Improving Inter/Intra Professional Relations

Establishing Rapport within the Medical Community
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
By Hope Rachel Hetico; RN, MHA, CMP™
Managing Editor
In our consulting work, publishing, speaking engagements and relate professional endeavors, we are often asked how to establish and even increase professional visibility in a particular medical, or even alternative-medial community.
While there is no-one-size-fits-all answer, the following [...]

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 [...]

Alternative Medical Communities

Credibility and Physician Referrals  
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
By Hope Rachel Hetico; RN, MHA, CMP™
Managing Editor
As a member of the Board of Directors, Anthony Robert “Tony” Narushka DC of Poland recently commented on the founding of the Polish Chiropractic Association [PCA]. Comments, largely private, have been interesting and prompted us to post this [...]

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 [...]

Risk Management: It’s Not All About Medical Malpractice Anymore

Book Review
By Murray J. Goodman; MD
In the narrow world of our day-to-day practice, orthopaedic surgeons often think of risk management strictly in terms of avoiding exposure to medical liability lawsuits. But, in the book Insurance and Risk Management Strategies for Physicians and Advisors, author, physician, and healthcare economist David E. Marcinko has assembled a cadre [...]

Culture Change in Nursing Homes

Commonwealth Fund Survey of Nursing Homes
Staff Reporters
The “medical culture change” movement is working to radically transform nursing home care, and help facilities transition from institutions to home.
Survey Highlights
The following highlights just a few of the findings from the Commonwealth Fund 2007 National Survey of Nursing Homes report, released in May 2008:

Fifty-eight percent of culture [...]

RAC Contractors to be Identified

CMS Aims to Reduce Fraud
Staff Writers
This month, the Centers for Medicare and Medicaid Services [CMS] will name the auditing firms that will review hospitals’ books for payment mistakes, while hospital officials say results in other states suggest the auditors will give priority to recovering overpayments.
The RAC Program
Under the so-called Recovery Asset Contractor [RAC] program, [...]

MD Compensation and Benchmarking Tools

MGMA and ValueSource Release Software
Staff Reporters
Free online compensation and productivity benchmarking tools for physician practices are now available from ValueSource Software and the Medical Group Management Association [MGMA].
Dashboards in the Cloud
The two web-based [internet computing] dashboards enable physicians and group practices to enter a few easy-to-find variables about physician compensation, and production and costs, [...]

CRNA Salaries Rise - Exceed Some MDs

Merritt Hawkins & Associates Study
Staff Reporters
Some nurses land higher salaries than primary care doctors, according to staffing firm Merritt Hawkins & Associates.
The Survey
In the past year, nurse anesthetists recruited through the staffing firm Merritt Hawkins & Associates, landed salaries that averaged $185,000; compared to the pay for family practice doctors hired through the [...]

Doctors Unite!

On the “Open Letter from America’s Physicians”
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
As we have seen in this healthcare-charged election season, almost every form of political activism or debate has moved online. So, it is no surprise that a coalition of disgruntled physicians would electronically socialize and network together, as seen with www.sermo.com
About Sermo - Peer [...]

About Tax Record Retention

Which Ones to Keep—How Long?
Staff Writers
By law, we are all required to keep records the IRS could use to determine our tax liability accurately. And doctors, more than most, know what it’s like to keep records. So you should retain whatever papers and documents support or clarify your calculations. If the IRS thinks you owe [...]

Concierge Medical Practice Fee-Setting

Pricing Decisions for Medical Providers
Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
Professional fee-setting and related pricing decisions for a concierge medical practice, like most businesses rather than most medical-entities, is complex and will significantly affect the doctor’s profits.
New Markets
When a concierge medical practice is first introduced into a local market, the physician-executive must make a choice between [...]

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, [...]

Selecting Tax-Return Preparers

What Doctors Need to Know about Preparers
Staff Writers
Most doctors and medical professionals are not thinking about tax season right now. But, according to Executive-Post supporter Rachel Pentin-Maki; RN, MHA “now may be the best time to rethink your relationship with your tax-preparer.”
All Tax Preparer’s not equal!
All tax return preparers are not the same. They [...]

Physician Buy-Sell Agreements

A Details Checklist
Staff Reporters
All medical practice and other business agreements that dictate what happens to a physician’s property should be addressed in a document called a “buy-sell agreement.”  
Definition 
A buy-sell agreement stipulates what would happen to your medical practice should you die, become disabled, leave, or wish to retire. The agreement states that your partner or partners [...]

