Eroding Doctor-Patient Relationships

The “Bed-Side Manner” Deterioration Continues
Staff Reporters
A growing chorus of discontent suggests that the once-revered doctor-patient relationship is on the rocks.
Results
About one in four patients feel that their physicians sometimes expose them to unnecessary risk, according to data from a Johns Hopkins University [JHU] study published in the journal, Medicine, while two recent studies show [...]

Medicare GAO Report on Radiology

Prior Imaging-Authorization Suggested
Staff Reporters
As reported in the Wall Street Journal, on July 14, 2008, Medicare may be soon requiring prior authorization to curtail unnecessary utilization of CT scans, MRIs and other forms of medical imaging, a new Government Accounting Office [GAO] report suggests.
The Medicare Report
To cut imaging costs, Medicare has been reducing certain physician [...]

Physician Recruiting Success

Senior Leadership’s Contribution
By Allison McCarthy; MBA
If you’re recruiting physicians to your organization, then you probably feel challenged by internal disconnects that hinder your progress. More than likely you deal with one or more of them daily. And for many of these issues you need your senior leader to be your ally, champion and advocate, [...]

1/3 of Medical Procedures Fail to Improve Health

A Startling Congressional Budget Office Report!
Staff Writers
Almost one-third of the procedures that doctors perform fail to improve a patient’s health!
Of course, this may come as quite a surprise to most citizens, but not so to readers of the Executive-Post, or the books, white-papers and dictionaries of its sponsor, the Institute of Medical Business Advisors, Inc [...]

Consumer Health Plan Satisfaction Survey

New Deloitte Center for Health Solutions Survey
Staff Reporters
Nine out of 10 Americans are not completely satisfied with their health plans, according to “The Deloitte Center for Health Solutions 2008 Survey of Health Care Consumers.”
The Survey:
According to the survey of what more than 3,000 Americans thought about a variety of healthcare issues; these findings [...]

Faux Healthcare 2.0 Collaboration for Terminal Patients?

American Society of Clinical Oncology Study
Staff Writers
Only one-third of terminally ill cancer patients said their doctors had discussed end-of-life care, according to a recent federally funded study presented at the American Society of Clinical Oncology conference in Chicago.
Study Results
According to the study, patients who had these talks were no more likely to become depressed [...]

The Consumer-Patient Purchaser Disclosure Project

Advancing Healthcare Transparency and Advocacy
Staff Reporters
The Consumer-Purchaser Disclosure Project http://healthcaredisclosure.org, and various collaborating organizations, recently announced that a “comprehensive national agreement” has been reached with “leading physician groups and health insurers on principles to guide how health plans measure doctors’ performance and report the information to consumers.”
Stakeholders-on-Board
Stakeholders signing on to support the initiative include AARP, [...]

Hospitals Avoiding Non-Emergency Care

Reducing Emergency Department Workloads and Expenses
Staff Writers
As most Executive-Post readers know, hospitals are under more intense pressure than ever to avoid bad-debt expenses and reduce write-offs. For example, according to one study, total emergency room visits, classified as non-urgent conditions increased from 10 percent 1997 to 14 percent in 2006, according to research by the [...]

Marketing Intangible Concierge Medical Services

Understanding Intangible Products
Staff Writers
Concierge practice and related medical services are intangible products; even though most marketing theories that apply to products apply equally to services. Yet, medical services do have some differences. For example, medical services are: 

Intangible,

Highly perishable,

Variable quality,

Inseparable from medical provider, and,

Difficult to quality-assess. 

Perishability
Of what value to an airline is an empty seat on [...]

Hospitals Auctioning Patient Debt

Online Sale of Patient ARs
Staff Reporters
In another sign of the contracting economic times, FierceHealthFinance is reporting that some struggling hospitals are using the internet as a new channel to cut their write-offs, and bad debt ratios which lower stock prices, if publicly-held.
Exit the Debt Collectors – Enter the Auctioneers
Rather than simply hiring agencies [...]

