Practice Management

Physicians writing on KevinMD about running a practice: staffing and overhead, the payer paperwork that arrives with every patient, ownership and consolidation, the administrators and executives who now employ most physicians, and the models physicians have built to get out from under all of it. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Physicians and administrators: what physicians say about who runs medicine, in their own words, and Private equity and corporate medicine: what physicians say, in their own words.

How burnout helped this physician find his purpose

James Turner, MD

Physician Finance

October 14, 2018

A common proverb teaches that, “The road to hell is paved with good intentions.” Medicine is a world where people are well-intended. Yet they fail to change a system that is broken and continues to produce burned out, depressed, and suicidal doctors. We can see their final destination, look back, and realize that we helped pave the road that carried them to that destination.

Today, I want to hammer home the purpose …

The empty celebration room on National Doctors’ Day

Suneel Dhand, MD

Physician

October 13, 2018

A physician recently recalled to me a situation he found himself in on the last National Doctors’ Day. Those of you reading who work in health care, will already be aware that this is on March 30th every year. I have seen this day celebrated in every hospital I’ve worked in since I first came to the United States over a decade ago. I actually think it’s a nice gesture, and …

How to avoid FOMO when investing

Passive Income, MD

Physician Finance

October 13, 2018

At some point in your investing career, you’ve likely heard of a stock that’s gone on a ridiculous run or a certain part of town that has now become the trendiest in the area, and you’ve kicked yourself for not investing. We’ve all been there.

Well, the cliche is true: hindsight is indeed 20/20. In hindsight, who wouldn’t have purchased as many shares as they could of Amazon or Apple back …

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How to avoid FOMO when investing

How positive deviance can address clinician burnout

Diane W. Shannon, MD, MPH

Physician

October 12, 2018

I love the idea of turning a negative approach to improvement in health care — looking for problems — on its head. Appreciative inquiry, a process of focusing on a group’s inherent strengths and fostering positive interactions among group members, is one way of fostering change with a positive approach. Positive deviance (PD) is another.

Basically, PD involves identifying what’s working and usual local solutions owned by the people involved to make …

7 essential steps to take during (and after) a restructuring or layoff

Health eCareers

Physician Finance

October 11, 2018

This article is sponsored by Careers by KevinMD.com.

Employer consolidation due to the mergers and acquisitions of hospitals and health systems is becoming increasingly common within the health care industry. In fact, merger and acquisition activity doubled in the first half of this year, with the volume of value health care sector deals increasing to Read more…

7 essential steps to take during (and after) a restructuring or layoff

Physician well-being: lessons from positive psychology

Sanj Katyal, MD

Physician

October 10, 2018

The absence of burnout does not equal wellness. While the focus on physician burnout as an epidemic is finally gaining more attention, we may be missing a larger issue. Most physicians are not burned out. We are able to function. We get through our days, make it to some of our kids’ activities and even manage to go out to dinner on the weekends. We survive the work week as …

Financial success as a doctor isn’t rocket science

Smart Money, MD

Physician Finance

October 10, 2018

We all know the importance of compound interest in building wealth. The fuel for compound interest is time — the longer you are committed, the greater chance your investments will grow. This applies not only to financial growth but also to essentially everything else. As a rule of thumb, the more you study for a test the better you ought to do. The longer you have practiced medicine, the more …

Medicine is a word with 3 meanings

Hans Duvefelt, MD

Physician

October 9, 2018

Everybody is a stakeholder these days in what we broadly call medicine, or health care. But there is little agreement on what medicine is and what the priorities of the health care “industry” should be.

I propose this breakdown of medicine into three separate phenomena.

1. Micromedicine
2. Macromedicine
3. Metamedicine

Let me explain:

Micromedicine: one on one, real doctoring

Doctors from antiquity have served their patients one on one, as individuals. Osler, the father of modern …

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Medicine is a word with 3 meanings

Meditation, yoga, and mindfulness aren’t going to solve physician burnout

Linda Girgis, MD

Physician

October 9, 2018

Recently, my inbox has been overfilled with offers for programs, yoga, meditation, and a whole host of mindfulness training opportunities to combat physician burnout. I think by now everyone knows that doctors are fighting high burnout rates. But, those sending these “special offers” don’t get the root of the problem. We’re not burned out because we work long hours in a stressful job with limited time off. Rather, we are …

Live your life the best you can, and don’t spend it all in the hospital

Cory Fawcett, MD

Physician Finance

October 9, 2018

If you have been following my writing, you know I have been out of the surgical workforce for a year and a half. I have settled into a much more relaxing lifestyle as an author who can set his own work schedule. This week I got a flashback of what my old life was like as a general surgeon when I attended a four-day conference called FinCon.

