J. Scott Litton, Jr, MD

As physicians embrace the EHR and the flow of information changes from the traditional physician narrative to a computer generated note, it is becoming increasingly difficult to add a narrative report to each patient note.

Certainly physicians are not all-knowing and there are times when the needs of the patient does not correlate with the assumptions of the third party payers, namely the insurance companies.

I can honestly say that certain techniques that I use in my practice to motivate staff have worked flawlessly for me for almost eight years now, and as such, our employee turnover is extremely low.

Can insurance companies please give us a step-wise plan for writing certain prescriptions? That’s just one of my pet peeves as a physician. I have many more.

For those of us in private practice, not only do we strive to provide nothing but the finest care to our patients, but we must also remember that we are providing a service to those patients. In essence, our patients are our customers.

It is this time of the year that I welcome medical students into my practice. And for the medical students about to enter residency and the residents about to enter private practice, I can certainly pass along some friendly advice.

It is very important for us physicians to remember that we must never neglect our families.

The final ACO rules are still being revised and the initial registration starts January 1, 2012. At this point, I will cautiously watch the events to transpire over the remaining months in the year and will very likely continue to assume a "wait and see" approach.

Although it can be a difficult decision to make for most physicians in primary care, the choice to use midlevel providers to provide open access for same day call-in visits can bring a high level of patient satisfaction to the practice.

Nice weather raises the question: How do we keep our office staff motivated to come to work each day and continue to put in an honest day's work when most would rather be planting flowers, mowing the lawn, and washing the car?

Certainly making rounds is not for everyone, but for those of you still in the trenches wearing that pager, please rest assured that your patients appreciate your extra hours of hard work and dedication.

With a multitude of available options for practitioners, staying current can be daunting. Here’s what I do.

Incorporating procedures into a medical practice certainly cannot occur overnight. Physicians must ensure that they are proficient and must devote the needed amount of time for proper training. But your patients will appreciate it.

Changes with ICD-9 and CPT codes have been commonplace for several years and will almost assuredly continue, even with the adoption of ICD-10 in 2013. We must adapt to the change by updating our practice management systems to include the changes to ICD-9, CPT, and new rules by CMS and insurance payers.

For many busy primary-care physicians, the daily task of managing scheduled appointments with adding call-ins or walk-in visits can be daunting.

Making the leap to adopting an EHR is a daunting task for those practices that are still using paper. After choosing your EHR wisely and incorporating each feature into your daily workflow, you will then be able to add this powerful tool to your clinical arsenal and provide more efficient care to your patients.

Making the leap to adopting an EHR is a daunting task for those practices that are still using paper. After choosing your EHR wisely and incorporating each feature into your daily workflow, you will then be able to add this powerful tool to your clinical arsenal and provide more efficient care to your patients.

As the landscape of medicine continues to change with increasing incentives from the federal government to move toward using an EHR in a meaningful way, there is no better time than the present to adopt an EHR for your practice.

The tablet PC is much akin to a new pair of shoes. Decide on what you need and then try it on. It can be a little stiff and cumbersome at first, but with each passing day it becomes more comfortable. Before you know it the daily use becomes second nature.

As many third-party payers tighten their belts even further with restraints for prescription drug coverage, radiology services, specialty referrals, etc., we physicians are left at the end of the day spending even more time with filling out more forms, seeing less patients, and seeing our total costs increase even more as our overall efficiency decreases.

I was once asked by a classmate of mine, “Why in the world do you take the extra time to go on house calls? Have you lost your mind?” My response was that I feel that I am doing exactly what I was called to do.