Medical practice

Case study: Kaiser physicians go on sales calls

Fri, 09 May 2008 06:59:55 -0400

It's not often that prospective health plan members get pitched directly by a physician. But at Kaiser Permanente Colorado, that's exactly what's happening. The HMO has launched a program under which doctors are going out into the field with sales personnel and meeting with both prospective and existing members. Not only does the program put a face on the plan's medical practice, it also allows patients to ask medical questions they might have otherwise postponed. The program had its origins in late 2006, when Dr. Jandel Allen-Davis, associate medical director for the plan's Colorado medical group, decided to accompany the sales team on calls during open-enrollment season. Since that time, Kaiser has recruited 23 doctors for its "sales ambassador team."

To learn more about the program:
- read this Denver Business Journal item

Judge overturns GA's medical malpractice damages limit

Fri, 02 May 2008 06:59:54 -0400

A Georgia judge has struck down the state's cap on monetary awards in medical practices, a move that could remake the state's 2005 tort reform law. The judge held that the state's $350,000 cap on noneconomic damages was unconstitutional, as in his view, it gave special protection to the medical profession. The case arises from injuries sustained by Cheon Park, who fell from a ladder and became a quadriplegic. Park's attorneys say that the treating facility, WellStar Douglas Hospital, missed injuries to the neck and spine that led to his quadriplegia. While the current decision doesn't apply to other cases, it will go to the Georgia Supreme Court if the defendants appeal. That court could officially overturn the state caps.

To learn more about the case:
- read this Atlanta Journal-Constitution piece

Related Articles:
CO considers raising medical practice caps
NC will limit some medical malpractice awards
Doctor's blog kills malpractice defense
San Francisco agrees to $5M medical malpractice settlement

San Francisco agrees to $5M medical malpractice settlement

Thu, 01 May 2008 06:59:56 -0400

San Francisco city officials have agreed to pay $5.1 million, one of the biggest payouts it has ever made, to settle a case of medial malpractice at its San Francisco General Hospital. The city admitted to mistakes in the case of John Weatherspoon III, who suffered cardiorespiratory failure in 2005. Medical staff failed to monitor Weatherspoon after dosing him with sedatives, and he spent nine minutes "down," which resulted in his suffering an anoxic brain injury. The funds will be used to pay for home care for the remainder of his life.

To learn more about the case:
- read this San Francisco Chronicle article

Related Articles:
Senate bill could transform medical malpractice
CO considers raising medical practice caps
NC will limit some medical malpractice awards
Doctor's blog kills malpractice defense

ALSO NOTED: EMRs may not save much money; Duke plans big expansion; and much more...

Tue, 20 Nov 2007 06:59:50 -0500

> A new report from the Congressional Budget Office suggests that electronic medical records may not be the financial cure-all some observers think. FierceHealthIT

> Duke University Health System is planning a $596 million expansion to its flagship hospital. Article (sub. req.)

> Pediatric medical practice Pediatrix Medical Group is continuing to expand. This time, it has acquired an Albuquerque, N.M.-based pediatric practice. Article

> Thanks in part to a gift from Walt Disney World, Orlando, Fl.-based Florida Hospital has closed its $100 million fund-raising campaign early, having already met its target. Article

And Finally... Aw, doctor, you're taking all of the fun out of my risk-taking! Article

Hot topics at the MGMA

Fri, 26 Oct 2007 06:59:59 -0400

This coming Monday and Tuesday (10/29 and 10/30), I'm heading to Philly to attend the Medical Group Management Association's annual conference. As usual, I'm expecting it to be an intriguing show.

Things are always colorful on the front lines of medical practice--after all, while industry changes can filter down for a while, they've really hit home when physicians get involved--but often medical practice debates boil down to hand-wringing over long-term managed care conflicts or pending state and federal regs. This time, however, I think there's some industry shifts afoot which could be more empowering than overwhelming, including:

* Pay-for-performance incentives
* Physician ratings by consumers, health plans and other outside organizations
* Electronic medical records adoption
* The growth of retail clinics

As FierceHealthcare readers know, these are the topics that (understandably) get physicians hot under the collar, as each stand the chance of changing the way their already-threatened business works. Still, each could also be seen as trends which can be ridden by physicians to grow their revenues.

If physicians there are kind enough to chat with me, I'm eager to pick up some inside stories of how they're coping with these challenges to their business. I'll let you know what I find out. And if you see me there, please feel free to say hello! - Anne

Primary care MDs ask patients for extra dollars

Fri, 03 Aug 2007 06:59:55 -0400

Struggling to pay even their basic expenses, primary care doctors are increasingly asking patients for an annual fee in addition to co-payments on insured services. This isn't a high-touch concierge medicine model--patients are getting traditional primary care--but rather, a method for desperate physicians to keep afloat financially, they say.

