you do?'” Simon says. “And we usually tell people what we do… And nobody really cares.”

Simon cited an example where he was at a social event, chatting with a friend and then, eventually, found himself face-to-face alone with his friend’s boss. Simon’s friend, however, failed to make a proper introduction—then just… walked away.

“Now, if I wasn’t starting with WHY, I’d say, ‘Hi, my name is Simon. I have a consultancy and I speak and I teach and I’m an author,’ and I’d go through all the things that I’ve done and all the people that I worked with, maybe some of my clients, all in an attempt to tell him who I am and why he should listen to me,” Simon says. “But then he would’ve pointed at the chips and said, ‘Nice to meet you,’ you know?”

Rule #2: Say WHY you do what you do

The reason simply saying the thing (or things) you do is ineffectual is because phrases like “senior marketing associate” or “VP of consulting” don’t define who you are. Your passions and your motivations do.

Take that previously mentioned instance, for example. Instead of describing what he did, Simon looked his friend’s boss in the eye and said, “I wake up every single day to inspire people to do what inspires them, and I know that your company is trying to increase the amount of customers it’s getting in one particular sector. The question is, are you inspiring people to do it? Because the only way people will give you loyalty is if you inspire them to do so. So I teach leaders and organizations how to inspire people.'”

Simon didn’t get into the details about his day-to-day work. He didn’t drop names or roll out a client list. He simply spoke about his WHY. Ultimately, Simon walked away with a new business card for the rolodex, and a plan to talk details later.

Rule #3: Once you’ve established your WHY, you can move to the WHATs and HOWs

“Don’t forget, a WHY doesn’t close the deal. It just opens it. It allows people in. It gets context,” Simon says. “All of these things need to work together: why you do what you do, how you do things, and what you do.”

This is all part of Simon’s “ Golden Circle .” Learning to start with WHY is especially crucial in business settings, whether you’re interviewing for a new job or pitching your services to a potential client. Simon shared that he regularly receives messages from individuals who have embraced starting with WHY. These individuals tend to secure the positions they interview for, not solely because of their accomplishments, but because they wholeheartedly explain why they do what they do.

“I don’t, for one second, believe that the WHY is more important than any of the other pieces,” Simon emphasizes. “It’s just the place we have to start, and it’s also the place we so often forget to include.”

Navigating organizational dysfunction: lessons from Boeing

Fri, 31 May 2024 23:07:25 GMT

If it ain’t Boeing, I ain’t going—at one time, public opinion of an engineering company run by engineers. Today, perception is a little different. The multinational conglomerate and defense contractor owns some staggering recent mishaps—safety systems, door plugs, unclear technical issues. A disconnect between senior management and hands-on employees is reported. Analysts consider recent events symptoms of longer-standing organizational pathology, finally coming to light.

In American business, executives win leadership positions in part by prioritizing superficial targets ahead of customers’ (or patients’) best interests. When dysfunction is not unique, it’s seldom singled out. Boeing might be mounting too much evidence to ignore, but it isn’t alone.

When it comes to safety, we focus on outcomes. But beneath outcomes we have processes; below those, culture. Most bad outcomes don’t result from individual error—they arise from deeper flaws.

Whether the company is a hospital system or an aerospace manufacturer, a strong culture looks the same: people are trained, empowered, and provided mentorship that allows them to grow as contributors. Individuals form high-functioning teams with complementary skill sets, driven by shared mission and common goals. Work aligns with beliefs. Waste is minimized. Long-term perspectives are natural. Education serves to advance knowledge and skills. People are encouraged to think and to ask questions and to offer suggestions which will be considered and, if they’re good, implemented. Risk is proactively sought out and minimized. The whole is better than the sum of its parts.

In a weak culture, training looks like computer modules that mainly shift blame onto frontline staff when the inevitable error comes. Individuals don’t cooperate well because their goals are not the same. Work might align with beliefs and values; it might not. Focus is narrow—sometimes as narrow as a few spreadsheet cells. Waste is everywhere because nobody sees the whole picture. Managers police compliance because they aren’t trained to do any better. Policies can be incongruous with the company’s purpose and may create only the appearance of something meaningful. Highly educated people function as technicians. Risk flourishes. Departments blame one another. The whole is worse than the sum of its parts—sometimes impressively so.

