Hospital-based physicians, physician employment, and other physician services, continue to be a source of much discussion in today’s healthcare news. As the debate and experimentation ensues, physician and medical staff rights, responsibilities, and medical necessity require second guessing. This has increasingly become evident with the rise of litigation and defensive medicine. However, there is now a more accelerated development, given the need for hospital and physician integration for the provision of a miriad of physician services.
This article by Amy Lynn Sorrel with Amednews lightly touches upon a few aspects of this new and ongoing discussion.
Hospital TeamCare is proud to launch its newest physician services – Hospital Medicine, and Pediatrics. These newphysician services will be offered throughout all existing US market areas. The physician service-line expansion is a natural progression from the existing hospital-based physician services of emergency medicine and anesthesia currently offered by Hospital TeamCare.
With the demand for hospital physicians rising, Hospital TeamCare strategically developed its service line to fulfill this growing market. Hospital executives understand the positive impact hospital-based physicians have on quality, efficiency, and outcomes. “Given all the change in healthcare delivery, hospitals are turning to those service providers that deliver exceptional patient care, quality oversight, and that are fiscally responsible,” says Dr. James McLean, Vice President of Hospital TeamCare West.
Built upon years of physician experience, leadership, and success, Hospital TeamCare’s Physician Specialty Vice Presidents lead each division. “Our specialty divisions are led by accomplished physician executives who still practice and lead on a daily basis,” says Dr. Paul Pugliese, Vice President of Hospital Medicine.
Their new video spot titled “Our Physicians, Your Success”, couples the announcement of Hospital TeamCare’s service line expansion while underscoring the Company’s purpose. Dr. McLean adds, “We are very proud of our new video production, as it truly defines our purpose, capacity, and commitment to each of our hospital partners.”
Experience the perfect balance of clinical excellence, with a physician staffing, and management company, who understands the business of hospital-based physicians. Our physicians, your success – request Hospital TeamCare today!
About Hospital TeamCare
Hospital TeamCare is a leading provider of quality hospital –based outsourced physician services. We offer physician outsourcing in emergency medicine, anesthesia, hospital medicine, pediatrics, radiology, and urgent care medicine. For more information about Hospital TeamCare, our hospital services, or healthcare solutions, visitTeamCare.com.
As the use of smart phones among physicians increases, so does the concern for medical errors. Although there is sparse evidence to demonstrate clear causation, several are raising the question. Much like any other profession, physicians at times will check text messages, emails, etc., while working – multi-tasking. Unlike other professions, outsourced physician services may frequently use smart phones for drug reference, clinical correlation, differential diagnosis, formula calculation, grading, staging, medical records, or even telemedicine.
In this article by amamednews.com one doctor notes ”Getting distracted is not a feature of technology but a feature of the fact that people don’t multitask particularly well,” said Dr. Feldman, who uses an iPad at bedside to make notes and order medications and tests. “I used to be a primary care doctor, where I had a nurse popping her head into the office every three minutes to tell me something. The constant bombardment of distractions — that’s what being a doctor is. If you can’t safely manage that, then you should do something else with your life.”
Originally cited from the works of Dr. Donald Berwick and the Institute of Medicine, 6 aims for health care improvement remain prudent today. The following are the Institute of Medicine’s six aims for health care improvement for both hospitals and all physician services:
Safe – Operational systems are in place; implement protocols
Effective – Evidence-based protocols are developed collaboratively with physician and nursing input.
Patient-centered – Care is delivered to the needs and values of the patient.
Timely – Protocols eliminate unnecessary waiting.
Efficient – Rapidly identifies AMI/ACS
Equitable – All patients receive the same evidence-based protocol.
The Institute for Healthcare Improvement’s vision for healthcare adapted the IOM’s six improvement aims as follows:
No needless deaths
No needless pain or suffering
No helplessness in those served or serving
No unwanted waiting
No waste
No one left out
Although as administrator for CMS, Dr. Berwick’s statements and position were a subject of controversy, his original works, and those of his previous organization remain relatively undisputed. According to the 2011 edition of the National Scorecard on US Health system Performance, there continues to be substantial erosion in access to care, and rising costs. The US earned an overall score of 64 out of a possible 100 when comparing national averages with best practice performances benchmarks.
