Best of convention hopping

After a whirlwind of conventions, it's time to head back to the office. But, before I go, a few non-clinical highlights:

Most unusual swag: It looks like a highlighter, but one end is a hand sanitizer spray, and the other is lip balm.

Rudest attendee: Raised his hand in the MIDDLE of a session and said, "I don't mean to be rude, but this is a little boring."

Strangest group psychology: the outsized appeal of free food. It's not as if any conference attendees would have trouble affording a couple of bucks for a snack. In fact, many of us are on expense accounts. But throw out a tray of muffins or a case of soda and we're stuffing our pockets like a horde of street urchins.

Weirdest souvenir: The ACR daily paper encouraged attendees to purchase a "Rodman Commemorative Gout Print." Your guess is as good as mine.

Strangest wardrobe: It may have related to the high percentage of foreign attendees, but spotted at ACR were a mullet, a pink fringed suit, and a study author's top so sparkly it could have blinded a cameraman.

Marketing gone wildest: In a montage promoting MGMA 2009, screen faded from e=mc2 to DEN=mc2, to DENVER. Hunh?

Most mysterious session title: Indian Hedgehog and Parathyroid Hormone-related Protein Regulate Articular Chondrocyte Differentiation.

Labels: MGMA conference, rheumatology

More

posted by Stacey Butterfield at 8:00 AM   2 Comments

Visiting the dark side at MGMA

Learning about the business of medicine can be fun, even inspiring. I'm looking forward to writing up MGMA sessions on reducing no shows and improving the wait room experience for upcoming issues of ACP Internist.

But this afternoon, a couple of sessions wavered in the delicate balance between profit and clinical motives. First, a hospital exec who was trying to up his patient satisfaction scores explained how his organization told their docs to improve patient contact by thinking about "how you would do things differently if you valued the person in front of you." Implication being that the average patient previously had no value?

Then I went to a session on a topic that always riles our high-minded readers: medical spas and retail medicine. (I didn't mean to be there. The "Day in the Life of an EMR Physician" session was unexpectedly cancelled.) And it was painful.

The speaker (a lawyer) started off by talking about the impending primary care shortage. Which seems to me like an argument against spa medicine, since we might need those few docs who are left for real clinical care, but I suppose it's also a market opportunity. Anyway, apparently these spas are offering everything for which patients will open their wallets, from massage and Botox to hormone replacement therapy. Wait, isn't HRT a medical therapy that you should provide to patients based on the (substantial, hotly debated) evidence rather than the price they will pay? (I didn't get to ask.)

After a brief discussion of all those pesky regulations that medical boards and government regulators impose on the fortune-making possibilities of medicine, we moved on to retail clinics. The speaker predicted that more physicians will be getting offers to supervise in-store clinics that are staffed by NPs and PAs. The bad news is, legal constraints mean they might actually have to do work, like reviewing charts. "It's not just show up at WalMart every two weeks and pick up a paycheck," he said.

I know, physicians need to be paid, and medicine is still a capitalist enterprise (although after banking, who knows what's next). But after my foray into the biz of medicine, I'm ready to hop back over to clinical side of the wall.

Labels: MGMA conference

More

posted by Stacey Butterfield at 5:31 PM   0 Comments

The requisite motivational lecture

This morning at MGMA, expert/consultant Quint Studer gave the group some tips on how to improve performance of their medical groups. His top recommendation was to fire your bad employees.

A few less obvious tips:

• He suggests using pre-visit phone calls to reduce no-shows. The interesting twist--while you've got them on the phone, ask for credit card payment of the copay. Saves time during check-in and gives them more to lose by noshowing.
  
• Studer's designed a little brochure called a "patient visit guide" that is intended to improve compliance and satisfaction. Patients write down their chief complaint on it, then nurses fill in vital stats, and docs add follow-up (particularly medication) instructions. Patients then take it home, and have a clear idea of what happened during the visit. There's supposed to be an online version of the form on Studer's web site, but I haven't found it. Will do some more investigation.

