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Should A Salaried Physician’s Decreased Efficiency Be A Concern?

For centuries, physician practices have been small  business enterprises built on the sweat equity of intensive medical training.  It was an economic reward system that often had physicians sacrificing family life for patient care.  It continues today as the  foundation of  fee for service.  We know it as the eat what you kill model of health care.

In the last ten years, physician practices have seen a dramatic shift from independent business practices to hospital owned practices. With that shift has come a titanic move toward the salary vs productivity  compensation model.

Is this a good thing?  Is a salaried physician better than a productivity based physician? That question can’t be answered because good depends on which part of the medical industrial complex you belong to and what you consider good.

As a physician, the answer on whether to become a salaried vs productivity based physician can only be answered after one defines what they value most.  We know, across the board, that physicians who work in a 100% productivity model earn Read more »

*This blog post was originally published at The Happy Hospitalist*

Survey Results Compare Hospitalist Earnings In 2011

Want to know if your hospitalist compensation package  is on par with other hospitalist groups around you?  I have previously written about the results of the  hospitalist salary compensation survey for 2010, 2011 (SHM and MGMA).  The parabolic rise appears to have no end in site.  Hospitalist demand continues to grow as witnessed by the rapid expansion of hospitalist subsidy/support payment for 2011, despite poor economic conditions.

Here’s another look at an exceptional 2011 Hospitalist Salary Survey done by the folks at Today’s Hospitalist.  If you are a hospitalist, you owe it to yourself to stay well informed about what you are worth in the market place.  As shown in the SHM/MGMA survey, hospitalist compensation Read more »

*This blog post was originally published at The Happy Hospitalist*

Is The Increased Patient Safety Of The EMR Worth The Inefficiency?

With all the talk about how EMR/EHR resources will make practicing medicine better, faster and safer, I learned of an unintended consequence that is probably under appreciated these days. Hospitalists are being asked to admit more and more patients because, for primary care doctors, when they compare EMR medicine with the old way of  doing things, EMR is just too time consuming to make it worth their effort.

That’s right, hospitalists are admitting more patients because the primary care doctors find their time costs for navigating their new EMR, which they bought to qualify for EHR stimulus funds under ARRA, are simply too great.  In a business where efficiency must prevail, EHRs Read more »

*This blog post was originally published at The Happy Hospitalist*

Are Regulations Preventing Hospitalists From Reaching Their Full Potential?

How many patients should a hospitalist average on any given day?   What do you think?  The Hospitalist asked that question to hospitalists and  421 of them responded.  They were given responses in quintiles of 10 or fewer,  11-15, 16-20, 21-25, and more than 25 total patient encounters per day.

Go check out their results.  I’m not surprised.  But, as they say,  there is no right answer.  The right number is the number that brings WIN-WIN-WIN-WIN to the patient-doctor-hospital-insurance quadrangle.   WIN-WIN-WIN-WIN is possible.  It just takes a great understanding of removing the barriers to efficiency.  Efficiency and quality of care can move in the same direction.  They don’t have to be opposing forces.  You can be better and faster if given the tools, whether those tools are driven by IT support, systems process changes, communication enhancement, physical and structural hospital layout changes or documentation support tools.  There are many others. Read more »

*This blog post was originally published at The Happy Hospitalist*

Check-In Kiosks At Your Physician’s Office: It’s All About Efficiency

The airline industry was a lot like physician practices several years ago.  Costs were  rising all around them while stagnant revenue caused declining margins.   Well, this is America, not North Korea.   How did the airline industry survive and thrive (except for American Airlines)?

  1. Efficiency
  2. Add on revenue opportunities

Physician offices are just now catching on.  What can doctors learn from the airline industry?  Here’s picture proof of efficiency in action.

Text from Sister Happy: Here’s how I just checked in at my orthopedists…it’s all by kiosk now.  Have to say…they were faster and nicer than many receptionists.  Only problem is… Read more »

*This blog post was originally published at The Happy Hospitalist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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