A 2022 review by the Office of the Inspector General in the Department of Health and Human Services found that more than 25% of patients with Medicare experience preventable harm while hospitalized. By Medicare’s definition—harm to a patient as a result of medical care or in a health care setting, including the failure to provide needed care—this must be a conservative estimate. Every elder who loses strength and endurance while hospitalized because administrators don’t provide enough staff to provide simple care—for example, keeping patients walking—is a patient harmed. Every person whose diagnosis is delayed by systems staffed only to find some acute problem for which to admit and bill them is a patient harmed.

How do aviation and health care connect? In each, we report surface outcomes when instead we should look deeper into culture and process, to systems and risk. These are problems not just of unfortunate results but of preventable risk—of allowing, through insufficient training, monitoring, and feedback, a certain likelihood of an adverse event.

A danger of dysfunctional systems is their effect of isolating the people at true fault from liability and moving solutions further out of reach. Systems are treated as too complex and remote to grasp rather than ideas created and enabled daily by people. Hospitals are not this way by accident: it is easier and more profitable—though in the short term only—to function this way than it is to recruit, train, and empower skilled managers and leaders who can start the engines of continuous improvement and build great companies. These solutions demand real commitment, and that’s not something that can be faked.

Safety is not a set of processes that managers can force compliance with and expect great results. When the underlying culture is right, safety is the inevitable result of allowing systems to function; when they are not, it is perpetually out of reach. This is as true in any industry as it is in aviation or health care. It will sooner or later affect each of us—through dissatisfaction with work, through the care we ourselves need to pursue, or through wasteful spending of our tax dollars. The root failure has been here all along, but for Boeing, a few visible errors have been the catalyst to draw attention to fundamental inadequacies. So many health systems are just one public mistake away from the kind of scrutiny that will bring deep and long-standing insufficiencies to light. Few are doing things as well as patients and health care workers deserve, and brand prestige doesn’t seem to be strongly correlated with the quality of underlying culture. But the good news is that it doesn’t take an accident or injury to start fixing these problems—it’s good for patients and good business to begin today.

John Corsino is a physical therapist who blogs at his self-titled site, Health Philosophy .

What’s love got to do with it? The emotional toll of the practice of medicine

Fri, 31 May 2024 23:06:11 GMT

In medicine, we are taught to be professional and, at all times, to keep our emotions at bay. While this approach may work for some professionals, it is particularly challenging in medicine, especially in primary care. As a family physician, I have witnessed the journey of my patients over the years—sometimes spanning generations within a single family. I have seen my teenage patients grow into responsible adults and parents. I have cared for pregnant mothers, witnessing the joy of welcoming their babies into the world and observing those children grow, from their first tooth to their first words and steps. Then, before I knew it, those children grew into teenagers. I have also had the privilege of caring for my older patients as they aged, supporting them as their health declined, and sometimes delivering complex diagnoses and witnessing the subsequent decline in their health. For some of these patients, I have been present during their last months, weeks, days, and sometimes hours of life. Simply typing these words brings a nostalgic sigh as I reminisce about these moments.

Given all these experiences, how does one separate their humanity, empathy, and the close patient-physician bond and not be impacted over time by the thousands of lives they have had the privilege to interact with?

How do you detach from the emotional impact when you truly listen to your patients and endeavor to understand them by putting yourself in their shoes?

In medicine, there is a concept called compassion fatigue . Compassion fatigue is the emotional and physical exhaustion that can occur when caregivers cannot refuel and regenerate. It’s a condition characterized by a gradual lessening of compassion over time. It can manifest in feelings of hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, and a pervasive negative attitude. Research suggests that health care professionals are at a high risk of experiencing compassion fatigue due to the intense emotional demands of their work. It can lead to a diminished capacity to provide effective care and detrimental effects on the health care provider and the patients they serve. This highlights the importance of addressing this issue in medical practice.

