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According to their medical training, physicians are concerned with treating patients according to commonly accepted “standard of care.” What about alternative treatments and techniques that are not considered part of conventional, Western medicine? As these approaches become more popular and requested by patients, doctors must decide what is acceptable in their practice and what isn’t….
Mind, Body and Beyond
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There is a growing awareness among many patients that the likely cause of their sickness or disease may be more than physical. After all, there are hundreds of web sites that discuss the mental, emotional and “spiritual” aspects of personal health and well-being—suggesting procedures, remedies, and therapies that fall outside conventional, Western medical practice. As patients learn more about holistic approaches to wellness, they expect their doctors to be informed on the subject and even make some recommendations as to what might fit into their self-help regimen.
Our monthly survey addresses a number of key questions: How familiar are most healthcare providers with Complementary and Alternative Medicine (CAM)? To what extent do they incorporate these procedures and therapies as part of their personal health program and in their own medical practice? Furthermore, do health professionals see a trend in greater awareness and acceptance of CAM as part of “standard medical care”?
Addressing the topic more analytically, our Special Report, “Making Complementary and Alternative Medicine Mainstream,” focuses on how CAM relates to important matters such as federal regulations concerning safety and effectiveness, clinical trials, insurance reimbursement, standards of practice, and medical malpractice liability.
To offer additional insights, we also feature personal commentary written by an Obstetrician and an interview with an Internist—both of whom are drawn to some aspects of complementary medical approaches that have benefited themselves and their patients. We hope you enjoy the diversity of viewpoints offered on an intriguing topic that is gaining additional exposure within the healthcare community.
Cordially,
Calvin Bruce
Managing Editor
New Plan to Insure Almost All Americans in 2008 Would Save $1.6 Trillion Over 10 Years
Source: Healthcare Finance News
Date: 05/14/2008
Commonwealth Fund researchers have created a plan that would insure 44 million of the estimated 48 million uninsured Americans in 2008 and save approximately $1.6 trillion over the next 10 years.
The plan is expected to cause minimal disruption for people satisfied with their current coverage, says the Commonwealth Fund, and any decisions to switch to the new coverage would be voluntary. Reports indicate financial savings would only be possible if coupled with efforts to reform how the United States pays for health care, investment in better information systems and the adoption of initiatives to improve public health.
As detailed by the article, the approach calls for:
-A national entity known as a “connector” that would offer individuals and small businesses a choice of private plans or a Medicare Extra plan.
-The requirement that all applicants be given health insurance at standardized rates regardless of their health status.
-Tax credits to make sure premiums are affordable. Premium assistance would be available to ensure that premiums do not exceed 5 percent of income and 10 percent of income for higher-income tax filers.
-The expanding of Medicaid and SCHIP to cover all low-income adults and children below 150 percent of the federal poverty level with modest copayments for health care services and no premiums.
-The requirement that everyone enroll in a health insurance plan - including uninsured individuals who file taxes, who would be automatically enrolled.
-The requirement that employers either provide health insurance or pay 7 percent of payroll (up to $1.25 an hour) into a pool to help finance coverage.
-Reforms that would extend Medicare extra benefits to current Medicare beneficiaries, eliminate the two-year waiting period for Medicare for the disabled and allow adults age 60 or older to buy into Medicare.
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The Picture of Healthcare
Source: Unique Opportunities Magazine
Date: 06/01/2008
With the American healthcare system generally agreed upon to have come to a crisis point, the topic is virtually inescapable in political discussions of recent. As 2008 is an election year, opinions on how to solve America’s healthcare woes are numerous and conflicting. An article in the May-June issue of Unique Opportunities takes a look at some of the options and opinions that make up the American discussion.
The article cites a survey by medical software firm Epocrates, Inc. from June of 2007 which found that 80% of respondents said healthcare reform was likely to be a central issue of discussion in the 2008 election. 50% of primary care physicians said that a single payer solution was the best answer to America’s healthcare woes. 60% of those said that the state of healthcare was likely to get much worse over the coming five years. The outlook among young doctors was even worse, with 32% of those responding that American healthcare would reach an even lower state.
