Business of Medicine » Practice Management

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

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.

Rent the Right Way: Medical offices require unique leases

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.

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

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.

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

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?

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

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.

Help or Hoopla?: Surgical robots can benefit otolaryngology

The large, roadside billboards advertised robotic surgery in bright, bold colors, something that struck David Eibling, MD, professor of otolaryngology at the University of Pittsburgh, as “fundamentally wrong.” Hospitals and physicians “should not be offering robotic surgery as a draw for patients,” said Dr. Eibling, who noticed the billboards while traveling through Florida earlier this year, “but rather as a potential tool to benefit the care of the patient.”

An Unofficial First-Line Treatment: Propranolol gains widespread use for infantile hemangiomas

Since the first report in 2008 of the effectiveness of propranolol to treat infantile hemangiomas, its use has grown among physicians who treat these tumors, which arise in 5 to 10 percent of infants. Among these infants, approximately 10 percent will require treatment to correct functional impairment or prevent lasting cosmetic deformity caused by the hemangioma.

Put It in Writing: Hiring a physician extender involves more than a handshake

Physician extenders, commonly referred to as mid-level providers or practitioners, often offer financial profitability for the practice as well as efficiency, improved quality of care, enhanced flexibility for physicians and greater patient satisfaction. When you hire an extender, it’s important to go beyond a handshake and clearly define the terms of the relationship in a contract. Below are some of the key issues that should be addressed in a mid-level provider’s employment agreement.