The House Health Care Bill; Public Plan Better for Physicians

From Physician News, Speaker Nancy Pelosi (D-Calif.) officially unveiled the House health care reform bill that is headed to the House floor.

Read a summary of the bill here:
http://edlabor.house.gov/blog/2009/10/affordable-health-care.shtml

The full bill is available online here:
http://docs.house.gov/rules/health/111_ahcaa.pdf

The Affordable Health Care for America Act includes a public health insurance option that would be required to negotiate with providers. The Huffington Post reports, to appease providers concerned about losing money to a more Medicare-like option, the proposed public plan in this bill would allow doctors and hospitals to negotiate rates as they do with private insurers. The catch is that a provision was removed from this bill that would have blocked cuts in Medicare payments to physicians. That provision has been made into its own bill.

American Recovery and Reinvestment Act: Healthcare IT Reimbursement

The American Recovery and Reinvestment Act (ARRA) allows reimbursements to providers for certain kinds of healthcare IT. However some providers are skeptical of the reimbursements and are not interested in utilizing the available funds.

Some providers argue that there are many problems with what is proposed so far and also that they don't see many doctors adopting HIT. Other providers believe collection of data could be used to punish them in the future, or, particularly in rural areas, the cost of implementing healthcare IT is too much for physicians to pay.

Read the full article from Healthcare IT news here:

http://www.healthcareitnews.com/news/providers-skeptical-meaningful-use-reimbursement-process

Practice for Sale? Tips to Make a Practice Sale or Purchase a Success

Many of our private practice clients recruit physician partners in buy-in circumstances. In these models ancillary services, physical assets, accounts receivable, hospital privileges, and case load are all taken in to consideration in the negotiation process.

There are also still many physician practices that are being sold entirely, either to a new solo practice physician buying the practice or even to hospitals or hospital organizations.

Whether you are interested in joining a practice with a buy-in or selling your practice to another physician or hospital, there are many important factors both parties need to be aware of during the negotiation process.

In their recent newspaper, Physician's News has published a good article what to include in a full buy-out to ensure a successful purchase.

Read the full article here:

http://www.livedigitaleditions.com/display_article.php?id=235041

AMA Lobbyists Support Health Overhaul

The battle for Health Care Reform continues, and the American Medical Association has been fighting to influence congress on new propositions affecting healthcare.

AMA has been lobbying to win a $247 billion, 10-year reprieve from scheduled reimbursement cuts for physicians who treat Medicare patients in return for supporting the White House push for broader changes in health care coverage.

AMA continues to fight to get heard, however they are losing supporters. Read the full article from the Washington Post here:

http://www.washingtonpost.com/wp-dyn/content/article/2009/10/28/AR2009102800170.html

IT Impoves Patient Care with a New Medical Model

A new model, The Medical Home, has been proved to successfully increase Primary Care physician's profit and also provide more one-on-one time with patients. Approximately 25 medical home projects are active across the nation in 17 states.

A Medical Home is a physician's office that combines a team of professionals to treat patients and also share in the overhead costs. The offices also use the latest technology, including electronic medical records. Physicians share technology with the medical home group. Using these methods also helped physicians ease their workload.

The technology also encourages continuation of care between primary care physicians and specialists.

Read the full article in Healthcare IT News or click here:

http://www.healthcareitnews.com/news/new-medical-model-it-could-improve-patient-care-family-practices

America’s Physician-Friendliest States

According to Physicians Practice’s biannual analysis, the states that are physician friendliest are Kansas, South Dakota, Texas, Oklahoma, and Indiana. The results are based on states that provide circumstances that affect a doctor’s ability to work relatively hassle-free while still making a nice living such as the state's malpractice climate, reimbursement, and cost-of-living.

This article also provides great resources to research a potential geographic area prior to your site visit or signing with a new employer. Check out the full article here:

http://www.physicianspractice.com/index.cfm?fuseaction=articles.details&articleID=934

2009 Physician Quality Reporting Initiative (PQRI)

In July 2008, the Federal government passed the Medicare Improvements for Patients and Providers Act to improve beneficiary quality of care and safety. One way to achieve this is through a Physician Quality Reporting Initiative (PQRI) which reimburses physicians based on their meeting specific quality and safety measures. Currently a pilot program, it will become permanent in 2010. For more information, please read the full article:

http://www.cms.hhs.gov/pqri/

Recession Causing Physician Practices to Lose Money

According to an article published by the American Medical News, practices are losing financial ground as the recession outpaces productivity. Doctors say there aren't enough hours in the day, or patient demand, to reverse the trend.