Opinions vary, however, as to how to deal with the crisis. While some doctors advocate a single payer system, others advocate increased access to health insurance with government assistance. Still others call for a decrease in government involvement, citing regulations as the primary drivers of prices and trusting in free market powers to straighten out the mess. As is, the issue seems certain to dominate discussion in the coming election and likely for years to come beyond that.
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Health Care in a Lousy Economy
Source: H&HN Magazine
Date: 06/01/2008
The recent economic downturn has troubled the waters in many sectors of American life, from politics to transportation to the energy sector. But what does it mean for the health care industry? An article in the June issue of H&HN Magazine explores what the economic troubles of recent may spell out for your hospital.
The author, a principal in Deloitte Consulting LLP, cites his life experience in the city of Detroit, which has experienced America’s worst economy over the last 18 months, as a reliable predictor of what to look for in the coming economy. The article goes against traditional wisdom that healthcare remains mostly unaffected by economic woes, citing the troubles of Detroit’s metropolitan hospitals as conflicting evidence. The author notes six lessons from Detroit’s situation that may be relevant across the nation as the economy worsens:
-Healthcare isn’t immune to economic cycles
-The payer mix changes as laid-off workers become self-payers
-Patient-responsible portions of bills increase, as does bad debt
-Hospital volumes drop as ER rates increase but admissions go down
-Everybody expands as hospitals increase geographic reaches to make up revenues
-Mergers happen quickly as hospitals join forces to survive.
The downturn can, however, have some good effects. The author notes a drop in nurse vacancy rates during economic downturns as well as strong performance by regional not-for-profits. Also, costs are cut and more efficient organizations emerge when the economy finally goes back on the uptick.
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Kaiser Doctors Making a Different Kind of House Call
Source: Denver Business Journal
Date: 05/02/2008
In August of 2007, Kaiser Permanente’s Colorado division began a program in which physicians join sales associates on sales calls and follow up meetings with current members to address questions related to medical care and to “put a face” on Kaiser’s services. As an MCO, Kaiser Permanente is focused on expanding the number of services offered to each member as much as they are on courting new members outright.
Based on early evidence, it appears that the biggest impact of the physician “sales ambassador” program has been the encouragement of existing member companies to enroll more employees or sign on for more services, perhaps due to an increased level of trust. According to Kaiser, the program also causes members to focus more on care issues and less on bottom-line details. Kaiser claims that the number of employees enrolled by participating members has increased fifty percent since the start of the program.
Twenty-three doctors were originally contracted to be part of the “sales ambassador team” that covers the Denver area. Each physician is expected to take part in only one or two visits per month.
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U.S. Court Of Appeals Upholds FTC Decision on Price-Fixing Texas Physician Association
Source: Mondaq.com
Date: 05/23/2008
Early in May, the U.S. Court of Appeals for the Fifth Circuit upheld an FTC ruling that North Texas Specialty Physicians, “an association of competing physicians and physician groups” in Fort Worth, Texas engaged in price fixing that did not result in “procompetitive efficiencies” or clinical integration.
The price-fixing in question was mostly related to non-risk contracts. In 2003, the FTC charged the group with polling physicians to negotiate and establish minimum payment terms that they would accept from payors. Payors that did not agree with the group’s terms and meet the minimum fee standards were simply not allowed to engage with the group’s participating physicians. Physicians and payors were discouraged from dealing directly.
The Court of Appeals ruling was made without a full market analysis because of the obvious anticompetitive implications of the practice, though the Court did ask the FTC to amend its original ruling that the group not deal directly with payors.
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Hospitals Have New Options to Increase
Source: Healthcarereview.com
Date: 05/01/2008
For hospital administrators, days of cash on hand is a figure that could always stand to be increased. How quickly hospitals can pay their bills is a major factor in determining how they’re run, according to industry finance experts. It is believed that more timely payment of vendor bills would result in increased savings for hospitals as well as lowered overall healthcare costs.
