As you sit down with your physician partners, practice manager, and perhaps consultant over the coming weeks contemplating direction for 2023, I thought it may be beneficial to offer a few pointers to help you along the way. For starters, you should pause to reflect upon new competitors in your catchment area, as well as current competitors and new initiatives they are taking on. For physician practices, a competitive analysis is a means to assess who your competitors are, what value they provide, understanding their (and your) strengths and weaknesses, and where your practice fits in. A good competitive analysis is a scouting report of the actual market terrain that your practice must navigate in order to be successful. While analyzing the competition is an essential component of your strategy, most medical practices don't conduct this type of analysis systematically enough. However, a thorough competitive analysis is indispensable.

Gather a list of your practice's competitors. 

Most of the time, such a list is comprised of who your practice considers to be its chief competitors. However, there may be other healthcare organizations that indirectly compete with yours, perhaps ones outside of your catchment area that offer services such as telemedicine or niche treatment modalities that are aiming for the same patients. You will also want to include information on healthcare entities that may be entering your market in the coming year. Once you have compiled the list, you can highlight those practices that will be the greatest challenge.

Analyze the competition's services in terms of features, value, and target patients. 

How do they market them? How do patients see your competition? How do referring physicians view your competition? Take an honest look at their offerings. Is your quality commensurate? Do you have similar offerings? What is the unique value you provide that competitors don't or can't? Emphasize these benefits in your marketing.

Compile a list of competitor strengths and weaknesses and remember to be objective. 

You'll do your practice no good if you allow bias toward your own physicians, staff, and services to cloud your judgment. Try to see the competition's practice as though you were them. What makes their practice so great? If they are growing rapidly, what is it about their practice that's promoting that growth?

Observe how your competitors market themselves through advertising, collateral material, and perhaps the use of physician liaisons. 

You will have to go to many different sources to get a complete picture. It takes practice and a little shrewdness on your part to piece together a complete picture of strategies and objectives, so the use of a qualified consultant may be to your benefit. Focus on the facts, be persistent, and trust your intuition to help you.

Determine the current market demographics for your practice.

 If the market is flat, then the competition for patients is likely to be fierce. Your practice will find itself scrambling to win market share. The outlook portion of your analysis may seem like forecasting, but it's really a measure of trends. By the time you've done most of your research, you'll have enough information to determine what the outlook really is.

By evaluating yourself against your competition, you'll likely find new ideas for your practice. While compiling a competitive analysis is an interesting piece of work, it can indeed be challenging. Consequently, you may want to seek the help of a healthcare consultant to guide you through this process. You'll learn a lot about your market and in the process become a more valuable resource for your patients and referring physicians.

From there, you will want to get into an abbreviated strategic planning process.That is, development of a plan (with timelines and objectives!) for what you plan to accomplish for 2023.Strategic planning is an essential business activity. However, several common mistakes must be understood so that physician owners can guard against them. Pointing out these mistakes is not a criticism of the process but acknowledgement of improper implementation. Medical practice leaders must recognize both the benefits and the potential pitfalls of strategic planning, because it is their responsibility to ensure that strategic planning is conducted properly to achieve the desired goals. Here are four of the most-common planning mistakes we find:

1. Attempting to forecast and dictate events too far into the future.

In part, this may result from the natural desire to believe we can control the future. It is a natural tendency to plan on the assumption that the future will merely be a linear continuation of present conditions, and we often underestimate the scope of changes in direction that may occur. Because we cannot anticipate the unexpected, we tend to believe it will not occur. In fact, most strategic plans are overcome by events much sooner than anticipated by practice leaders.

This is not a criticism of detailed strategic planning but of planning in more detail than the conditions warrant. This pitfall often stems from the natural desire to leave as little as possible to chance. In general, the less certain the situation, the less detail in which we can plan. However, the natural response to the anxiety of uncertainty is to plan in greater detail, to try to cover every possibility. This effort to plan in greater detail under conditions of uncertainty can generate even more detail. The result can be an extremely detailed strategic plan that does not survive the friction of the situation and that constricts effective action.

3. Tendency to use planning as a scripting process that tries to prescribe actions with precision.

When practice leaders fail to recognize the limits of foresight and control, the strategic plan can become a coercive and overly regulatory mechanism that restricts initiative and flexibility. The focus for staff members becomes meeting the requirements of the strategic plan rather than deciding and acting effectively.

