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How to destroy a great ER: A step by step guide Print E-mail
Written by Thomas Paine, MD | KevinMD   
Tuesday, 19 April 2016 00:00

I took a fantastic emergency medicine (EM) job when I finished residency. There was no question in my mind that it was the best job within a hundred mile radius, maybe more. When I first started, my expectations were met. My group held a contract to staff a busy but well-staffed suburban emergency department, and had held that contract for almost 20 years when I signed. The hospital was independent, locally administrated, and not part of a mega healthcare system. Its atmosphere was collegial and clinician-friendly.

The ER was well-staffed with all-star nurses and techs with experience. Everyone who worked in the hospital wanted to get a job in the ER. There were three nurses per nine-bed zone with a float nurse (gasp!) in each zone. Sure there were snags and busy days, but it ran about as efficiently as an ER could. The patients were well-cared for and generally pleased.

About a year after I took this job, a large regional health care system bought our hospital. It was called a merger, but we all knew otherwise.

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Last Updated on Wednesday, 20 April 2016 08:38
C-Section Rates Extremely High In Florida Print E-mail
Written by Sammy Mack   
Wednesday, 13 April 2016 00:00

Sammy Mack reporting for Health News Florida:

Florida hospitals continue to have some of the highest Caesarean delivery rates in the country, according to a new analysis out from Consumer Reports.

"People might find differences in nearby hospitals, so they really have to look at a map and at the rates and see what stories the numbers are telling," said Doris Peter, director of the Consumer Reports Health Ratings Center.

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Last Updated on Saturday, 16 April 2016 15:38
New Research Confirms Looming Physician Shortage Print E-mail
Written by Association of American Medical Colleges   
Thursday, 07 April 2016 00:00

Shortages Particularly Acute in Specialties Most Needed by an Aging Population

Under every combination of scenarios modeled, the United States will face a shortage of physicians over the next decade, according to a physician workforce report released today by the AAMC (Association of American Medical Colleges). The projections show a shortage ranging between 61,700 and 94,700, with a significant shortage showing among many surgical specialties.

The study, conducted by the Life Science division of the global information company IHS Inc., is an update to a 2015 report prepared on behalf of the AAMC and reflects feedback from the health care research community, as well as the most recent workforce data.

"These updated projections confirm that the physician shortage is real, it's significant, and the nation must begin to train more doctors now if patients are going to be able to receive the care they need when they need it in the near future," said AAMC President and CEO Darrell G. Kirch, MD.

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Debating inpatient vs. observation Print E-mail
Written by FHI's Week in Review   
Tuesday, 29 March 2016 17:06

Suneel Dhand, MD, in a March 26, 2016 KevinMD post, writes:

The observation versus inpatient distinction is rightly getting more media and public attention with each passing month. In a nutshell, for anyone reading who is not familiar with what this is all about, it's essentially a way of categorizing people when they get admitted to hospital.

You are either deemed an inpatient (basically a more complex case) or an observation (a less serious case). The individual reasons and checkboxes that have to be fulfilled in order to be an inpatient are beyond the scope of this article, but the distinction initially came from Medicare (at the federal government level) and has now been adopted by insurance companies too.

Because patients who are classed as observation are responsible for more out-of-pocket costs than those who are inpatients, there's little doubt that the intended consequence of this is to reduce central health care costs and shift more burden onto patients for the less acute cases. Even more worrying is that year by year, the criteria for being classified as an inpatient appear to be getting stricter.

Read more in the current issue of Week in Review>>

Last Updated on Tuesday, 12 April 2016 18:18
Physicians Choosing Concierge Medicine Can Double Revenue Per Hour Print E-mail
Written by Vera Gruessner |   
Friday, 25 March 2016 16:00

"We specifically analyze the revenue generated by physicians individually and collectively within a practice," Wayne Lipton, Managing Partner at Concierge Choice Physicians, told about his facility's revenue cycle management practices. "The revenue per hour in a concierge program that we set up is usually twice the revenue rate per hour spent than they would generate in a traditional practice."

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Last Updated on Saturday, 16 April 2016 15:14
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