Practice Management

Reimbursement for the HPV vaccine; Dealing with sales reps; ER coverage

What's holding you back? Cost? Worries about managing pain or complications? An expert debunks common excuses for not doing more office-based procedures and explains why you need both U/S and diagnostic hysteroscopy-and the rewards you can reap from taking your practice in this direction.

See our NEW department! Have a Practice Management question you need answered? Send it to cog@advanstar.com and Dr. Hayworth will consider it for a future column.

Florida lawmakers have been busy lately trying to ensure tort reform in medical malpractice cases, according to Medical Liability Monitor (5/2006). Florida Gov. Jeb Bush, for one, signed into law a bill that would require physicians and businesses to pay only the amount of damages according to their level of responsibility-not their financial ability to pay.

In our final series installment, Dr. Hayworth discusses establishing a compensation system, investing in staff training, whether to bring on fellow physicians as partners or employees, and much more.

At least that's what Clement J. McDonald, MD, emphasized in an article in the Annals of Internal Medicine (4/4/06). Presenting an actual case, in which two patients were misidentified when a mix-up occurred with their bar-coded identification wristbands, McDonald drew several conclusions to improve risk management

Doing so may actually enhance the patient-physician relationship, according to a study in the Archives of Internal Medicine (3/27/06).

Watching his state's medical care system crumble and many of hispartners shutter their practices spurred one Mississippi ob/gyn totake a personal stand on tort reform. His run for elected officewas successful-in more ways than one.

What right does a teenager have to confidential health care? What influence does HIPAA have on that right? How you apply the answers in your practice could determine whether an adolescent seeks health services-or forgoes necessary care.

After 4 years of negotiations with trial lawyers and physicians,Washington Gov. Christine Gregoire has brokered a liability tortreform package acceptable to both parties.

How do you get the best terms on an HMO or PPO contract? Should you merge with another practice to gain more negotiating clout? Do you need a specialty lawyer or consultant? These are just a few of the questions answered in Part 2 of our series.

Practicing medicine in post-Katrina New Orleans is not always easy. There are no 15-minute appointments.

New Jersey is now the 24th state to pass a law providing contraceptive insurance equity. The new law, A.B. 292, requires most insurers in the state to provide coverage of prescription contraceptive drugs and devices. The law provides an exemption for qualifying religious employers if contraceptive coverage conflicts with the employer's "bona fide religious beliefs and practices," according to the American College of Obstetricians and Gynecologists (Government Relations Newsletter, 1/13/2006).

President Bush used his State of the Union address to once again urge Congress to pass medical liability reform, specifically citing the crisis in obstetrics and gynecology. He said, "And because lawsuits are driving many good doctors out of practice?leaving women in nearly 1,500 American counties without a single ob/gyn?I ask the Congress to pass medical liability this year."

New Jersey is now the 24th state to pass a law providing contraceptive insurance equity. The new law, A.B. 292, requires most insurers in the state to provide coverage of prescription contraceptive drugs and devices. The law provides an exemption for qualifying religious employers if contraceptive coverage conflicts with the employer's "bona fide religious beliefs and practices," according to the American College of Obstetricians and Gynecologists (Government Relations Newsletter, 1/13/2006).

You may not have been trained as a CEO, but unless you sharpen your business skills, your clinical skills may be all for naught. In the first of our 3-part series, a seasoned physician executive outlines the tools needed to manage people, profits, and policies.

More and more health plans are taking up the onus of getting information technology into physicians' practices. They are offering free or subsidized e-prescribing or electronic medical record (EMR) systems to physicians in the hopes that the effort will ultimately save money and improve quality of care.

If so, you are not alone. More than 50% of doctors younger than 35 in developed countries use a personal digital assistant, according to a review in The Lancet (10/1/05). The review stated that physicians used PDAs in daily clinical practice most often for drug reference (80%). They also used it for scheduling (67%), medical calculations (61%), prescription writing (8%), and billing (4%).

Malpractice rates continue to be a hot topic across the nation. Here's a look at recent developments in three states, as reported by the electronic newsletter American Health Line (9/16/05):

There is no secret to finding, hiring, and keeping great office staff. Prepare before you need to hire, hire correctly, and be the best boss in town.

We have the technology to enhance patient safety and care. Now we have to use it.

Sen. Olympia Snowe (R-Maine) introduced a bill that would require all health plans that cover prescription drugs to include coverage of FDA-approved forms of contraception.

A recent study on closed malpractice claims in Texas found that "insurance market dynamics"—not increasing payouts in lawsuits—were to blame for rising insurance premiums, according to Medical Liability Monitor (April 2005). The study, authored by three law professors, was promptly criticized by medical groups and insurers.

Tort reform measures in three states seem to be improving the environment in which to practice medicine, according to American Medical News (3/28/05).

In a previous article, we reviewed coding changes for vaginal colpopexy. This article looks at a related code introduced in CPT 2005 and how to report multiple services provided during the same surgery.

As I write this I am post-call, which may account for the tone of my meandering discourse. At my age, the problem is not so much taking call but surviving the next day. While tackling clinical challenges can be exciting, what I find most stimulating is the chance to teach and learn from my residents.

Senate Majority Leader Bill Frist, R-Tenn., wants to put politics aside and get momentum behind stalled medical malpractice reform in Congress.

A coalition of patients, attorneys, physicians, and hospital administrators is promoting an alternative way to control medical liability costs, in lieu of tort reform. And all it requires is an apology and an offer of fair compensation to the patient if a medical error occurred.