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.

Articles

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

, 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. 

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 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 

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!

Your weekly dose of wisdom from the Physicians Practice experts.

Practice tip of the week: Learning a new language can benefit a physician’s practice

 since its inception in 2010. He brings a wealth of clinical and technical expertise associated with consumer-patient engagement and provider practice operations. Gary drives corporate strategy, product innovation, and direction toward one common objective: to enable providers to successfully engage and empower their patients to attain successful outcomes. Over the years, Gary's work has led to the evolution InteliChart's 

 into a full suite of engagement solutions that address automated patient scheduling, appointment reminders, digital intake, telehealth, patient feedback, and population health initiatives. Prior to InteliChart, Gary held leadership positions with Integrated Healthcare Solutions and Atlantic Healthcare Management.

In March of 2019, the Office of the National Coordinator for Health Information Technology (ONC) issued what is commonly referred to as the Information Blocking Rule to the 21st Century Cures Act. Information blocking was defined as any practice that is likely to unreasonably interfere with the access, exchange, or use of electronic health information.

As the American Medical Association points out, 

 can occur in several ways and doesn’t necessarily have to be intentional on the part of providers. For example, patients might encounter information blocking if they are unable to access health records or transfer data to another physician. This could ultimately lead to patient complaints and potential penalties.

 have been filed against more the 170 health care providers in 2022 so far, there have been no investigations for information blocking by individual provider practices – yet. The Office of the Inspector General (OIG) has provided guidance on potential sanctions including up to a $50,000 

 for each incident, and one thing is clear: practices must act quickly or soon face regulatory compliance issues.

The best way to protect your practice is to ensure you are using patient engagement technology that complies with regulations, specifically a patient portal that makes access to health information easy and is positioned to adjust as patient and regulatory expectations around access to health information evolves.

Patient engagement, patient portals, and the Cures Act

Online patient portals are the critical patient engagement gateway to digital information access and Cures Act compliance. Through patient portals, patients are given 24/7 entry to secure personal health information from anywhere, anytime, and with no costs to download records.

Something to bear in mind is that patient portals are not created equal. Often, legacy portals utilize outdated integration methods and have interfaces that are neither modern in appearance nor intuitive to use, which can put healthcare organizations at risk. Patients that have trouble with portal technology may mistake a poor user experience as an intentional attempt at information blocking and lodge a complaint.

A portal that automatically delivers information to the patient, rather than relying on provider or staff action to trigger data moving from the patient record to the portal, is another critical functionality to recognize. Lab results, for example, are often anticipated by patients. Portals that automatically push results, within normal limits, to patients greatly reduce patient wait times, while also protecting providers from any accusations of information blocking.

For providers, patient portals and patient engagement tools can solve an array of other needs, such as:

 – Portals and digital patient engagement tools, such as patient intake and registration with online forms, can streamline front desk activities to reduce labor while decreasing time patients spend in the waiting room. Online patient self-scheduling greatly reduces phone calls to the office and allows patients to schedule appointments after working hours, a convenience many have come to expect in today’s consumer environment. Tools that notify patients of upcoming appointments and overdue balances decrease no-shows and accelerate cash flow.

 – Secure messaging has long been the backbone of patient communication within portals, reducing inbound phone calls and stimulating engagement. Modern solutions further augment messaging with workflows that allow patients to confirm or reschedule appointments, pay bills through text, and ask questions about their most recent results. As consumer demand for digital engagement increases, there will be continued growth in the adoption of not just these tools, but newer technologies like video telehealth as well. Remote visit options increase patient access to healthcare and their ability to stay on track with their care plans, while creating additional revenue streams for healthcare organizations.

 expanded its definition of information blocking. Today, data that must be accessible not only applies to the data elements contained to the United States Core Data for Interoperability, but also to electronic protected health information (ePHI). ePHI is the Designated Record Set (DRS) as defined in the Health Insurance Portability and Accountability Act (HIPAA). In other words, any data a patient has access to under HIPAA now applies to information blocking. An integrated portal solution can be mapped to confirm this data is included. Patient portals can also help providers manage proxy relationships for minors in states that limit access to health information by parents or caregivers.