To combat the emotional toll of medicine, here are five actionable strategies:

1. Have a life outside of work unrelated to medicine. Please don’t let your life revolve around work. You must detach yourself from it, watch a comedy show, explore hobbies, or stay up late with friends, watching movies and laughing.

2. Recognize that your feelings are valid, but acknowledge that you did the best considering the multiple factors involved in patient care. In my career, I remember a first-time patient presenting to my office after 12 months of rectal bleeding and weight loss. Despite the challenging diagnosis, I did the best I could. Having family members of the patient ask me about the diagnosis was tough. Trying to convey to them that the prognosis was not good wasn’t any easier.

3. Practice self-care. In my experience, when I let go of unnecessary stressors and significantly lightened my workload, I could think clearly. When I found a better work situation that gave me more autonomy and significantly less administrative work, it was much easier to prioritize self-care. Self-care might look different, but I strongly recommend self-development as part of your self-care routine.

4. Let off some steam. Obviously, you want to do this constructively. Examples include exercise, journaling, or engaging in hobbies that bring joy and relaxation.

5. Establish healthy boundaries. It is not OK to repeatedly sacrifice breaks for nutrition just to “squeeze in one extra patient.” As much as possible, create healthy boundaries and maintain them firmly.

As health care providers, we must nurture our humanity while navigating the complexities of our profession. By acknowledging our emotions, practicing self-compassion, and establishing healthy boundaries, we can continue to provide exceptional care without sacrificing our well-being. In doing so, we honor the sacred bond between patient and physician, ensuring that love remains integral to our practice.

So, as we continue on this journey, let us carry with us the lessons learned from each patient encounter, the strength gained from overcoming adversity, and the compassion that binds us together. For, in the end, it is not just what we do in medicine but the love and empathy we bring to every interaction that truly matters.

Tomi Mitchell , a family physician and founder of Dr. Tomi Mitchell Holistic Wellness Strategies , is not only a distinguished international keynote speaker but also a passionate advocate for mental health and physician’s well-being, hosting her podcast, The Mental Health & Wellness Show . With over a decade of experience in presenting, public speaking, and training, she excels in creating meaningful connections with her audience. Connect with her on Facebook , Instagram , and LinkedIn and book a discovery call .

First, don’t disappear: Independent practices continue losing ground to hospital systems and corporations

Fri, 31 May 2024 23:04:34 GMT

Doctors in independent practice are continuing to fade from the health care landscape, a new report finds.

The report from the Physicians Advocacy Institute and Avalere Health shows hospitals, health systems and corporate entities now employ 77.6% of the nation’s doctors, up from 44% in 2018, and own 58.5% of medical practices. Both are the highest percentage ever.

In addition, for the first time, corporate entities such as health insurance companies, private equity firms and pharmacy chains own a greater share of practices (30.1%) than do hospitals and health systems (28.4%).

“Corporate entities are assuming control of physician practices and changing the face of medicine in the United States with little to no scrutiny from regulators,” Kelly Kenney, PAI chief executive officer said in an accompanying news release. “Physicians have an ethical responsibility to their patients’ health. By contrast, corporate entities have a fiduciary responsibility to their shareholders and are motivated to put profits first. In some arrangements, these interests can conflict with providing the best medical care to patients.

“It’s absolutely critical that physicians retain autonomy over medical decisions and the relationship with patients remains grounded in providing the best clinical guidance,” he added.

The COVID-19 pandemic accelerated the movement away from independent practice, the report shows. From January of 2019 through January of 2022 the number of doctors working for hospitals or corporate entities increased by 29%, from 375,400 to 484,100. The rate of increase has since slowed to about 4%. Overall, 127,700 more physicians became employees of hospital or corporate entities between January of 2019 and January of 2024.

Broken down by geographic region, the northeast saw the largest percentage increases in both hospital-employed physicians (23.4%) and hospital-owned practices (23%). The Midwest had the smallest increase in hospital-employed physicians (13.3%), while the west had the smallest in hospital-owned practices (13.9%).

