Dr. Ghannam is a patient-focused physician with a particular interest in creating ways for physicians and patients to interact and be cared for without geographical constraints. Dr. Ghannam is constantly seeking innovations in technology that can provide unparalleled care.]

Even though patients are starting to feel comfortable again with in-office visits, their desire for virtual visits will likely not diminish. But what do providers desire?

From my perspective, telehealth is not only the best option for access to care, but it’s the future of medicine. I strongly believe that even more integrated solutions will be the next frontier. Bringing multi-disciplinary specialties to rural locations through telehealth will address and minimize healthcare inequalities while leveraging value-based care practices.

Rural and critical access hospitals started using telehealth services long before the pandemic. Back then, the technology was used mostly for nighttime admission services. Today, though, as more providers have become comfortable with virtual care delivery, telehealth’s relevance has ingrained itself in an integrated approach.

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This is due in large part to providers. Learning to use virtual technology during the pandemic added yet another burden to already stressed providers and clinicians, yet they did it willingly. Their willingness to immerse themselves in an unfamiliar technology has borne significant increases in access, nurses’ and residents’ job satisfaction, and quality of care. Significantly, for chronic cases, telehealth has proven to reduce time-to-care in rural and acute facilities (from 10 minutes to fewer than five minutes) and faster access to specialists.

Telehealth services that make clinical providers available at any time contribute meaningfully to rural, critical care and post-acute hospitals’ daytime rounding, which help offset the serious provider shortage. For these hospitals, incorporating virtual specialty service lines allow for more robust service offerings to patients who would otherwise not have access to this kind of care. That, in turn, not only saves hospitals the cost of recruiting and staffing in-house providers but increases revenue through expanded services and fewer gaps in care. 

Another reason providers welcome telehealth is that it eases tension between nurses and providers. Nurses in rural and acute hospitals now carry the added burden of managing critically ill patients who cannot gain access to nearby at-capacity facilities. Nurses can put in a patient encounter request and the orders are generated in the patient’s electronic health record. This limits verbal orders which can be a cause of medical error. With virtual care, an on-call provider can quickly respond to this request to avoid delays in care, improving nurses’ productivity since they do not need to enter orders themselves.

In addition, nurses are getting little coverage support and are taking on a steady increase in patient ratios. Often these cases bring increased complexity. With a telehealth solution that includes 24/7/365 provider availability, virtual care can increase nurse productivity. Instead of trying to explain a patient story telephonically, the nurse (and patient and provider) benefit from a provider being in the room, virtually, to assess and manage the patient first-hand and enter orders remotely.

Results from a survey by the American Medical Association

 in late 2020 suggest that 60% of providers report telehealth has improved their patients’ health, and more than 80% think it has improved the timeliness of care. Providers are benefitting from telehealth, too. Provider experience has been shown to affect patient experience, and virtual care enables a seamless, convenient, and accessible channel from which both parties benefit.

We providers should welcome the new frontier. This new virtual world allows us to work from wherever we live or travel and still administer care to patients. We can serve our communities with greater impact by delivering care to a wider patient base. We can practice at the top of our licenses by delivering quality healthcare to patients who would otherwise go without it. For providers who have retired from private practice, virtual care offers a way to drive a continuous income stream.

Articles

Patient desire for virtual visits will likely not diminish. But when it comes to telehealth, what do providers desire?

Embrace telehealth and virtual visits to enhance the patient experience

, associate professor of clinical medical psychology at Columbia University discuss the rise of virtual medical education and how they used these tools to curate a publicly accessible course on eating disorders.

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Even before the pandemic, online medical education tools were taking off in particular specialties.

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Being successful and competitive as an independent medical practice means filling that appointment schedule. Here are tips from practice management experts to do just that.

Top five ways to increase patient visits

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Patient visits have a direct impact on the success of your independent practice. Here are six tips from the experts to put into action.

Top six ways to increase patient visits

is the Educational Program Director and a CERTIFIED FINANCIAL PLANNER

 at MEDIQUS Asset Advisors, Inc. He specializes in wealth management solutions

The most valuable asset a physician has is their ability to practice and earn a significant income in their specialty. Physicians can make millions of dollars during their career, and this income is often relied upon to save for important goals like retirement, funding their children’s college educations, and purchasing a new home. What would happen if a physician became sick or disabled and were unable to continue practicing? Without disability insurance, many of that physician’s life goals may need to be sacrificed. Disability insurance can be a significant expense, but it can also ensure many goals are still achieved. 