4. Tendency for rigid planning methods to lead to inflexible thinking.

While strategic planning provides a disciplined framework for approaching problems, the danger is in taking that discipline to the extreme. It is natural to develop planning routines to streamline the strategic planning effort. In situations where planning activities must be performed repeatedly with little variation, it helps to have a well-rehearsed procedure already in place. However, there are two dangers. The first is in trying to reduce those aspects of strategic planning that require intuition and creativity to simple processes and procedures. Not only can these skills not be captured in procedures, but attempts to do so will necessarily restrict intuition and creativity. The second danger is that even where procedures are appropriate, they naturally tend to become rigid over time. This directly undermines the objective of strategic planning — enabling the organization to become more adaptable. This tendency toward rigidity is one of the gravest negative characteristics of strategic planning and of strategic plans.

Strategic planning is one of the principal tools used to exercise operational control because it will help you to decide and act more effectively. Remember though, that strategic planning involves elements of both art and science, combining analysis and calculation with intuition, inspiration, and creativity. To plan well is to demonstrate imagination and not merely to apply mechanical procedures. Done well, strategic planning is an extremely valuable activity that greatly improves practice performance and is an effective use of time. Done poorly, it can be worse than irrelevant and a waste of valuable time. The fundamental challenge of strategic planning is to reconcile the tension between the desire for preparation and the need for flexibility in recognition of the uncertainty of the healthcare industry.

Nick Hernandez, MBA, FACHE, is Founder & CEO at ABISA, LLC

Articles

It's never too early to start planning next year's strategy.

Planning your 2023 strategy

Dr. Alex Marsh is the Chief Medical Officer of Reperio, and a practicing emergency physician in North Dakota.

The post-Covid healthcare crisis is upon us, with gaps in preventive care in 2020 morphing into full-blown chronic diseases in 2022, putting the 

 who live with at least one chronic health condition at higher risk for adverse events.

Meanwhile, physician shortages — driven largely by 

 — have left community hospitals without the staff to attend to patients who need critical, often lifesaving, care. As a physician working in a small critical access hospital in North Dakota, I never imagined we’d be so understaffed to the point we’d need to fly our patients out of state to other facilities that can handle a higher level of acuity.

Given these converging trends, we need to rethink healthcare in a big way. Our healthcare system needs to be redesigned to work smarter to address chronic disease, mitigate risk factors, and get ahead of future health emergencies. As we acclimate to pandemic life, with an eye toward the horizon, it’s clear that the only way forward involves a massive shift toward prevention and preventive care.

The technology we choose, as providers, and the technology we recommend to our patients, is a major element of this movement.

Telehealth and other home-based health tools and applications proved 

, when non-emergency health facilities temporarily shut their doors. But over the last year or so, as health facilities began seeing a resurgence of patients who had put off preventive care, telehealth use has declined again in most areas outside of behavioral health because of a lack of payment parity (while coverage is pretty universal, only 

 have payment parity laws for telehealth).

Yet many of the benefits of virtual care and other technologies used by patients outside of healthcare settings are underestimated. We don’t need physical locations for pre-operative consultations for routine procedures such as colonoscopies, and many pediatric visits can be done remotely.

Given the ongoing physician shortage crisis, policymakers need to think about reimbursement discrepancies, and whether they’re truly supporting future healthcare-delivery needs. Healthcare providers must also ask themselves how to invest technology that engages patients in a convenient way, while also driving better outcomes and cost savings.

For example, if a technology application or tools can help a 27-year-old patient who rarely visits their doctor identify a major health risk (e.g., prediabetes), that’s huge. About 

 young adults have diabetes, but many don’t know it until they end up in the hospital in an emergency. In this new world where hospitals are chronically short-staffed, every prevented emergent care visit counts.

Also, as part of our overhaul of healthcare, we need to reimagine preventive care through the lens of convenience. We need to ask ourselves what we can do at home, and how we can make home-based health technologies compelling and even fun to use.

As we rethink healthcare delivery, health leaders, physicians and other stakeholders need to focus more on prevention — so patients have the tools and resources they need to stay out of the hospital.

We can’t shift toward a prevention-mindset, however, without supplementing or enhancing in-person care – at our PCPs, OBGYNs, etc. – between scheduled visits. We need to engage our 28-year-old, 48-year-old and 68-year-old patients in a way that drives behavioral change and prevents adverse events and chronic disease. Here’s how health leaders, clinical workers and other can do this in the movement toward a new model of convenient, prevention-focused, value-based healthcare:

 be done remotely? These questions are the starting point for any investment in patient-facing technology or solution that patients should engage with between in-person visits. If a physician, for example, wants a patient to track their food intake and exercise to manage their diabetes, they should recommend the use of an app or program that offers health coaching and/or dietary counseling, and can potentially share data with the physician to hold the individual patient accountable.