Among corporate-employed physicians, the biggest increase occurred in the south at 59.5%, while the northeast saw the smallest at 30.4%. For corporate-owned practices, the south had the largest gain at 115.6%, and the Midwest the smallest at 87.4%.

Physician groups expressed concern over the report’s findings. Gary Price, MD, president of The Physicians Foundation said, “These trends have ominous implications regarding accessibility and costs of healthcare. The report does also raise serious questions about physician's ability to continue to exercise independent judgement in the best interest of their patients at a time when a steady erosion of autonomy is a key factor in burnout.”

“Hospital and corporate entities acquiring primary care practices are often motivated to leverage physicians to maximize savings or profit somewhere upstream,” noted R. Shawn Martin, executive vice president and CEO of the American Academy of Family Physicians. “When these incentives are misaligned, physicians lose clinical autonomy, and often experience moral injury as they are asked to prioritize organizational needs over those of their patients.”

Older adults embrace non-traditional medical care sites, poll finds

Fri, 31 May 2024 23:03:21 GMT

In a shift emblematic of evolving health care trends, a survey conducted by the University of Michigan's National Poll on Healthy Aging has revealed that older adults, aged 50 to 80, are increasingly turning to non-traditional sites for medical care. The survey, supported by AARP and Michigan Medicine, sheds light on the preferences and behaviors of this demographic regarding urgent care centers, retail clinics, and other alternative care facilities.

Over the past two years, the poll indicates that 60% of individuals in this age group have visited alternative care sites, such as urgent care clinics or those situated within retail stores, workplaces, or vehicles. Urgent care centers emerged as the most popular alternative, with 47% of respondents having sought care at least once, and 23% making multiple visits within the same timeframe.

The motivations behind these visits varied, with 44% citing a desire to avoid emergency room visits, while 35% sought services such as vaccinations, tests, or examinations. The convenience and accessibility of these sites, particularly during the COVID-19 pandemic, played a significant role in their appeal.

However, despite the increasing utilization of alternative care sites, a clear preference for traditional primary care providers persists among older adults. The majority expressed satisfaction with the quality of care and the sense of connection experienced at their regular clinics. For 74% of respondents, this preference for their primary care provider remained the primary reason for not opting for alternative care in the future.

Dr. Jeffrey Kullgren, the poll director and a primary care physician, highlighted the transformative impact of these alternative care options on the health care landscape, emphasizing their role in addressing the nationwide shortage of primary care providers .

Key findings from the poll include variations in the utilization of alternative care sites based on age, gender, and geographic location. Younger individuals, women, and those residing in urban or suburban areas were more likely to seek care at non-traditional sites. Moreover, while cost considerations were not the primary driver for utilizing alternative care, a notable proportion expressed concerns about affordability and insurance coverage.

Looking ahead, the poll suggests a continued trend towards the adoption of non-traditional medical care among older adults, with 43% expressing likelihood of seeking care at alternative sites in the next two years. As health care delivery continues to evolve, policymakers and clinicians are urged to ensure that these alternative care options are integrated seamlessly into the broader health care system, prioritizing quality, accessibility, and patient satisfaction.

Exposed to Agent Orange at US Bases, Veterans Face Cancer Without VA Compensation

Fri, 31 May 2024 23:02:16 GMT

As a young GI at Fort Ord in Monterey County, California, Dean Osborn spent much of his time in the oceanside woodlands, training on soil and guzzling water from streams and aquifers now known to be contaminated with cancer-causing pollutants.

“They were marching the snot out of us,” he said, recalling his year and a half stationed on the base, from 1979 to 1980. He also remembers, not so fondly, the poison oak pervasive across the 28,000-acre installation that closed in 1994. He went on sick call at least three times because of the overwhelmingly itchy rash.

Mounting evidence shows that as far back as the 1950s, in an effort to kill the ubiquitous poison oak and other weeds at the Army base, the military experimented with and sprayed the powerful herbicide combination known colloquially as Agent Orange.