Protect your practice with integrated patient engagement solutions

The volume of data healthcare organizations needs to manage increases daily and the regulations concerning the data will likely continue to evolve. Practices that provide modern patient portals and patient engagement solutions are best positioned to protect themselves from information blocking complaints and potential fines while enhancing the patient experience throughout the care journey.

since its inception in 2010. He brings a wealth of clinical and technical expertise associated with consumer-patient engagement and provider practice operations. Gary drives corporate strategy, product innovation, and direction toward one common objective: to enable providers to successfully engage and empower their patients to attain positive outcomes. Over the years, Gary's work has led to the evolution of InteliChart's Patient Portal into a full platform of engagement solutions that address automated patient scheduling, appointment reminders, digital intake, telehealth, patient feedback, and population health initiatives. Prior to InteliChart, Gary held leadership positions with Integrated Healthcare Solutions and Atlantic Healthcare Management.

The best way to protect your practice is to ensure you are using patient engagement technology that complies with regulations.

The 21st Century Cures Act: How patient engagement can help your practice remain compliant  

Judi Mitchell serves as a Strategic Account Executive with UPSTACK, the platform that transforms the way businesses design and select digital infrastructure solutions. In her role, Judi implements a range of voice, data, and cloud-based communications services for clients across a variety of sectors. Prior to UPSTACK, Judi served as a Convergence Solutions Manager at Universal Telecommunications . Throughout her over forty years in the industry, Judi has led multiple teams of account executives and engineers, ensuring that her clients’ digital infrastructure initiatives are seamlessly deployed. Judi launched her career in Sales and Sales Engineering with BellSouth in 1991.

Digital technologies are transforming healthcare by reducing human errors, facilitating the coordination of care, and improving efficiencies within medical practices. Healthcare IT enables providers to more easily manage the practice, big or small, so they can focus on serving their patients. Because of the sensitive personal and health information stored and transmitted via digital health services, there are many regulations designed to protect patients. This makes regulatory compliance a critical element of any healthcare practice.

Healthcare is a massive industry in the U.S, with healthcare spending representing over 

 of GDP in 2020, or an estimated $12,530 per person annually. Estimates show that health spending will reach $8.3 trillion by 2040, up from $4 trillion in 2020. And the global digital health market is expected to reach 

Healthcare providers, from physicians’ offices to hospitals, have many choices in how they engage with patients and they focus on providing the best patient experience. Technologies like electronic health records and encrypted communications protocols, including faxing and texting, are designed to make it easier to serve patients. The reality of digital health is that in addition to addressing patient health needs and providing the care they were trained to give, doctors, nurses, and other practice leaders have to make choices about which technologies to choose and how to secure patient healthcare records and personal information.

Add to that decision-making process that many healthcare providers are dealing with legacy systems, like PBX, which can make it difficult to take advantage of all the features and benefits new technologies have to offer. Another issue practice leaders must take into account when using digital health is how to effectively integrate solutions from multiple vendors, with different contract agreements and unrelated lifecycles for each piece of equipment.

One more obstacle adding to the complexity of adopting information technology is human behavior. Making the transition from antiquated systems into the new digital healthcare environment is not as simple as purchasing software. It includes changing how the practice does business and doing so strategically, looking through the lenses of patient experience, security, and regulatory compliance.

Security is the number one challenge with all health IT—digital security to prevent hacking or unintended disclosure of information, and physical security, like locking down the communications room and ensuring that computer screens are only visible to the person at that workstation.

It’s easier sometimes for a doctor or nurse to call or text a patient from a personal cell phone, or ask a patient to text a photo of a wound. But those are both HIPAA violations since they are the transmission of health information over unsecured channels. The practice may require confirming patient information at check-in, but saying an address out loud or asking for insurance details at the front desk where other patients can hear potentially reveals private patient information and are not secure.

Doctors, nurses, and practice leaders focus on the patients, not the technology. Their job is to examine patients, provide diagnoses, carry out procedures, and enable patients to get back to their daily lives. They don’t have time to think about IT security and regulatory compliance of their communications technologies, their health records, or the remote patient monitoring devices they prescribe their patients.

Yet the failure to pay attention to the security of health IT could put practices at risk—of large fines, lawsuits from patients, loss of affiliation with hospitals, or a threat to insurance coverage, in addition to reputational damage if there is a high-profile breach.