It’s clear that for physician services in today’s healthcare, we are still at the breaking point.
Hospital TeamCare, a leading provider of quality hospital-based outsourced physician services, introduces new video. The 60 second video captures the essence of physician services offered.
Experience the perfect balance of clinical excellence, with a physician staffing, and management company, who understands the business of hospital-based medicine. Our physicians, your success! Request Hospital TeamCare today! (800) 616-8236 www.TeamCare.com
Khat held by Vendor in Yemen: image via Wiki Commons
Chewing herbal amphetamine (khat) increases risk of death and stroke in patients with heart disease, so says researchers in a recent study published in Circulation: Journal of the American Heart Association. Researchers find that there are worse in-hospital outcomes among acute coronary syndrome patients who chew khat. In particular, khat chewers were more likely to present with ST-segment–elevation myocardial infarction.
Khat leaves (from the Catha edulis plant) have been chewed since ancient times by people in the Arabian Peninsula and East Africa. The use of khat has spread throughout Western Europe and into the United States. Hospital physicians must be particularly observant for this as an exacerbating factor for Acute Corornary Syndromes. Furthermore, all physician services should be cognizant of this herbal amphetamine.
“Global awareness of the negative impact of khat chewing on health and social life is warranted before it becomes endemic,” said Jassim Al Suwaidi, M.B., Ch.B., study co-author and Consultant Cardiologist and Director of Cardiovascular Research in the Department of Cardiology and Cardiovascular Surgery at Hamad General Hospital in Doha, Qatar. “This report underscores the importance of improving education about the cardiovascular risks of khat chewing as well as the need for further studies in the field.”
These physician researchers found the worse in-hospital outcomes were associated with patients with delays in seeking care after the onset of symptoms, and failing to receive thrombolytics or beta blockers. These core measures require strict adherence by hospital physicians. Additionally, it is clear that past medical history, travel, and social histories should be carefully explored in the clinical presentation of ACS.
It seems technology is advancing the lives of hospital physicians, allowing them to approach patient care more effectively and efficiently, while maximizing the capabilities of nurses.
“A Florida hospital has developed a system for wireless real-time monitoring and reprogramming of cardiac devices, including pacemakers and defibrillators, using an iPad. A doctor can suggest changes to a cardiac device’s settings, then relay the information for a nurse in the hospital to execute using a touch screen laptop,” as reported in “MobiHealthNews,” a publication that chronicles mobile technology trends within the healthcare sector.
The system, developed by E. Martin Kloosterman, MD, Director of the Electrophysiology Laboratory and Chief of the Cardiology Department at Boca Raton Regional Hospital, enables hospital physicians to lay out instructions for nurses to follow, allowing them to adjust their patients’ cardiac device’s settings. This saves the physician time, and ultimately, the hospital money.
“The project came to mind several years ago,” said Dr. Kloosterman, in a press release. “First, the evolution of the electronic medical records disseminated computer terminals with internet connections in the medical work space allowing clinicians ready access to patient information.
“Then recently, the iPad emerged providing the ability to be online in seconds anytime, anywhere, allowing remote access to computer information. The combination of these two new innovations led me to the creation of the new technology: the remote-K-viewer. I designed and constructed a dedicated cart that hosts the programmer connected to a touch screen laptop with a wireless internet connection and a printer. The remote-K-viewer cart is mobile and designed to be used by nurses or non-specialized physicians with minimal training.”
‘Data already has been successfully reviewed internationally as well as during airplane flights,” according to “MobiHealthNews.”
This system will undoubtedly enhance the lives of hospital physicians as well as outsourced physicians who are placed in various hospitals; it will encourage medical staff to work together and create more of a team-orientated environment.
“We are excited [about] the possibilities that this application has to offer in regards to the development of a new generation of programmers and service models in the near future,” as stated by Dr. Kloosterman (in a press release).