 Disability insurance typically covers up to 60-70% of a physician’s pre-disability income. If a physician were to suffer a long-term disability, the policy will pay out a monthly benefit amount. These funds can be used to pay for necessary expenses and save for important financial goals. Here are a few key terms to pay attention to when shopping for a disability insurance policy or reviewing an employer provided plan.

: This is the period of time the insured must be sick or disabled and not working 

 the policy will start paying out a benefit. Common elimination periods are 90, 180, and 360 days. Most people try to align their elimination period with the length of time their emergency fund will last.

 This is the maximum length of time a policy will pay out a monthly benefit. Benefit periods could be shorter, in the 3- to 5-year range, or up to retirement ages between 65 and 70 years. A physician should always consider a benefit period up to the age they expect to become financially independent.

: Definitions of disability can vary widely. For example, an Own Occupation definition of disability only pays out if the insured is unable to work and earn income in any type of work. An Own Occupation definition of disability will reduce or eliminate the benefit the policy pays out based on the income the insured is able to earn in any other line of work. A true Own Occupation definition of disability will pay out the full monthly benefit even if the insured is able to earn income in another line of work. A true Own Occupation is a specialty specific policy and provides the greatest level of protection. Physicians should prioritize getting true Own Occupation policies.

If a physician needs disability coverage, they should consider getting that coverage as soon as possible. The premiums are lower the younger you are when you get a policy. There is also less likely to be red flags in your medical history which could lead to not being approved for a policy. Additionally, if you are a medical resident or fellow, many insurance companies offer discounts as high as 20% if you get a policy while still in training.

The differences among records and what’s legally required to be in them

Most people don’t enjoy paying for insurance and some don’t see the importance of having coverage. However, disability insurance protects your most valuable asset—your ability to practice and earn an income in your specialty field. It can be the difference between accomplishing all or most of your goals or accomplishing none of them.

Jeff Witz, CFP® welcomes readers’ questions. He can be reached at 800-883-8555 or at 

200 North LaSalle Street - Suite 2300 - Chicago, Illinois 60601

312-419-3733 - Toll Free 800-883-8555 - Fax 312-332-4908 - www.mediqus.com

Investment advisory services offered through MEDIQUS Asset Advisors, Inc. Securities offered through Ausdal Financial Partners, Inc. Member FINRA/SIPC ∙ 5187 Utica Ridge Rd ∙ Davenport, IA 52807 ∙ 563-326-2064 ∙ MEDIQUS Asset Advisors and Ausdal Financial Partners, Inc. are independently owned and operated.

Disability insurance protects your most valuable asset—your ability to practice and earn an income in your specialty field.

Disability insurance is likely worth the added expense

Jon Luehrs is the Co-Founder of Data Driven Marketing Group. 

Based in Atlanta, GA, Data Driven Marketing Group specializes in growing patient volume for healthcare practices with data powered SEO and digital marketing strategies.

As a physician, you know that a large part of successfully marketing your practice is dependent on how easily new patients can find you when searching online for the best local doctors in your specialty. If your practice’s website does not rank in the top three results on search engines like Google, you are missing out on valuable leads and new patients.

Below are the three most important 2021 SEO tactics that you can implement on your website today to improve your patient acquisition rates.

How to make a great first impression at your medical practice

1. Optimize for Your Practice’s Specific Location

Most new patients search by the city when looking for healthcare providers in their area. Therefore, develop a location specific SEO strategy that optimizes your websites content to include geographical location by 

. For example, make sure your city is mentioned at least one time in all your blog posts, page titles, and URLs. You may also want to make sure your practice location and contact information is registered and up-to-date on Google Maps and other local directory websites, which will improve your visibility in local searches.

2. Research SEO Keywords for the Healthcare Industry at Least Every 3 Months

The most successful practices revisit and update their SEO strategies at least every three months. The healthcare industry is constantly changing—especially during the ongoing COVID-19 pandemic—which means updating your website content is essential for staying relevant and attracting new patients.

