physician reimbursement Articles - Medical Practice Trends

Medical Practice Trends Podcast 38: Saving Money on Medical Practice Office Expenses

March 27, 2012 By Peter Polack Leave a Comment

MPT Podcast 37 - Saving Money on Medical Practice Office Expenses, from 101 Ideas to Increase Revenue & Decrease Costs – Part 4, with guest Mary Pat Whaley of ManageMyPractice.com. Ms. Whaley shares more of her many suggestions for increasing profit for your medical practice.

This Issue (8:29):

Are the Yellow Pages an expensive dinosaur?
Could your postage machine encourage petty theft?
What are group purchasing entities?
Why office supplies may be sneaking out your back door

Click the play button to hear the podcast

Right-click to download

Doctors Going Broke

January 6, 2012 By Peter Polack 1 Comment

Although most of us in medicine know the struggles of running a private practice, it is still disconcerting – albeit not surprising – to hear that some doctors are having to file for bankruptcy.

In an article on CNNMoney.com, some physicians talk about having to get business loans or use personal funds to keep their practices afloat. In some cases it is a matter of sudden changes in reimbursement policy, such as cuts in oncology pharmaceuticals; in others, it is the slow death of decreased revenue in the face of increasing costs.

For the rest of practices that are in a somewhat better situation, the annual drama in Washington DC over Medicare reimbursement has led to a paralysis in strategic planning of any kind. Doctors cannot plan for growth, for expansion, or for investment in new technology with the spectre of 30% fee cuts constantly looming over their heads.

Debunking The 7 Myths of Concierge Medicine

January 2, 2012 By Peter Polack Leave a Comment

Guest Post, John T. Kihm MD

Myths abound concerning concierge medicine (CM). Unfortunately these myths prevent good doctors from converting their practices to CM. Let’s look at those myths—maybe you need to work on yourself and your own beliefs. If you practice quality medicine your patients will value you and your work and will pay a fee to join your CM practice. CM is a value story. If you provide solid value, you needn’t believe these myths–value trumps myth.

The myths:

My patients are not wealthy/can’t afford CM. I have a lot of Medicare/Medicaid patients.
My patients will not like this concierge idea.
My patients can’t do without me.
I have bad practice demographics. I am rural. My patients are too old. My patients are too young.
24/7 coverage sounds too hard.
Is this legal? What are the ethics?
The conversion process will overwhelm me.

My patients are not wealthy. If your patients value you and your work, you can devise an affordable program. Patients will find the money to keep you if they value you. Be creative with pricing if necessary. You can make it work. Amazingly, I have patients who live in housing projects who joyfully belong to my practice because they see the value. Conversely, all of us in CM practice have wealthy patients who say the fee is too high, do not see the value, and do not join. Patient income generally does not predict CM success or failure. Perceived value predicts success. Focus on value and the rest will follow

My patients will not like this concierge idea. Do not project onto patients negative beliefs, as those beliefs may become unnecessary self-fulfilling prophecies. Patients’ enthusiasm will mirror your own. Patients possess a survival instinct and will recognize your opportunity for better care, along with your belief in providing that care. Moral: be enthusiastic! Believe in yourself and your patients will follow. Above all, emphasize value and opportunity in your CM practice.

My patients can’t do without me. Primary care doctors are famously codependent. Get over it. Patients not seeing the value in your practice can and will vote with their feet. You do not decide who can live with or without you—patients decide. Patients who truly “can’t live without me” will see the value and stay with you. There is nothing unethical about letting patients decide who they need. Do not project your own needs onto your patients. Patients who do not wish to stay with you are responsible for their own lives. Let go of your codependency.

I have bad practice demographics. You can overcome demographic obstacles by providing great value to your patients. Patients of all stripes, ages, and locations will stay with you if you take excellent care of them. For example, farmers in my practice understand, respect and value hard work. All of my farmer patients signed my contract. The elderly do tend to value their care more that the youthful, but the health-conscious young will sign-up as well. Meet demographic challenges by making sure your patients see value.

24/7 coverage sounds too hard. 24/7 sounds impressive, and it does demonstrate value. Taking call has never been easier for me. First, with fewer patients in the practice, the calls decrease in proportion to number of patients. Second, the very patients who respect and value me enough to contract with me demonstrate discretion in calling after hours. Mutual respect is the norm in CM. Inappropriate calls come few and far between, so 24/7 call is not hard.