Crafting a Medical Practice Mission Statement

Solidifying Guiding Principles
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
The mission statement is an important and fundamental document that reminds doctor’s why they are in medical practice. This document reflects the physician-executive’s beliefs about life, practice, patients, employees, reimbursement and medical vendors. It serves as a guide for him or her to make choices about how [...]

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 [...]

Majority-Minority Relationships in Practice Appraisals

Disparate Principles Affect Medical Practice Worth
Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
Did you know that majority shareholder-doctors in a medical practice have a fiduciary obligation to minority shareholders-doctors?
Actions Scrutinized
Yes, it’s true. In fact a minority medical practice owner is entitled to scrutinize every action made by the majority owner. In particular, majority shareholders have fiduciary obligations to [...]

Relationship Marketing for Concierge Medical Practices

Developing a Deep-Niche Focus
Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
As a concierge medical practitioner, you know that personalized marketing leads to new patients and subscribers; improved financial health for you, and improved community health for the geographic area you serve.
Know your Patients
In any marketing situation, the more you know about your target patient audience, the [...]

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 [...]

Determinants of Medical Practice Value

Understanding Goals and Objectives
Dr. David Edward Marcinko; MBA, CMP™
By Hope Rachel Hetico; RN, CPH, MHA/MBA, CMP™
Much has been written, and much has been said about the goals, objectives, reasons, techniques and methodology of professional medical practice appraisals online at the Executive-Post.
And, even more actionable information is presented in our institutional 1,200 pages, 2-volume print [...]

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: [...]

Evidence Based Medicine

Emerging EBM Trends
Hope Rachel Hetico; RN, MHA, CMP™
The next emerging trend in healthcare is evidence-based medicine. EBM offers the promise of improving the quality of clinical services and reducing costs.
Definition
Evidence Based Medicine may be defined as the use of any techniques from science, engineering, risk-management and meta-statistics analysis - to medical literature reviews [...]

External HIT Data Storage

Enter Cloud Computing
By Dr. David Edward Marcinko; MBA, CMP™
After a long time in development, Google publicly launched its free, Web 2.0 collaborative, online personal health records platform on Monday. It joins the likes of RevolutionHealth and Dossia. The operation first made headlines when Google announced it at the Healthcare Information and Management Systems Society [HIMSS] meeting [...]

Internal Healthcare Marketing and Patient Satisfaction

Managing Expectations and Perceptions
By Dr. David Edward Marcinko; MBA, CMP™
By Dr. Gary L. Bode; MSA, CPA, CMP™ (Hon)
Patient satisfaction occurs when patient perceptions exceed their expectations. They get an intangible “something extra” from the visit, above what they, or their TPA / health plan / Medicare / Medicaid plan, paid for. 
Managing Perceptions
We’ll concentrate on [...]

Bad Medical Debt Expense Crunch

More Patients Fiscally Solvent?
Staff Writers
First there was the housing and credit crunch for us all, and now there is the bad medical debt expense [BMDE] crunch for the healthcare industry.
As a medical professional, if you are struggling to manage your personal, or practice bad debt load - you’re not alone. But, some of the pain [...]

Enhancing Revenue Cycle Accounting

Hospital Claims Denial Management
By Karen White; PhD 
Typically, denied and rejected hospital and health systems claims quickly surface as a source of multi-millions in revenue leakage and unnecessary expense.
And, it is the same for medical practice accounting, regardless of size. 
Increasing Costs 
Payers have been struggling with increased costs for the past decade. They thoroughly inspect claims [...]

Physician Compensation Trends

Don’t Give up Medical Practice; Just Yet!
Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief 

By now, all physicians, medical practitioners, nurses and healthcare executives know that in 2006 the Medicare Trustees Report projected a 4.7% reduction in physician reimbursement for 2007, and 37% in cumulative cuts over the next nine years.  
It also noted that each year in the [...]

Cash Based Compensation Medical Practices

Business Model Related to Concierge Medicine
Staff Writers 

A Cash Based Compensation (CBC) medical practice business model attracts patients who pay cash for desirable services, such as surgeons who dispense scar reducers or in areas such as pain relief, weight loss, aesthetic procedures, and natural health. 
Model Parameters 
According to consultant Michael Wallerstein, any well-rounded CBC program should include [...]

Medical Building Facility Fees

Surcharging Startled Patients
Staff Writers 
 
As all print subscribers to Healthcare Organizations [Financial Management Strategies], and regular readers of the “Executive-Post” are aware, medical billing is complex enough without throwing another factor into the mix. 
Medical Facility Fees?
Increasingly, however, it seems that patients are being caught off guard by a new “facility fee” for visiting doctors who are [...]