When you consider that the U.S. Department of Health and Human Services Office for Civil Rights has tracked more than 

 in healthcare in the last year, compliance is imperative.

Hospitals on the whole are doing a good job of regulatory compliance. Doctors and physician groups that support hospitals tend to have challenges when it comes to compliance issues. The goal of regulations to protect patients is to ensure that practices meet all professional, ethical, and legal standards; and that means that security and compliance are the responsibility of anyone in the practice who interacts with patient data. All while still providing high-quality healthcare to the patients.

There are several laws designed to protect patients and required to be in compliance. The two major regulations that protect patient privacy in the digital realm are the Health Insurance Portability and Accountability Act (HIPAA), protecting health information stored or transferred electronically, and the Health Information Technology for Economic and Clinical Health Act (HITECH), which expands the scope of HIPAA with standards for using IT to implement electronic health records.

There is also a new requirement on the horizon: Doctors affiliated with hospitals will soon have to return patient texts or phone calls within 30 minutes. How can they achieve that, and do it securely, while also attending to patient needs? And how can they monitor compliance with that?

It is possible, even in small practice groups. Whether individual doctors, physician groups, urgent care facilities, or nursing facilities, the first step to success is ensuring the right person in the practice understands the importance of security and regulatory compliance.

For practices that are ready to sell, private equity firms require penetration testing and many of them fail. Don’t wait until you are trying to sell the business, you’re hacked and sensitive patient data is leaked, or you are forced by insurance to adopt more secure practices.

Making the change—to deciding the right technologies based on the requirements of the practice, such as updating legacy systems or better integrating existing health IT—requires strategy and care. The first step is to fully understand the current state of the practice including what is being done currently and how. Then you can address what needs to change and decide how to accomplish that. In some cases, doctors' groups get together and hire an organization to oversee and handle all the IT. Others hire a firm to do a risk assessment and help navigate the world of health IT and determine where to get started.

Whether you are dealing with outdated systems or lack of time to focus on security and regulatory compliance, UPSTACK can help. We work with healthcare clients to ensure compliance is enforced and the practice communicates the importance of cyber and physical security. Contact us today to learn how we can help.

Failure to pay attention to the security of health IT could put practices at risk.

Risk assessment in health care IT: The role of compliance in protecting patients

Pamela Kohl is the Vice President of Marketing at 

. With over 25 years’ experience in financial services, Pamela has worked closely with banks, alternative finance, and other fintech platforms to develop core banking services, as well as establish new card programs, lending programs, and global payments platforms. She has been nationally recognized for creating innovative solutions, leveraging new markets, and developing winning strategic partnerships. Pamela earned a B.A. from Marshall University, summa cum laude, and M.A. in International Economics from the University of Miami, where she graduated with Distinction.

If you own a physician’s practice and you’re researching medical practice loans, you may be wondering whether secured or unsecured funding is the better choice. The short answer is that if you do not have any collateral to secure a medical practice loan, then you’ll need to apply for unsecured financing.

Today we’ll talk about unsecured medical practice loans and explore the different financing options for your practice. Let’s get started.

What Are Unsecured Medical Practice Loans?

Unsecured medical practice loans do not require you to offer any type of business asset as collateral, such as property or equipment. While some traditional lenders offer unsecured funding, most banks and SBA loan programs will require collateral in order to secure medical practice loans. Alternative online lenders, on the other hand, primarily offer “unsecured” medical practice loans that do not require collateral.

Since the risk of an unsecured loan is higher for the lender, unsecured medical practice loans may come with additional conditions, such as:

Personal guarantees (if you default, the lender may come after your personal assets)

UCC liens—a blanket lien that allows lenders to attach any or all of your practice’s assets if you default.

4 Types of Unsecured Medical Practice Loans

Unsecured medical practice loans are available from three types of lenders: banks and traditional lenders, alternative online lenders, and peer-to-peer lenders. Let’s take a closer look at four common types of unsecured medical practice loans:

Available from banks and alternative lenders, lines of credit are the most flexible financing option, allowing physicians' practices to draw and repay from the line as needed.Traditional banks may require collateral or a personal guarantee for a line of credit, while alternative lenders typically do not. No matter the lender, unsecured lines of credit often have lower credit limits with higher rates than secured credit lines.