Tailor and update your practice's website content as needed based on the latest healthcare 

 and your competition's keywords as well. For example, many people are now researching at-home telemedicine appointments for common, straightforward requests or illnesses which eliminates visits to your practice. To capitalize on this specific trend, write blog posts about the risks of telemedicine treatments and the benefits of in-office professional treatment. This ensures you capture traffic from both search variations about telemedicine appointments.

7 Financial Reports Your Practice Needs to Run

3. Focus on Low-Competition Keywords with High Search Volumes for your Practice's Specialty

This is one of the best ways to stay on top of SEO trends and rank above your competitors. Low-competition keywords are those that are not yet widely used on other doctors’ websites. Focusing on low-competition keywords that are just starting to gain traction can put your healthcare practice at the top of the search results and 

 as one of the leading industry experts for that specific trend.

Next, write and publish content featuring those keywords or topics before the competition has a chance to jump on them. Using low-competition keywords also results in a higher number of original, organic content on your website that is generally favored by Google’s algorithm.

A sound SEO strategy has been proven to significantly grow your online presence with increased organic traffic which in turn will grow your new patient appointments. With so many other medical practices vying for a spot on the first page of Google, it’s important to continually refine your SEO strategy. We know it can be difficult to rank in the top 3 spots on Google for certain keywords, but by implementing the three tactics outlined in this article (such as optimizing your website by including key words and phrases) you will see your page rise above your competition over time. Many physicians across all specialties use these same expert tips and achieve their goal of seeing new patients come through their door.

How you can get new patients by using Google and other search engines. 

Three easy ways to boost your practice’s search rankings

Ericka L. Adler, JD, LLM has practiced in the area of regulatory and transactional healthcare law for more than 20 years. She represents physicians and other healthcare providers across the country in their day-to-day legal needs, including contract negotiations, sale transactions, and complex joint ventures. She also works with providers on a wide variety of compliance issues such as Stark Law, Anti-Kickback Statute, and HIPAA. Ericka has been writing for Physicians Practice since 2011.

As the end of the year approaches, physician practices need to start planning for 2022. From a legal perspective, this planning should include a review of the practice’s compensation methodology to assure compliance with Stark regulation clarifications, which will take effect January 1, 2022.

The Stark law generally prohibits a physician from referring a Medicare patient for a designated health service (DHS) to an entity with which the physician has a financial relationship, unless there is an applicable exception. DHS includes many ancillaries which are used in physician practices, such as DME, laboratory, and radiology services. Referrals within the physician practice implicate the Stark law since physicians have a financial relationship with their own practice.

Physician practices that qualify as “group practice” under Stark’s definition can take advantage of an exception to Stark known as the in-office ancillary services (IOAS) exception. Under this exception, physician practices can self-refer Medicare patients for DHS by generally meeting certain location, billing, and supervision requirements.

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A key component of being a “group practice” under Stark is making sure that the group practice is allocating revenue for DHS profit in a compliant manner. This means that a physician practice must have a methodology that at all times allocates the revenue from DHS in a manner that does not reward physicians directly for their referrals. Although Stark’s DHS allocation rules have been in place for years, CMS felt that clarification of the requirement was appropriate. Among the key points CMS clarified about the profit allocation rules were the following:

A group practice cannot distribute profits from DHS on a service-by-service basis (also known as "split pooling"). This means, for example, that dividing up MRI DHS equally, but dividing up lab DHS based on overall profits, is not acceptable. Instead, CMS wants group practices to aggregate all revenue and expenses from all DHS service lines and then distribute that revenue using the same methodology. Popular approaches to allocate revenue and expenses within a group practice included equal distribution, based on ownership percentage, or based on overall productivity (not including the DHS).

A group practice can also segregate and allocate DHS profits generated by "pods" of at least five physicians and within those pods, the group is permitted to use different profit allocation methodologies. However, within each pod, groups must use the same one methodology for all DHS.

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To start the process of evaluating a practice’s compensation approach, consider the following:

Draw a diagram of the practice so you can clearly see which physicians are rendering services in the practice and how they are organized (i.e., location, specialty, etc.)