Incorporate more virtual tools into brick-and-mortar operations.

 As technologies advance, so do our abilities to use them to enhance and speed up care. Telestroke applications, for example, have enabled hospital emergency departments to speed up care by connecting patients experiencing symptoms of a stroke to neurologists throughout the country. As 

, telestroke hospitals had relative rates of reperfusion treatment that were 13% higher and relative rates of 30-day mortality that were 4% lower, compared with non-telestroke hospitals. Exploring virtual care use cases that can enhance primary or specialty care is going to become more essential as resources dwindle. The sooner physician practices can find out how and where to leverage telehealth, the better off they’ll be.

Empower and encourage patients with the right home-based tools, coupled with the right guidance.

 Putting the right screening tools in front of the right patients at the right time — and in the right place — can make a measurable difference in outcomes and outlook. Home-based screening kits that can measure multiple biometric values, such as weight, BMI, cholesterol, blood-glucose and more, in a convenient home setting and communicates and processes data through a mobile app to a central hub are game changers: They can enhance patients’ awareness of their overall health and generate metrics that can be shared with physicians and other healthcare providers, who can recommend next steps. At-home cholesterol or diabetes screening kits have the potential to help health plans, providers and patients broaden and deepen their population health risk assessments: If 10% of seemingly healthy individuals had diabetes but hadn’t been diagnosed yet, a home testing kit could gauge any abnormalities in blood-glucose levels.

Shifting to a prevention-centered mentality is more critical than ever, given physician shortages and the rise of chronic disease. Encouraging patients to engage with their health while at home will foster a new kind of relationship with the health system, one that emphasizes disease prevention and accountability. And by connecting patients to preventive-care tools that are convenient and engaging, we’re lessening the burden of our emergency medicine providers, while also helping patients live their best lives.

To lessen the strain on our emergency medical systems, we need to amplify our focus on preventive medicine. Home-based health tools and applications, and screening solutions can help us do that.

Rethinking health care delivery through home-health technology advancements

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. He contributes a weekly video for 

 on practical ideas to enhance productivity and efficiency in medical practices.  His 5–7-minute videos and short articles provide practical ideas that can be easily implemented and incorporated into any medical practice. Dr. Baum can be reached at 

There are two types of employees: the go-getters and the gunnas. The go-getters are those who have a clear vision of setting out to do something, giving it their all, and accomplishing it. They don’t need to be monitored. They are the first to arrive for a meeting or at work and the last to leave at the end of the day. They are self-starters and serve as role models for others. They are the ones when given a task who declare that they 

 to get it done. The go-getters are the ones you want to hire and have on your team or in your practice.

On the other hand, the gunnas are the ones who are gunna get around to doing what you ask of them. They are the ones that have excuses and reasons why they didn’t do what is expected. They are the ones who declare that they will 

 and do what is asked or expected of them. The gunnas must be led by the hand and they constantly need to be reminded of task completion and deadlines. They are a drag on morale in the office and you constantly ask, “Why did I hire this person?”

Who do you want on your team, the go-getters or the gunnas? This blog will provide you with suggestions for identifying the go-getters and how to include them in your practice or on your team.

They have visions of themselves making great accomplishments. They have lofty goals, and they genuinely believe that they can achieve them. When interviewing a potential go-getter, ask him\her where they want to be five- and ten-years after they are accepted as an employee. Ask them how many goals they have already achieved?

Go-getters are visible from first thing in the morning and at the end of the day

Arriving before everyone else and leaving after the others have departed is not a pithy adage. It marks the behavior of a go-getter.Ask a potential employee about their last job and what was their typical day like; when did they start the day and when did their day end? When doing a reference check, ask previous employers about the arrival and departure of the employee. This one-character attribute will tell you about the discipline of the potential hire.

Go-getters keep score and reward themselves

Yes, it would be nice if your employees received daily or regular accolades about their performance. But this is not likely to happen.Consequently, it is go-getters who recognize their own accomplishments and give themselves a pat on the back and not wait for others to acknowledge their success and achievements.

There’s a story about Supreme Court Justice Sandra Day O’Conner who had a sign in her chambers that said, “If you want a pat on the back, lean here!” I am sure that is why SDO was surrounded by go-getters not waiting for verbal compliments.

