Reverse Recommendation; Hire Well; Hacker's Delight

October 6, 2013

Noteworthy items from Physicians Practice.

Stat: 48

Percentage of physicians who use a combination of a smartphone, tablet, and laptop/desktop in a professional capacity, according to a recent mobile trends report.

Source: Epocrates

Reverse Recommendation

"Well, I am here to apologize. ...I didn't review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis."

Sanjay Gupta, MD, announcing his reversal of a long-standing opposition to medical marijuana in an article for CNN.com.

Stressful Work

"Some days I find myself facing patients and feeling more like a harried airline clerk than a real doctor."

Internist and University of Oklahoma School of Community Medicine educator John Henning Schumann, in a written article for NPR.

Great CPA? Check!

Physicians think about a lot of things on a day-to-day basis, but business essentials aren't always among them. However, there are at least two dozen business-related resources physicians should be using, writes legal/business expert Ike Devji, in a recent Practice Notes blog. Topping the list in the third installment of his "Doctor's Business-Planning Checklist"? A professional accounting service. "A 'good' [CPA] tells you what you owe; a 'great' one proactively looks for ways to help make that number as small as the law allows," notes Devji. "Taxes and payroll are just the beginning. Today's demanding business climate means you must have a sophisticated fiduciary who proactively offers solutions and shows you legal tax-avoidance options in addition to the exacting administrative and reporting functions we rely upon them for." For more must-have business resources, see http://bit.ly/docbizlist3.

Hire Well

The hiring process for medical practices can be costly and time consuming. That's why it's especially important to have a great employee pre-screening system in place, writes P.J. Cloud-Moulds, a medical practice consultant, in her regular column for Practice Notes. Her first tip: When placing your employment ad, consider the team you have in place. Is there a skill set you are missing that might round out your team? Are you planning to reorganize your department? Do you have a leader? Craft your ad according to your needs. For additional guidance, see http://bit.ly/hirepracticetips.

Ignoring Recommendations

Despite numerous guidelines on how physicians can manage routine back pain, docs are not following advice, says a recent study published on the JAMAInternal Medicine website. Using national survey data, Harvard Medical School researchers identified nearly 24,000 outpatient visits between 1999 and 2010 during which the patients' main symptom was back or neck pain. The study found that the number of physicians who doled out non-recommended remedies, such as advanced imaging, referrals to other physicians, and prescriptions for narcotics, increased, Modern Healthcare reported. Donald Casey Jr., a member of the New York University School of Medicine's department of population health, suggested in an editorial accompanying the study that physicians may not have followed guidance due to greater availability of imaging facilities and the fear of being sued for "missing something."

Hacker's Delight

Think your practice's healthcare data is being targeted by a rogue hacker? Turns out you do, indeed, have at least some cause for paranoia. A new report by ID Experts, a data security provider, reveals healthcare data breaches have not only evolved, but are now more likely to be targeted incidents by cyber criminals, as opposed to accidental exposures. Rick Kam, president and cofounder of ID Experts, said every study he has seen indicates that medical records hold an average black market value of $50 per record, American Medical News reported. Because data can now reside in multiple locations, including unsecured smartphones, laptops, and tablets, and can be transported to an infinite number of locations, data is easier to target, he said. "These criminals essentially are finding ways into those systems to go after very specific pieces of data, and using [those] data to create bigger frauds."

Embracing Dr. Google

Nearly one out of three patients is going online to check symptoms. And while some physicians have taken issue with consulting Dr. Google, more physicians are actually fine with it, CBS News reports. Doctors may have had a change of heart in part because medical websites are getting more advanced, or because they are spending more time on the Web themselves.

"I think it's personal bias. Doctors spend an average of 12 to 18 hours a week doing medical work and getting medical information from the Internet," CBS News contributor Dr. Holly Phillips said on "CBS This Morning: Saturday." "In fact, it's the first place I turn if I have a tough diagnosis. I think we're all using it and we're all getting used to that idea." Currently 59 percent of U.S. adults use the Internet to look up health information, according to a recent survey of more than 3,000 people by Pew Research Center's Internet & American Life Project.

'Dr. Feelgood' Arrested

A New York physician was arrested in late July for allegedly acting more like a drug dealer than a doctor by selling highly addictive painkillers directly to patients - without even examining them. Internal medicine physician Anand Persaud, 44, who is being charged with illegally selling Oxycodone on two occasions, has offices in Jamaica, Queens, and Baldwin, the New York Daily News reported. Investigators believe he made $1.4 million from 5,800 office visits in 2011 and 2012 during which he prescribed the addictive meds to patients, according to reports. "It's unconscionable that a doctor, a trusted licensed professional, would violate his professional duties and abuse his license to traffic in prescriptions for narcotics," said New York Attorney General Eric Schneiderman, whose office conducted the investigation.

Virtual Reality

3-D simulation technology via online virtual content generator Second Life could be the basis for a new tool to help surgical residents fine tune their patient management skills, according to research recently published in the Journal of the American College of Surgeons. Researchers from Imperial College at St. Mary's Hospital in London built three virtual environments - a hospital ward, an intensive care unit, and an emergency room - to help surgical residents with varying experience levels in making diagnoses and managing their patients, FierceHealthIT reported. Most participants seemed to find the exercise beneficial, said researchers.

Data Exchange Rises

New research published in Health Affairs from the Office of the National Coordinator for Health Information Technology (ONC) shows that health information exchange (HIE) between hospitals and other providers jumped 41 percent between 2008 and 2012. The research suggests that EHRs and health information organizations are complementary tools used to enable health information exchange. Here are other notable highlights:

• 58 percent of hospitals exchanged data with providers outside their organization in 2012; and exchanges between hospitals of different organizations more than doubled during the study period.

• Between 2008 and 2012, the percentage of hospitals exchanging radiology reports, laboratory results, clinical care summaries, and medication lists with hospitals and providers outside of their organization significantly increased.

• 84 percent of hospitals that adopted an EHR and participated in a regional health information organization exchanged information with providers outside their organization.

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