While the U.S. military used the herbicide to defoliate the dense jungles of Vietnam and adjoining countries, it was contaminating the land and waters of coastal California with the same chemicals, according to documents.

The Defense Department has publicly acknowledged that during the Vietnam War era it stored Agent Orange at the Naval Construction Battalion Center in Gulfport, Mississippi, and the former Kelly Air Force Base in Texas, and tested it at Florida’s Eglin Air Force Base.

According to the Government Accountability Office, however, the Pentagon’s list of sites where herbicides were tested went more than a decade without being updated and lacked specificity. GAO analysts described the list in 2018 as “inaccurate and incomplete.”

Fort Ord was not included. It is among about four dozen bases that the government has excluded but where Pat Elder, an environmental activist, said he has documented the use or storage of Agent Orange.

According to a 1956 article in the journal The Military Engineer, the use of Agent Orange herbicides at Fort Ord led to a “drastic reduction in trainee dermatitis casualties.”

“In training areas, such as Fort Ord, where poison oak has been extremely troublesome to military personnel, a well-organized chemical war has been waged against this woody plant pest,” the article noted.

Other documents, including a report by an Army agronomist as well as documents related to hazardous material cleanups, point to the use of Agent Orange at the sprawling base that 1.5 million service members cycled through from 1917 to 1994.

Expanding your practice? Here’s how to manage an unruly tech stack

Fri, 31 May 2024 23:00:46 GMT

As the healthcare landscape continues to evolve, more and more small healthcare businesses are expanding to new locations , merging with other businesses or being acquired by larger groups . When healthcare practices scale rapidly, they tend to accumulate an unruly, disharmonious tech stack that can complicate administrative, communication and marketing efforts. Growing a multi-office practice can uncover outdated, incongruent tools that muddy office processes, damaging the experiences of both staff and patients.

The ability for organizations to have access to a single centralized view, configuration and reporting are critical to ensuring essential business functions in multi-office environments. By unifying office operations to streamline admin and create new efficiencies, these multi-office practices can increase access to patient care and improve employee engagement, allowing them to compete with bigger healthcare conglomerates. Let’s take a closer look at some of the pain points healthcare businesses face during expansion and how using connected technology across multi-office locations eases these challenges.

Integrating technology across the healthcare system

When opening a new location, whether as a result of growth and expansion or even through consolidation, one of the first challenges practices face is how to integrate old systems of record with existing offices. Migrating practice management systems can lead to days of production loss and massive headaches for practice owners. It can create frustration for employees and patients alike, turning what should be an exciting new opportunity into a painful experience.

To help avoid these growing pains, it’s important to plan your tech stack with growth in mind. When selecting technology for your practice, consider your future expansion plans, and invest in tools that complement a growth mindset. Technology should be used to make practitioners’ lives easier, not to create new headaches. The most helpful tools will make migrating systems of record easy and merge relevant data on your behalf when expanding.

If you’re already operating with multiple locations, ask yourself: Are our systems congruent with one another? Do staff members complain about inconsistencies or file-sharing issues across locations? Is it simple or challenging to generate reports comparing office performance? These issues may be present in your organization already, but they will especially come to light when you are setting up systems at a new location.

Connecting front desk communications

In addition to the essential technology running in the background, another potential pain point providers face when adding a new location is front office communication. A smoothly operating front desk is essential to offering the best patient experience. However, there may be times when staff members are bogged down with administrative tasks or an overwhelming influx of calls or patients at once, and they are unable to answer patient requests on time. This can leave patients frustrated or stressed by an inability to contact staff, and in turn, employees may feel overwhelmed by their workload.

When healthcare practices have interconnected offices, quieter locations can reduce the burden of busier ones. For example, if a patient calls their provider when their office is experiencing a large volume of in-person requests, the call can be forwarded to another location with more availability. This ensures that staff at the first office can dedicate the necessary time to in-office patients, while the patient calling in is still cared for by employees at the second location.

