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Renew Your NMA Membership and Receive a $50 Discount – Discount expires February 1, 2011!
It’s time to renew your membership with the National Medical Association. Your renewal allows us to be one-voice stronger in our effort to end health disparities and improve the quality of health care for minorities. With all of the important changes in health care – now more than ever, the NMA is dedicated to serving you and your professional goals. Don’t delay; take advantage of the $50 discount. Renew online today! Prefer to renew by phone? Contact Member Services at (202) 347-1895 ext 220 or 224.
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NMA News
Leonard Weather, Jr., R.Ph., M.D. installed as 111th President of the National Medical Association
Delivering his inaugural address as the 111th president of the National Medical Association (NMA), Leonard Weather, Jr., R.Ph., M.D. shared his plans to focus on health disparities, as well the issue of women’s health, and problems facing African American physicians during his administration.
Dr. Weather is the Director of Omni Fertility and Laser Institute, Clinical Professor at Xavier University, a former member of Xavier University Research Centers in Minority Institution Advisory Council, and a Past President of the International Society of Laser Surgeons. Weather also developed a laparoscopy procedure called Optical Dissection Pelviscopy.
Dr. Weather is also the author of "Why Can't We Have a Baby" and numerous articles on laser surgery and female disorders. In addition, he is formally the Chief of Obstetrics and Gynecology of New Orleans General Hospital, Secretary and Treasurer of Medical Staff of Humana Hospital, Vice-Chief of Obstetrics and Gynecology at Pendleton Memorial Methodist Hospital and Clinical Instructor at Tulane University Medical School. To read more
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Mark Your Calendar: 2010 NMA Scientific Assembly Certificates of Credit Available Online in September!
Registered attendees to the 2010 Scientific Assembly in Orlando, Florida may claim their CME certificates of credit online starting in September. To obtain credit and complete the activity evaluation please log-on to: www.nmanet.org. Attendees may claim credit for the 2010 Scientific Assembly via the website for up to 180 days post activity.
All AMA PRA Category 1 credit hours will be awarded to the registrant based on:
*Educational activity attendance
*Completion of the online or “on-site” activity credit form
*Completed evaluations
For additional information or clarification please contact the CME Office at: cme@nmanet.org
Take the NMA/ACS Prostate Cancer Survey and win an IPAD
In recent months, much has been made of changes in screening guidelines for breast and prostate cancer. The result of the controversy has been a lack of understanding and agreement on what these guidelines are and the implications for our patients' health. To this end the National Medical Association is partnering with the American Cancer Society and embarking on a study to assess current thoughts on the screening guidelines, how they are used in the primary care setting, and what resources physicians need to help communicate them.
The survey should take no more than 10 minutes to complete, and to encourage participation, every NMA member who completes the survey will be entered into a drawing to win an iPAD. During the 2010 NMA Scientific Assembly we announced the winner of one iPAD to a member who completed the survey. In order to collect additional data we have extended the survey for a few more weeks and will announce the second winner at the end of the survey release cycle.
Please take a few moments to complete this survey.
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2011 Scientific Assembly Call for Abstracts
The National Medical Association is currently accepting abstract submissions for its Annual Scientific Assembly in Washington, DC, July 23 – 27, 2011. Abstracts -- from all medical specialties and disciplines -- related to topics of health disparities are welcome.
Abstracts are due no later than Monday, November 1, 2010 but are reviewed on a rolling basis and early submissions are strongly encouraged.
To submit an abstract
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Practice Management News
5 Ways to Cut Overhead Without Layoffs
Physicians Practice (08/10) Beckel, Abigail; Michael, Sara
Physicians can lower their practice overhead without cutting staff positions by following a number of strategies, such as purchasing bulk office and medical supplies, and buying only what is necessary rather than automatically restocking overfilled inventories. Another strategy is to review facility costs and/or rent out extra space. Establishing a policy that all overtime must be sanctioned by a supervisor also can help reduce overhead. A fourth strategy is to comparison shop contracts for such services as phone and Internet, copier maintenance, and accounting and bookkeeping in an effort to get the best rates. Finally, cutting staff work hours can save money, and the reduction in paychecks can be less onerous to employees if more flexible scheduling is offered.
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Are You Using Checklists?
