Big Biases; Collect Better; EHR Benefits vs. Costs

November 6, 2013

Noteworthy items from Physicians Practice.

Stat: 72

Percentage of medical students who said they are likely to practice patient-centered care, the involvement of patients and families in treatment and decision making, in a survey of 1,026 medical students in all 50 states.

Source: Epocrates

There She Is

"I just won $50,000 … and I'm currently applying for medical school. I'm kind of interested in psychiatry, but I'm sure it's gonna change once I start being exposed to different fields of medicine."

Nina Davuluri, in an interview with "Good Morning America," one day after being crowned Miss America.

Big Biases

"Step one is that you have to at least acknowledge that this anti-obesity bias exists and that it influences your decisions."

Internist David P. Miller, in an article for American Medical News on physician bias toward and mistreatment of obese patients.

Collect Better

Collecting payment from patients isn't always easy, but there are some easy-to-avoid mistakes that could be preventing your practice from getting its dues. At the top of the list, according to Practice Notes blogger Carol Stryker, a medical practice consultant, is failing to confirm and update information. Other mistakes include failing (more than once) to update a patient's address, and failing to provide the patient with the information necessary to pay their balance. For tips on how to address these mistakes, as well as a personal story of how they affected a real-life patient, see http://bit.ly/collection_fixes.

Customer Service Tips

Sure, your practice's doctors do a great job with patients. But is your clinic overlooking the basic premises of customer service? If so, you're not alone - and there are some easy ways to fix that, says Audrey "Christie" McLaughlin, a former practice nurse who is now a healthcare consultant. In a recent Practice Notes blog, McLaughlin offered physicians and administrators 10 great customer service tips that can be implemented right away. Among them: Listening and acting when your patients complain."Deal with every complaint, as complaints can be opportunities to build a lifetime of loyalty from a patient," writes McLaughlin. "Make sure that you listen to the complaint, check the validity, take action to resolve it, and then let the patient know how it was resolved." For more, see http://bit.ly/better_service_patients.

EHR Benefits vs. Costs

Is your EHR worth the money you paid for it? According to EHR vendor athenahealth's Physician Sentiment Index, slightly more physicians would say "no" than "yes," iHealthBeat reports. The fourth annual survey, based on athenahealth's polling of 1,200 physicians in March who use the company's Epocrates electronic decision support and clinical work-flow tools, also found that 69 percent of docs have a very favorable or somewhat favorable opinion of EHRs. However, just 55 percent of respondents said the patient-care benefits of EHRs outweigh the costs.

Sexist Pay Gap?

We've all heard about the gender gap in earnings. But for doctors it seems especially large, according to research published in the Journal of the American Medical Association, as reported by Modern Healthcare. Researchers found that from 2006 to 2010, male physicians made $56,019, or 25.3 percent more per year than their female counterparts. However, Washington Post writer Sarah Kliff cited data from the Association of American Medical Colleges that more than 50 percent of pediatricians, but fewer than 10 percent of orthopedic surgeons, are women - yet researchers "failed to adjust" for physician specialty. Specialists tend to earn more than primary-care physicians, she noted.

Money Motivates

Obstetricians are performing more Cesarean sections today than in previous years, and money may be a big reason why, suggests a new paper published by the National Bureau of Economic Research. Nearly one in three babies today is delivered via C-section, compared with one in five babies in 1996, NPR, which covered the story, noted. While there are big variations in the frequency of C-sections in different parts of the country, OBs in many medical settings are paid more for performing them - which often equates to several hundred dollars more for doctors, and a few thousand more in reimbursement for hospitals - noted authors Erin Johnson and M. Marit Rehavi, two healthcare economists. In analyzing disparities in medical settings where docs were paid a flat salary, Johnson and Rehavi found there was a disincentive to perform the more timely surgical procedures, NPR reported.

Cap Issues

California's medical malpractice cap may be one of the reasons many physicians like to practice there. But the cries from patients who take issue with the 1975, Medical Injury Compensation Reform Act (MICRA), are starting to grow louder. The Consumer Watchdog organization and "medical negligence survivors" are working to get the Troy and Alana Pack Patient Safety Act on the November state ballot. Among other things, the measure would adjust the $250,000 cap for inflation to $1.1 million, Modern Healthcare reported. Meanwhile, the California Medical Association argues that MICRA has kept medical liability premiums in check. "California's critical MICRA protections are a national success story, safeguarding patients and their access to care for almost 40 years," the association stated.

HHS Addresses Gun Violence

HHS' Office for Civil Rights sent a proposal to the Office of Management and Budget (OMB) outlining its plan to ease legal barriers under HIPAA that prevent some states from reporting certain medical data to a federal gun-purchase background check database. As Health Data Management reports, the OMB review is one of the last steps before a rule is published in the Federal Register. The National Instant Criminal Background Check System, or NICS, is used by gun dealers to ensure they are not selling weapons to individuals who are prohibited from owning firearms, such as people with substance use disorders and those with severe mental health issues, according to iHealthBeat. However, many medical groups are not so keen to the proposed HIPAA amendment, and have called it unnecessary - potentially interfering with the patient-physician relationship.

Employer Priorities

Primary-care physicians are in high demand by every type of healthcare employer, from urgent care centers to community hospitals. But that's not the only interesting trend physician recruiter Merritt Hawkins revealed in its annual report: "Review of Physician and Advanced Practitioner Recruiting Incentives." The report, based on 2012 search data from Merritt Hawkins, AMN Healthcare, and other physician placement agencies' online engines, also reveals:

Family docs were the most requested search for the seventh year in a row, followed by general internists.

Physician assistants and nurse practitioners made the list of "top 20 search assignments" for the first time, as did geriatrics.

Hospital employment of physicians continues, as 64 percent of employer searches featured hospital employment of physicians, up from 11 percent in 2004.

39 percent of searches featured production bonuses that rewarded physicians for quality of care, up from fewer than 7 percent in 2011.

This article originally appeared in the November/December 2013 issue of Physicians Practice.