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As patients take on more financial responsibility for their healthcare, dermatologists are finding themselves in a challenging new role - being a commodity in a marketplace where patients shop for services. Success in this new environment requires your dermatology practice to retain its current patients, and attract new ones.

The EHR Incentive Program offers bonus payments for eligible professionals who make meaningful use of a certified system. Although the government's initiative is labeled under a single moniker, there are really two distinct programs for eligible professionals: Medicare and Medicaid. When you register for the EHR Incentive Program, you must choose one or the other.

Succeeding in social media requires focusing on high-impact outlets, investing time and conveying a personal touch. Unlike word-of-mouth, today's social media allow people to connect with others outside of their traditional social circle without constraints of time or space.

The economic downturn has certainly affected your dermatology practice, decreasing patient volume and employee morale while increasing your overhead. The most significant challenge, however, may lie in the impact of the recession on your patients.

The number of older physicians who are practicing is giving rise to questions from groups such as the National Patient Safety Foundation. On Call asked dermatologists whether there was any process in their area for handling doctors whose mental and physical abilities might be diminishing, but who were unaware their ability to practice effectively was being hampered by slowing cognitive abilities.

From IT costs to insurance contracts, economic pressures are pushing solo practitioners and small private practices to join larger groups, sources say. But despite many physicians' belief that small dermatology practices are a threatened species, some predict that viable niches for well-run small practices will persist into the foreseeable future. Still, the numbers show a downward trend.

The movement toward quality EMRs for dermatologists is great. It will help providers have better notes and legible accounts of the patient-physician encounter, and it will also help with ICD-9 and CPT coding. In the end, however, providers still have to know what they did in the exam room, realize whether it is a chargeable event, and if it is, choose from an array of codes.

The anticipation is over: Registration for the government's incentive program for electronic health records (EHR) opened Jan. 3. Revealed in February 2009 as part of the then-new stimulus package, the legislation promoting EHRs was aptly named the HITECH Act - the acronym for Health Information Technology for Economic and Clinical Health.

The 2011 Medicare physician fee schedule published Nov. 29 by the Centers for Medicare & Medicaid Services (CMS) offers valuable insight into reimbursement for 2011. The final rule adjusts work relative value units downward for many services, but dermatology emerges as one of winners, getting a 4 percent increase overall.

One part of the healthcare reform package mandated under the Patient Protection and Affordable Care Act includes a measure to give physicians a financial incentive for developing "meaningful use" of their certified electronic health record technology. As I learn more and more about the meaningful use provision, I realize it involves a great deal more than just digitalizing patients' medical records.

Reducing patients' time to wait is certainly a noble goal and one that you should always strive to achieve. Eliminating wait time, however, is impossible for most dermatology practices. Steps you take to improve the quality of waiting time can do more than reduce frustration; they may turn the experience into a positive impression for patients.

Dr. Buttox travels to Europe to learn about a new botulinum toxin that is popular there. He understands he can't use the product in his office without FDA approval, but his marketing department gets him to discuss the product with the national press. Does the FDA have jurisdiction over Dr. Buttox in this instance, and if so, to what extent?

As the nation - and your patients - struggle with healthcare costs, building patient loyalty will be an important success factor for all dermatology practices. Outside of your own skills as a dermatologist, nothing builds patient loyalty as effectively as knowing how to manage the "moment of truth." The "moment of truth" occurs when a patient has the opportunity to make a snap judgment about the quality of your practice's services.

New dermatology criteria from the Certification Commission for Health Information Technology (CCHIT) can simplify electronic health record (EHR) purchasing decisions, sources say. But, so far, these criteria are driving few dermatologists to implement EHRs who weren't already planning to do so, these experts add.

Dr. Derm spends 10 percent of his annual gross earnings on marketing, much of which is Internet-based. He often finds himself telling his peers how wonderful Internet marketing is, until one day he finds out that a disgruntled patient has damaged his reputation on the Web. Dr. Derm is concerned that this malicious act may ruin his career. What can he do?

There is a battle brewing in Washington by men and women who wear white coats to work. It's a battle over the manner in which non-physicians, such as nurses and nurse practitioners, can market or promote their level of service and expertise, and it has resulted in legislation being introduced in the U. S. House of Representatives.

The adoption of electronic health records (EHRs) among dermatologists is hitting a stumbling block - namely, the onerousness of final "meaningful use" rules recently released by the federal government. The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) recently released guidelines for earning government incentives for implementing the paperless systems.

Mid-level caregivers are taking on an ever-larger role in dermatologic care. According to professional organizations, about 11,500 board-certified dermatologists practice in the United States. In addition, there are about 3,000 dermatology physician assistants and 1,650 nurse practitioners working in dermatology offices - or the equivalent of about one mid-level dermatologic caregiver for every 2.5 dermatologists.

Experts say a few clear rules will help physicians effectively engage patients via social media. They advise making a plan and writing a policy that delineates privacy and other requirements. Avoid postings that sound like sales pitches, and don't "friend" your patients.

Two years ago, Dr. Reputation noticed a slowdown in his practice, which he attributed to the poor national economy. Recently, however, other dermatologists have reported an upturn in their schedules. One day, a loyal patient tells Dr. Reputation that a popular physician grade website gives Dr. Reputation a failing grade. Can Dr. Reputation sue to find out the methods used by the website?