Go-getters have passion and fire in their bellies

Very little can be accomplished if there is a lack of excitement about the job or the project. It is helpful when trying to identify a go-getter to ask what they are passionate about.If there is no response, you may be interviewing a gunna! Go-getters are passionate about what they do and are excited to work on something they care about.

At the end of the interview, ask the interviewee if they have any questions. If the answer is no that they don’t have any further questions, this is an indicator that that they have little curiosity and are probably going to be a gunna and do the minimum amount of work. If, however, they have done their homework, did some research about the practice on Google, looked at the walls of the office manager or the doctor where the interview takes place and ask questions about one of the diplomas, the artwork, or even the mounted deer head on the wall, then you have learned about the level of curiosity of the potential new employee.

If you receive a thank you note in a timely fashion from the interviewer, especially if it is handwritten, you are likely to identify an employee who will be nice to patients, physicians, and fellow staff members. Failure to receive a thank you note, is a sign of self-importance and lack of appreciation, i.e., you have discovered a gunna!

Bottom Line: Good employees are hard to find especially in this sellers’ marketplace. Ideally, you would like to have an entire staff of go-getters. By using a few of these suggestions, I think you can identify the go-getters. Remember, go-getters will get you to the top; gunna’s will drag you down. So go for the go-getters and avoid at all costs gunnas.

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,

which has sold over 225,000 copies and has been translated into Spanish. He contributes a weekly video for Medical Economics on practical ideas to enhance productivity and efficiency in medical practices. 

Who do you want on your team, the go-getters or the gunnas?

Finding go-getters and avoiding the gunnas

, 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. 

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 a February 2021 story on how to make winter storm damage insurance claims, Ike Devji, JD writes the following:

“It’s vital that you are adequately insured for both liability and loss, including property damage, contents, and business interruption, among others. Make sure you understand vital policy details like the difference between being covered for replacement cost (the dollar amount needed to replace a damaged item with one of similar kind and quality, 

) and actual cash value (which pays only the amount needed to replace the item at its current market value 

It’s vital that you are adequately insured for both liability and loss, including property damage, contents, and business interruption, among others.

Most polices require you to take reasonable measures to prevent further damage to your property like covering a hole in a roof with temporary shelter, calling 

a qualified and licensed restoration contractor

As is reasonably possible, document the damage to your home and/or office with an inventory of any damaged items you can immediately spot, including personal property in your home, damage to vehicles and medical equipment, fixtures, signage, and office equipment, as well as documenting any appointments that had to be cancelled and other loss of revenue related to the damage.”

 to read the rest of the article and be sure to check back next week for another 

Your weekly dose of wisdom from the Physicians Practice experts.

Practice tip of the week: How to make winter storm damage insurance claims

Dr. Acey Albert is a board certified internist and pediatrician and director of clinical content at 

, the #1 mobile medical reference app among US physicians

There are currently many challenges in healthcare causing physicians to experience burnout and question their career paths – the pandemic, staffing shortages, and payor requirements, to name a few. One well-described burnout driver is physicians feeling a lack of autonomy and control in their profession. Unfortunately, it can be difficult for non-clinical administrative leaders to understand the severity of burnout and the nuances of the underlying causes, and efforts to address burnout can fall flat. To mitigate physician burnout with efforts that land on target, more physicians need to step into leadership roles. By taking the reins of leadership and channeling their expertise and adversity into leadership activities, physicians can improve their own career satisfaction and simultaneously drive meaningful change for both physicians and patients within their healthcare organization.

Why more physicians are needed in the C-suite

Physicians have the capability to become leaders and innovators beyond direct patient care. Many are natural born leaders who hone their leadership skills every day, patient by patient. In healthcare, it doesn’t take long for a physician to realize that the best quality and experience of care for their patients relies on their ability to lead patients and clinical staff. Medicine is truly a team sport and physicians need to become a master coach to drive better healthcare outcomes. In this way, physicians possess a unique skill set that healthcare leadership needs.

Physicians need a seat at the leadership table because they are uniquely qualified to keep the care in healthcare. Physicians are the ultimate advocates for patients, particularly in organizations and systems in which patients don’t have a formal voice. That’s hard to come by in a typical healthcare organization’s executive suite. Health system CFOs don’t see patients sacrifice heat in the winter because their bill for an admission went to collections. The medical group COO doesn’t see a patient show up to a clinic in florid heart failure because it took two weeks to get an appointment. The resource utilization director of a pharmacy benefit management company doesn’t see a diabetic patient lose a foot to infection because they couldn’t afford their insulin. Those experiences happen only where doctor and patient meet. 

