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Docs Saying No to Medicare; Paying Patients to Use Cheaper Services


Noteworthy items from Physicians Practice.

Noteworthy items from Physicians Practice


56.1 The percentage increase in total operating cost per FTE physician since 2001

Source: Medical Group Management Association

26 The percentage of primary-care physicians who say they are in financial difficulty.

Source: QuantiaMD's monthly Physician Wellbeing Index survey


"I refer to them as drug dealers in white coats."

Florida Attorney General Pam Bondi, of Florida doctors suspected of prescribing or dispensing unnecessary drugs.

Source: Los Angeles Times

"I think physicians have ... to be open to the fact that compensation is going to change, probably rapidly over the next three to four years, and they have to expect that that's going to occur."

Peter Geiss, MD, "Physician Compensation Survey"

Medicare Unwelcome

Medicare reimbursement could fall even lower if this year's scheduled 27 percent pay cut due to the flawed Sustainable Growth Rate (SGR) formula is not averted. To determine the consequences of such a cut, we asked readers to weigh in:

If this year's scheduled pay cut due to the SGR is not averted, what will you do?

I will be forced to close my practice and/or retire - 11%

I will be forced to opt out of Medicare - 55%

I will continue treating Medicare patients - 27%

I have already opted out of Medicare - 7%

No-shows no Problem

Practice Notes blogger Audrey "Christie" McLaughlin recently shared some tips for how to reduce no-shows.

Remind: Have one staff member call every patient the day before their scheduled appointments.

Encourage: Ask patients to provide 24-hour notice for cancellations or rescheduling requests. Don't threaten them with no-show fees.

Give a little: Have a policy for handling lateness and try to accommodate late patients. That reduces the likelihood that they'll forego appointments entirely if they realize they are running late.

Be honest: Tell patients if you are running late, and ask if they would like to reschedule.

Cash in for Care

Some patients in New Hampshire, Connecticut, and Indiana are cashing in for cheaper healthcare choices. Many patients insured by Anthem Blue Cross and Blue Shield in these states receive anywhere from $50 checks to $200 checks if they get certain tests or procedures done at less expensive facilities than the one their physician recommends, according to the Washington Post. Some physician groups are concerned that insurers are pushing patients to choose physicians based on cost, rather than credibility and quality.

Health Reform 'User's Manual'

Two medical students, confused about what health reform entails, are taking matters into their own hands. They recently wrote and published "The Health Care Handbook," a 175-page paperback and e-book, which The New York Times dubs an "astonishingly clear 'user's manual' that explains our healthcare system and the policies that will change." Nathan Moore, one of the book's coauthors, told The Times, "We wanted to write the book we were looking for."

Weighty Issues

One physician in Massachusetts is in the spotlight for turning away a patient because of her weight. The patient claims primary-care physician Helen Carter refused to treat her because she is clinically obese, according to WCVB-TV. Carter, however, told the news station she implemented a weight-related policy after three of her staff members became injured helping overweight patients. Turning away patients because of their weight is not illegal, according to the AMA.

Forced Hand Washing

To improve hand hygiene among healthcare workers, some Israeli hospitals are implementing hand-washing alert systems, according to Co.Exist. The hospitals place the hand-washing units throughout their systems and employees wear wristbands. As employees approach patients, nearby hand-washing units send vibration alert reminders to the wristbands. The wristbands also alert employees if they haven't washed hands thoroughly enough because the units, provided by Israeli company Hyginex, sense how much liquid is used and how long hands have been washed. Managers can even review Hyginex data to measure specific employees' hand-washing compliance. The company plans to expand to the United States, according to Co.Exist.

Burnout Higher in Docs

A recent study sheds new light on how much more common burnout is in doctors than in other professionals. The study, appearing in the Archives of Internal Medicine, compared a survey of more than 6,000 physicians of all specialties to a survey of more than 3,000 working adults in the general population. Overall, 10 percent more doctors (about 38 percent) had symptoms of burnout, characterized as loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.

This article originally appeared in the November/December 2012 issue of Physicians Practice.

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