Journal of the American Academy of Physician Assistants (07/21/2010)
Checklists in the operating room can serve as effective tools to guard against memory lapse and to promote attention while also improving team performance, complying with standards of care, and protecting patient safety. The Agency for Healthcare Research and Quality defines a checklist as "an algorithmic listing of actions to be performed in a given clinical setting; the goal being to ensure that no step will be forgotten." Checklists can minimize risk and improve performance, especially in environments where many routine functions have been consolidated into a complex system. The simple checklist ensures that the most important steps are not forgotten. A study on the impact of using a 19-item surgical safety checklist shows statistically significant reductions in all measured events. The Safe Surgery Saves Lives program selected eight global locations with more than 3,700 patients for the baseline and nearly 4,000 patients after introduction of the checklist. The occurrence of any complication was reduced from 11 percent at baseline to 7 percent after checklist implementation, deaths dropped from 1.5 percent to 0.8 percent; surgical-site infections declined from 6.2 percent to 3.4 percent; and unplanned returns to the operating room fell from 2.4 percent to 1.8 percent. A similar study, the Keystone ICU project, revealed that catheter-related bloodstream infections were reduced from 2.7 infections per 1,000 catheter days at baseline to no infections at three, six, nine, 12, 15, and 18 months after implementation of the checklist. Checklists cannot solve every patient problem and can only be used in situations where discrete tasks can be identified and there is empirical support for those listed items. Effective checklist implementation also requires a pervasive culture of safety to already be present within an organization.
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Best I.T. Practices for Small Medical Practices
Physicians News Digest (07/16/10) Sullivan, Chris
Small and mid-size medical practices often are hesitant to implement information technology (IT) solutions due to concerns about the lack of in-house expertise or the time and money to devote to such projects. However, experts say I.T. can help them expand and improve both workflow and patient satisfaction. There are many things smaller practices can do to benefit from IT, and in most cases, a server solution that can accommodate upgrades and add-ons offers the appropriate infrastructure. Upgrading their infrastructure with a server solution or implementing electronic medical records can make it easy for practices to go paperless, which also helps them meet HIPAA and other government mandates for the secure use and storage of patient information. Practices should consider solutions with other security features, including automatic tracking capabilities and automatic updates. Additionally, they could boost productivity and improve care through mobile applications that allow physicians to look at lab results, read e-mail and text messages, and share information in real-time. Those that implement virtual communications tools can eliminate travel costs for staff meetings and training sessions, as well as allow physicians to consult with patients from remote locations. Finally, practices that offer remote access to files make it possible for physicians to see more patients during the day and complete documents at home in the evening.
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What Final Meaningful Use Rules on EMRs Mean for Doctors, Hospitals
Computerworld (07/14/10) Mearian, Lucas
The U.S. Centers for Medicare and Medicaid Services (CMS) has issued its final version of meaningful use rules, which the government will employ to qualify electronic medical record (EMR) deployments for billions of dollars in incentives. CMS decreased the number of quality measures from 90 to 44, and doctors only have to report electronically on three. CMS does little to push the electronic exchange of EMRs between hospitals and among states in the final rules, and there remains a rigid 2015 deadline for implementing EMRs as mandated by the Health Information Technology for Economic and Clinical Health Act of 2009.
According to the final rules, reimbursement payments for Medicare providers may commence no sooner than October 2010 for qualifying hospitals, and no sooner than January 2011 for eligible health care professionals; the rules permit providers to start EMR deployment in 2012, 2013, or 2014, and still have two full years to implement stage one standards, says GE Healthcare IT's Mark Segal. Health care providers only have to record 90 days of EMR data to disclose to CMS in order to be eligible for reimbursement, rather than 12 months as required in the preliminary rules; also, Segal says CMS amended the percentage of patients that had to be sent electronic reminders for care management, from 50 percent of all patients 50 years old or over to 20 percent of all patients 65 and over.
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A New Practice: The Doctor Will See You Today
Boston Globe (07/14/10) Arnst, Catherine
Dr. Dennis Dimitri, a family physician in the Boston area, moved to open-access scheduling after becoming vice chairman of the University of Massachusetts Medical School's Department of Family Medicine. Forced to spend less time at his private practice, he viewed same-day appointments as a way to prevent overbooking. Dimitri schedules patients in 15-minute increments, with patients calling as early as 9 a.m. for an appointment that day. Two to three hours per day are reserved for advance bookings, and there are openings for walk-ins or emergencies. Most appointments take less than the allotted 15 minutes, so he can easily accommodate emergencies and spend more time with patients as necessary. Staff also call or e-mail patients when it is time for their follow-up appointments. The practice has seen a decrease in no-shows, and even though his schedule is full, patients generally do not have to wait to be seen. While many physicians are hesitant to get rid of their appointment books, experts say the use of performance measures should change their minds over time.
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Doctor's Notes: You Can Read Them, but Should You?
