Private Practices: How to Survive and Thrive

With the changes in healthcare, IT, and government there has been a lot of press on the deterioration of the private practice; however in this environment as well as in the future private and small physician practices can still be very successful and fulfilling.

The key is for small practices to identify and acquire the tools needed to adapt and grow in changing times. Medscape Today has provided 3 actions small physician practices can take to help survive and thrive even though the rules of the game are about to change:

• Hire an NP or PA
• Adopt an EHR
• Get a Real Website

Private Physician practices can still be rewarding, both financially and in career fulfillment. If practices are run correctly with good administration and technology they will always be a competitive contender in the medical marketplace.

Read the full article in Medscape Today, or click here:

http://www.medscape.com/viewarticle/730497

Hospitals Lure Doctors Away From Private Practice

According to MGMA, in 2009 approximately 50% of new physicians hired were hired by hospitals. Currently, 1 out of every 6 physicians work directly for a hospital, and there is a significant increase in the percentage of physicians choosing hospital based positions.

Hospitals are more prepared to entice physicians to hospital employment models because of their business strategies. Hospitals project hiring more physicians as employees guarantees a more steady stream of patient referrals and improves patient care through better coordination of services.

Physicians, particularly young physicians out of training, are preferring hospital based and hospital employed positions because of the added security and benefit packages along with the better quality of life hospital practices tend to offer, call shared amongst several other physicians as well as not worrying about the time and expenses associated with a private practice such as leases, hiring administrative and medical staff, and billing.

Hospitals are being more competitive in their offers with not only salary options but also RVU (production) based incentives allowing physicians to be in better control of their income based on how much they wish to work.

One concern experts have is employing more physicians could give hospitals more negotiating power with health insurers, thus driving up health insurance prices.

Read the full article in Physicians News Digest, or click here:

http://www.physiciansnews.com/2010/10/14/hospitals-lure-doctors-away-from-private-practice/

Physician Shortage Increasing

The physician shortage continues to increase, with certain states affected more significantly by the current and impending shortage. According to the American Medical Association, the nationwide physician shortage is expected to reach as many as 159,000 physicians by 2025. At least 22 states and 15 medical specialties had reported physician shortages as of June this year.

Virginia is one of the states dramatically affected by the current shortage, mainly because of an increase in demands for specialty services for the aging population as well as coverage for the uninsured with healthcare reform.

According to the Association of American Medical College, Virginia ranks 31st nationally in retaining graduates, 61% of residents go to other states after completing their training.

Nearly all US States are experiencing physician shortages, and with healthcare reform pending the shortages are predicted to increase dramatically. Rural areas in Virginia as well as all states are experiencing a harder time retaining and recruiting new physicians.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/10/04/prse1005.htm

Incentive Plans Playing Bigger Role in Physician Earnings

Many hospital employed opportunities as well as private practice salaries or shared earnings in partnerships are becoming more affected by incentive plans. RVU based incentives based on the individual physician's volume and revenue have played a part in physician compensation for awhile both in private practice opportunities and hospital employment positions, however now other incentive plans are also gaining popularity.

Particularly amongst hospital employment positions physicians are being compensated based on patient satisfaction, readmissions, clinical outcomes, and other performance metrics.

The Hay Group's "2010 Physician Compensation: Prevalence and Planning Report" found that 69% of the health care organizations surveyed used some kind of annual incentive plan in 2010 for employed physicians, which is up from 2008 which reported 49% of health care organizations based some physician compensation on annual incentives.

Physician's income, particularly in hospital employment positions, has become more of a base salary model with these types of incentives rewarded on top of base salaries.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/10/04/bise1004.htm

MGMA: Increase in RVU from Last Year

The results from MGMA’s “Cost Survey for Multispecialty Practices: 2010 Report Based on 2009 Data” have been released and it looks as if RVUs have experienced a slight increase from last year's data.

Over the last 5 years an almost 1% increase has been experienced by non-hospital/ IDS-owned medical groups in total RVUs, and almost 13% increase in work RVUs per patient.

Multi-specialty groups (hospital/IDS-owned) had slightly different results with just under 6% decrease in total RVUs and almost an 18% decrease in work RVUs per patient.

The report also provided specialty specific information. Family practice, Anesthesia and Orthopedic Surgery reported increases in total medical revenue after operating costs, while Cardiology, Pediatrics, Gastroenterology, and Urology reported decreases in the same category.

Over the last 10 years the study reports the average total operating costs as a percentage of total medical revenue increased over 3% for practices non-hospital/ IDS owned. Hospital/ IDS-owned practices' average total operating costs decreased almost by 1%.

