Practice Management

Edward Zurad, MD, FAAFP, a solo family practitioner in rural Pennsylvania, found himself one of four defendants in a medical malpractice lawsuit. The plaintiff was not one of Zurad's regular patients. The case was not settled out of court. Zurad shares his experience in being sued and being acquitted by a jury.

A step-by-step examination of a malpractice suit in which a patient claims to be suffering from multiple myeloma and asked for opioids. When it is revealed the patient lied about the need for opioids, the physician assistant changed the medical records before a lawsuit.

When patients visit your office, they may already have a diagnosis in mind. Google says that one of every 20 searches on its search engine are conducted to obtain health-related information. With that in mind, how can a primary care physician (PCP) win a patient’s trust and resolve conflicts if the patient wants tests or treatments that the physician believes are unnecessary?

Little guidance is available to help physicians determine how finding information about a patient online may affect the relationship with the patient.

In the current medical practice landscape, physicians are increasingly frustrated when it comes to the issue of payment for the care they provide. Doctors and their staff members often find themselves chasing patients and insurance companies to get paid, and frequently are forced to write off bills that could and should be paid.

What role should physicians play in discussing the financial impact of treatment decisions, and how can they better manage these conversations?

Medical Economics is proud to unveil the third-place entry in our 2015 Physician Writing Contest.

By a vote of 92-8, the U.S. Senate last night approved legislation ending the long-reviled formula for determining Medicare reimbursements. The vote came just hours before a 21% reimbursement cut would have gone into effect. The measure, which the U.S. House of Representatives passed three weeks ago, now goes to the president, who is expected to sign it.

The Asthma and Allergy Foundation of America estimates that 50 million Americans suffer from allergic rhinitis, which includes hay fever and seasonal or perennial indoor/outdoor nasal allergies. These conditions are thought to affect up to 30% of adults and 40% of children, according to reports from the American College of Asthma Allergy & Immunology. This represents a marked increase over past decades; in the 1940s, hay fever was estimated to affect only 1% of the U. S. population.

The current procedural terminology guidelines state that you should code signs and symptoms when a definitive diagnosis has not been confirmed. Therefore, you will need to document and code the signs and symptoms that a patient presents with at his/her visit. Common diagnosis codes for allergy-related signs and symptoms include those listed below.

If you want to retain your independence while finding some shelter from the storm of regulatory challenges and cost increases facing primary care physicians today, joining an independent physician association (IPA) may be an option to consider.

Direct secure messaging (Direct), a standardized protocol for exchanging clinical messages and attachments, has not caught on significantly among physicians. Even advocates of the secure messaging system acknowledge it is still in an early stage of adoption, comparable to the first year of electronic prescribing.

Medical Economics is proud to unveil the second-place entry in our 2015 Physician Writing Contest. We believe the three winning essays exemplify what connecting with your patients is truly about, and demonstrate the levels of heart, determination, and empathy you strive to bring into every exam room, every day. Thanks for reading.

Saying no to a patient request can be a challenge. Physicians strive to maintain good relationships with patients, while not wanting to agree to anything not medically indicated. While this is certainly not a new problem, it is likely expanding due to inaccurate information on the Internet and direct-to-consumer advertising can increase patient requests for specific things.

Physicians today must understand a myriad of laws and regulations that govern not only how they practice medicine, but also how they bill and refer their patients for services both within and outside their own practice.

Your biggest risk and greatest exposure as a physician is in the area of professional services. But liability also can arise when it comes to the business side of a medical practice, however, and it is in this area where other types of coverage become highly important.

The push is on for physicians to embrace the concept of high-value care, providing patients with appropriate treatment while avoiding wasteful or unnecessary tests. But high-value care requires physicians to navigate many pitfalls, including lack of time to talk with patients and malpractice pressures.

It appears that the highly-anticipated repeal of Medicare’s Sustainable Growth Rate (SGR) formula-also known as the “doc fix”-will have to wait at least a couple of weeks longer.

Fewer than half of physicians have met Stage 2 Meaningful Use requirements and, despite a promise to add flexibility to reporting requirements in 2015, the Centers for Medicare & Medicaid Services (CMS) has released a proposed rule for Stage 3 of the Medicare and Medicaid Electronic Health Record Incentive Program that some stakeholders say is anything but flexible.

According to comments made by Michael Chernew, PhD of the Harvard Medical School at the ACC meeting, the healthcare system must transform its payment methods. ACOs may be a solution to control spending.

The conclusion of a talk by Melanie Everitt, MD, Director Heart Transplantation, Children's Hospital Colorado is that medical therapy should be optimized first before moving on to treatment of children suffering from heart failure with a device or transplantation.

Despite recently published hypertension guidelines for those over the age of 60, it is still appropriate to focus on blood pressure targets set by an older guideline recommended by the American Heart Association and the American College of Cardiology.

Atrial fibrillation (AF), once thought of as a disease with a simple diagnosis, is now being seen as a disease of great complexity and now requires clinical judgement for effective managing.

Key market trends are placing pressure on healthcare providers to adapt new ways of delivering care more efficiently while improving patient outcomes. Cardiovascular care (and the importance of coordinating cardiovascular care) is critical because it comprises a significant portion of the overall healthcare spend, particularly in light of changing demographics.

For clinicians who aspire to leadership positions within their healthcare organization, keys to success include the ability to embrace ambiguity, not being afraid to fail, and falling in love with the problem and not the solution.