Overall, physicians took a hit to their income last year because they are collecting less, practice revenues are dropping, and operating costs are increasing.

Read the full article here:

http://www.ama-assn.org/amednews/2009/10/26/bil21026.htm

Senate Rejects Medicare Plan

Senate voted on October 21st to repeal Medicare physician payment formula in advance of other health system reforms, laying the foundation for a new system to update doctor rates. However the new repeal was rejected because of the potential cost of the repeal.

The Senate will revisit a proposal for a Medicare payment solution later this year when they are reviewing the national health system reform bill.

Read the full article from the American Medical News here:

http://www.ama-assn.org/amednews/2009/10/26/gvl11026.htm

Economy: Physican's Collections Becoming More Challenging

With the current state of the economy, an MGMA survey finds the biggest challenges for practices are covering expenses and getting paid by patients. Physicians who were already concerned with the financial success of their practices last year are getting even more worried this year because of the economy and threat of collecting from their patients.

The "Medical Practice Today: What Members Have to Say," MGMA survey found, for the second year, that the top two challenges for physician practices are rising operating costs and declining revenue, and maintaining compensation levels in the face of declining reimbursement rates.

Read the full article at American Medical News, or click here:

http://www.ama-assn.org/amednews/2009/08/31/bisa0831.htm

Should Doctors Use Twitter?

According to American Medical News, early physician adopters say the social media site can help physicians promote their practices and also to communicate with colleagues.

Physicians most often use Twitter as an extension of their Web presence, a patient communication site, a marketing tool or a virtual water cooler with their colleagues.

Read the full article on the pros and cons of using Twitter here:

http://www.ama-assn.org/amednews/2009/06/29/bisa0629.htm

Follow Harlequin Recruiting on Twitter here:

www.twitter.com @DOMDRecruiter

Health Care Reform: What Will Pass

What is the answer for health care reform? Most Americans believe something needs to change, but the answers to the problem are divides amongst all parties. McCain and Obama agree we need health care reform, but neither of their plans is likely to pass Congress without drastic changes.

What will pass? Any type of change would require heavy government expenditure, something significant to take in to consideration in our economy.

Read the full article posted on CNN here:

http://money.cnn.com/2008/10/21/smallbusiness/healthcare_reform.smb/index.htm

2009 Physician Comp/ Signing Bonus Comparison

According to the New England Journal of Medicine, primary care physicians’ compensation and signing bonuses are significantly lower than their specialists counterparts, with the exception of emergency medicine.

The NEJM has published a comparison chart in their September/ October 2009 Newsletter.

Read the comparison table here:
http://www.nejmjobs.org/rpt/physician-salary-comparison.aspx

Small Providers May Not Have to Deal With Red Flags Rule

The Red Flags Rule, which will start being enforced in 2 weeks, requires healthcare entities considered to be "creditors" to implement an identity theft prevention program. However there is a possibility small healthcare providers may not have to deal with the new rule. Congressmen filed a bill on October 8th that would exempt a healthcare practice with 20 or fewer employees from the FTC's Red Flags Rule requirement.

Read the full article from Health Leaders here:
http://www.healthleadersmedia.com/content/240693/topic/WS_HLM2_COM/Small-Providers-May-Not-Have-to-Deal-With-Red-Flags-Rule.html

Physicians Less Likely to go Solo

The number of physicians initiating solo practices has been declining over the years. The decline in solo practices has been attributed to lower reimbursements in a solo practice, the declining economy, and overhead expenses. Physicians are also looking for a good balance between family and work life, typically it is easier to share call in hospital based or group practices than in solo practices.

The NEJM paper estimated the number of doctors who owns at least part of a practice has declined about 2% annually for the past 25 years.

American Medical News has written an article on the continue decline of physicians choosing a solo practice. Read the full article here:

http://www.ama-assn.org/amednews/2009/10/19/bisa1019.htm

October FDA Calendar Stocks

Seeking Alpha has reported on 6 stocks with expected catalysts during the month of October, including 3 pending FDA decisions, updated clinical trial data, and an expected FDA filing to expand the label of an existing product.