Los Angeles Times (07/19/10) Roan, Shari
Researchers led by a team at Beth Israel Deaconess Medical Center in Massachusetts have launched a pilot program called the OpenNotes Initiative that will allow about 25,000 patients in Massachusetts, Pennsylvania, and Washington to read their doctors' notes on a secure Internet portal. The patients and doctors will then fill out questionnaires about whether the project helped or hurt. Some experts say allowing patients to read the doctors' notes will help them better understand their condition and improve communication and shared decision-making between the doctor and patient, but skeptics worry that the notes may confuse or upset patients.
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Taking Medical Jargon Out of Doctors' Visits
Wall Street Journal (07/06/10) Landro, Laura
About nine of every 10 adults have trouble following routine medical advice, mostly because they do not understand it, according to the Centers for Disease Control and Prevention. Two-thirds of state Medicaid agencies are calling for health material to be rewritten at a reading level between fourth and sixth grades. Poor health literacy can drive up healthcare costs and worsen patient outcomes. One study linked health illiteracy and poor health outcomes in a study of 14,000 diabetes patients. More than 50 percent of the patients reported problems learning about their conditions, and 40 percent needed help understanding the medical materials. These patients who struggled were 30 percent to 40 percent more likely to experience hypoglycemia than those with adequate understanding. Some insurers are responding to the problem with a software program that replaces challenging medical terms with more plain-language alternatives.
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Some Doctors Join Facebook, Twitter; Others Wary
USA Today (07/08/10) Rubin, Rita
Although some physicians have embraced social media as a way to educate patients and market their practices, others have remained wary because of time and patient privacy concerns. Most doctors who do participate in social media, however, say that they have had few problems using sites such as Twitter and Facebook, particularly if they keep an eye out for privacy. Jeff Livingston, one of the doctors at an Irving, Texas, OB-GYN practice who launched the practice's Facebook page, says that often one patient's question or problem is an opportunity to inform others who may have the same issue. Also, Livingston says, "the time is really not an issue. Just make it a part of your normal day." Interesting medical stories often get posted on Facebook and Twitter, but they can still be skipped if the workday gets too busy. Nashua, N.H., internist Kevin Pho wrote in a USA Today op-ed piece in January, pointing out that "there is little guidance on how physicians can incorporate [social media] into their medical practice." In acknowledgement of that problem, the American Medical Association's Council on Ethical and Judicial Affairs last month passed a resolution to "study the issue of physicians' use of social networking, as exemplified on sites such as Facebook and Twitter" and report the results to the AMA's House of Delegates at a meeting in November. One roadblock to physicians' use of social media, Pho said, is that doctors usually get paid only for talking to patients in the exam room, which gives them little financial incentive to communicate to them online. At the same time, Pho has pointed out that doctors who do not participate in online communication may also become marginalized.
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Physician-Patient E-mail Improves Quality, Study Finds
HealthLeaders Media (07/13/10) Carroll, James
A new study published in Health Affairs suggests that physician-patient e-mailing may improve the quality of care. Researchers at Kaiser Permanente followed 35,423 patients with diabetes, hypertension, or both over a two–month period. Those that used e–mail to communicate with their doctors saw a statistically significant improvement in measures from the Healthcare Effectiveness Data and Information Set. The study was a follow–up to a previous one, which found that e–mail communication could reduce the need for office visits by up to 10 percent and reduce the telephone calls to a practice by 14 percent.
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HP Offers Hospitals, Doctors EHR Help
InformationWeek (07/13/10) McGee, Marianne Kolbasuk
Small, independent physician practices are often widely distributed throughout the United States, making communication difficult. Affiliated hospitals can be helpful for informing these small practices about the government's meaningful use of health IT programs. Hewlett Packard has introduced a new program, HP EHReady, to help hospitals work with affiliated doctors to deploy electronic health records (EHRs). HP EHReady allows hospitals to use customized or standard marketing support services to educate affiliated physicians about programs to get them to deploy EHRs in their practices. The new offering also provides doctors with flexible financing options for purchases of HP laptops, desktops, tablets, scanners, and other gear necessary for healthcare IT. Hospitals that are assisting, supporting, or encouraging doctors to deploy e-health records can use EHReady to communicate to those doctors about the programs available to them. Beginning in 2011, hospitals and doctors will be eligible for financial rewards from the Centers for Medicare and Medicaid Services for "meaningful use" of healthcare IT, including EHRs, under the $20 billion-plus HITECH Act signed into law in February 2009. Despite the encouragement, only an estimated 20 percent of U.S. healthcare providers are currently using fully functional health IT systems. Hospitals can help in various ways, including offering affiliated doctors hosted e-health record applications, subsidizing a clinic's software purchases, providing discounts through volume deals with EHR vendors, or allowing doctors to access the hospital's e-health records systems.
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Physicians Starting a la Carte Pricing?
Hartford Business Journal (07/12/10) Orlosky, Michael J.