Physicians often wish they could do more for patients, and that’s made possible when a leadership opportunity presents itself. In my own career, a mentor who offered me a leadership position asked me how many patients I care for per day. Accounting for office visits and all the phone calls and portal messages, I guessed around 50 to 70 patients. He then said I would have the ability to care for hundreds of thousands of patients every day in a leadership role, and that really opened my mind.

Physicians – Start small to step into leadership 

Physicians who are feeling a lack of control can start small to expand their impact and solve problems beyond patient care. They don’t have to step into a huge leadership role right away. The healthcare industry is peppered with problems to solve, and even the most seasoned physician leader can’t solve every issue at once. They can find one small issue to solve instead of letting frustrations build. For example, if a physician struggles with an EHR template, they can volunteer to work with the responsible party to offer changes and updates. If they are concerned about patients with communicable respiratory illnesses sharing the same small waiting room as healthy elderly patients at high-risk for hospitalization for those illnesses, they can brainstorm and offer a solution.

Physicians can’t do it alone – How organizations can support physician leadership

Care organizations need to support and encourage physicians to be drivers for change. This comes to fruition with systems that drive encouragement, opportunity, mentoring, and training. Physicians must be encouraged by their organization to offer solutions, share feedback, and take on projects they feel passionate about. This can be amplified with mentoring and training programs. Business school isn’t entirely necessary for physicians to move up the ranks in healthcare leadership. Instead, physicians need more visibility into different functions and business partners who can help translate things like HR policies and balance sheets, just as those physician leaders need to translate the practice of medicine to those partners. This way, physicians can understand key aspects of these business functions and use their experiences in patient care to collaboratively drive improvement in operations and patient care. 

Instead of feeling helpless, physicians need to understand the power they have to make a change beyond face-to-face patient care. Simultaneously, healthcare organizations need to establish processes that allow physicians to become leaders with more visibility and development opportunities. With more physicians in leadership, the industry will see more physicians fulfilled in their career, and ultimately a stronger healthcare system.

Physicians need a seat at the leadership table because they are uniquely qualified to keep the care in healthcare.

Why healthcare leadership needs more physicians

Brendan Crotty is head of product Management at InstaMed a J.P. Morgan company.

For a modern medical practice, efficiency is everything. Labor costs continue to increase, putting a pinch on practices that are still recovering from pandemic shutdowns.

An August 2022 snapshot of practices shows that, although physician productivity is increasing, 

Every person in the practice must work at peak efficiency, from the physicians and nurse practitioners to assistants, front-office staff, medical billers and coders. Reducing manual processes can result in increased revenue while freeing up staff to perform more value-added functions to grow the practice or expand service offerings.

Receivables are the lifeblood of every practice. However, many practices still send paper statements and limit means of electronic payment that patients increasingly prefer.

Hendersonville Pediatrics, which serves Western North Carolina, faced this situation, with paper statements that confused and frustrated families and resulted in increased call volume. By adopting electronic statement and payment processes, the pediatrics practice increased total online payments by 123% and total patient payment volume by 82% while greatly reducing call volume that was sapping employee productivity.

Take notice of these four key payment trends that are impacting pediatric practices:

Although the percentage of Americans using 

 (HDHP) decreased between 2020 and 2021 to 28%, 

 for 2023 are $3,000, with a maximum out-of-pocket for in-network services of $15,000. Families could be financially liable for dozens of in-office visits and procedures before insurance pays for anything.

Even for those with more traditional insurance, deductibles and co-pays continue to increase, placing more payment burden on patients and their families. According to the InstaMed Trends in Healthcare Payments Twelfth 

, nearly half of American households incurred healthcare expenses in the previous 12 months. Nearly one-fifth of respondents (17%) owed more than $1,500. It’s not surprising, then, to discover that nearly one-third of Americans declined to seek medical care due to the cost of that care.

Medical practices can learn from payment trends among hospitals, which show higher balances and increasing difficulty to pay. 

 accounts dropped to 55% in 2021, down from 76% the previous year. The percentage of balances in excess of $7,500 more than doubled between 2018 and 2021, growing to nearly 18% of all balances. Even more troubling, 60% of patient bad debt in 2021 could be attributed to self-pay after insurance accounts, a 450% increase from three years earlier.

