Healthcare issues are heating up. Take, for example, recovery audit contractors (RACs), Z-Picks (bounty hunters for the commercial carriers), Obamacare being challenged in the U.S. Supreme Court, the Office of Inspector General (OIG) "hit list" targeting providers for overpayments, fraud and abuse allegations, and 5010 playing havoc with our claims processing system. What else can go wrong?
Motivation, opportunity and rationalization. This may sound like the title of a new James Bond film, but in reality, it's the triad of factors that provides fertile ground for the internal fraud that is an all-too-common occurrence in dermatologists' offices. A recent survey by the Medical Group Management Association (MGMA) revealed that 82.8 percent of managers had worked in a practice that experienced embezzlement.
Dermatology Times welcomes Albert C. Yan, M.D., as the newest member to its Editorial Advisory Council. Dr. Yan is the chief of pediatric dermatology at Children's Hospital of Philadelphia, where he is also an associate professor of pediatrics and dermatology at the Perelman School of Medicine at the University of Pennsylvania.
The estate of a deceased patient has sued Dr. Mole for not making a melanoma diagnosis earlier. The plaintiff's attorney has offered a settlement agreement for $1 million. He is concerned about the settlement being listed in the National Data Practitioner Data Bank. His attorney assures Dr. Mole that as this late point in his career this will do little to no impact on his reputation.
On Call asked dermatologists around the country what they, or their practices are planning this year as they await a determination of what healthcare delivery will look like. Are they making any major changes, expanding or downsizing their practices?
Accurately coding for evaluation and management (E&M) services billed to Medicare requires mastering subtleties that aren't always spelled out in coding instructions, said Allan S. Wirtzer, M.D., medical director, Mid Valley Dermatology and Cosmetic Surgery Center, Sherman Oaks, Calif., at the 2012 annual meeting of the American Academy of Dermatology.
Physicians with the most satisfied patients aren't necessarily the ones who spend the most time with patients. Sometimes, even getting the highest-quality goods or services doesn't make up for a poor interaction.
In my early years in dermatology, there were many distinguished and acknowledged experts whose published findings became part of the core of the discipline. When they presented their findings at medical meetings or in print, one assumed that the data was valid and accurate, and it was often translated into specific management options for our patients.
On March 22, the GOP-controlled U.S. House of Representatives voted to repeal the controversial Independent Payment Advisory Board (IPAB), established by the new healthcare law now being challenged in the U.S. Supreme Court, and intended to provide a mechanism to control increasing Medicare costs. That, of course, has been sought by large numbers of physicians groups, including the American Academy of Dermatology Association.
Teledermatology just got a boost: A new study shows that "remote viewing" by skincare specialists improves the accuracy of dermatologic diagnoses in the primary care setting by almost 70 percent.
Experts estimate it takes six months to a year to convert a traditional dermatology practice with paper charts to one with an electronic medical record (EMR).
William Lascheid, M.D., was in his early 70s when he and his wife, Nancy, retired from four decades of dermatology practice. The couple lived in the lap of retirement luxury in Naples, Fla., and had dreamed about the days when they’d be free to sleep in and spend sunny afternoons by the pool.
The American Board of Dermatology has warned residents that the practice of using so-called “airplane notes” to cheat on certification exams is illegal, the board’s executive director says.
National report - Many mid-level providers get their dermatology training on the job, but continuing education and advanced training opportunities also are available.
Politicians on Capitol Hill once again have dermatologists - and all physicians who serve Medicare patients - wondering what in the name of common sense they are going to do. Just before Christmas, Congress delayed a 27.4 percent Medicare fee cut from its original Jan. 1 implementation date. The cut is now scheduled, barring any further congressional action, to take effect Feb. 29.
In 2009, the federal government launched its Electronic Prescribing (eRx) Incentive Program. Although this program (which was authorized in the Medicare Improvements for Patients and Providers Act of 2008/MIPPA) is now three years old, physicians remain confused about the details. Fortunately, the eRx Incentive Program is straightforward.
Analyzing 18th and 19th century (Victorian-era) paintings can help dermatologists think beyond their established habits and preconceptions in the search for visual and other diagnostic clues, says Irwin Braverman, M.D., professor of dermatology, Yale School of Medicine.
Dermatologists are increasingly turning to "extenders" - physician assistants and nurse practitioners - to combat a shortage of doctors in the specialty. These mid-level providers and the physicians who hire them say teamwork and training are among the keys for successful collaborations.
At various times throughout my professional career, I have frequently asked many older physicians this question: What was the best thing about practicing medicine during your career? I have always been intrigued by their answers.
The good news is that the battle over the budget in Washington has opened the door to serious consideration for reforming the formula used to pay physicians under Medicare. The bad news? Proposals being considered to pay the tab could bring considerable pain.
I have always looked for evidence of volunteerism on the applications of every candidate seeking a residency training position in dermatology. I've found that medical students who make the effort to volunteer their time to help someone in need truly make the best residents. They are generally caring, thoughtful individuals who recognize that the special gifts they have been given deserve to be "paid back" to society in some way.
A survey by Merritt Hawkins found that patients wait 22.1 days on average to see a dermatologist, with waits ranging from 3.4 to 104.4 days, depending on the geographical location. Physician assistants and nurse practitioners offer dermatologists an excellent way to expand their availability to more patients, but the value of these advanced practice providers goes well beyond scheduling.
Jessica J. Krant, M.D., M.P.H., says one of her goals at her Fifth Avenue, New York, dermatology practice is to go totally paperless. So she has implemented several online options - including appointment booking - that not only eliminate paper, but also help streamline the office's workload. "Patients love it," she says.
Superior service doesn't just happen. Experts say it requires having a proactive plan for an element of medical practice that many physicians unfortunately overlook. As physicians, says Victor J. Marks, M.D., "Service is what we do. We don't make or grow anything. We serve other people."
The Department of Health and Human Services is proposing a new rule that would allow patients to have direct access to their lab test results. The tests that dermatologists send, such as biopsies, can indicate serious medical conditions. On Call asked dermatologists around the country what they think about patients being able to access their lab results directly, without the benefit of the physician's knowledge and experience to interpret their meaning.