The 6 Companies and new products are:

• BioSante Pharma (NASDAQ: BPAX): LibiGel
• GTx Inc. (NASDAQ: GTXI): Toremifene
• Amgen (NASDAQ: AMGN ): Prolia
• ImmunoCellular Therapeutics (OTC: IMUC.OB): Dendritic Cell Based Cancer Antigen Vaccine
• Questcor Pharma (NASDAQ: QCOR): H.P. Acthar Gel
• Transcept Pharma (NASDAQ: TSPT) : Intermezzo- Prescription Sleep Aid

Three of the stocks (BPAX, IMUC, QCOR) do not carry the added risk of depending on an actual decision by the FDA.

Read the full article, including more information about the products to be released and stock projections, here:
http://seekingalpha.com/article/166923-october-fda-calendar-stocks-tricks-or-treats

State Medical Malpractice Tort Laws

Do you know which states are tort reform states? Since 2000, the issues of medical liability insurance costs and medical malpractice lawsuits have been prominent on both state and federal legislative calendars. Many of the candidates we work with want to know which states are tort reform states and approximate malpractice and liability in each state.

We have found some good resources to research a state prior to considering a potential physician practice opportunity.

The National Conference of State Legislatures has provided a table on state medical malpractice tort laws, view the table at:
http://www.ncsl.org/print/standcomm/sclaw/tortchart04.pdf

Medical Malpractice Tort Limits and Health Care Spending Background Paper provided by the Congressional Budget Office here:
http://www.cbo.gov/ftpdocs/71xx/doc7174/04-28-MedicalMalpractice.pdf

You can read more on Medical Malpractice Tort Reform from the National Conference of State Legislatures at:
http://www.ncsl.org/StateFederalCommittees/LawCriminalJustice/MedicalMalpracticeTortReform/tabid/16217/Default.aspx

Physician Salaries

Academic, Hospital Employed, Private Practice, and Clinic starting salaries offer huge variations in monetary remuneration. Here are the results of a survey we have found helpful to compare physician salaries.

These figures are 2003- present and were compiled by Allied Physicians, Inc., Los Angeles Times, and Rand McNally

See the table here:

http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

Academic Career Resilience

Academic physicians commit to a lifetime of learning and also teaching the next generation of physicians. That doesn't sound easy enough? It is also a challenge to move up the ladder in the academic world and assume a leadership role. However, a lifetime of academics can be professionally fulfilling and self actualizing.

Academic Physician and Scientist published an interested article on the long and satisfying journey of a career in academic medicine. Read the full article here:

http://www.acphysci.com/aps/resources/PDFs/APS_0909_CareerWatch.pdf

Physician Employment Contract

Do you know what to look for when reviewing an employment contract? Compensation is the first thing most physicians check for, however there are many other very important components that should be in an employment contract. Other criteria should be considered such as benefits, malpractice, partnership track, CME, and relocation.

This is an older article from the New England Journal of Medicine but provides very helpful advice and the anatomy of a physician contract. Read the full article at:

http://www.nejmjobs.org/career-resources/physician-job-contract.aspx

Neurosurgeon Non-Compete Agreement Upholds

In Pittman v. Coosa Med. Group PC, the Georgia Court of Appeals upheld a trial court's decision to grant an interlocutory injunction enforcing a non-compete provision that prevented Dr. H. Harris Pittman from practicing neurosurgery within a 30-mile radius of CMG’s principal office in Rome, Georgia.

The non-compete provision is contained in an employment contract that Pittman signed with CMG in 1999. Read the full article here:
http://www.tradesecretslaw.com/2009/10/articles/noncompete-enforceability/georgia-court-of-appeals-upholds-noncompete-provision-against-neurosurgeon/

What do Physicians think of new technology?

According to a survey by the American College of Physician Executives, physicians use new technology but don't like it. The Washington Post Business Journal published an article on the new trend of abandoning traditional paper record-keeping and input patient information in electronic form.

ACPE said it received comments that the technology lowers productivity, that the cost is prohibitive and that systems don’t do a good job of talking to one another. The survey findings were released a few weeks after approval of a federal $787 billion economic stimulus that includes $19 billion for health information technology, including $17 billion for incentives and penalties to encourage doctors and hospitals to abandon paper record-keeping and go high-tech beginning in 2011.

