Wednesday, July 29, 2009

Here is the quote of the day from my AIS newsletter...

$1.76 billion ... has been awarded to Johnson & Johnson subsidiary Centocor Ortho Biotech Inc. as a result of a patent dispute with Abbott Laboratories involving the blockbuster rheumatoid arthritis drug Humira.

As physicians providing care we make approximately 10% of the GDP of US healthcare. It is estimated that rate cuts in medicaid/medicare will save in the neighborhood of 2%.

You doctors know what the cost of pharma as a percentage of the us healthcare gdp is??

I'm guessing better than 10%.

There is a way to significantly slash your practice costs with a service line providing house calls AND let the pharmaceutical industry subsidize ( almost ) the entire cost of your software platform. Want to know how??

Come Hear Me speak at Mayo clinic September 15th about customer experience in making house calls and how health care social media, online community, wireless, and emerging device industry enable a massive disruptive innovation you can take advantage of today in your practice, to beat your competition, improve your professional satisfaction, income and lifestyle. House calls are fun and patients love them, is the bottom line.

Natalie Hodge MD FAAP

Friday, July 24, 2009

Dismal Study from Physician's Foundation

The State of Primary Care

A Startling Report from The Physician's Foundation

A recent study by The Physicians Foundation and Merritt Hawkins surveyed 12,000 physicians in primary care practice in 2008. At a time when our government is calling for expanded heathcare access and solutions to our healthcare crisis, the state of physicians current practices is an important crucial viewpoint. The results of the study paint a grim picture that will drastically impact the future of our nation's healthcare.

* 50% of physicians - more than 150,000 primary care doctors nationwide- say they plan to reduce the number of patients they see or stop practice entirely.
* 94% say the time they devote to nonclinical paperwork in the last three years has increased, 63% say th paperwork is causing less time per patient in visits.
* 82% of physicians said their practices would be unsustainable if proposed cuts to reimbursements were made.
* 60% of doctors would not reommend medicine as a career to young people.

Physician plans for the future

Of the 45 % of physicians who plan to reduce the number of patients seen 7% plan to switch to cash pay models of care. The remainder are split between pursuing nonclinical healthcare jobs, early retirement, and jobs entirely unrelated to healthcare.

Perspectives and Practice Plans

The majority of physicians 65% find their medical practice either "less satisfying" or "unsatisfying" Unsatisfying aspects of practice include "reimbursement issues" " defensive medicine pressures" and "government regulations" as well as "difficulty with managed care organizations"

Practice Financials and Workload

Only 17% of physicians reported their practices to be financially rewarding and profitable. Over 30% of practices are not making a profit. This fact should be not only concerning for any primary care physician, but for any resident considering embarking on a career in primary care. Our current system requires an accelerated pace to offset external financial pressures.
63% of physicians are working 51 or more hours per week. and 38% are working 61 or more hours per week. The majority of physicians 63% feel that they "sometimes do not have the time" or "do not have the time to fully communicate with patients"

The Myth of "Expanding Coverage"

The numbers of physicians closing their panels to medicare/medicaid and HMO panels is accelerating. One third are closed to medicaid. 30% are closed to certain HMO's and 5% have closed their panels to new patients entirely.
These numbers illustrate coverage does not equate access. Expanding coverage may only lengthen the lines to see physicians as happened in Masachussets since advent of health reform in that state.

Reimbursement Woes are Universal

In addition 64% of physicians note Medicaid reimbursement is lower than the cost of providing office based care. 43% say that HMO and PPO plans often reimburse less than the cost of proviing office based care. 36% Say that medicaid reimbursements are less than the costs of providing care. Due to flat or declining reimbursement, 39% of physicians have been unable to provie staff with raises, 35% have not been able to purchase new equipment. 77% of physicians do not have the financial resources to make capital purchase of EMR hardware/software and IT personnel.

Physician Morale is low

42% of physicians report that morale of collegues is low. Physicians ranked " practice closures ue to declining reimbursement/rising costs" as the top reason for the shortage in primary care. Many physicians put in writing written comments within the survey that voice being tired of the battle with third party payors that rob them of time, money, energy and empathy.

"Costs of running a solo practice and the time needed to manage practice administration are killing me"

"We are drowning in a sea of regulation and paperwork"

"Primary Care medicine is the most vital to our healthcare system, and is the poorest reimbursed. "

" It amazes me how paralegals an plumbers make more money per hour than pediatricians. As fewer medical graduates pursue primary care, everyone will suffer."

Strategy – The Art of Creating and Sustaining Competitive Advantage

Successful private practices approach strategy as the compilation
of processes to define the boundaries of the business, redefine the basis of competition through innovation, and create a medical practice capable of success in ever-changing and unpredictable markets. Primary care practices face unparalleled challenges in these challenging days.

Strategic Vision- Choose the Future

A strategic vision is the guiding theme that articulates a practice's intent for the future. In a challenging business environment it is easy to focus on the myriad problems that face you in your day. But it is critical to focus on the future in order to create a new reality for your career.

Strategic Innovation- Find new customers

Innovation is the hallmark of competitive strategy. Successful practices pursue innovation, in products, in methodologies, in services that they provide to customers. It takes disruptive innovation and new thinking to deliver value in private practice. For primary care practice to succeed in this market they must innovate, find new ways to serve customers, and rethink the broken model of third party payor practice. There are four major recent innovations that enable a return to a simpler more gratifying service line of your medical practice. Wireless internet, ecommerce, social media and device ( iphone/tablet pc), SAAS (software as a service)

Start calling patients "customers"- Ideas into Action

It is time for primary care physicians to move into action and plan for your future through disruptive innovation and new thinking. Personal Medicine International would like to share with you our weekly webinar which features a disruptive innovation that any primary care practice can implement today, with

*no upfront licensing costs
*no risk of losing revenue from leaving your current practice
*minimal additional overhead structure
*no costly servers, IT staffing for server maintenance
*cutting edge social networking strategies for cash pay top line growth
*turn key local marketing strategies for new referrals
*malpractice discounts for emerging attentive model of care
*integrated customized web design to feature you in your zips of interest
*ecommerce platform for systematized patient payments

this will transition you into a new practice environment with a segmented group of your customers, adding an attentive high tech, high touch service line of house calls in a direct medical practice model. Please visit for our webinars, patient testamonials, free weekly newsletter and let us know how we can assist you. You have the capabilities to strengthen your practice's long-term position
in the face of unreliable third party payors, impending government interventions, and organizational challenges of traditional office practice management.

Friday, July 03, 2009

Ah Oh.....

Now Primary care physicians.... what are you going to do???

Breaking News from Modern Physician

Physicians will receive a 21.5% cut to their Medicare payments starting Jan. 1, 2010, under a proposed rule issued by the CMS. The agency is also proposing to remove physician-administered drugs from the formula used to calculate physician payments under Medicare.

As we move through this challenging practice climate. It is time to consider a house call service line that is indepenant of Obamacare and continued reimburement cuts.

Come hear me speak at Mayo Clinic about house calls and the iphone.

September 13th through 15th.

Natalie Hodge MD FAAP