Another benefit of having connected front office communication is that it provides multiple offices with access to patient information. Therefore, when a patient call is answered by an office they don’t typically visit, the staff member assisting them can easily schedule their new appointments or pass messages along to their doctor.

For example, Dental Care Alliance (DCA) is a provider with interconnected communication in place. DCA is a dental service organization supporting more than 370 practice locations across the U.S. Using upgraded, connected phone systems, the organization’s individual offices are able to fill each others’ schedules and take each others’ calls, allowing them to better engage with patients and prospects.

Improving employee & patient satisfaction

Connecting healthcare offices through modern technology and digitized communication comes with significant improvements in patient and employee satisfaction – the latter of which is especially crucial as healthcare worker burnout rates continue to climb . Inter-connected multi-location practices can streamline time-consuming administrative tasks and effectively organize patient data, creating a less stressful and more productive work environment. As a result, staff members can better address patient needs calmly and empathetically. Patients, in turn, will have their needs met quickly and experience higher-quality care.

Expanding healthcare practices can face several challenges during expansion, but a complicated, confusing tech stack doesn’t need to be one of them. Unified, interconnected technology paves the way for continued growth, streamlines front office admin and creates a better experience for employees and patients alike. Forward-looking practice owners will do well to prioritize tech investments that ease business processes today and also have the ability to scale with them in the future.

Branden Neish is the Chief Product & Technology Officer at Weave . He has a proven track record of driving business growth through product management, design and engineering. Adopting a customer-centric approach, Branden has consistently added significant value to various businesses in multiple leadership roles throughout his career.

What’s Behind America’s Doctor Crisis?

Fri, 31 May 2024 22:59:30 GMT

Physicians are retiring in greater numbers as burnout levels increase at the same time Americans are placing higher demands on the health care system.

Problems securing appointments to see doctors in the United States are exacerbated by soaring health care demand and fewer doctors. Many specializations are increasingly affected by this trend, but primary care and emergency medicine are among the hardest hit.

7 Ways to protect independent practices

Fri, 31 May 2024 22:15:09 GMT

The Medical Group Management Association (MGMA) made a series of suggestions in prepared testimony sent to the House Committee on Ways & Means Subcommittee on Health’s “The Collapse of Private Practice: Examining the Challenges Facing Independent Medicine” hearing .

The suggestions call for policy changes to remedy the exodus of doctors from private, independent practice .

Practice tip of the week: Reducing accounts receivable turnaround

Fri, 31 May 2024 22:11:45 GMT

With all the useful information available on Physicians Practice, it is easy to become overwhelmed.

With this in mind, the tip of the week is a chance to reflect on some of the wisdom found all across the site. In this October 2019 article on reducing the accounts receivable turnaround time, Alpha B. Journal, PA-C, MBA gives this tip:

Preempt denials

Invest in solutions that can help significantly reduce the number of mistakes in submitted claims. When there are mistakes in a submitted claim, the payers may deny it. You will then have to file a denial appeal. The process of clearing the account receivable will take longer than normal then. Thus, it is imperative to submit a clean claim if you want to receive the payment at the soonest time possible.

Click here to read the rest of the article and be sure to check back next week for another Tip of the Week! With all the useful information available on Physicians Practice, it is easy to become overwhelmed.

Preempt denials

Click here to read the rest of the article and be sure to check back next week for another Tip of the Week!

How behavioral health integration benefits primary care

Fri, 31 May 2024 22:08:54 GMT

Mary Gabriel, M.D., lead for collaborative care at University Hospital Health System (UHHS) in Cleveland, explains the clinical and health equity benefits UHHS has seen by making behavioral health services available through its primary care practices.

Staff shortages — The root cause of the problem

cnebel@freedomrevenue.team (Cathryn Nebel) — Fri, 31 May 2024 21:38:06 GMT

The general employee exodus following the COVID-19 pandemic has been referred to as “ The Great Resignation .” The resulting shortage has affected the health care profession and will ultimately affect the care that physicians provide their patients. Many medical practices and hospitals need to fill positions, placing stress on the existing staff. This article will discuss the health care shortage, and the second article in this series will describe possible solutions.