Physician practices have adopted new billing strategies in response to increasing expenses and falling reimbursement rates. Some are imposing fees for missed or canceled appointments or to fill out forms for schools, employers, or summer camps. Private contractual agreements that are legal and comply with the medical code of ethics are allowed, but physicians must inform patients of these agreements in advance. Insurers consider the completion of forms to be part of the basic office fee, and physicians cannot bill for forms filled out without an office visit. Also, billing an insurer for a no-show appointment is considered fraud, as no service was rendered. Some physicians are switching to boutique practices, in which the patient base is reduced and patients pay an annual membership fee for greater access to their doctors. However, critics says patients who lack the money for such VIP service are excluded from these practices. Meanwhile, the use of e-mail and video conferences by physicians and patients is not covered by insurers, although the healthcare field is moving in the direction of telemedicine.
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Computer Technology Helps Doctors Target Underserved Patients
Sify Finance (07/10/2010)
Researchers at Northwestern University Feinberg School of Medicine are using computer kiosks that feature multimedia talking touchscreens to target patients with a variety of language, literacy, and computer skills. These touchscreens deliver questionnaires, provide education material, and collect data from patients. The text on the screen has sound attached to it, and users press buttons to record their answers. This technology is currently in use for the Cancer Care Communication study, involving three Chicago-area cancer clinics. In the study, these clinics administer educational material to patients with newly diagnosed breast or colorectal cancer. Elizabeth Hahn, an associate professor in the department of medical social sciences at Feinberg, developed the touchscreens to help close the health disparities in underserved populations. Currently available in English and Spanish, the computer touchscreens allow people to complete questionnaires in their native language, at their own pace, with privacy. The study includes up to 200 study participants, half of whom received standard, printed educational information, and half of whom received the same information via the multimedia talking touchscreen. Hahn said: "Our goal is to demonstrate that information from a multimedia touchscreen can improve satisfaction with communication, knowledge, self-efficacy and adherence to treatment compared to information provided in standard booklets." Hahn says that she hopes every clinic waiting room will have talking touchscreen technology in the future, allowing patients to access information and feed their data into an electronic medical record after registering at the front desk.
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Private Practice: Surviving the Economy
Gerson Lehrman Group (07/04/2010)
A clinic-based internal medicine physician in central Arkansas writes about the steps taken to remain in a private practice. One step was opting out of Medicare, which has saved time on phone calls and paperwork, and more time to see private-pay insurance patients. Medicare patients are able to enter into a cash contract, and the physician has decided to be a provider for BCBS. The physician also cut payroll by firing the cleaning lady, dividing the office cleaning among the remaining employees, including the physician. Although the practice does not provide health insurance, it provides free medical care to employees and family. More outgoing physicians may also earn money by speaking for pharmaceutical companies, which can also be a networking opportunity. The physician also offers Lipo-Ex, a nonsurgical alternative to liposuction, lipodissolve, etc., for removing fat and tightening the skin. Cutting back on family lifestyle, such as limiting spending and reducing debt, also helps a private practice during a recession.
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Physicians Who Adopt EHRs Now Can Reap Benefits
Modern Medicine (07/01/10) Woodcock, Elizabeth W.
Physicians who have debated the purchase of an electronic health record (EHR) for their practice may now wish to do so for several reasons. The available technology has advanced significantly in the past 12-18 months, and moving to EHRs is not labor-intensive. The American Recovery and Reinvestment Act outlined a series of economic stimuli, including bonus payments, which take effect Jan. 1, 2011, for eligible physicians who successfully use a qualified EHR in a meaningful manner. The payments are available through Medicare (up to $44,000) and Medicaid (up to $63,750), and are intended to pay for, or offset, the cost of an EHR purchase. Physicians must also acquire specific technology to participate in pay-for-performance (P4P). Experts maintain that an EHR is necessary for successful patient identification, application of measurements, quality indicator reporting, and other tasks required by P4P programs. An EHR will also allow practices to go paperless, or at least minimize paper use, thus cutting costs and giving practices a marketing edge for gaining new patients and recruiting residents. EHRs can also help sustain patient flow and boost staff support.
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Mission of the NMA
To advance the art and science of medicine for people of African descent through education, advocacy, and health policy to promote health and wellness, eliminate health disparities, and sustain physician viability.
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NMA News e-newsletter is an executive summary of noteworthy articles pertaining to all aspects of the business and practice of medicine and is distributed every month to our subscribers. Subscriptions are free and available by registering here: Membership@NMAnet.org
Join President Lee C. Bollinger and notable alumni to discuss what inspires creativity, how to develop craft, and how Columbia contributes to creative development.
Brian Dennehy ’60CC
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