Handoffs or Fumbles: Transferring Care Amongst Physicians

There are many patient hand offs during EVERY physician’s day.  Primary care physicians hand their patients off to ED docs, who in turn hand them off to hospitalists or specialists, who in turn (eventually) hand them back to their out patient physician.  Additionally, there are hospitalist to hospitalist hand offs and specialist to specialist hand offs.  [...]

The Medicare No Pay, Never Ever List

The Centers for Medicare and Medicaid Services announced 10 hospital acquired conditions for which it will not reimburse.  The no pay rule has been in effect since October 1.  So, with out further ado: (drum roll):
“Stage III, IV pressure ulcers
Fall or trauma resulting in serious injury
Vascular catheter-associated infection
Catheter-associated urinary tract infection
Foreign object retained after surgery
Certain surgical site [...]

PookieMD Airlines: How aviation check lists apply to medicine

I am married to an electrical engineer that loves to fly around in a small airplane.  Because I hang out with him, I’ve been forced to observe the intricacies of not crashing into other planes and landing safely.  I’ve learned a lot.
Pilots have a check list for everything.  Plane manufacturers include an entire book of checklists [...]

Don’t Recoil: Marketing Your Practice

Yes, we will talk business today.  No more fluff on being efficient, knowing where the speculum is, and handing out tricolor business cards.  Let’s get to the meat of it: YOU CAN’T SEE PATIENTS IF THERE IS NO ONE TO SEE. 
Sadly, many practices have a dearth of patients.  How could this be?  Some are located [...]

Taking on the JAMA JDs

Being the socially responsible, business minded physician that I am,  (NO this is not an oxymoron!), I read with interest the commentary from  the Jama, October 15, 2008 issue (pp 1806-1808), titled, “The Professional Ethics of Billing and Collections,” by Mark A. Hall, JD and Carl E. Schneider, JD.  After I calmed myself about having [...]

10 Ways to Waste Money in Primary Care

Continuing on the primary care waste theme  (no, primary care is NOT a waste!),  I would like to give you my 10 top ways that primary care physicians waste money. 
10 TOP WAYS TO WASTE MONEY IN PRIMARY CARE:
1) Open the office at 9:00, close at 5:00 and have 90 minute lunch. 
This practice started back in [...]

How To Listen So Patients Will Talk

I wish that in medical school and residency we had spent more time learning how to communicate.  We finish training stuffed with knowledge (think a brat on a grill!) but are horrible at distilling that knowledge to help people.  As a hospitalist I have tried to hone my interviewing skills, but feel that I could [...]

21 Primary Care Time Wasters

In my travels as the ExtraMD, I have seen many different practices, different styles and hundreds of ways practices waste time and annoy patients.  In my quest to help primary care physicians stay afloat, I will list my observations of time wasters that suck the joy out of medicine.  I will also include my incredibly astute [...]

Ancillary Services as a way to Increase Revenues (?)

It was with great interest that I read the Medscape article, “Ancillary Services in Primary Care,” posted today on Medscape Internal Medicine.  The author, Leslie R. Kane  (okay, I can’t help it but I immediately thought arcane,)  goes through several strategies to boost revenues.  She investigates botox, dermal fillers, lab/lab draws, holter monitors, laser hair removal, and weight [...]

Entering the Lions Den: Negotiating With Health Plans

Fighting with insurers isn’t something I anticipated doing when I was in my “save the world through medicine” phase (?haze?) during medical school, but none the less, here we are!  I came across an interesting article in Modern Medicine titled: “You Can Negotiate With Health Plans,” by Robert Lowes, from the Jan 4, 2008 edition.  I will [...]