HealthLeaders Media PhysicianLeaders - December 10, 2009 | Small Practices Face Big Challenges View as a Webpage | Subscribe for Free
Small Practices Face Big Challenges
Elyas Bakhtiari, Managing Editor

In Atul Gawande's latest piece in The New Yorker, the physician-author compares the current pilot-project approach to reforming healthcare with efforts in the early 1900s to improve agricultural production. Gawande offers long-term and clear-eyed hope amidst a lot of short-term nay saying and pessimism about the future of healthcare. But his analogy may not be very reassuring to one segment of physicians. [Read More]
  December 10, 2009
Editor's Picks
AMA Opposes Medicare Expansion
After struggling to get 60 votes in support of the original public option proposal, Democratic Senators may replace it with a plan that would allow people as young as 55 to buy in to Medicare. The AMA, which wasn't thrilled with the public option but had endorsed reform efforts overall, said it opposes expanding Medicare because of the annual reimbursement cuts physicians face under the program and because many Medicare patients are struggling to find a doctor. The new proposal comes at a time when Medicare payments are still scheduled for a 21% cut in less than a month. [Read More]
20 People Who Make Healthcare Better
HealthLeaders' annual list of 20 People Who Make Healthcare Better is out this week, and there are some very admirable people this year. I profiled Guy Chisolm, PhD, who spearheaded Cleveland Clinic's initiative to disclose physician-industry ties on its Web site. Notable physicians on the list include writer Atul Gawande, Daniel Sands from Beth Israel Deaconess Medical Center, C. Gresham Bayne (who is working to bring back house calls), process re-engineer Brian Jack, and hospital CEOs Patricia Gabow and Jeffrey Thompson. [Read More]
Three Steps to Improve Physician-Nurse Relationships
My colleague Rebecca Hendren wrote an excellent column this week based in part on a survey of nurse executives that found 98% had witnessed behavioral problems between nurses and physicians in the past year. While there were complaints about nurse behavior, both physicians and nurses reported that physicians were a large cause of disruptive behavior. Her final point is worth remembering: "No matter how good you think the relationships at your organization are, they can always be better. And if they are, then patients will be safer." [Read More]
Doctors say consult code elimination will hurt Medicare access
Four out of five endocrinologists may reduce the number of Medicare patients seen in their practices if CMS follows through with its decision to eliminate consultation codes, according to a survey conducted by the American Association of Clinical Endocrinologists. I'm a little skeptical of surveys about physicians dropping Medicare, because we hear these threats anytime there's a potential cut in reimbursement. That said, the new rule will hurt some specialists who rely on a high volume of consultations and now have to bill for new or existing patient visits. [Read More]
Business Rx
Implementing Lean in a Physician Practice
The first step toward implementing Lean in a physician practice is to assess the current work flow. It's crucial to first understand the practice's current state and the minutiae of what is going on in its environment. [Read More]
Physician News
Senators seek to shine light on medical industry relationships
Chicago Tribune - December 10, 2009
FDA Issues Interim Recommendations on CT Scans
John Commins, for HealthLeaders Media - December 8, 2009
Another medical school reports doctors' industry ties
Wall Street Journal Health Blog - December 10, 2009
Senator Grassley seeks financial details from medical groups
New York Times - December 8, 2009

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From HealthLeaders Magazine
20 People Who Make Healthcare Better
HealthLeaders December 2009
The very essence of healthcare is to make a difference for good. In our annual HealthLeaders 20, we offer profiles of some who are doing just that. [Read More]
Service Line Management
Emerging Service Lines
Hospitals that lead the way in emerging service lines may find themselves positioned to be market leaders in the future. Here's a look at which services are emerging and why. [Read More]
PhysicianLeaders Forum

Avoiding a Professional Disciplinary Action: Contributor Alan Lambert, MD, Esq., offers simple lessons for avoiding professional disciplinary actions based on an analysis of investigations and prosecutions in New York. [Read More]
Audio Feature

Real-Time Records: Louis Cornacchia, III, MD, president and CEO of Doctations, discusses the advantages of Internet-based medical record systems over standard electronic health record systems. [Listen Now]
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Resources From HealthLeaders Media

Sign up to receive our new, free e-mail publication that offers concise updates on the top nursing leadership headlines, as well as best practices, practical advice, and expert strategies from nurse industry thought leaders.
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.
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