2. Inefficient Manual Processes Harm Productivity and Collections

Like many practices, Hendersonville Pediatrics was relying on paper statements to collect balances from families. The InstaMed reports notes that 70% of consumers receive medical bills via mail, but that only 9% want to pay that bill with a paper check.

According to practice leaders, the statements were confusing for families and balances often did not reflect insurance adjustments or clearly detail the amount owed. Families sometimes received balance-due bills even though they didn’t owe the practice anything. Because statements were confusing and often misleading, a significant amount of call volume coming into the practice concerned billing questions and what families owed.

Manual billing processes can slow payments that are vital to the 

. However, 70% of providers say it takes more than 30 days after a patient visit to collect on that visit and 74% say that means more than one statement. As a result, nearly one-half of practice leaders say their A/R days increased during 2021.

The potential savings from electronic transactions are huge, with the Council for Affordable Quality Healthcare (CAQH) estimating that healthcare could 

 by fully adopting electronic transaction methods.

3. Consumers Want Digital Payment Options

In terms of billing and collections, patients are far ahead of providers in the acceptance of electronic statement and payment options.

The InstaMed payments report shows that 75% of providers primarily use paper and manual processes for collections, while 74% of consumers prefer online payment options for medical bills. While four in 10 providers believe their billing and collection effort have no impact on the patient experience, five in 10 consumers overall say they would consider changing providers for a better healthcare payments experience, including 74% of Millennials — those ages 25 to 40. Millennials overwhelmingly want digital platforms for medical bills (80%) and mobile apps for medical bills (85%).

Overall, 87% of consumers want to make all their healthcare payments in one place, and 25% of consumers have ended a transaction for a medical bill because the provider didn’t offer credit/debit payment options. Although 73% of consumers indicate a willingness to receive electronic statements, just 3% are enrolled in them. One possible reason for the poor adoption could be a failure on the provider’s part to widely publicize the availability of electronic statements, which cost considerably less to compile and send than paper statements.

4. Electronic Practices Bring More Revenue

Hendersonville Pediatrics now uses an electronic payments platform that integrates with its practice management system so users can see the full clinical and financial picture in one place.

Intuitive and consumer-tested bill design makes it easy for families to see what they owe and understand how that amount was calculated. Statements have also improved the overall family experience, practice leaders say. As a result of online options, patient pay volume has increased by 82% and total online payments have increased by 123%.

The practice now offers electronic statements, which comprise 20% of all statements. Families can manage their statement and payment information in one place and also receive text payment reminders. And if families need more time to pay a large balance, the practice can set up an automated payment plan.

As healthcare costs continue to rise and the payment burden shifts more toward patients, providers must do a better job of collecting payments as soon as possible. Consumers have expressed an overwhelming interest in electronic statement and payment practices, but providers have been slow to offer such options.

Experience show that electronic statements and payments not only help to cement positive provider/patient relations, they can also improve practice finances.

Reducing manual processes can result in increased revenue while freeing up staff.

4 Key payment trends impacting physician practices

Richard Payerchin is associate editor of Medical Economics.

Physician burnout is a problem. So is physician suicide. But often, the way we conflate these two crises are not accurate, and do damage to efforts to confront the problems. Medical World News® sat down with Christine Yu Moutier, MD, chief medical officer for the American Foundation for Suicide Prevention, to discuss these topics. The transcript below was edited for length and clarity.

Can you discuss some of the key differences between physician burnout, depression and suicide? Sometimes those get lumped together, but they’re not necessarily the same thing. Can you explain?

 I’m really glad that you’re asking the question in that way. As a national suicide prevention expert … I actually got my start and my interest in suicide prevention more broadly, in my own personal and professional experiences as a medical student or resident, and then a dean in the medical school at University of California, San Diego, where I was really doing my best at that local institution level to address well-being, as well as suicide prevention for the medical students, residents and faculty physicians. And I think there has been a lot of conflation of any form of distress. The research is very weakly linked … . We’ve just published some data that show that among health workers and trainees who have burnout alone, depression alone, or the combination of burnout and depression, it’s really only the group that has depression present, whether burnout is present or not, that has those higher risk factors for suicide such as suicidal ideation.

MWN: Do you think it’s helpful? Or is it harming the conversation to sometimes group these together?

