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Hospitalist Compensation Increasing With Productivity

Hospitalists in adult medicine reported an increase in median compensation from $215,000 to $220,619 in 2010, while pediatric hospitalists median compensation rose from $160,038 in 2009 to $171,617 in 2010. Though hospitalists earned more in 2010, they also reported higher productivity. The annual median adult hospitalist physician work relative value unit (wRVU) rate was 4,166, a 1.4% increase over last year.

According to the Medical Group Management Association (MGMA) and Society of Hospital Medicine’s (SHM’s) State of Hospital Medicine: 2011 Report Based on 2010 Data, compensation varied by how it was structured. Adult hospitalists with 50% base salary or less reported median compensation of $288,154, while adult hospitalists with 51-70% base salary reported median compensation of $249,250. Adult hospitalists who reported 71-90% base salary earned Read more »

*This blog post was originally published at ACP Hospitalist*

Changing Regulations To Give Patients Greater Access To Health Records

On September 14, HHS released for comment draft lab results regulations that will, if finalized, effectively bathe the Achilles’ heel of health data in the River Styx of ¡data liberación! All lab results will be made available to patients, just like all other health data.  (See the HHS presser and YouTube video from the recent consumer health summit.  Todd Park, HHS CTO, is also the chief activist for what he calls ¡data liberación!)

Forgive me for mixing my metaphors (or whatever it is I just did), but even though there are just a couple dozen words of regulations at issue here, this is a big deal.

When HIPAA established a federal right for each individual to obtain a copy of his or her health records, in paper or electronic format, there were a couple of types of records called out as specifically exempt from this general rule of data liberation, in the HIPAA Privacy Rule45 CFR § 164.524(a)(1): psychotherapy notes, information compiled for use in an administrative or court proceeding, and lab results from what is known as a CLIA lab or a CLIA-exempt lab (including  “reference labs,” as in your specimens get referred there by the lab that collects them, or freestanding labs that a patient may be referred to for a test; these are not the labs that are in-house at many doctors’ offices, hospitals and other health care facilities — the in-house labs are part of the “parent” provider organization and their results are part of the parents’ health records already subject to HIPAA).

(“CLIA” stands for the Clinical Laboratory Improvement Amendments of 1988, which established quality standards for certain laboratory testing.)

This carveout of lab results from patient-accessible records has long been a thorn in the side of the e-patient.  This month, Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

Do Most Hospitals Have Similar Performance Scores?

Quality measures. Patient satisfaction surveys. With our new health care reform law, these “performance measures” are the new black in health care.

Hospitals are currently spending, conservatively, tens of millions of dollars to bolster these “performance measures” in hopes of securing a refund of a mere 1% of payments that CMS will soon withhold from them in the name of “assuring” quality improvement.

But what if, nationwide, there wasn’t a big difference in these measures between hospitals? What happens then? Might payments then be made on political grounds?

Performance measures have been collected for some time now in anticipation of this new payment initiative by the government, so data exist to evaluate. In fact, Kaiser Health News was nice enough to aggregate the findings from our government’s Hospital Compare website for my review.

So I calculated the mean, median and standard deviation of the results of all of this data collected across 50 states and 2 territories and found very little difference in measures collected between states: Read more »

*This blog post was originally published at Dr. Wes*

The Downfall Of EMRs: Capturing Too Much Data

We have a new EMR system.  I like it because I type well.  I’m facile at using a keyboard and touch-screen.  Not everyone in my group is so blessed, and we’ve had some difficulties using the voice-transcription software.  Nevertheless, my gut tells me that in a month or two more, we’ll be getting along with our new system swimmingly.  It’s the sort of thing I have wanted for a while, since I truly hate to dictate; and especially hated dictating the information the nurses had already entered into the computer!

However, I have an issue.  Not so much with our EMR, but with all EMRs.  I have an issue with the deeply-held delusion that computerization will automatically improve charting and patient care.

Some time ago, the inimitable, world famous blogger Dr. Wes (who can be found at http://drwes.blogspot.com/ ) told me that his facility’s conversion to EMR caused him to spend far more time at the computer than with the patient.  And true to his great wisdom and insight, that’s where I find myself.  It isn’t the location of the computers.  We have portable ‘tough-books’ that can go to the bedside. Read more »

*This blog post was originally published at edwinleap.com*

Healthcare: One Person’s Waste Is Another Person’s Job Security

Someone I know works at a non-profit organization (supported by health insurers) that is trying to simplify the administrative processes in healthcare. He’s tasked with finding ways to make data transfer between doctors’ offices and health insurance companies more uniform and straightforward. His work is such a success that it was promoted to President Obama as a clear example of health insurers’ efforts to reduce waste and simplify healthcare. There is even talk of his project becoming mandated.

So why is this simplification strategy now in jeopardy of being tabled rather than legislated? Vendors and clearinghouses who exist to transfer data from one disparate health insurance bureaucracy and medical practice to another are fighting to block this progress because their business model is at risk. If health insurers and physicians can safely and efficiently exchange data – then they become less reliant on middle men.

One person’s waste (non-uniform, inefficient data exchange) is another’s (clearing houses and vendors) job security.

And we wonder why it’s so difficult to reform healthcare?

Sigh.

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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