For example, geriatrics specialist Dr. Mary Colburn of West Palm Beach, Fla. began asking all of her 400 patients to pay an administrative fee of $250 per year last month. "I wish it were not so that we were in this position. But we are," she said. And she's not unusual. According to the Society for Innovative Medical Practice Design, which promotes the fees, hundreds and hundreds of doctors are taking this tack. "It's not going away," says president Chris Ewin.

To find out more about this trend:
- read this South Florida Sun-Sentinel piece

Related Articles:
Study: Primary care costs, reimbursement low. Report
White paper: Building Teams in Primary Care: Lessons from 15 Case Studies. Report
SPOTLIGHT: Upping pay for primary care. Report

Payments lagging for popular cardiac treatment

Tue, 10 Jul 2007 20:01:37 -0400

Atrial fibrillation is fairly common in the United States, affecting at least 2.2 million people. This condition, which creates rapid and irregular heartbeats, often serves as a warning hearts are deteriorating and can be a major cause of stroke. Increasingly, physicians are hoping to treat it with a costly procedure known as catheter-based ablation (CBA), rather than the fairly toxic drugs often used for this condition.

The problem is that the FDA hasn't approved any of the devices typically used for this procedure, which shut down abnormally-functioning portions of the heart muscle. FDA officials note it will be difficult to gather enough data on atrial fibrillation to make a determination, given how widely the condition varies among patients. That leaves hospitals and doctors struggling to get reimbursed for the procedure, which costs anywhere from $25,000 to $50,000. However, patients continue to demand CBA, which is less invasive than open-heart surgery and seems, anecdotally, to have great potential for success.

To find out more about this trend:
- read this article in The New York Times

Related Articles:
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California releases cardiac bypass death numbers. Report
Number of cardiac surgery jobs falling. Report

Flood of new MDs overwhelms TX board

Mon, 09 Jul 2007 20:01:37 -0400

Texas's new limits on medical malpractice awards has triggered a substantial migration of doctors into the state, overwhelming the state medical board and slowing down the process of screening newly-arriving physicians. These days, the Texas Medical Board is so bogged down that some doctors must wait months before they can actually begin seeing patients. In 2006, the board received 4,000 applications for medical licenses, a huge increase over the 2,992 it got last year. That has led to a backlog of almost 2,400 applications.

To speed things up, state legislators have approved funds to hire six more employees to process applications. It also has hired temporary workers and is paying overtime. Still, in some cases it takes more than six months to process an application, which includes verifying an applicant's medical education and doing a criminal background check. Insiders say it could be a year or more before the screening backlog goes away.

To find out more about the Texas MD licensing backlog:
- read this Associated Press article

Related Articles:
MD says Texas tort limits work. Report
MDs, insurers see big benefits from tort reform. Report

Doctor shortage slows Massachusetts health reform

Mon, 09 Jul 2007 20:01:36 -0400

Making sure uninsured citizens get health coverage sounds good--but it won't work if physicians aren't on board. And it looks like that's a real hurdle for Commonwealth Care, the new insurance-for-all plan offered by the state of Massachusetts.

Primary care physicians aren't thrilled with the requirements for participating in Commonwealth Care products, which include making sure a patient has a first appointment within 45 days and is seen within 48 hours for urgent-care issues. Not only that, physicians are complaining about Commonwealth care reimbursement levels, which are comparable to rates paid by state Medicaid program Mass Health. So with few primary care physicians participating, many Commonwealth Care patients are waiting weeks or even months to find practices who will see them--even to refer them to specialists.

To get more information on the shortage:
- read this Cape Cod Times piece

Related article:
Shortage of primary care docs in Massachusetts. Report

When healthcare providers spread infections

Wed, 04 Jul 2007 20:01:34 -0400

Particularly when it comes to surgeons, who are particularly at risk for nicks and cuts, providers may pose more of a infection-control risk than previously thought. Because viruses like hepatitis B and C and HIV are spread by blood-to-blood contact, healthcare workers are more at risk than the general population, given their more-frequent contact with bodily fluids. And since there are no laws requiring surgeons to be tested for blood-borne viruses--not to mention that infected healthcare workers generally aren't barred from practicing medicine--the risk a provider will pass along an infection mounts.

CDC officials say despite the infection hazards faced by clinicians, the risk of their transmitting nasty bugs like hep B, C or HIV is "very, very" remote, in part because healthcare providers usually get hep B vaccinations. Still, at least in New York, public officials have investigated at least two cases where clinicians may have infected their patients with hepatitis.

To get more background on this issue:
- read this piece in The New York Times

Related Article:
Prison hepatitis C poised to infect U.S. Report