Practices that need a cash flow cushion or access to working capital

Available from banks, business credit cards function like lines of credit, but tend to have much higher rates and lower credit limits—typically up to $50,000. There are no restrictions on how credit cards can be used and you can avoid interest altogether if you pay your balance in full each month, but there can be significant charges or fees for missed payments.

Because of higher interest rates and penalties for missed or late payments, credit cards are not ideal for funding larger growth initiatives. Business credit cards are ideal for:

Available from alternative lenders like Greenbox Capital®, merchant cash advances (MCAs) are a form of asset purchase known as a purchase of future receivables. MCAs give you a cash advance in exchange for a portion of your practice’s future revenue. Lenders then take a portion of your daily or weekly debit and credit card sales until the advance has been repaid.

MCA approvals focus heavily on your practice’s monthly sales and revenue, and less on your credit or financial history. No collateral is required for MCAs.

Practices that have a large number of card transactions

Practices in need of flexible working capital

Available from some banks and alternative lenders, invoice factoring is another unsecured financing option that’s often called “accounts receivable financing.” Medical practices essentially sell their unpaid invoices to a lender, called a “factor,” who then “owns” the invoice(s). Factors will advance roughly 70-90% of the money that your clients already owe you, and the remainder of the invoice’s value (less any fees) will be paid once your client pays the invoice. In this case, the unpaid invoices essentially act as collateral to secure the loan.

Accessing working capital by leveraging your unpaid invoices

Practices with long accounts receivable periods and large invoice amounts.

Is an Unsecured Medical Practice Loan Right For You?

Just because you don’t have collateral doesn’t mean you don’t have options. Depending on your goals and needs, you could be approved for unsecured medical practice funding such as merchant cash advances, invoice factoring, alternative business loans, or a line of credit.

With over 25 years’ experience in financial services, Pamela Kohl has worked closely with banks, alternative finance, and other fintech platforms to develop core banking services, as well as establish new card programs, lending programs, and global payments platforms. She has been nationally recognized for creating innovative solutions, leveraging new markets, and developing winning strategic partnerships. Currently, Pamela serves as Vice President of Marketing at 

. Pamela earned a B.A. from Marshall University, summa cum laude, and M.A. in International Economics from the University of Miami, where she graduated with Distinction.

If you do not have any collateral to secure a medical practice loan, then you’ll need to apply for unsecured financing. 

4 Unsecured financing options for medical practices

Jeffrey Bendix is the senior editor of Medical Economics.

Confidence in the public health system has eroded since the start of the 

, and public health officials themselves are partially responsible, according to a group of experts in the field.

“There are a lot of unforced errors that we in public health made [during the pandemic,]“ said Leana Wen, MD, former commissioner of 

 and a professor of health policy and management at George Washington University. “And I think it’s easy to point our fingers at, quote, the other side, like social media and politicians spreading misinformation, but we also need to take a hard look at what we in public healthmight have done better.”

Wen’s remarks came during a panel discussion, “The Broken Trust Between Public and Health” at the 2022 HLTH conference in Las Vegas.

Looking back, Wen said, public health officials could have better explained how evolving understanding of COVID caused changes in recommendations for countering the disease.

“If there’s anything I wish we had done differently, it’s emphasizing that change is the bedrock of good 

 policy. If the science changes, if circumstances change, you would expect that the recommendations also change. And I think that could have been communicated more forcefully,” she said,

Ezekiel J. Emanuel, MD, PhD, professor and vice president for global initiatives at the University of Pennsylvania’s Perelman School of Medicine and a venture partner at Oak HC/FT, cited changing CDC and World Health Organization recommendations on slowing the aerosol spread of COVID. “If you get something wrong that is so fundamental, and you’re resistant to changing it, I think it undermines public trust,” he said.

In addition, officials didn’t always consider the impact that decisions made in the interest of public health had on peoples’ lives. “A lot of the public felt during the pandemic as if the government wasn’t taking their situation into account,” Emanuel said, citing the example of school closings. “People had a sense like, ‘those government officials did not understand how this one action really turns my life upside down. That attitude really does undermine people’s confidence.”

Panelists say lack of clear explanations for public health policy decisions adds to problem.