The Journal of medical practice management : MPM最新文献

This was a retrospective, cross-sectional study to determine whether a relationship exists between work relative value unit(wRVU) awareness and wRVU accumulation among faculty physicians. Physician wRVU awareness was obtained by a distributed survey to faculty physicians in early 2016. wRVU accumulation was pulled from a faculty productivity database. Productivity data from FY14-FY15 was used to determine wRVU accumulation relative to each respondent's specialty-specific benchmark. Data were analyzed to investigate the nature, of the relationship between awareness and accumulation. The analysis showed that physicians with above-average awareness were significantly more likely to surpass their wRVU benchmark when compared to physicians with below-average awareness. Additionally, wRVU awareness accounted for a significant percentage of the variation in wRVU output. Considering the financial importance of wRVU generation for healthcare organizations, there is a need to devote more time and resources to developing physician awareness of wRVUs.

Under the Americans with Disabilities Act (ADA), a leave of absence may be a reasonable accommodation if it is likely to enable the employee to return to work. Employers should review their attendance and disciplinary policies to ensure that they are not violating the ADA when enforcing these policies. When an employee requests time off, the employer should determine the employee's rights under all of the relevant statutes if the request is related or possibly related to a disability. Importantly, the ADA is not a free pass for violations of an employer's attendance policy. Employers are within their rights to require doctor's note or other documentation to substantiate an employee's need for leave.

As the healthcare environment evolves, physicians are taking on new roles and responsibilities. In addition to clinical care, physicians must now be knowledgeable about administrative concepts and understand healthcare finances. However, these nonclinical subjects usually are not taught during residency training. Introducing these topics into all residencies in the form of standardized lectures, reading materials, and management rotations is a way to bridge the knowledge gap and better prepare future physicians as they enter the workforce. Currently, very few programs have a curriculum that addresses the required elements. Implementing a specific operating room management curriculum will, ideally, allow residents to gain practica and theoretical experience in this area and develop a better understanding of the scope of administrative medicine.

Patient care has changed over the years, primarily due to insurance issues and changes. Practices should go back to improving patient care by putting patients and their preferences and needs first. Scheduling an appointment should be an easy process for the patient. Wait times should be decreased, both for getting in to see the physician and while at the appointment. Training of staff to better accommodate the patient should be a priority. Patients need to feel good about your practice.

The default position of many healthcare systems seeking physician alignment is to acquire the practice and employ the physicians, but there is another approach that poses far less firancial risk to both parties and is far easier to undo if necessary: leasing the practice. The group stays as it is, but renders services for which the hospital receives the reimbursement and commits to paying the group a fixed amount for a stable quantum of work. Additional alignment features can be added, including medical directorships, comanagement, quality bonuses, and more. Potential problem areas include post-termination restrictive covenants and dispute resolution. Planning in advance for both fair market value disputes and addition of new practitioners is useful.

There are two distinct paths within a Patient-Centered Medical Home transfor- mation: one that centers on the completion of the application and another that focuses on the true care transformation. Either one without the other does not provide a true patient-centered medical home. A tremendous amount of work and resource allocation is required to complete enough of the 178 factors re- quired in the application process to achieve the level of recognition desired. A thorough and complete understanding of a practice's current state, readiness for transformation, and willingness to change is necessary before embarking on such an involved transformation.

Inpatient training is a fundamental aspect of undergraduate and graduate medi- cal education. Physicians in training spend considerable time interacting with patients in a hospital setting during their time in medical school, residency, and fellowship. This time is crucial not only for the trainees to develop their techni- cal and diagnostic abilities, but also to improve their interpersonal communica- tion skills. The need to improve the nontechnical skills of trainees has already been recognized at the graduate medical education level. Our study aimed to examine medical student perspectives on certain nontechnical aspects of the patient-physician interaction and the effect of student demographics and cul- tural and religious preferences on their opinions. The study found that two-thirds of students had never had their teachers discuss how posture could be used to facilitate the medical interview, and 85% of the students agreed that their cur- riculum should include discussions on the appropriate posture for patient com- munication in an inpatient setting. We believe integrating some form of cultural awareness and competency training into the curriculum at the undergraduate medical education level would help prepare future physicians for an increasingly diverse patient population.