Practice

The Peril of Online Physician Reviews

Online reviews are not a reflection of medical care quality. Patients do not like receiving medical bills and do not like rude clinic staff. They are unhappy if the physician disagrees with them, they abhor long wait times, and they detest prior authorizations, (news flash, so do physicians!) Yet these criticisms are not a reflection of the healthcare quality provided by the physician. It is doubtful these grievances even have an impact on the mortality rate.

Is the Marital Status of a 5 year old Child Important?

Doctors have spent decades honing their clinical skills and should be entitled to choose the documentation method they find most effective and efficient. Some physicians find electronic records helpful and should be encouraged to use them. My pediatric practice will keep surviving on a shoestring, a prayer, and good old-fashioned paper. It warms my heart to know each chart note contains helpful information and not one human being leaves with NONE as their diagnosis.

Bronx-Lebanon Hospital: Believe Them the First Time

I remember the first time someone threatened my life as a physician. It was my day off, so I was not in the clinic that day; a Children’s Hospital specialty group was working there instead, and after a staff member called the police, she notified me. A father had walked in saying he wanted to kill me for “taking his children away from him.” Wracking my brain as to this man’s identity, I drew a blank.

The Small Giants of Healthcare

My advice for patients everywhere: Whenever possible, find an independent practice, whether a solo doctor or direct primary care clinic, and patronize that physician. Your care will be more personalized, cost less in the long run, and your health will be better for the investment you made in yourself.

GEHA’s Seven-Year “Glitch”

After reviewing more than 100 EOB’s personally, a clear and definitive pattern of fraud emerges demonstrating GEHA makes every single patient responsible for $50-100 in out-of-pocket costs for immunizations. Language in our GEHA contract clearly states we must follow their specifications according to each EOB we receive.

2020-05-04T03:12:48+00:00May 17, 2017|Categories: Policy, Practice|Tags: , , , , , , |

Gaming the System: Pediatrics, Mammograms, and MACRA

Imagine what quality metrics the pediatric cardiac surgeon is going to track. He would do well to collect statistics on how often he images patients for appendicitis because it is likely a rare occurrence. Things are really looking up for the use of data and technology in healthcare. Costs are likely to keep rising with everyone scoring in the 99th% percentile once they figure out how to game the system. But we certainly cannot stand in the way of science or progress now can we?

2020-05-14T03:27:54+00:00February 21, 2017|Categories: Policy, Practice|Tags: , , , , , , |

Free-market Medicine:  Can Independent Practices Stay Viable Using Price Transparency?

I need a light, a stethoscope, and a pen to heal and comfort human beings; the rest is basically nonessential. This Mexican physician and I fundamentally do the same thing every day; except he has no receptionist, no billing personnel, no manager, no administrator, no care coordinator, and definitely NO EMR in his emergency clinic. He documented the visit in less than 3 minutes (like I do), signed it, and handed me the top page for my records. His care was good, his skills were solid, and his decision-making sound; I would have treated any other child the same way.

2020-05-14T03:25:58+00:00February 10, 2017|Categories: Policy, Practice|Tags: , , , |

Meaningful Use: A Bird’s Eye View from the Penalty Box

Welcome to the penalty box, with no term limit. Every single visit, procedure, counseling session, or medical intervention will have 2% shaved off the top. The average family physician receives about $100,000 a year in Medicare reimbursements, so a 2% penalty for 2017 will become 3% in 2018, and increase to 4% in 2019—a combined three-year total of $9,000.

2020-05-04T01:54:53+00:00January 24, 2017|Categories: Policy, Practice|Tags: , , , , , , |