Is this legal? What are the ethics? Concierge medicine is legal and is ethical. In CM, you provide a service for which patients pay. If you elect to file insurance, your CM practice needs to provide a non-covered service. Some argue that by charging a fee, you limit access to patients, hence CM is not ethical. Your response should be, “I need to see fewer patients to practice a high level of care. I cannot take care of all patients who need a doctor. It is not my responsibility to see all patients or attempt to cure all of society’s ills. I just focus on my own patients.” Explain this truth to your patients. They will understand you. It is ethical for you to stay alive and in business by practicing concierge medicine.

Conversion process will overwhelm me. Conversion to a concierge practice is do-able, and challenging. You have one chance to do it right. We do not recommend going it alone. Conversion need not be overwhelming. Simply ask for help.

If you know in your heart that you need a better alternative than hamster treadmill high volume medical practice, consider concierge medicine. Do not shoot-down CM based on any of the above myths. Focus on value. If you can provide value to your patients and if you want a better life for your patients and yourself, bust these myths and get going. Contact us, we can help.

Dr. John T. Kihm blogs on ConciergeMedicineDirect.com – the original article can be read at Debunking the 7 Myths of Concierge Medicine

Medical Practice Trends Podcast 33: 101 Ideas to Increase Revenue and Decrease Costs

December 29, 2011 By Peter Polack 1 Comment

MPT Podcast 33 - 101 Ideas to Increase Revenue and Decrease Costs, with guest Mary Pat Whaley of ManageMyPractice.com. Ms. Whaley shares some of her many suggestions for improving your practice’s bottom line.

This Issue (10:42):

Does it really pay to work harder?
Should your practice have a minimum-number-of-physicians policy?
Do doctors take too much time off?
How adding a single patient a day can make a big difference in revenue

Click the play button to hear the podcast

Right-click to download

Concierge Model Criticized for Worsening Doctor Shortage

December 12, 2011 By Peter Polack Leave a Comment

With looming reimbursement cuts a perpetual end-of-year drama, more physicians are foregoing insurance plans altogether and going into the ‘concierge medicine’ business.

But as an article on Fierce EMR reports, some are blaming this trend on a growing shortage of physicians.

In Vermont, one of a few states considering a single-payer system, the number of primary care physicians is becoming evident. Although the number of concierge practitioners is small – on the order of a few thousand – this has doubled in the past two years.

Doctors who are dropping Medicare are reporting less stress and more professional satisfaction, but apparently this is leading to many patients who can’t afford the cash-pay model to be dropped by their doctors.

Grandma and the Big, Bad SGR

December 8, 2011 By Peter Polack Leave a Comment

This video from the Texas Medical Association shows us the Medicare reimbursement issue from a child’s perspective.

Grandma and the Big Bad SGR!
A huge Medicare cut looms for doctors and Medicare patients. Who might that affect? People like grandma – and those who love her, as the child in this video shows. Unless Congress acts, on Jan. 1 doctors who care for Medicare patients face a 27.4-percent pay cut, because of a flawed funding formula called the SGR. Then millions of seniors (like grandma) and people with disabilities — and military families whose insurance is TRICARE — might have trouble finding a doctor´s care.

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The Six Myths of Concierge Medicine

September 8, 2011 By Peter Polack Leave a Comment

In his book Concierge Medicine, Stephen D. Knope MD discusses the six myths of concierge medicine:

Concierge Medicine is just for the wealthy. This is no longer true, he believes. “The cost of concierge medicine depends upon the services that are offered by the individual doctor…. and range from $1,500 per year to $15,000 per year.”
Concierge Medicine is just a referral source for specialists. Dr. Knope believes that concierge physicians have time to deal with most medical problems on their own without the need for referring to specialists, thus lowering the cost of medical care while improving patient outcomes.
Concierge care is too expensive because I still need health insurance. Although most patients still need catastrophic medical insurance to avoid bankruptcy in the event of serious illness, he believes that many people can lower their total medical care cost “by combining a high deductible health insurance plan with a health savings account (HSA). This can make concierge medicine quite affordable.”
Concierge doctors are greedy and don’t care for the underprivileged. On average, a concierge physician earns the equivalent income of a specialist, according to Dr. Knope, often seeing about 10% of their patients for free.
Concierge Medicine will only worsen the shortage of primary care doctors. Although he agrees that most doctors will decrease the size of their practice when they switch to a concierge model, he believes that this would be more than offset by the retention of physicians who are leaving family practice in droves, due primarily to frustration with a “broken system”.
Concierge Medicine is unethical. On the contrary, says Dr. Knope. Doctors who practice traditional medicine signed contracts with insurance companies in exchange for referrals, agree to ration care to help maximize profits for these companies, and in some cases are prohibited from sharing information with their patients.

(check out our related podcast: Is a Concierge Practice Model Right for You?)