Employee turnover , which includes physicians, nurses and allied health care professionals, is one of the costliest challenges in health care and threatens to worsen as the demand for care exceeds the supply of workers. If a practice only focuses on employee retention, it will experience understaffing, financial insolvency, deterioration in patient satisfaction, reduced online reputation, increased malpractice claims, increased absenteeism and perhaps a negative impact on patient outcomes.

The sobering statistics of the shortage of health care workers

About 1 in 5 health care workers have left medicine since the pandemic began.
Since the pandemic started, 18% have quit , 12% have been laid off, and 31% have considered leaving.
In 2022, nearly 1.7 million people quit their health care jobs – equivalent to almost 3% of the health care workforce.
It is estimated that the cost to replace a health care employee averages the amount of a year's salary for that position.

8 Reasons for employee departure from health care

1. Concerns about health care administration and leadership

During the pandemic, employees worked erratic schedules with mandatory overtime. Fitting available square pegs into shift holes resulted in some good employees being turned off to the health care profession. Unfavorable shifts may be unavoidable, but flexibility and timely communication from office managers and other health care administrators can make a difference. A lack of consideration by leaders is a sign of disrespect toward health care workers. Providers aren't exiting the field because they can't handle their jobs – they're quitting because they can't handle being unable to do their jobs.

2. Lack of recognition

Health care workers often complain about not being valued by management. They know they play an essential role in the health care system. Yet, doctors, office managers and hospital administrators tend to undervalue their work. This underappreciation may spill over to the workers developing expectations that patients need to appreciate their extra work and challenging conditions. Health care workers do not expect to be thanked for every task they perform. Still, employees want to be recognized as valuable health care team members. But if the rationale behind an award, such as “employee of the month,” or a perk, such as a convenient parking space, isn’t well explained, those rewards are meaningless to employees.

3. Lack of advancement opportunities

This is another management deficit for health care workers. They often don't want to remain in their current position even if it is highly specialized. Many practices need to offer more opportunities for advancement or a path to get there. These opportunities can mean more to employees than better pay or compensation packages. Employees are leaving the profession because they desire more from their current role. With the flexibility of their medical background and knowledge, many employees can realize their income potential in a related field, not clinical medicine.

4. Burnout

Before the pandemic, between 35% and 54% of U.S. nurses and physicians experienced one or more symptoms of burnout . Now, burnout has increased in frequency, resulting in mental and physical issues for workers, so more health care employees are leaving the field. A recent survey of 1,000 health care professionals showed that 28% quit a job because of burnout.

5. Work-life balance issues

Many employees are evaluating their work-life balance, contemplating why they continue to clock into a job that does not fit their desired lifestyle. Medicine is a great career, but it may not be worth the time away from home compared with other professions. Allowing more time away from work can provide workers the clarity to figure out what they want their careers to look like.

The pandemic allowed many health care providers to work remotely, and now many are deciding they want a position, even if it is in another area or profession, that will enable them to work in such a way. Childcare is a significant concern for some employees. Depending on a worker’s family situation, it might make more sense for one parent to stay home or work part time.

A health care career can be exhausting. The exhaustion makes it easy to lose sight of why men and women entered this profession. When employees can't take care of themselves, they find it harder to care for others.

6. Mental health issues

Medicine is a mentally exhausting career. Many employees are put into difficult situations and often have little time to process or cope with work-related stress. Over time, it can take a toll on the employee's mental well-being, and the person may leave the health care profession. For many health care employees, it is often difficult to seek guidance or help if they are struggling.

7. Employer prioritization of profits before patients

Health care workers need help justifying situations where profits are prioritized before patients. Most health care workers enter medicine as a calling and are idealistic and altruistic. They want to help patients, and their inability to adequately do so takes a toll on them.

I have noted disappointment in middle-aged and older physicians who are employed by hospitals or large medical groups. In these settings, their productivity is measured in relative value units, and they are told how many patients they need to see in an hour or day to reach quotas set by their employer.

