Reputation Management; EHR Equality; Docs on Fire

September 13, 2013

Noteworthy Items from Physicians Practice.

STAT: $1.57 million

Average revenue generated per primary-care physician for affiliated hospitals in 2012.

Source: Merritt Hawkins

Obesity, Redefined

"Sometimes obese patients need [a higher dose] of a drug. That's where an AMA decision or a more global look will really help treatment paradigms. … It's more one-size-fits-all right now, because obesity is not seen as a disease. Whether you weigh 100 pounds or 200 pounds, the FDA only approves one dose."

Cleveland, Ohio, rheumatologist Elaine Husni, on why the AMA's reclassification of obesity as a disease will positively affect patients, as told to WebMD.

Positive Changes

"It's encouraging to young physicians to see the tide changing. For years, primary care has been undervalued."

Family physician Richard Budensiek, head of the Colorado Academy of Family Physicians, on the payment boost to physicians who treat Medicaid patients in the state, as told to The Denver Post.

Reputation Management

Online reputations are becoming increasingly important. When managing theirs, doctors should consider a number of do's and don'ts, writes physician Michael Woo-Ming, for Practice Notes, Physicians Practice's blog. One big no-no: Posting fake positive reviews online to buffer the blow of negative ones. "What many people fail to realize is that astroturfing, fake reviews, or reviews done in exchange for something, is illegal," writes Woo-Ming, adding that docs should also avoid incentives to patients for writing something positive. "While you can suggest to your happy customers to leave a review for your practice, it is best to avoid offering them something, such as a discount, gift, or money, for doing so." For more tips, see http://bit.ly/doc_online_reps.

Overcoming AWV Barriers

The Medicare Annual Wellness Visit (AWV) is one of the key components to changing healthcare for the better, and it can improve quality, decrease costs, and engage patients. But implementing it can be a hassle. "The AWV is complex, has many components, and is time consuming," writes Averel B. Snyder, a cardiothoracic surgeon and contributor to Practice Notes, Physicians Practice's blog. Another barrier: Providers have a hard time making a paradigm shift and incorporating the AWV into their practices. To help make the transition, he encourages practices to take advantage of "numerous technological tools to make the visit less time-consuming and [more] efficient." For more guidance, see http://bit.ly/actions_AWV.

Docs on Fire

To learn how to better treat gunshot victims, Saginaw, Mich., area physicians recently underwent a training exercise whereupon they were "stun gunned" and then allowed to shoot real guns at a firing range. The stun gun exercise shocked some, including one physician who told local TV station WNEM, "It kind of felt like my entire body was on fire." Still, the pain helped doctors build empathy for patients who suffer from gunshot wounds, according to reports.

False Promises

A California physician who coaxed $1 million out of patients with promises to cure cancer and other diseases was recently sentenced to 14 years in federal prison. The physician, 58-year-old emergency medicine physician and ordained minister Christine Daniel, was found guilty of 11 counts, including wire fraud, tax evasion, and witness tampering, Fox News reported. Daniel told patients to avoid chemotherapy and painkillers and instead pay $100,000 for six-months of treatment that had a 60 percent to 80 percent success rate, according to New York Daily News.

EHR Equality

UC Davis Health System announced June 13 that it would become the "first health system in the country" to incorporate sexual orientation and gender identity as standard demographic elements within its EHR. UC Davis physicians and patient advocates say the new measure is an important step toward improving healthcare for lesbian, gay, bisexual, and transgender (LGBT) individuals who often avoid medical clinics out of fear of being embarrassed or rejected. The announcement, made just days before the Supreme Court struck down the Defense of Marriage Act, comes two years after a 2011 Institute of Medicine report that shed light on how the meager amount of research data about LGBT health consistently pointed to severe health disparities for LGBT communities.

Alert Overload

Does your EHR give you so many alerts that you feel fatigued? If so you could be at risk of exposing patients to adverse events, according to a case study published in the June issue of Pediatrics. The study analyzed the hospitalization of a 2-year-old boy in the pediatric intensive care unit at Stanford University's Lucile Packard Children's Hospital who was admitted for respiratory distress and a rash, FierceEMR reported. But while the child's health record noted that he suffered from a drug allergy to sulfonamide antibiotics, clinical staff overrode more than 100 drug-allergy alerts to provide the patient some medications. The patient suffered an allergic reaction because the staff gave him a medication that was contraindicated. Going forward, researchers recommended pairing alerts with medications that pose "minimal" theoretical risks to a patient, according to the report.

EHR Enthusiasm

While more doctors and hospitals are adopting EHRs, a handful of reports suggest interest in CMS' meaningful use incentive is declining, American Medical News reports. According to three reports on health IT adoption published in Health Affairs, the adoption of EHRs among office-based physicians jumped from 51 percent in 2010 to 72 percent in 2012. In an interview with AAFP News Now, Jason Mitchell, director of the American Academy of Family Physicians'  Center for Health IT, said the CMS' most recent report on EHR use shows that family medicine "still has the greatest participation both by percentage and by the numbers." However, the report also revealed a drop in the retention rate of attesting physicians. In fact, of the 11,578 family physicians who attested to meaningful use in 2011, only 9,188 did so in 2012, representing a 21 percent decline.

Wrong Tools

Doctors in a Moldovan state-run hospital were caught on camera in July using construction tools to perform surgery. The shocking video taken of physicians in the state, formerly part of the Soviet republic, was leaked and published on the Internet, which spurred a massive backlash from the public and government officials, International Business Times reports. Physicians at the hospital have defended their actions by saying that the hospital has not received any new equipment for years.

Investing in Tech Professionals

A recently released report from the Medical Group Management Association (MGMA) based on 1,350 medical practice professionals reveals that salaries for medical practices have grown more than 7 percent since 2011. Here's what else the report revealed:

• The median compensation for CIOs grew from $123,597 in 2011 to $132,898 in 2012.

• The median compensation for information systems directors grew from $91,319 to $100,308.

*To see more survey data points or download the entire survey, visit MGMA.com.

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