Hospital physicians, outsourced physicians and most other patient care providers have expressed mixed feelings about anticipated changes to Medicare Accountable Care Organizations. However, Centers for Medicare and Medicaid Services recently redesigned ACOs, making them more physician-friendly.
“As many as 270 ACO networks are expected to participate in the Medicare pay model that encourages physicians and hospitals to coordinate patient care in a way that improves quality and saves the program money. From 2012 through 2015, Medicare could save an estimated $1.8 billion and let groups share in $1.3 billion in bonuses for hitting savings targets, thus saving Medicare a net of about $500 million,” as reported in a news article, published by “American Medical Association.”
“As the cost of forming an ACO is high, physician practices will also benefit from the new advance payment initiative created through the Center for Medicare and Medicaid Innovation to provide financial assistance for physician-owned organizations,” said Dr. Peter W. Carmel, President of the American Medical Association.
The article further explained that a notable number of people representing the physician service sector [through a series of letters] had expressed disapproval of the proposed ACO rule; this is what brought about the redesigned ACOs.
The American Medical Group Association conducted a survey of its members earlier this year and the results found that “93% of respondents said they would not participate unless the proposed rule underwent major revisions.”
“We are optimistic that the model will get rolled out nationally on Jan. 1, 2012, with sufficient participation to allow the promise of this ideal of better, less costly, more coordinated care will become a reality over time,” said Donald W. Fisher, President and CEO of The American Medical Group Association.
Only time will tell, but it seems patient care providers can find some comfort in this news; considering all of the uncertainty physicians have been facing, I’d consider this a step in the right direction.
There’s no question – in the unpredictable, yet dynamic, world of healthcare, physician outsourcing is becoming a popular outlet among hospitalists.
Considering the increasing shortages of hospital physicians, economic pressures, and advances in tele-medicine, it’s no wonder the number of hospitals partnering with companies that offer outsourced physician services is a steadily increasing solution.
“The Hospitalist” recently ran an article that emphasized the fact that “hospitalists will likely encounter — if they haven’t already — outsourced physician services ranging from off-site medical transcription and language interpreters, to long-distance radiology and electronic intensivist services.”
“Our need to be able to harness technology to provide [a high] level of intensive care to patients, no matter where they are, is going to be very strong,” said Rick Wade, an executive with the American Hospital Association. “I think we will see more of this [outsourcing]. But I also think we’ll see a much greater emphasis on trying to train new physicians. Outsourcing is part of the same phenomenon as medical tourism.
“Hospitals that go this route are going to have a responsibility to demand high-quality physicians, demand Joint Commission certification, and demand to know the background and training of these [outsourced] physicians, because the patients and families are going to have questions. That’s part of the doctor-patient relationship that the hospital is going to create.”
Healthcare experts are predicting the physician-hospital employed model will likely continue to be a top trend in the healthcare industry for the next several years.
“Healthcare organizations are eager to augment market share and leverage large numbers of employed physicians for payer rate negotiations. That, coupled with the growing rate of physician employment opportunities, springing from hospitals throughout the United States, whether it be by direct hire or through physician outsourcing, is resulting in more physicians being placed in hospitals and other health systems,” as reported in “HealthLeaders Media.”
“I don’t know if it will be the complete demise of the independent physician, but I think the economic environment and regulatory one is driving physicians to look for something else other than independent practice,” says Mark Nantz, CEO at Greenville, S.C.’s Bon Secours St. Francis Health System. “The reimbursement cuts hurt these [independent] physicians. Plus, there’s strength in numbers and these physicians are looking for some strength when it comes to their [payer] contracting — getting a negotiation position of influence when you’re a one-to-two-doctor practice is hard to do.”
According to Nantz, hospitals employing physicians is a key strategy in light of the ever-changing world of healthcare that we are already beginning to experience.
“You’ve got to have the patients, and therefore, you’ve got to have the physicians,” said Nantz. “And the physician-hospital employed model is the most likely relationship to encourage doctors to lead the charge toward [care] transformation — so we can all survive and thrive in a post-reform environment.”
January 28, 2012
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