Free Pleasers; EHR Help Sought; Unhealthier Patients

January 11, 2014

Noteworthy items from Physicians Practice

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Percent of respondents in a survey of more than 1,000 medical groups who said health insurance exchanges will have an "unfavorable" effect on their practices.

Source: Medical Group Management Association

Doc Disses ACA

"Obamacare is really, I think, the worst thing that has happened in this nation since slavery … and it is slavery in a way because it is making all of us subservient to the government."

Neurosurgeon Ben Carson, speaking at the 2013 Values Voter Summit in October

Pricy Cocktails

"In addition to injury, illness, disease, and death, it costs our society billions of dollars through reduced work productivity, increased criminal justice expenses, and higher healthcare costs."

CDC Director Tom Frieden, MD, MPH, in a statement issued in response to a new report on the healthcare costs of alcohol abuse, published in American Journal of Preventive Medicine

Free Pleasers

Improving patient satisfaction doesn't need to cost a fortune. In fact, you can do it for free, writes practice management expert Carol Stryker in Practice Notes, Physicians Practice's blog. To start, make sure you use the patient's name in conversation, and wear easy-to-read nametags just below your right shoulder. And in addition to making eye contact, make sure staff tells patients what to expect during each part of their visit. For more tips, see bit.ly/free_patient_satisfiers.

Inside-job Protection

Financial data present an ongoing asset-protection issue for physicians and medical practices. And when a data breach can be linked to an employee, you're in especially hot water. One thing your practice should consider to mitigate liability risks (including those due to inside jobs)? Cyber liability insurance. "These policies cover a variety of issues in our increasingly electronic world, including not only outside theft or loss of medical records but also the intentional misuse of patient data by employees," writes attorney Ike Devji in Practice Notes, Physicians Practice's blog. For more practice protection strategies, see bit.ly/insider_protection.

EHR Help Sought

Want to hire someone to help you implement your practice's EHR? If so, you're certainly in good company. About 2.5 percent of all healthcare job openings between 2007 and 2011 sought those with experience in EHR system implementation, informatics, or other health IT strategies, says a study published in Industrial Relations: A Journal of Economy and Society, EHR Intelligence reported. What's more, EHR implementation support was mentioned in 43 percent of 434,282 health IT job listings during those years. Lead study author Aaron Schwartz suggested the HITECH Act was associated with an 86 percent increase in job listings each month related to EHRs or clinical informatics.

Follow-up Suit

Lishan Wang, the unemployed physician and Chinese National from Beijing who is accused of killing rival doctor Vajinder Toor outside Toor's Connecticut home in 2010, is now pursuing a lawsuit of his own as he awaits his murder trial. The lawsuit claims that the Brooklyn hospital he worked at, Kingsbrook Jewish Medical Center, was biased when it fired him. Wang recently mailed a five-page single-spaced rant to the judge presiding over the suit, according to New York Daily News. The rant is full of famous quotations and accusations against the hospital, according to reports. Regarding the murder, Wang stated in the letter that that cops "embarked upon a false theory" that led to his arrest.

Pot Draws Profiteers

While prominent physicians like commentator Sanjay Gupta are warming up to marijuana's medical merits, physician groups are wary of renegades looking to exploit patients who seek it.

Massachusetts' recently revamped medical marijuana law has sparked a flurry of new Internet companies promising to match patients with physicians who will certify they need pot for health reasons, The Boston Globe recently reported. The Massachusetts Medical Society has raised concerns that a number of the companies are run by entrepreneurs with no medical background. In fact, some of the sites, according to the society, "appear to be tiptoeing just inside state rules," which require a "bona fide physician-patient relationship" before marijuana can be prescribed, the Globe reported.

Unhealthier Patients

If you're seeing a rash of overweight and stressed-out patients, you've got plenty of company. The Human Capital Index, which the World Economics Forum uses to rank more than 150 countries based on 51 variables, placed the United States at 43rd for overall "health and wellness." The news isn't necessarily earth-shattering: According to the 2012 America's Health Rankings report, put together by the United Health Foundation, we're experiencing a surge in sedentary behavior, obesity, diabetes, and high blood pressure.

Hack-proofing Cheney

Is it possible that a terrorist would try to hack your patients' wireless, implanted medical devices to obtain information for identity theft, or worse? Apparently, former Vice President Dick Cheney and his doctors thought so. Cheney recently told "60 Minutes" that the wireless function of his implanted cardiac defibrillator was turned off in 2007 in case a terrorist attempted to hack into the device and kill him. And it's not just Cheney's medical team that sees this threat as more credible than a Sci-Fi thriller plotline. A Government Accountability Office report stated that certain medical devices such as defibrillators and insulin pumps are vulnerable to hacking. In June, the FDA issued a recommendation that medical device companies develop additional security controls, iHealthBeat reported.

App of the Month

More than two million people in the United States contract infections that are resistant to antibiotics, and at least 23,000 people die as a result, according to CDC data. Unfortunately, what wipes out bacteria in one part of the country doesn't wipe it out in another. So how does a doctor know whether to prescribe the usual antibiotic for a UTI? One solution: Tapping into "Epocrates Bugs & Drugs" - a new iPhone and iPad app for iOS 7 recently unveiled by athenahealth and its subsidiary Epocrates. The free app uses GPS to alert physicians to geographic locations at the center of new infections and potential drug-resistance patterns.

Compensation Shift

Many physician compensation plans are beginning to reflect quality and patient satisfaction scores. That's according to the 13th annual "Provider Compensation, Production, and Benefits Surveys" report from ECG Management Consultants, Inc., a healthcare management consulting firm, which conducted surveys of nearly 21,000 providers this spring. Other survey findings include:

• Primary-care physician compensation decreased slightly by 0.4 percent between 2012 and 2013, while specialist compensation increased 3.4 percent.

• While the majority (91 percent) of organizations continue to utilize physician production to determine physician compensation, nonproduction-based metrics such as quality and patient satisfaction are being adopted rapidly, at 63 percent and 47 percent of organizations, respectively.

• Retirement contributions averaged $17,524 per physician, driving up overall benefit costs to 16.3 percent of compensation, or $43,501 per physician.

This article originally appeared in the January 2014 issue of Physicians Practice.