Read the full article on the Washington Business Journal at http://washington.bizjournals.com/washington/stories/2009/03/09/daily31.html

Surgeon Workforce

What is the market like for new surgeons entering the workforce? The American College of Surgeons Institute for Health Policy Research and the Association of American Medical Colleges have published statistics tracking active surgeons in the market place. How in demand is your specialty?

Read more in their report at:
http://www.acshpri.org/documents/ACS_IHPR_Workforce_US_Database_Figures_Tables_4-15-09.pdf

Academics vs. Private Practice: Training Today's Physicians

Our firm represents both academic and private practice or hospital employed opportunities. Choosing between an academic practice or a private practice model is a decision most physicians make when they graduate residency; depending on how the physician desires to utilize his or her training is a big factor in choosing between teaching the students of tomorrow or treating patients in a private practice. However, which opportunity provides a better training throughout the physician's career?

The American Hospital Association has published an interesting article documenting that teaching hospitals play a key role in providing patient care and ensuring a well-trained health care workforce. Read more in their Trendwatch Newsletter at http://www.aha.org/aha/trendwatch/2009/twsept2009teaching.pdf

MGMA Physician Placement Starting Salary Survey Highlights

Most of the facilities we work with establish their starting salaries or guarantees based on MGMA guidelines. What are MGMA guidelines and how are they determined? The New England Jounal of Medicine's recent newsletter has an article dedicated to explaining what MGMA guidelines are based on and how they are determined by taking recruiting surveys from hospitals and physician recruiters.

Physician recruiting in today's market requires a comprehensive understanding of market dynamics, and the Physician Placement Starting Salary Survey is one more tool to help build that understanding.

The 2009 Physician Placement Starting Salary Survey is a valuable tool that recruiters and the hospitals and medical groups for which they recruit can use to develop competitive offers in an increasingly competitive market. Recruiters who submit data for the survey can receive complimentary copies of it. The NAPR encourages greater participation each year to make survey data richer. In fact, respondents can now enter data on a perpetual basis so that the information can be entered when placements are made. They can then be stored, compiled, and submitted at the end of the year, rather than requiring respondents to save the data as its obtained and then enter all of it for the year in one sitting. Depending on the volume, this can be very time-consuming.

Check out the full article at the New England Journal of Medicine, http://www.nejmjobs.org/rpt/starting-salary-survey.aspx

Medicaid Pay Cut Possible in 2010

According to American Medical News, Medicaid pay could be cut again when stimulus money runs out. Thirteen states have reduced Medicaid rates for physicians in fiscal 2010, the most since at least 2004.
Medicaid cuts that were unthinkable a few years ago may be necessary in the coming year. As the stimulus money runs out, physician Medicaid pay is an obvious target. Additional Medicaid funding from the stimulus package expires on Dec. 31, 2010. Nine states are increasing Medicaid pay for physicians next year, but 13 are making cuts. This shifts the balance from last fiscal year, when 19 states increased pay and eight cut it.

Read more information at the American Medical News website, http://www.ama-assn.org/amednews/2009/10/12/gvl11012.htm

Resident Fatigue

Dr. Michael S. Krasner, M.D., of the University of Rochester Medical Center in Rochester, New York has developed a CME course to improve physician well-being. Physician and Resident burn-out has been a growing concern and has been linked to poorer quality of care, including patient dissatisfaction, increased medical errors, and lawsuits and decreased ability to express empathy. Resident fatigue (and the need to limit resident duty hours) gets much of the attention, but distress caused by financial woes and personal or family concerns can also lead to significant increase in resident's medical errors, according to a study in the September 23/30 JAMA.

With the new course, Dr. Kranser and colleagues designed a continuing medical education (CME) course to improve physician well-being. "One proposed approach to addressing loss of meaning and lack of control in practice life is developing greater mindfulness-the quality of being fully present and attentive in the moment during everyday activities," the researchers write. The course is based on 3 techniques: mindfulness meditation, narrative medicine, and appreciative inquiry.

You can check out more information in a recent article from Medical News Today by following this link: http://www.medicalnewstoday.com/articles/164943.php