Identify any groupings of five (5) or more physicians.

Identify the DHS being offered by the practice. This should include Medicare ancillary services only. Confirm the current DHS codes at 

https://www.cms.gov/license/ama?file=/files/zip/list-codes-effective-january-1-2021-issued-december-1-2020.zip

. Note that some DHS are not listed based on CPT Code, but the category of the service is considered DHS, such as drugs, pathology and durable medical equipment.

Identify how revenue and expenses of the DHS are being allocated to physicians in the group practice. If all DHS is being allocated in a permissible manner among all physicians in the practice, the analysis is complete.

If DHS is being allocated in multiple different ways among the practice physician, the practice must choose a single methodology to put in place starting January 2022. If the group has identified pods of five or more physicians, a single methodology must be chosen to allocate the DHS generated by the pod. It need not be the same methodology as the remainder of the group practice as long as it is compliant. 

If the group determines that it has been allocating DHS in a manner that is based on physician referrals, the group should take steps to bring the practice compensation approach into compliance by January 2022. The practice should then talk with counsel for guidance about reporting any Stark non-compliance. CMS has a specific Self-Referral Self-Disclosure Protocol to report identified Stark compliance issues. 

Put in place a plan to review the group practice’s compensation approach annually. Because group “pods” can change in size over time as physicians join and leave a practice, and DHS covered by Stark changes annually, it is advisable to conduct an annual audit of the group practice’s compensation methodology.

Compliance with Stark is essential for physician practices that see Medicare patients and self-refer for DHS. The consequences of non-compliance are financially and legally significant. Talk to your health law counsel and financial advisors so that a plan can be in place before the end of the year.

, JD, LLM has practiced in the area of regulatory and transactional healthcare law

for more than 20 years. She represents physicians and other healthcare providers across the country in their day-to-day legal needs, including contract negotiations, sale transactions, and complex joint ventures. She also works with providers on a wide variety of compliance issues such as Stark Law, Anti-Kickback Statute, and HIPAA. Ericka has been writing for Physicians Practice since 2011.

Here’s how to make sure your practice is in compliance with Stark regulation clarifications taking effect January 1st, 2022.

Review your practice’s compensation methodology before the end of the year

, JD, has practiced law exclusively in the areas of asset protection, risk management and wealth preservation for the last 16 years. He helps protect a national client base with more than $5 billion in personal assets, including several thousand physicians. He is a contributing author to multiple books for physicians and a frequent medical conference speaker and CME presenter. 

Asset Protection Attorney and regular Physicians Practice contributor 

, an investment advisor representative and the founder and president of 

 to discuss the most common and costly asset protection and wealth preservation mistakes high-earners make, what high earners need for a compressive asset protection and wealth preservation plan, and more.

Two experts discuss the most common and costly mistakes high-earners make.

Ike Devji, JD and Anthony Williams, Part 2

Is your practice plagued with no shows, cancellations, and a schedule filled with blanks? Are your waiting rooms only half filled? Well, let me ask you this question: Do you have the contact information for all of your patients in a place that is easily accessible? I'm guessing it's somewhere in your medical record going unused. Let me teach you how to hack one of the most important things to a successful practice: patient retention.

I promise if you follow these instructions, you will be well on your way to marketing automation and this will keep your patients in your practice for the long term.

Retain more patients with these four tips

, is passionate about using technology to improve the lives of patients and healthcare providers. She graduated from the University of Illinois College of Medicine and was a pediatric resident in the Kaiser Permanente Oakland/Berkeley MPH program before making a career shift into digital health. She advises and directs early-stage health technology startups with her carefully honed skills in communication, strategy, research, and product development. She is a licensed California physician and runs a boutique medical practice in San Francisco specializing in health optimization.

These four tips can make current patients long-term ones.

Alfredo Rosing is the Vice President of Marketing at Greenbox Capital®. 

With over 25 years of combined experience in marketing and financial services, Alfredo is an expert on innovative financial technologies with a passion for connecting consumers and businesses with socially responsible funding. Prior to joining the Greenbox Capital team, Alfredo launched an award-winning online lender that was recognized as the winner of the 2017 Fintech Awards US Firm of the Year for Lending Innovation Award. Alfredo is a graduate of Southern New Hampshire University with a BS in Marketing.

