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Business of Medicine

A Blessing and a Curse: Health care reform comes at a steep price

September 2, 2011

There is a Chinese proverb that is both a blessing and a curse. The blessing is, “May you live in interesting times,” and the curse is, “May you live in interesting times.” All of us would like things to stabilize into a constant, comfortable and predictable environment for us to live our lives, raise our families and care for our patients. We are entering the most complex and challenging period that medicine has experienced since the 1960s when Medicare was introduced. From now on, everything we have come to know and are comfortable with in our professional lives will change.

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Rent the Right Way: Medical offices require unique leases

September 2, 2011

As tenants of medical office spaces, physicians often create special leasing issues. Medical tenants use hazardous materials, generate biomedical waste, demand confidentiality of patient records and require compliance with occupational safety standards—all unique aspects of the medical profession. Yet, often, physicians will sign “form” medical office lease agreements provided by the landlord without the benefit of legal counsel. Typically, the landlord provides a standard fill-in-the-blank lease form with the tenant’s name and the general business terms (including the term of lease, rental rate and commencement date). Tenants may gloss over the legal boilerplate provisions included in the lease agreement, assuming that these terms are standard to all leases and are not subject to negotiation.

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New Speech-Language Pathology Rule: Supervision of videostroboscopy and nasopharyngoscopy no longer required

September 2, 2011

Medicare requirements for physician supervision of speech-language pathologists conducting videostroboscopy (CPT 31579) and nasopharyngoscopy (CPT 92511) will move from the strictest level of oversight back to no national supervision level starting in October.

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Chaos Control: Plan ahead to ensure your practice survives a disaster

September 2, 2011

Ten years have passed since the U.S. was attacked on September 11, 2001 and six since Hurricane Katrina slammed into the Gulf Coast. And, while disasters of that magnitude are rare, hundreds of smaller-scale disasters occur every year, including tornadoes, blizzards, fires, earthquakes, airline crashes and chemical spills.

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The Future is Small: Nanotechnology promises big changes for head and neck surgery

September 2, 2011

The biggest gains in the future for surgical and therapeutic treatments of head and neck cancer will likely include the use of imaging techniques, radio-enhancers and drug delivery vehicles that are really, really small.

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The Lost Art of Medicine: Patient care is paramount in practice

August 2, 2011

The science of medicine continues to expand rapidly, and this is obviously good for humanity. The art of medicine, on the other hand, has been largely forgotten. This skill is the basis of the time-honored physician-patient relationship and is an important aspect of good patient care. So why have so many physicians forgotten this basic skill? Why would a caring physician disregard any expertise that would benefit his patient?

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Update Your Practice: Follow these tips to select the right EMR for your group

August 2, 2011

I have been working with electronic medical records (EMR) for many years, having first become interested in 1996, when I was looking for a tool to collect data for pediatric sinusitis. As we designed a product to collect this data, our scope expanded into developing a subspecialty-specific EMR. I have since learned a great deal about developing and codifying information and am currently participating in my third and largest implementation of an EMR at Boys Town National Research Hospital in Omaha, Neb. In this column, I would like to discuss what to look for in an EMR and give some initial thoughts on implementation.

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Work Overload: Sense of achievement key to combating professional burnout

August 2, 2011

Most microvascular and reconstructive free-flap head and neck surgeons experience at least moderate professional burnout, according to a study published in October 2010 in the Archives of Otolaryngology and Head and Neck Surgery.

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Structural Support: Surgeons extol the cartilage stability provided by a new nasal implant

August 2, 2011

For patients who undergo septoplasty to repair a crooked septum, reconnecting pieces of cartilage and stabilizing the cartilage during the healing process is critical to achieving straight alignment of the nasal septum. Stabilizing cartilage is particularly challenging for patients who require correction of severe septal deviations or severe post-traumatic deformities that are often both functional and cosmetic.

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Sleep Studies Clarified: New guidelines amplify the role of PSG for children with sleep-disordered breathing

August 2, 2011

For otolaryngologists seeing increasing numbers of children with sleep-disordered breathing, whether or not to refer children for a polysomnography (PSG) prior to surgery is not a decision easily made. Currently, only about 10 percent of otolaryngologists request a sleep study in children with sleep-disordered breathing prior to surgery.

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