Many health care workers believe their employers fail to look out for their best interests and the interests of the patients. Instead, they complain that the employers only care about the monthly profit and loss spreadsheet. Providers aren't exiting the field because they can't handle their jobs – they're quitting because they can't handle being unable to do their jobs.

8. Salary dissatisfaction

A medical career is gratifying, and doctors and other health care workers can earn a lot of money. Still, an outside offer of more money is sometimes the only reason a worker leaves the health care profession. In some areas of the country, employees must work multiple jobs to make ends meet. The low pay and high student debt overwhelm many people who wanted to be health care workers. Some are making moves that could allow for a more sustainable career that pays more than their health care salary.

Bottom line: The health care industry's workforce shortage is a significant problem. If one-third to one-half of nurses and physicians express their intentions to reduce their work hours and work part-time or leave, there won’t be enough staff to meet patients' needs.

Neil Baum, MD , a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.

Make the most of the season by following these simple guidelines

websitebuilder@thryv.com — Mon, 12 Dec 2022 15:59:27 GMT

The new season is a great reason to make and keep resolutions. Whether it’s eating right or cleaning out the garage, here are some tips for making and keeping resolutions.

Make a list

Lists are great ways to stay on track. Write down some big things you want to accomplish and some smaller things, too.

Check the list regularly

Don’t forget to check in and see how you’re doing. Just because you don’t achieve the big goals right away doesn’t mean you’re not making progress.

Reward yourself

When you succeed in achieving a goal, be it a big one or a small one, make sure to pat yourself on the back.

Think positively

Positive thinking is a major factor in success. So instead of mulling over things that didn’t go quite right, remind yourself of things that did.

Keep in touch with site visitors and boost loyalty

websitebuilder@thryv.com — Mon, 12 Dec 2022 15:59:27 GMT

There are so many good reasons to communicate with site visitors. Tell them about sales and new products or update them with tips and information.

Here are some reasons to make blogging part of your regular routine.

Blogging is an easy way to engage with site visitors

Writing a blog post is easy once you get the hang of it. Posts don’t need to be long or complicated. Just write about what you know, and do your best to write well.

Show customers your personality

When you write a blog post, you can really let your personality shine through. This can be a great tool for showing your distinct personality.

Blogging is a terrific form of communication

Blogs are a great communication tool. They tend to be longer than social media posts, which gives you plenty of space for sharing insights, handy tips and more.

It’s a great way to support and boost SEO

Search engines like sites that regularly post fresh content, and a blog is a great way of doing this. With relevant metadata for every post so search engines can find your content.

Drive traffic to your site

Every time you add a new post, people who have subscribed to it will have a reason to come back to your site. If the post is a good read, they’ll share it with others, bringing even more traffic!

Blogging is free

Maintaining a blog on your site is absolutely free. You can hire bloggers if you like or assign regularly blogging tasks to everyone in your company.

A natural way to build your brand

A blog is a wonderful way to build your brand’s distinct voice. Write about issues that are related to your industry and your customers.

Tips for writing great posts that increase your site traffic

websitebuilder@thryv.com — Mon, 12 Dec 2022 15:59:27 GMT

Write about something you know. If you don’t know much about a specific topic that will interest your readers, invite an expert to write about it.

Speak to your audience

You know your audience better than anyone else, so keep them in mind as you write your blog posts. Write about things they care about. If you have a company Facebook page, look here to find topics to write about

Take a few moments to plan your post

Once you have a great idea for a post, write the first draft. Some people like to start with the title and then work on the paragraphs. Other people like to start with subtitles and go from there. Choose the method that works for you.

Don’t forget to add images

Be sure to include a few high-quality images in your blog. Images break up the text and make it more readable. They can also convey emotions or ideas that are hard to put into words.

Edit carefully before posting

Once you’re happy with the text, put it aside for a day or two, and then re-read it. You’ll probably find a few things you want to add, and a couple more that you want to remove. Have a friend or colleague look it over to make sure there are no mistakes. When your post is error-free, set it up in your blog and publish.