Practice Management

We need to define shift mentality simply as a time commitment, not as a measure of our level of care.

The stiff-upper-lip approach to dealing with medical errors doesn't help your practice, your patients, or you.

Tempted to tell patients when you've made an error but afraid that too much honesty isn't the best policy? Here's how to do it safely.

In eleventh-hour negotiations before Congress ended its session last year, legislators found funding to prevent a scheduled 5% cut in Medicare reimbursements to physicians and provide additional payment to those who report quality measures. While the reprieve is good news for 2007, it will not roll over into 2008. Instead, the Congressional Budget Office reported that the recent tax and health bill will result in a 10% cut in Medicare payment rates next year, according to Modern Healthcare (1/8/2007).

Despite efforts in 2006 to reconcile two significantly different Senate and House bills on health information technology, Congress this year hopes to create new legislation that both chambers can agree on. And the new Congress-with a Democratic majority-";will likely pay a large part in determining how information technology priorities will be handled," reported American Medical News (1/1-8/2007).

Information about how well pay-for-performance programs are doing within commercial HMOs might help the Centers for Medicare and Medicaid Services, which is considering adopting this approach for Medicare reimbursement. To that end, Boston researchers conducted a survey of 252 HMOs from 41 metropolitan areas across the country to identify the traits of these incentive programs.

Will the employers-physicians, hospitals or other covered entities-also be held accountable and subject to prosecution? That's what a 2005 Department of Justice memo seemed to imply.

Thanks to a ruling by Michigan's Supreme Court, physicians in the state may now sue hospitals and peer review committees for wrongful peer review. The high court's ruling overturns almost 25-year-old case law, which kept courts from getting involved in hospitals' staffing decisions because of its lack of expertise. As a result, physicians' claims of unfair peer review were often rejected.

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.