Survey on Convenient Care Medical Clinics

Possible Solution to the Healthcare Dilemma?
Staff Reporters
Another new survey suggests that convenient care medical clinics (CCMCs) could be a potential solution to health care issues, if fears can be alleviated; at least in the Keystone State.
The Survey
The survey by Widener University in Elder Pennsylvania, found that while baby-boomers aged 43 to 64 were most [...]

New Hospital Rating Service

Consumers Union
Staff Reporters 
The nonprofit Consumers Union is launching a new hospital ratings service, adding to the growing competition to provide online consumer information about health care, as reported in the Wall Street Journal.
A Consumer Reports Publication
The effort, by the publisher of Consumer Reports magazine, is a gamble that the credibility of the magazine’s [...]

Electronic Patients

Revolutionizing Healthcare
Staff Reporters
Included among our most popular Executive-Post topics are: medical practice valuations, Wal-Mart, DNPs, business and medical marketing plan, investments, asset returns, medical ethics, the financial services industry and various op-ed posts.
We believe however, there will soon be another very popular post, with comments on how e-patients will revolutionize healthcare!
Revolutionize Healthcare
According to Susannah [...]

Nurses in e-Charge

Trends in Clinical Information Systems Technology 
Staff Reporters
Recently, iMBA Inc www.MedicalBusinessAdvisors.com and the Executive-Post participated in a Healthcare Informatics survey on nursing clinical information systems [CIS].
The top five CIS functions were:

Electronic documentation

PACS

EMR/EHRs

Automated alerts

Cross-continuum patient records

Assessment
The following link has a summary of white-paper results from that survey
http://survey.opinionresearch.com/surveys/J35584NOV2007/First_Look.pdf
Conclusion
You thoughts and comments are appreciated.
Related Information Sources:
Practice [...]

Patient Survey of Retail Health Clinics

One-Third Lack a Family Doctor
Staff Reporters
According to results of an online survey of 4,937 US adults conducted by Harris Interactive® between May 2 and 6, 2008 for the Wall Street Journal Online’s Health Industry Edition, 30% of patients who used retail-based health clinics do not have a primary care provider.
Other findings include:
 

The use of [...]

Office Appointment “Reservation Fees”

Minimizing the Patient “No-Show” Problem
Staff Writers
In what is perhaps the next evolution of office-based medical practice - at least according to American Medical News reports - some physicians are now making their patient’s reserve office appointment slots with a cash deposit in case of “no-show.”
Much like their plastic surgery, new-wave anti-aging esthetics, cash-only, cosmetic-dental or [...]

Wal-Mart Health Care

Healthcare’s New [Old] Innovative Disruption
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
So, the American Medical Association [AMA] couldn’t or wouldn’t do it; nor could/would the American Osteopathic Association, American Podiatric Medical Association, American Dental Association or any combination thereof.
Neither could/would Hillary Clinton in 1992, nor the US Congress, US Senate, Insurance Association of America [...]

Stemming the Primary Care Exodus with DNPs

Doctor of Nurse Practice – Filling the Void
Dr. David Edward Marcinko; FACFAS, MBA, CMP™
Publisher-in-Chief
As the shortage of family doctors and primary-care physicians mount, and the domestic uninsured problem exacerbates to > 40 million uninsured Americans, the nursing profession is stepping up-to-the-plate by offering one possible solution to healthcare reform.
Cause and Effect
And, it is not [...]

Pre-Noon Patient Discharges

Improving Emergency Department Flow
Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
We all know that hospitals across the US are struggling to figure out how to get patients through the emergency department [ED] quickly, safely and efficiently.
In fact, this and related issues were eloquently and contemporaneously addressed by Dr. Robert Wachter of UCSF [Average Time of Discharge: [...]

Reimbursing Acute Care Episodes

A Proposed New ACE Payment Scheme
Staff Writers
Did you know that the Centers for Medicare & Medicaid Services [CMS] announced a planned demonstration project last week that would combine payments for both hospital and physician services for a select number of episodes of care? Its intent is to determine if such an approach will be more [...]