Whether you’re opening a private practice, supplementing your cash flow, or expanding your offices, medical practices of all sizes and specialties can benefit from an infusion of working capital.

Between traditional SBA and bank loans and new forms of alternative funding, it can be difficult to determine what medical practice funding is best for you. Keep reading to learn more about 6 of the most popular physician business loans.

Two things every standout healthcare manager does

1. Small Business Administration (SBA) loans

SBA loans are not actually provided by the SBA—they are disbursed by partnering banks and guaranteed up to 85% by the SBA. Multiple SBA loan options exist, including the popular 7(a) Guaranteed Loan program, microloans, express loans, and 504 Local Development Company Program loans.

SBA loans typically offer the lowest rates, longest terms, and largest loan amounts (up to $5M), making them the preferred option for many physicians. However, these loans are the most difficult to acquire with the longest application process and extensive paperwork requirements, including years of detailed business and personal financial documentation. Collateral or a personal guarantee are typically also required.

Business owners with exceptionally strong credit seeking a long-term loan

Bank loans may be easier to acquire than SBA loans, especially if you have an existing relationship with a lender. Terms and rates are competitive and typically depend on the size of the loan; however, similar to SBA, it may take weeks or longer to learn whether you’ve been approved, and approval is never guaranteed. Collateral or a personal guarantee is often required.

Some lenders, including Wells Fargo and Bank of America, offer funding options designed specifically for doctors. These loans consider the unique profile of medical practices, including factors like student debt or low cash reserves.

Start-ups looking for customized funding that considers unique circumstances like student debt

Established, larger practices with strong financial histories and a clear idea of how they’ll use their funding

A merchant cash advance (MCA) is a non-loan form of financing that is available from alternative lenders, including direct online lenders like Greenbox Capital®, OnDeck, and Kabbage. With an MCA, a business is granted a cash advance in exchange for a percentage of their daily or weekly debit and credit card sales until the advance has been repaid.

Rates may be higher than traditional forms of funding, but lending requirements are more flexible and the application process is significantly streamlined. Approvals are based on the overall health of your practice, not just your credit records and financial history. In some cases, approval can even be made in as little as one business day.

Businesses who need immediate funding or fast access to working capital

Businesses seeking smaller loan amounts and shorter terms

Businesses who would not be approved by traditional lenders, such as businesses with low credit scores

Lines of credit are available from traditional banks and alternative lenders. They function similarly to a business credit card, but typically for longer terms and with larger limits.

Lines of credit offer the most flexibility, allowing you to draw and repay from the line whenever needed. You only ever pay interest on the amount borrowed.

Business with a strong credit history who want a cushion to fill cash flow shortages

Businesses who need flexible access to working capital

Practice acquisition loans are designed specifically for the purpose of 

purchasing a retiring doctor’s practice

Some lenders, including Wells Fargo and the Bank of America, offer specific lending programs designed for doctors looking to purchase an existing practice. Collateral or a personal guarantee are required.

Practice acquisition loans are ideal for:

Established businesses with strong financial histories who are looking to expand to a new location

Start-ups looking to purchase an existing practice from a retiring physician

Why you should know your patient’s behavior styles

Medical equipment can be expensive to purchase and repair. Equipment financing is designed to finance the purchase or repair of medical equipment, such as imaging machines, diagnostic equipment, lab equipment, exam tables, computers, wheelchairs, and more.

The equipment serves as collateral, and terms will typically match the lifespan of the equipment. A down payment may be required.

Businesses with significant or immediate equipment needs

The best medical practice loan ultimately depends on your goals and your practice’s creditworthiness. 

Six medical practice funding and physician business loan options

Founder and CEO of San Francisco based Curebase

Their solution is a decentralized clinical trial software platform and clinical service provider. Curebase enables any patient, anywhere, to participate in clinical trials at home and with their own doctor.

The COVID-19 pandemic proved that the healthcare industry’s traditional model for clinical trials represents a limited model for medical research. What we define as conventional trials are costly, slow, and cap diversity and participation, and as a result often stifle the research that they are intended to promote. However, decentralized clinical trials (DCTs), which leverage technology to collect patient data remotely, are now changing the industry by helping to increase trial access and participant diversity.