An article on Healthcarereview.com examines an offering from Security Capital called Vendor Insta Pay. The service allows hospitals, surgery centers, medical organizations and larger medical practices to pay vendors in full. Security Capital reimburses the vendor at the generally lower price offered for prompt payment, and then the medical organization pays Security Capital with extended terms, usually an additional 60 days.
The program’s organizers claim the service adds no additional costs for practices and can be easily set up within a few days. The cost savings to hospitals, practices, and other medical organizations is being touted as a means of reducing health care expenditures for organizations and eventually patients.
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As Doctors Get a Life, Strains Show
Source: The Wall Street Journal
Date: 04/29/2008
American medicine is undergoing a cultural revolution as young physicians intent on balancing work and family challenge the assumption that doctors should be available to treat patients around the clock. While quality-of-life issues have been long-festering for physicians, today’s medical field is more accommodating, and younger doctors’ attitudes are giving rise to different types of practice options, ranging from small, membership-based primary-care facilities to hospital-specific jobs that keep doctors on predictable schedules.
At the same time, the attempt by new doctors to lead a less-pressured work life is putting additional strain on America’s healthcare system. Many are eschewing fields such as internal medicine, pediatrics and family medicine, choosing instead specialties that offer both higher pay and more predictable work hours. In family medicine, for example, hundreds of medical residency positions go unfilled every year. But competition for slots in dermatology residencies is fierce.
To adapt, American medicine is drifting away from the old standard—in which a single doctor handled almost all of a patient’s needs—and toward a more team-based approach. This system includes not only multiple doctors but also more nurse practitioners and physician assistants.
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Survey of Medical Schools is Critical of Perks
Source: New York Times
Date: 06/01/2008
A ranking released by the American Medical Association finds that most US medical schools fail to adequately limit the perks handed out to doctors and trainees by pharmaceutical companies, with just one in seven schools receiving above average assessments regarding their conflict of interest policies.
Conflict of interest policies are judged to be important for an untainted educational experience according to student advocates. The exposure to waves of advertising from pharmaceutical companies is thought to lessen the overall experience and even prove to have a negative and biasing effect on the education of future physicians.
The AMA called recently for an outright banning of the free food, gifts, and educational seminars offered to students and their instructors by pharmaceutical companies.
Of the 150 medical schools graded in the study, which was conducted by impartial students knowing nothing of the identities of the schools they were grading, only 7 received A’s, while 14 received B’s. Some 28 of the schools were in the process of revising their conflict of interest policies at press time.
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Physician Recruitment: Are We Using Our Time and Resources Wisely?
Source: Journal of the ASPR
Date: 06/01/2008
The writer proposes the idea of “Advanced Access” scheduling and practice model as a solution to physician recruiter woes. This model uses Queuing Theory to reengineer the standard appointment scheduling system, leaving most appointment slots open for same-day-calling patients. As a result, patients are seen in a more timely manner and the system improves scheduling, quality of care, and continuity. Waits and delays are dramatically reduced. Applying the Advanced Access aesthetic to recruiting, the author recommends moving nonessential tasks from physicians to clerical staff, PAs, NPs and nurses. The same goes for recruiting tasks, ensuring a more streamlined workflow for recruiters and increased overall practice efficiency.
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Neurology: Locum Tenens Specialists Meet Increasing Need
Source: LocumLife
Date: 05/01/2008
An article in the May issue of LocumLife explores the possibilities and opportunities for neurology specialists in the locum tenens field. Besides providing an opportunity for travel to other geographic regions, the locum path allows for practitioners to practice medicine without administrative distractions, experience different settings and practice styles, and learn new techniques, among many other benefits.
The article points out the Midwest and South as areas particularly in need of neurology services. In addition to potential salaries of up to $225,000, the locum tenens profession also provides a gr |