Pump Up Poor Performers; Patients Distrust Fat Doctors

June 7, 2013

Noteworthy items from Physicians Practice.

Stat: 70

Percentage of U.S. physicians who say at least one of their patients is sharing health measurement data with them.

Source: "Taking the Pulse U.S.," Manhattan Research's study of 2,950 U.S. physicians in the first quarter of 2013

QUOTABLES

Marriage Equality

"If a child has the living and capable parents who choose to create a permanent bond by way of civil marriage, it is in the best interests of their child(ren) that legal and social institutions allow and support them to do so, irrespective of their sexual orientation."

Statement from American Academy of Pediatrics

Keeping Traditions

"I'm a physician. I practice with homosexuals … I'm not in opposition to anybody. We're just in favor of protecting an institution that has existed for 6,000 years."

Robin Armstrong, MD, an internal medicine physician and Texas Republican national committeeman, speaking to Politico, on legalizing gay marriage

Pump Up Poor Performers

Chances are you've got at least a few underperformers at your practice. So how do you motivate them to do better? First, writes P.J. Cloud-Moulds, a contributor to Practice Notes, Physicians Practice's blog, you should try to identify them. Look for workers who seem bored, tired of the job, or perhaps have no expectations or accountability placed on them, she noted. Next: Work on understanding why they're unmotivated so you can work on ways to help them get excited again. For more tips, visit http://bit.ly/prac_underperformers.

New Financial Realities

New reimbursement models and payer plans are putting more financial burdens on patients. Therefore, it's critical that physicians and practice managers adapt to these new realities, Chastity Werner, a contributor to Practice Notes, Physicians Practice's blog, recently noted. To help patients get onboard with changes, such as higher deductibles, Werner suggests setting up an automated payment system and allowing patients to pay online. For more tips, visit http://bit.ly/financial_realities.

Patients Distrust Fat Doctors

Do patients feel judgmental toward overweight or obese physicians? Absolutely, says a study published in the March 19 International Journal of Obesity. The study, based on an online survey of nearly 400 adults by Yale University researchers, shows patients, regardless of their own body weight, negatively perceive overweight or obese physicians' credibility - and may be less inclined to follow their medical advice. To help strengthen physician-patient relationships, overweight or obese physicians should discuss their weight during office visits with new patients or when discussing health behaviors, Los Angeles-based internist and infectious disease specialist Phyllis A. Guze told American Medical News.

Telehealth = True Savings?

New study results suggest that telehealth may not be a cost-effective solution for long-term chronic care. The study of 965 patients with various long-term conditions - including heart failure, chronic obstructive pulmonary disease, and diabetes - failed to show significant cost savings when patients monitored their symptoms via telehealth equipment at home. "We have got to find ways of better adjusting the equipment to suit the circumstances of the individual patient," Martin Knapp, professor of social policy at the London School of Economics, one of the leaders of the study, told Reuters. "Just at the moment we don't find the advantage that people had hoped for."

Acting for Empathy

A program for physicians at Boston Children's Hospital is employing actors to help physicians improve their empathy and communication skills. The program retains a dozen or so professional actors selected for their improvisational skills to simulate difficult conversations faced by doctors and other medical professionals, the Boston Globe reports. Psychiatrist Helen Riess, director of Massachusetts General Hospital's Empathy and Relational Science Program, told the Globe that "Acting as if you care, with empathic facial expressions, posture, and tone of voice, can actually result in feeling that you care."

Fewer Hours, More Mistakes

Two studies appearing in JAMA Internal Medicine show that shorter resident shifts don't necessarily result in fewer errors, CBS News reported. The first study, conducted by Johns Hopkins University researchers in Baltimore, showed that shortening shifts to 16 hours reduced the amount of training time interns received and increased errors (though it should be noted that the shorter shift also increased the amount of handoffs of patients from one trainee to another, a possible culprit for more errors). Study No. 2, led by researchers at the University of Michigan in Ann Arbor, showed that the number of medical errors that caused harm to patients went up after a 16-hour shift implementation - but that may be due to the fact that interns felt they had to do the same amount of work in fewer hours, authors suggested.

Medical Marijuana … For Kids?

While there's growing support for medical marijuana, the debate is ramping up over whether pediatricians should prescribe medical marijuana to children, particularly the terminally ill. At issue: the long-term consequences of marijuana therapies, specifically, how the drug affects the developing brain. Doctors who recommend the drug to young patients also face potential liability risks. One example: if a child who uses marijuana later develops a mental health problem, psychiatrist Stuart Gitlow, president of the American Society of Addiction Medicine, told American Medical News. The American Academy of Pediatrics doesn't "recommend medical marijuana under any circumstances for children," pediatrician Susan Levy, chair of the American Academy of Pediatrics Committee on Substance Abuse, told the publication.

Longer Physician Wait Times

How long do your patients wait for a visit after arriving at your practice? If your answer is "more than they did last year," your practice is on par with the rest of the country. A new report from Vitals.com, an online healthcare information hub, reports the shortest average physician wait time increased more than a full minute between 2011 and 2012. Also of note:

• Alaska topped this year's list of states with the shortest average wait time of 16 minutes, 28 seconds, up from last year's lowest average wait time of 15 minutes, 26 seconds (Wisconsin).

• Wisconsin still did pretty well, coming in with the second-shortest average physician wait time of 16 minutes, 29 seconds.

• Mississippi topped the list of states with the longest average physician wait time with 24 minutes, 25 seconds.

This article originally appeared in the June 2013 issue of Physicians Practice.