As DCTs continue to evolve, we see that technology is allowing us to bring research into almost any clinical setting. In fact, patients can even identify trials and bring their own physician on board to administer most of the care. This is a concept I like to call “Bring Your Own Physician” (BYOP). 

Abrupt switch to patient-centric decentralized clinical trials

 encouraging CROs, PIs, and sponsors to adjust their clinical trials to better navigate the challenges presented by the pandemic. Some trials that began centralized became DCTs, making the process more patient-centric. The industry quickly saw that the recruitment, diversity, and speed benefits of the DCT approach were compelling. The FDA continues to support this guidance today. 

The volume of DCTs is expected to grow in the coming years, as demonstrated by 

 that captured the dramatic shift in attitudes by pharmaceutical companies and contract research organizations (CROs) toward virtual clinical trials. In December 2019, 38% said they expected virtual trials to be a significant component of their portfolios, and 48% expected to run a trial with most activities conducted in participants’ homes. However, a year later, in the midst of the pandemic, 100% expected virtual trials to be a major component of their portfolios, and 89% expected to run a trial with most activities conducted in participants’ homes. The industry is changing. 

In the foreseeable future we will see DCT continue to evolve and find the best methods for executing effective and efficient research. During this time of iteration, technology will be leveraged to advance DCT solutions around issues like recruitment, data integrity, trial diversity, and security. But most importantly we will see research trials becoming part of a healthcare practitioner’s daily arsenal for treating their patients. More simply, research will center around the patient and their healthcare team, not the other way around.

Leveraging participants’ doctors as part of the trial team

One of the industry’s most recent and significant DCT innovations is BYOP. The idea is simple, focus on working with the patient’s preferred physician administering the majority of standard medical care and data collection, while validating and submitting the details through technology to the PI’s team, thereby improving recruitment, compliance, and completion rates. This approach is exceedingly valuable to the industry because not all trials can be done from home, many require detailed and intricate treatment plans, and people are reluctant to travel to participate.

The BYOP model is crucial to unlocking the greatest capabilities for a decentralized trial. First, travel issues are eliminated by the program design and the local accessibility is more attractive to the patient. Second the patient continues to use with their trusted care team, which improves engagement and compliance with the trial, regardless of complexity. And finally, recruitment is markedly improved with the ability for medical doctors across the nation to make the trial available to their patients.

Mid-pregnancy is a time when you are very unlikely to pry an expectant mom away from her clinician and into a research environment. However, leveraging the BYOP model, the patient’s own trusted care team can conduct regular exams, collect real-world data, and talk about trial-related issues and experiences, while adding this information to the trial database.

Having trial participants work with their own OB/GYN can also improve trial retention and consistent compliance. Simply, moms-to-be are already attending many health appointments, so additional touchpoints are rarely necessary, making the experience easier on the patient. Also, these trusted patient-physician relationships establish more open lines of communication, enabling trial sponsors to boost the quality and accuracy of information gathered throughout the process.

Further, technology integrations mean that OB/GYNs are not required to do any additional work, in most cases. The data is recorded as part of the patient’s normal care, then technology securely provides the necessary information to the researchers.

Overcoming patient transportation barriers to care

Thanks to modern technology, both patients and physicians can suggest the idea of a clinical trial as a care option under the BYOP model. Clinical research could then potentially be considered a standard interventional treatment offered as a care alternative to eligible patients, making local primary care physicians, specialists, and clinic teams key members of many clinical trial teams. Furthermore, solving for the many challenges associated with recruitment and compliance will dramatically advance research as a whole.


The future of medical research is patient focused. Increasingly, qualified patients will participate in clinical trials locally with their own doctors via BYOP and trial participation will become a standard of care option. As access and diversity expand, each study’s scale, depth, and quality will continue to improve. Although there are undeniably some state and federal 

 ahead, DCTs have already demonstrated their efficacy and earned the support of regulators and other industry stakeholders. The future of clinical trials is here, and it is a future of decentralization, virtual technology, greater patient access, and wider participant diversity.

Technology is allowing physicians to bring research into almost any clinical setting.