HealthLeaders Media PhysicianLeaders - October 29, 2009 | Cutting Costs by Profiling Physicians View as a Webpage | Subscribe for Free
Cutting Costs by Profiling Physicians
Elyas Bakhtiari, Managing Editor

Atul Gawande's influential article about healthcare costs in the New Yorker earlier this year sparked a debate about overutilization. The article was forwarded throughout the industry, became mandatory reading at the White House, and may even shape future healthcare policy. All of this from a relatively simple comparison of Medicare costs in two Texas towns. Kind of broad brush, isn't it? The problem is that policymakers are trying to address how physicians use resources, yet most of the data that drives policy decisions and healthcare research measures how regions use resources. [Read More]
  October 29, 2009

Editor's Picks
What do physician leaders think?
The 2010 edition of the HealthLeaders Media Industry Survey for Physician Leaders is now open online at Included this year are new questions that seek your thoughts on service lines, the HIT stimulus package, and healthcare reform efforts, among others. Plus, we build on key benchmark questions from last year, checking on your top priorities and your assessment of key healthcare initiatives. This comprehensive survey should take about 14 minutes to complete, and closes the night of Monday, Nov. 2. Be sure to provide contact information and we'll enter your name in a drawing for a $1,000 gift card. [Take the Survey Now]
Study: Number of doctors was overestimated
A new study suggests there are already fewer doctors practicing than had been estimated because of a lag in reporting retirements. The new study, published in the Journal of the American Medical Association, estimates that the United States has 788,000 active doctors—65,000 fewer than calculations have suggested. The doctor work force is also younger than previously estimated, with a greater proportion of doctors in their 20s and 30s and fewer who are 65 and older. By 2020, there will be 957,000 physicians, the new estimates show, rather than the 1.05 million previously projected. [Read More]
Overutilization from the patient's perspective
This is an interesting account of one physician's trip to the ER for a simple case of shingles, and the $9,000 hospital bill that followed. Jack Coulehan, MD, had already diagnosed himself when he went in, and even had a treatment plan in mind, but by the time he got out of the ER he had consults with an ophthalmologist an neurologist, two MRIs, and a CT scan—all of which were unnecessary. "I've lost the smugness and condescension I often felt when listening to others' stories about being trapped by the system and manipulated into excessively complex and specialized medical situations," he writes. [Read More]
Alegent CEO resigns after clash with doctors
Alegent Health CEO Wayne Sensor has resigned, and recent votes of no confidence against him by medical staffs at two Alegent hospitals may have been the reason. My colleague Philip Betbeze digs a little deeper into the departure in his latest column. It was spurred, in part, by Sensor's attempts to switch from an affiliated to an employed medical staff model, he says. "Managing a transition from affiliated to employed physicians is filled with land mines, especially when you are hiring physicians to perform the same work that referring physicians do," Betbeze writes. [Read More]
Physicians and faith
American Medical News reports on an interesting study that looks at the link between medicine and religion. Research found that religious doctors were no more likely to care for the poor than nonreligious physicians (31% to 35%). More than half of doctors (55%) said that their religious beliefs influence how they practice medicine. And 76% of doctors said faith helps patients to cope. [Read More]
Business Rx
Look to Professional Organizations for ICD-10 Resources
CMS has given providers access to free resources to help them prepare for the transition to ICD-10. However, some ICD-10 codes do not have a predecessor in ICD-9, so coders must rely on other sources of information, as well. [Read More]
Physician News
Public report cards compare and contrast physicians
Wall Street Journal - October 28, 2009
Senators Push for More Healthcare Fraud Prevention in Health Reform
Janice Simmons, for HealthLeaders Media - October 29, 2009
With critical-care specialists in short supply, remote monitoring offers a solution
Wall Street Journal - October 27, 2009
Medical Mission Trips Motivate Nurses and Give Back to Communities
Rebecca Hendren, for HealthLeaders Media - October 27, 2009
Primary concern: Fewer family doctors
Minneapolis Star Tribune - October 27, 2009

Audio Conferences/Webcasts
December 17, 2009: Women's Health: Building a More Profitable Service Line With Existing Assets
November 17, 2009: Service Lines Strategies Workshop 2009: Stroke Care
November 10, 2009: RAC Strategy: Preserve Margin, Prevent Take-backs, Promote Alignment
October 29, 2009: Flexible Medical Staff Models of the Future

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From HealthLeaders Magazine
Care Team Architecture
HealthLeaders October 2009
Creativity and flexibility count, sure. But underlying the successful care team design is a foundation of essential and lasting values. [Read More]
Service Line Management
State of Emergency
The nation's emergency departments are feeling the effects of the economic downturn, but innovations in patient throughput and other strategies offer hope for a beleaguered system. [Read More]
PhysicianLeaders Forum

Which Patient Gets into the OR First? Contributors offer a new method for prioritizing urgent and emergent surgical cases based on a case study at Wellstar Kennestone Hospital in Marietta, GA. [Read More]
Audio Feature

Physicians, Patients, and PHRs: Larry Garber, MD, medical director of informatics at Fallon Clinic in Worcester, MA, talks about his experiences implementing a personal health record system and how it has affected physician-patient relationships. [Listen Now]
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Resources From HealthLeaders Media

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