Read the full article in Healthcare Finance News, or click here:

http://www.healthcarefinancenews.com/news/mgma-productivity-costs-and-revenue-affect-practice-ownership

The Changing Face of Academic Medicine

In an article from Med Center Today, Academic Medicine has been dominated by males across all specialties, however more women are entering in to the academic medicine setting. Women entering in to a male dominated territory run across obstacles in addition to the normal competitive nature of jobs in academic medicine.

It will take a combination of top-level leadership and females taking stronger rein over their own career development to help women find their place in academic medicine. Academic institutions are already competitive, although women may be a minority it is important for these programs to become more diverse and create more women mentors for new students entering training.

According to the AAMC, as of 2003, women represented 50% of first-year medical students, 41% of all residents and 30% of all faculty members. However there is a significant shortage of women in leadership roles in academic centers.

There is also an interesting article from JNS documenting women in and entering in to Neurosurgery. Read the full article by clicking here: http://thejns.org/doi/full/10.3171/JNS/2008/109/9/0378. Neurosurgery, like most surgery and specialties, is also largely dominated by men. However more women Neurosurgeons are entering in to the marketplace which creates more women mentors for new medical students selecting their specialties and even deciding to enter in to medical school.

Given the complexity of the challenge, medical schools are implementing a number of initiatives to raise the profile of women, including extending the timeline for gaining tenure and advancing to full professorship, and exploring policies for part-time faculty. There also are a number of steps women can take to enhance their own careers and help build a climate that encourages other women to pursue and stay in academic medicine.


Read the full article in Med Center Today, or click here:
http://www.medcentertoday.com/article.php?id=55&chapter_id=16&PHPSESSID=o43oa6516ph8i36khum81tugv0

Health Reform Losing Support

With elections coming up in November, voters are changing their opinions of health reform. While the proposition barely passed this spring, more voters are becoming opposed to the new law. According to the August Kaiser Health Tracking Poll 10% of voters are opposed to health reform since July.

Amongst voters health reform law's coverage expansions and consumer protections continue to be popular, however many are opposed to the requirement of having health insurance.

Some sources track more consistent results from American voters; Pollster.com, a compilation of national polls, has found that public opinion on the national health reform law has remained fairly steady since early summer, with nearly 48% opposing the law and 42% supporting it.

With elections coming up in November, health reform ranks approximately third of issues voters have a problem with. The economy and dissatisfaction with government are first and second respectively.

Read the full article at American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/09/13/gvse0914.htm

Potential Tax Hikes for Physicians

The changing political environment not only affects healthcare reform and how hospitals and insurance companies will change from our current system, but tax laws also may change in the upcoming tax year for individual tax payers.

The tax cuts that were implemented in 2001 and 2003 lowered taxes for every American across the country and are set to expire at the end of this year. Because of their income potential, many physicians may be significantly affected by the potential changes.

There is currently much speculation as to what Congress and the Obama administration will try to change in the tax code prior to November. The current tax cuts will be effective through the end of the year and will not affect the 2010 tax year. We will have a better idea of what potential changes may take place after the November election, however we can only speculate as to what those changes may be until the administration makes the official changes and new laws effective at the beginning of the 2011 tax year.


Read the full article at Physician's News or click here:
http://www.physiciansnews.com/2010/09/16/physicians-should-be-prepared-for-potential-tax-hikes/

Healthcare Sector Employment Continues to Rise

According to the latest employment report from the Bureau of Labor Statistics the healthcare sector continued its rise last month.

Jobs in the healthcare sector have remained strong through the unsteady job market and current economy. In August healthcare jobs increased by just over 28,000 jobs.

The biggest increase in healthcare jobs is in ambulatory care services (primarily in physician offices) with hospital jobs directly behind.

The changes in healthcare and healthcare reform will create many new healthcare jobs for employees in all positions in healthcare. Physicians will see the current shortage increase, specifically for Primary Care physicians which are already experiencing a significant shortage.

Read the full article in Healthcare Finance News, or click here:
http://www.healthcarefinancenews.com/news/healthcare-still-hiring-hospital-employment-ends-summer-swoon

Physicians Running for Office

This has been a year of dramatic change in the healthcare sector. With healthcare reform pending, physicians are stepping up to contribute to the new laws and are running for office. According to AMPAC, American Medical Association's nonpartisan political action committee, more physicians are running in this election than in any other past election.

At least 47 physicians filed the paperwork necessary to run for a congressional seat and 15 physicians are running for re-election in Congress.

With all of the changes in healthcare reform it is important for physicians, who will be heavily impacted with these changes, can be a part of making the final decisions in the law making process.

Congress officials have decreased in popularity; 69% of American's have disapproved of lawmaker's performance. The economy has been a large factor in affecting voter's decisions and opinions. Many Americans don't believe that the stimulus act, health reform law, and other actions by the Congress have helped reduce unemployment.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/09/06/gvsa0906.htm