Labels: MGMA conference

More

posted by Stacey Butterfield at 1:05 PM   2 Comments

What the managers are thinking

I (and the rest of the press pool) had lunch with MGMA president and CEO William F. Jessee, MD, today and he offered some thoughts on current events.

Already, the effects of the economic meltdown are starting to be felt among MGMA member practices, who are reporting recent decreases in patient volumes. There are also expectations that uninsured populations will go up along with the unemployment rate. In addition, practices are now holding off on big capital expenditures, Dr. Jessee said. That's bad news for the MGMA conference, for one, since you can't walk the exhibit hall without tripping on an EHR vendor. "I'm curious to see how our conference will look next year," said Dr. Jessee.

The MGMA is challenging the next president to concentrate some of his administration's health reform energy on payment reform. "Neither of the candidates is addressing the core issue," said Dr. Jessee. Key points that he would like to see addressed: universal coverage (the MGMA has not taken a stand on single vs. multiple payer); changing reimbursement to reward physicians for keeping patients healthy; aligning incentives so that physicians, hospitals and payers can work together instead of against each other; and reducing administrative waste.

Toward that last goal, the MGMA is starting a big push for standardized patient ID cards. Right now, they're doing research to show that insurance cards with magnetic stripes or bar codes that have basic patient and payer info encoded in them would save time and money for everyone involved. The next step is getting payers on board with the idea. A small step toward simplifying the administrative nightmare that is modern healthcare. Says Jessee, "We pitched this one because it's so simple even a legislator can understand it."

Labels: MGMA conference

More

posted by Stacey Butterfield at 5:37 PM   0 Comments

EHRs at 8 a.m.

I'm at the Medical Group Management Association's annual meeting this week, in not-so-sunny San Diego.

This morning, I started off by going to a lecture about the operations of the Certification Commission for Health Care Information Technolgy, the recognized certification body for electronic health records, which was founded by the Healthcare Information and Management Systems Society and HEY! DON'T FALL ASLEEP! I'M STILL TALKING HERE!

Anyway, I managed to stay awake for a few interesting facts. First, despite all the talk about how Stark exceptions will let hospitals give EHR systems to physicians, very few are actually doing that. Specifically, the MGMA rep said that he's never met anyone who got their EHR that way, and the CCHIT director suggested about 100 hospitals have actually done it. Biggest hurdle, according to the speakers: disputes over who controls the data in the records.

But, one entity that actually is encouraging EHR adoption: malpractice carriers. Both speakers said they've talked to liability insurers that are offering up to 5% off premiums if you have an EHR. (There's no proof yet that electronic records lower claims, but they do improve documentation.) Depending on the size of your premium, that discount might pay for a significant chunk of your EHR costs, the experts suggested.

And, a few of the mysteries of CCHIT certification were revealed. When you're looking at an EHR, the more recent the certification, the better, but don't rule out a system that's still 2008 certified in the spring of 2009, they said. The certification cycles run from August to August, so no one will have the current year's certification until the summer at the earliest. Also, certifications are good for two years, but vendors should state in their contracts that they will get renewal of their certifications when needed.

Labels: MGMA conference

More

posted by Stacey Butterfield at 12:28 PM   0 Comments

It's that time again

After the traditional summer slowdown, conference season is about to get underway, and that means it is once again time for...Ill-advised Session Titles. Here are a few treasures from the Medical Group Management Association, whose annual meeting I'll be blogging from Oct. 20-22.

"The Ring in the Rubble: Dig Through Change and Find Your Next Golden Opportunity" People, how many times do we have to tell you that metaphors are like fudge--a little bit is amazing, but a lot is unhealthy and nauseating?

"How to Get Your Front End to Meet Your Back End" What do you bet several attendees arrive with absolutely the wrong idea in mind? This is a business seminar!

"I Hate to Wait!" Fair enough, but I'd better not have to sit around while you fiddle with your PowerPoint.

and our nominee for Excessively-Wordy-But-Can't-Miss-Session-Title, "Our Physicians Make More Money, Go Home on Time and Provide Better Care".

Labels: Ill-advised session titles, MGMA conference

More

posted by Stacey Butterfield at 12:00 PM   0 Comments