June 4th, 2011 by RyanDuBosar in News, Research
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Physicians don’t make money from the tests, prescriptions, procedures and admissions they order, according to a new survey by the staffing and technology company Jackson Healthcare. At most, 6.2% of physicians’ total compensation comes from the doctor’s orders, the survey reported.
Direct income from medical orders comprised:
–0.5% from charges from prescriptions,
–1.0% from charges from lab tests,
–1.1% from charges associated with hospital admission,
–1.3% from charges associated with facility fees for surgeries, and
–2.3% from charges from diagnostic imaging.
The survey of 1,512 physicians challenged claims that physicians won’t stop practicing defensive medicine because they profit from their medical orders, the company stated in a press release.
“Many outside the industry believe that physicians make a lot of money on the tests, prescriptions, procedures and admissions they order,” said Richard Jackson, chairman and CEO of Jackson Healthcare. “The reality is that most (82%) do not make any money from their orders. For the remaining that do, it constitutes a fraction of their total compensation.” Read more »
*This blog post was originally published at ACP Internist*
May 13th, 2011 by John Di Saia, M.D. in Opinion
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A mother called the office today. Her daughter had breast implants placed by a surgeon in another state and the two ladies are not happy. They called for a second opinion.
It is dicey dealing with situation like this as a second opinion consultant. The first question is whether or not the first surgeon did anything wrong. A botched boob job is not any boob job that the patient or mother do not like. “Botched” indicates fault. Sometimes there is fault on the part of the surgeon and sometimes there is not. Sometimes patients ask for surgery on the cheap and decline breast lifting or other associated surgery that might have made things look better. Sometimes the patient choose a surgeon of limited skill or qualifications. Sometimes infection, cigarette smoking or scarring can distort an otherwise good procedure. It is not always clear.
The second question for a consultant is whether or not the patient wants him or her to fix things or just wants to return to the original surgeon. No smart consultant wants to end up embroiled in a patient’s lawsuit with the original doctor. It is a waste of time and time is money.
*This blog post was originally published at Truth in Cosmetic Surgery*
April 27th, 2011 by AnneHansonMD in Health Tips, Opinion
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Sideways Shrink posed a great question recently in a comment on my post “When A Thick Skin Helps.” The question was whether or not physicians are allowed to hit a patient who tries to assault them.
Certainly, physical assaults on patients are not the standard of practice in psychiatry or any other medical specialty. Psychiatrists do undergo some training about physical management of violent patients: I remember in residency we had to get trained in “take down” and restraint procedures. As a group we practiced applying pressure point joint locks on each other in order to make a patient break a grip on us, and to do two person restraints to hold someone immobile until security could arrive. None of this involved any “Crouching Tiger, Hidden Dragon”-type kung fu moves, there was no kicking or hitting or loud kiai karate yells. There was a lot of talk about the importance of being as least forceful as possible. Frankly, I’m not sure how much of that I would have remembered if I had ever been in a position to have to use it. The few times when I was actually assaulted by patients the incidents happened so fast there really wasn’t anything I could have done. (OK, so the little manic lady who hit me with a stuffed dog really couldn’t count as an assault, and she was already restrained in a geri-chair to begin with.)
But the real question is: will a doctor get into trouble for defending him or herself? Read more »
*This blog post was originally published at Shrink Rap*
April 4th, 2011 by RyanDuBosar in News, Research
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Improving handoffs from the emergency room back to the primary care physician will require changing how electronic health records are used, better reimbursement to both the hospital and ambulatory doctors, and malpractice reform, according to a study. The rising use of hospitalists and larger primary care practice sizes has contributed to the difficulties faced when an ER doctors tries to reach a physician who best knows the patient.
Haphazard communication and poor coordination can undermine effective care, according to a new research conducted by the Center for Studying Health System Change. Researchers conducted 42 telephone interviews between April and October 2010 with 21 pairs of emergency department and primary care physicians, who were case-matched to hospitals so the perspective of both specialties working with the same hospital could be represented.
Among the findings in the report, telephone communication was essential in some cases, but particularly time-consuming. Both emergency and primary care physicians reported successful completion of each telephone call often required multiple pages and lengthy waits for callbacks. While placing and receiving telephone calls might seem straightforward and quick, providers said each small action multiplied across dozens of patients can become a daunting burden, with little immediate reward or reimbursement. Read more »
*This blog post was originally published at ACP Hospitalist*
March 29th, 2011 by admin in Health Policy, News, Opinion
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More and more patients these days are seeing their physician pull out an iPhone or iPad to look up drug dosing information, review lab and radiology data, or help teach them more about their medical condition. And as developers, and the increasing number of physician-developers, continue to find more creative ways to bring medical resources to the point of care, we can certainly expect smartphone platforms and medical apps to become pervasive at the bedside. However, just as healthcare providers and patients are noticing this trend, there are number of others who are paying attention as well – for WebMD, one of the largest companies in this industry, it is the lawyers who may be watching that are worrisome.
As they put it in their annual statement to the SEC,
If our content, or content we obtain from third parties, contains inaccuracies, it is possible that consumers, employees, health plan members or others may sue us for various causes of action.
We’ve talked in the past about potential liability issues for healthcare providers using medical apps and the developers who produce them, as well as similar issues related to electronic health records. The fact that WebMD found the issue significant enough to report it to the SEC and their investors clearly indicates the issue is still unresolved and the remainder of their statement adds some further interesting perspective. Read more »
*This blog post was originally published at iMedicalApps*