Improving Patient Communications

Managed Care Ethical Considerations
By Render S. Davis; MHA, CHE
In contemporary medicine, and managed care, ethical dilemmas in communications are increasingly common and may come in many different forms. For example: 

Physician’s failing to communicate necessary clinical information to patients in terms and language the patients can truly understand;

Physicians’ offering only limited treatment choices to patients because [...]

CMS Shells Out to Compare Hospitals

“You show me – I’ll show you”
Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
The Centers for Medicare and Medicaid Services [CMS] just launched an advertising campaign to demonstrate how some patients get needed help … and how other hospitals give surgical patients antibiotics! Say what?
Site Traffic Quadruples
Yep! All told, the ads include more than 2,500 hospitals, according [...]

Physician’s Managed-Care Dilemma

Caring for [Retail] Patients -or- [Wholesale] Populations
By Render S. Davis; MHA, CHE
Crawford Long Hospital at Emory University
Atlanta, Georgia, USA
In today’s health care environment, physicians face a myriad of dilemmas in their daily practice. Time constraints, diminished professional autonomy, declining incomes, explosive growth in technology, and deteriorating public trust combined with increasing public demands are only [...]

Hospital, Clinic and Physician Pricing

Emerging Medical Transparency Initiatives
By Hope Rachel Hetico; RN, MHA, CMP™
In 2007, federal and state legislatures first called for hospitals across the country to make their prices “transparent.” 
Definition
The term transparency was defined as the full, accurate, and timely disclosure of hospital charges to consumers of healthcare, as well as the process employed to arrive at [...]

Risky Business of Web 2.0 Doctor Bloggers

A Mashed-Up Opinion
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
Today, after personally reviewing far too many blogs, and according to www.NPR.org, there are more than120, 000 health care forums on the Internet with opinions ranging from pharmaceuticals, to sexual dysfunction, to acne.
The same goes for commercial doctor blogs that promote lotions, balms and potions, diets [...]

Health Plans Financially Squeeze Providers

Patients Squeezed, Too!
Staff Reporters
As regular readers of the “Executive-Post” know, several leading health plans have taken a profitability beating over the last several months. The reasons for the economic decline include operational issues, rising medical costs and financial market losses. For example, WellPoint, missed Wall Street’s estimates by a wide margin making financial analysts more [...]

Role of Retail Medical Clinics

Transformation
[Symposium on Innovative Healthcare Delivery: Mayo Clinic]
Reprinted: October 15, 2007
http://transformationsymposium.wordpress.com
With a million visits a year and a satisfaction rate of 97% to 100%, those patients who experience MinuteClinic (www.minuteclinic.com) seem to love it. But in the world of retail clinics, does more convenient care mean better care?
The CEO Opinion
Michael Howe, the CEO [...]

Medical Quality Drill-Down Analysis

Finding Sources of Treatment Variation 
By Brent A. Metfessel MD, MS, CMP™ (Hon)
If a medical provider or healthcare facility is found to have a significant variance from the norm on a measure, such as economic cost, drill-down analysis is important to find the reason behind the variance. 
Episodes of care case-mix adjustment is naturally suited [...]

Case-Mix Severity Methods

Measures and Benchmarks
By Brent A. Metfessel MD, MS, CMP™ (Hon)
In a previous Executive-Post, we asked readers if they knew of any case-mix severity measures other than those utilizing expected values.
The Black-Box
When an MCO or HMO analyzes provider practice patterns, it is imperative that the organization educate providers on the methodology and validation of the adjuster, [...]

Case-Mix Medical Adjustments

The Centerpiece of Quality Practice Patterns
By Brent A. Metfessel MD, MS, CMP™ (Hon)
It is difficult to construct an adequate medical practice pattern profile without case-mix or risk adjustments. There needs to be an algorithm that adjusts for the medical severity of patient mix. 
For example, a tertiary care center in New York City cannot be [...]