 I think the main thing that we worry about when it’s all lumped into one big, conflated grouping is that the key difference between depression and burnout is that depression is a very serious medical illness that has potentially life-threatening consequences, if not addressed, and well-researched treatments that can be used to bring depression to bear. And so, what we worry about is that if, say, a physician who is truly severely depressed is only being recognized by himself or herself or by someone who is trying to support that person as being burned out, they may or may not make a referral to actual treatment. …

Self-care strategies and peer to peer, and debriefing — all of those things are essential … for all of us. But we wouldn’t want to miss the opportunity to effectively address and treat the medical illness of depression.

MWN: Just how powerful is that stigma attached to mental health care in relation to ability to practice medicine?

I think the stigma is still alive. And there’s a lot of confusion. And there are a lot of current and historical reasons that those barriers are still in place. … The bottom line is that mental health is a part of human health, just like physical health is. And we would never [assume] that a physician with diabetes or hypertension, or cancer or other physical health problems, produce an absolute 100% of the time. We know that there are gradations of symptoms and different ways that different types of symptoms might affect a physician’s performance, depending on their scope of practice. And that is a very … nuanced thing. And in fact, most physicians, especially the older we are … the more likely we all are to be managing one or more medical and/or psychiatric conditions. And there should not be an assumption of impairment unless there’s evidence of that. I think that’s … one great misunderstanding that we need to really reframe and correct.

MWN: What would you like to say to primary care physicians about this topic?

 Anyone who is a physician and front-line health worker, especially in primary care, you know better than anyone that you and all of your colleagues are human beings, that mental health is very dynamic, depending on a whole set of factors that relate to things like your genetic loading, your early childhood experiences, all of the things that we know are multifactorial determinants of a complex health outcome, like any of the mental health conditions. … . We can become much more proactive, and it’s not that it’s all on the individual. We need institutional change; we need those questions in the medical licensing and hospital privileging boards to be changed. We need access to treatment that’s confidential and appropriate, all of that. But it also does take our own effort as individuals, not only for ourselves, but to be on the lookout for colleagues whom you might be noticing, who are struggling, and to really take the mindset that we are part of a community together; we can make a difference. We don’t need to be their doctor or therapist, only a colleague and a friend; if we approach someone … we notice isn’t in their usual state of health, to just ask the caring questions, to let them know that you’re there to support them. It should be normal to get the help and support that we need.

Burnout, depression, and suicide among physicians

Taking a Section 179 tax deduction for the cost of a luxury SUV is being widely encouraged by finance influencers on social media. We unpack the myth of the “millionaire SUV tax loophole” and look at why so many doctors and business owners are considering buying new cars before the end of the year.

We provide annual warnings on various tax plans that are marketed to affluent physicians and business owners at the end of every year. In some cases, the 

 and fraudulent and will result in penalty to the taxpayer regardless of who implements it. In other cases, the strategy is legitimate and 

On tax issues, I use two sources, the I.R.S, itself and experienced CPAs and tax lawyers. In this case, I turned to 

, a Scottsdale Arizona CPA with 20 years of corporate and private experience that works with medical practices and business owners, many of whom have inquired about and implemented this strategy as part of their larger tax planning. Essentially, consumers are being told by many sources, including a number of high-profile social media accounts, is the following:

Why do rich people all drive luxury SUVs? Because they write them off! They get it for their business and get to drive Escalades, Land Cruisers, Range Rovers and G-Wagons. And this year you can deduct 100%! Here’s a list of the cars that qualify, go get one!

Sound too good to be true? Here are a few surprising facts:

depreciation of a variety of business equipment

Passenger vehicles that meet a certain weight limit do qualify for significant deductions, including 

Qualified taxpayers can deduct up to the whole price of the vehicle this year using “bonus depreciation”

Some of the benefits are being reduced after this year, so many buyers are taking delivery of new vehicles before December 31, 2022

You may deduct the whole cost of the vehicle, even if you leased or financed it

If that was you need to know, you’d be on your way down to your favorite dealership right now. But as always, there’s fine print you need to be aware to do this right.

Bluntly, you can’t just buy a car for yourself or your spouse and write the entire thing off this year without 50%+ qualifying business usage.

Here’s some of the important fine detail Aarti shared with me, and why 

I wouldn’t touch this strategy without the help of an informed CPA.

“Business owners can deduct ordinary and necessary expenses incurred on vehicles used for trade or business using the 

The actual cost method allows for deductions on depreciation, registration fees, licenses, gas, insurance, oil, repairs, maintenance, etc.

The depreciation deduction, including bonus depreciation, is capped on a standard luxury passenger car, SUV, Truck, and van (

. gross vehicle weight rating (GVWR)) at $19,200 for 2022, and decreases annually thereafter.

