HealthLeaders Media PhysicianLeaders - November 20, 2008 | Can Midlevels Save Primary Care? View as a Webpage | Subscribe for Free
Can Midlevels Save Primary Care?
Elyas Bakhtiari, Managing Editor

When workforce shortages reach a certain threshold, they often begin to feed on themselves, creating a self-reinforcing cycle that is difficult to break. Take the primary care shortage. Many of the root causes are financial: medical students rack up enormous debt through the course of their training, and the higher salaries offered in medical and surgical specialties simply provide a better return on investment. But a consequence of the shortage has been a strain on practicing primary care physicians. [Read More]
  November 20, 2008

Editor's Picks
Confronting doctor-patient racial barriers
Prompted by Barack Obama's success in breaking the highest racial barrier on November 4, Pauline Chen, MD, revisits racial barriers in healthcare in this New York Times column. There are plenty of studies to suggest a problem—patients report better healthcare when their doctor is of the same race or ethnicity, white patients are more likely to report a medical error with a non-white physician, and researchers have documented significant treatment disparities across racial lines. Obama's success didn't eliminate racial barriers in healthcare, Chen concludes. But perhaps it will provide a catalyst for addressing those issues on a more consistent basis. [Read More]
Medicaid delays discourage participation
That may seem like an obvious conclusion, but this Center for Studying Health System Change study points to a pretty big flaw in the Medicaid bureaucracy. Many states use higher fees to encourage more physicians to participate in Medicaid—only about half of doctors accept all new Medicaid patients. However, payment delays and other administrative burdens discourage doctor participation, essentially offsetting the effects of higher fees. Average reimbursement times for Medicaid varied from a low of 36.9 adjusted days in Kansas to a high of 114.6 days in Pennsylvania. [Read More]
MGMA applauds Daschle appointment
President-elect Obama's appointment of Tom Daschle as the next secretary of the Department of Health and Human Services may give us an idea of how the next administration will approach healthcare, and at least one physician group is happy. The MGMA immediately released a statement commending Obama for the appointment, and MGMA CEO William F. Jessee, MD, said, "Sen. Daschle combines substantive knowledge of the issues with the political acumen necessary to confront the challenges of healthcare reform. He is clearly the right person at the right time to lead the president's team." [Read More]
Defensive medicine costs Massachusetts $1.4 billion
The Massachusetts Medical Society says 83% of physicians surveyed have practiced defensive medicine and that an average of 18-28% of tests, procedures, referrals, and consultations, and 13% of hospitalizations, were ordered to avoid lawsuits. The practice is adding an estimated $1.4 billion to annual healthcare costs in the state. This is an area that will probably go overlooked in federal healthcare reform legislation, but it's a major cost driver nonetheless. [Read More]
Happy Thanksgiving!
From all of us at HealthLeaders Media, have a happy Thanksgiving holiday. HealthLeaders Media PhysicianLeaders will not publish next week, but will be back December 4.
Business Rx
Create the Right Governance Structure for Your Practice:
Although some private practices might think of business strategy in immediate terms, it is important to think about the long-term goals, or governance, of the organization. Not doing so could prove disastrous to a practice's future business. [Read More]
Physician News
The doctor will see you now—online
New York Times - November 20, 2008
Atlanta home buyers' extra perk: Healthcare
Atlanta Journal-Constitution - November 20, 2008
Radiologists are in great demand in Pennsylvania
Pittsburgh Post-Gazette - November 17, 2008
South Florida family doctors leaving practices
South Florida Sun-Sentinel - November 17, 2008
Audio Conferences/Webcasts
January 6, 2009: Service Line Strategies Workshop 2009: Women's Health
December 16, 2008: What Your Practice Is Worth: Calculating Fair Market Value
On Demand: 5 Ways to Hospital-Physician Quality: Goals, Incentives, Dialogue, Staff, IT
From HealthLeaders Magazine
What's Your Brand?
HealthLeaders November 2008
That’s what your patients want to know. But hospitals are discovering the same old differentiators aren’t good enough anymore. Is YOUR organization ready to deliver on its brand promise? [Read More]
PhysicianLeaders Forum

Secrets of Hospitalist Practice Success: Contributor David Bowman, MD, executive director of IPC-Tucson, IPC The Hospitalist Company, Inc., discusses what he has learned in 10 years at one of the first multi-physician hospitalist practices in the country. [Read More]
Audio Feature

Engaging Physicians in Quality: Joel J. Reich, MD, senior vice president for medical affairs at Eastern Connecticut Health Network, discusses the disconnect between physicians and hospital administrators when it comes to quality improvement efforts, and offers potential solutions for bridging that gap. [Listen Now]
Sponsor PhysicianLeaders

Contact Lisa Brown, Director of Integrated Sales, at or call 781.639.1872.
Resources From HealthLeaders Media

Improve patient satisfaction, CAHPS scores, and quality with the strategies and tools in Physician Entrepreneurs: The Quality Patient Experience.
Learn how to harness the power of a large organization, either by expanding the practice or partnering with hospitals, private investors, or other physician groups, with Physician Entrepreneurs: Strength in Numbers.
Read about the latest business strategies to help you grow beyond traditional practice models in Physician Entrepreneurs: Going Retail.
Start marketing your practice or refine your existing marketing program with Physician Entrepreneurs: Marketing Toolkit, a new HealthLeaders Media book that combines expert tips with marketing samples, tools, forms, and checklists that will help grow your practice.