Each morning of the …

Avoid the power drain of life

DocG, MD

Physician Finance

October 9, 2018

I believe we have power. That deep inside each of us resides a unique purpose and identity that are unstoppable. That embracing this power leads to lifelong contentedness. Finding this well of vitality is complicated. Certainly it starts by telling ourselves the right stories about our lives. By becoming the protagonist of our own unique narrative, we dive deeper into ourselves. In the past I have even gone as …

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Avoid the power drain of life

A scrum master for primary care

C. Todd Staub, MD

Physician

October 9, 2018

We should consider a new position in our primary care teams — that of the scrum master. “Scrum” is a rugby term that comes from agile, a work methodology for software development that now is being applied to industry and health care.

In rugby, a scrum is a huddle where the teams come together with interlocked arms to regroup and start play again. In agile, scrum masters facilitate team huddles and …

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A scrum master for primary care

How to plan for an uncertain financial future

Wall Street Physician, MD

Physician Finance

October 8, 2018

The tricky part about retirement planning is uncertainty.

Uncertainty in retirement planning comes from three major sources.

1. Current and future income

Doctors are fortunate in that they have very high job security. Even if you were to be let go from your current position, there will almost always be another position somewhere in the country (although you might have to move out of your current metropolitan area).

However, the high income doctors currently …

Clicking checkboxes doesn’t meaningfully improve care

Fred N. Pelzman, MD

Physician

October 7, 2018

Earlier this week, I was pleased to learn that my practice had achieved a statistically significant increase in box clicking.

In reviewing data from our accountable care organization, graphs were shown to us demonstrating improved compliance with several of the measures that they’ve instituted institution-wide for the purpose of reporting back to Medicare on how well we are taking care of our patients.

One of these measures is the ever popular “falls …

It’s time to advocate for a new culture in medicine

Dianne Ansari-Winn, MD, MPH

Physician

October 6, 2018

The National Taskforce of Humanity in Healthcare recently published research showing physician burnout is impacting quality safety, and health care system performance — estimating that “costs for burnout-related turnover may be as high as $1.7B annually among hospital-employed physicians, and $17 billion across all U.S. physicians.” At Stanford Medicine, physician burnout costs at least $7.75M yearly.

These numbers are staggering. Growing numbers of physicians are leaving medicine (surely impacting the physician …

7 keys to having a medical career that serves your life

Stephanie Wellington, MD

Physician

October 5, 2018

Doctors spend their early adulthood preparing for medicine. In college, we take classes to satisfy prerequisites and prepare for the MCAT exam. Medical school has a life of its own. The volume of material to master is extensive, and the pressure mounts to be your best. Next is the interview process for residency training and the anticipation of Match Day.

Then life will begin. Maybe?

Now, you are in your late 20s …

Should your practice hire a physician assistant or nurse practitioner?

Health eCareers

Physician

October 4, 2018

This article is sponsored by Careers by KevinMD.com.

Nurse practitioners and physician assistants are both advanced-practice providers with considerable autonomy, but they’re not interchangeable. Each brings something slightly different to the table, and if your practice is considering hiring an advanced-level practitioner, it’s important to understand the differences so you can hire appropriately for your need.

Because medical facilities are …

The 5 stages of financial independence

DocG, MD

Physician Finance

October 3, 2018

I have talked in the past about coping with financial freedom. Once we reach the mountaintop, we undergo a number of emotional changes. It is, however, a mistake to believe that the transformation only begins once we have attained our goal. In my humble opinion, there are five stages of financial independence. These stages begin with conception and meager bank accounts, and end with financial freedom and hopefully …

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The 5 stages of financial independence

5 urban legends about risk-adjusted diagnosis coding

Betsy Nicoletti, MS

Health Policy

October 1, 2018

When I talk to medical practices about hierarchical condition category (HCC) and risk-adjusted diagnosis coding, I receive a lot of questions that point to the existence of persistent urban legends!

Let’s separate fact from fiction.

Urban legend #1: CPT fee-for-service coding will be a distant memory when we switch from volume to value

Not anytime soon. Medicare’s newer payment models starting with Medicare Shared Savings Programs (MSSP) and Accountable Care Organizations (ACOs) are …

The answer to your prior authorization problem is simpler than you think

Dan Richards

Medications

September 30, 2018

Prior authorizations (PAs) have become increasingly burdensome for providers — they contribute to 92 percent of care delays and an estimated 77 million are submitted manually each year. In fact, the process has become so burdensome that many physicians get fed up with the process end up writing for less-effective prescriptions because they know the preferred drug will require a prior …

Practice Management

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