SUVs, trucks, vans, and other heavy vehicles (used or new) 

. in GVWR are not subject to the cap above and are eligible for 100% bonus depreciation in 2022 if the vehicle is used over 50% in the business. Heavy vehicles, therefore, continue to be an attractive buy for most business owners.

This 100% bonus depreciation starts phasing out starting 2023.

The deductions need to be prorated for business use if the vehicle is available for personal use.

If the standard mileage method is used, the business owner gets to deduct 58.5 cents a mile for the first half of 2022, and 62.5 cents a mile for the second half of 2022.

She also cautioned that, “Proper recordkeeping is critical to substantiate the deductions claimed. A daily log showing business purpose, beginning, and ending odometer readings is important. Business owners should also have the odometer reading at the start and the end of the year recorded to calculate personal vs. business use miles. There are several apps available to help ease this recordkeeping burden including MileIQ, TripLog, MileNote, Falcon etc.”.

This is not tax advice, consult with a tax professional about your specific facts.

 JD, has practiced law exclusively in the areas of asset protection, risk management and wealth preservation for the last 16 years. 

Unpacking the myth of the “millionaire SUV tax loophole.”

The SUV tax loophole: Fact vs. fiction 

 advises clients on compliance, transactions, government administrative actions, and litigation involving healthcare, cybersecurity, corporate and securities law, as well as False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at Baylor College of Medicine in Houston. Rachel can be reached through her website, 

The Holidays and weekends are a time for disconnecting, which can also create distractions. Cybercriminals are poised to capitalize on this, especially during the Holiday Season.

 was issued by the Federal Bureau of Investigation (FBI) and Cybersecurity & Infrastructure Security Agency (CISA) highlighting their observation that “an highly impactful ransomware attacks occurring on holidays and weekends – when offices are normally closed.” The FBI and CISA reminded readers to remain vigilant in network defense practices and implement the recommended “best practices and mitigations” to mitigate the risk of cyberthreats, which includes ransomware.

, which reinforces that weekend and Holiday ransomware attacks remain an issue and result in greater revenue losses and increased recovery time. In 2021, Cybereason conducted a global survey, which led to alarming results. Specifically, “most companies were unprepared for a ransomware attack during ‘non-business’ hours, largely because they didn’t have contingency plans in place to address them and because they cut staffing levels during these times.” A year later, the findings remained the same – many persons were not prepared to handle a ransomware attack on weekends or holidays.

Thirty-four percent of 1,200 surveyed cybersecurity professionals whose organizations had been hit by ransomware on a holiday or weekend said it took them longer than usual to assemble an incident response team.” Meanwhile, 34% of health care “respondents said that it took their organizations longer to assess the attack scope, and 35 percent of” health care “respondents reported lengthier recovery times.

One startling question that was posed – “[h]ave you ever missed celebrating a holiday or participating in a weekend event because of a ransomware attack?” 88 percent “Yes”. So what are some suggestions to mitigate cybercriminals ruining your holiday or weekend? The following items are prudent solutions:

Explore different staffing models for SOC analysts and incident responders;

Identify optimal staffing for holidays and weekends;

Lock down privileged accounts during weekends and holidays;

Replace traditional antivirus products with behavior-based tools, which are capable of identifying attacks at their earliest stages.

In sum, don’t neglect cybersecurity hygiene while attempting to prevent your turkey or pumpkin pie from burning. Being proactive now can lead to reduced risk and a more enjoyable Holiday Season with peace of mind.

Rachel V. Rose, JD, MBA, advises clients on compliance, transactions, government administrative actions, and litigation involving healthcare, cybersecurity, corporate and securities law, as well as False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at Baylor College of Medicine in Houston. Rachel can be reached through her website,

Cybercriminals are waiting for your guard to be down.

Turkey, pumpkin pie, ransomware safeguards – Check!

Ray Blakney is the CEO and co-founder of 

, a renowned online language learning platform.

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 a February 2021 story on 

learning a new language to benefit a physician’s practice

“Are you looking for new ways that your physician’s practice can innovate to attract new patients? Do you also want to make a change that will help you be the best healthcare practitioner you can be?

Here is how mastering a foreign language can benefit your practice and you, yourself, as a physician:

1). Reach and attract a whole new market of potential patients

2). Be the best healthcare practitioner you can be

3). It physically changes your brain for the better

4). It will give you a morale boost in today’s pandemic era”

 for the rest article. Be sure to come back next week for another Tip of the Week!