3 Tips for Dealing with Frustrating Problems

Medical practice managers and physicians are faced with difficult, complex problems almost daily. When issues snowball into frustrating problems, your stress level is likely to increase, and your professional satisfaction is likely to decrease. Here are three tactics to help you better manage situations:

  1. Shift your focus. Sometimes when a situation you encounter at your medical practice doesn’t seem to be solvable, and you are at loggerheads, the most appropriate step might be to forsake the issue for awhile, and to focus on something completely different. For instance, it might be better for you to abandon what you’ve been doing, and seek to help someone else. Perhaps one of your colleagues needs help solving a different problem. By delving into that problem, you give yourself the type of break that you cannot otherwise experience when you’re entrenched in your own “stuff.” Helping somebody else within your office offers the side benefit of having others see you in a more positive light. After all, in the midst of your troubles you’re able to turn your attention to someone else. As a byproduct of helping others, sometimes you experience the “eureka effect,” the solution to your problem jumps out at you when you seemingly weren’t attempting to find a solution. Your mind works in mysterious ways. It’s working for you even when you’re not conscious of it. This is why you get great ideas while shaving or putting on makeup, certainly in the shower, and sometimes while resting in the hammock in the backyard.
  2. Acknowledge your emotions. When you ask yourself, “How do I feel right now?” and you’re accurate and honest with yourself, something strange and wonderful happens. By stopping and noticing how you feel, you can dissipate some of your feelings about being upset. The same works for being overly stressed or anxious. It’s as if the act of noticing how you’re feeling competes with the actual emotion itself and decreases its intensity. Perhaps competing energies cannot occupy the same space at the same time. Feeling upset and noticing that you are feeling upset, in a way, “compete” for the same space. Once you notice how you feel, you’re better able to make the leap from the raw feeling of experiencing to the potentially more beneficial one of noticing how you feel.
  3. Recognize that a problem comes with a solution. Charles F. Kettering, a co-founder of the Sloan-Kettering Institute, was a brilliant inventor in the last century, akin to Thomas Edison, but Kettering is barely known today. He perfected the diesel engine, chrome painting procedures, automobile ignition systems, and dozens of other innovations that transformed the automobile industry in the 1920s and 1930s. Kettering’s approach to problem solving was unsurpassed. He believed that the major distinction between a problem and a solution was that people more readily understood a solution. He noted that solutions involved merely a change in perception, since the solution to the problem must have existed all along, within the problem itself. A problem solver’s job was not to master a problem, but to make the problem generate its solution. When it comes to problems that you experience, perhaps even long-standing problems, a solution exists. And, as with Kettering’s insight, the solution has existed all along in tandem with the problem itself. When you lash out at someone, or experience headaches, hereafter, recognize that the solution does not lag the problem. You can explore the problem’s key questions, and the answers invariably generate solutions that you are seeking.


Source: physicianspractice.com

Five Ways to Say No to Professional Obligations

Despite a well-known songster’s suggestion that sorry is the hardest word to say, most of us find saying no even harder. Sometimes it’s because we’re uncertain about a pending decision, and other times it’s due to our own disorganization. But more often than not we hesitate to say no — even to things we know we’re not interested in — because we either don’t want to miss out on anything or, more likely, we don’t want to let someone down. As a result, many of us take the easy way out by saying yes to almost everything, which leaves us harried, hurried, and hopelessly overcommitted.

While saying a firm no can be challenging, it is also a skill that can be learned. Here are five recommendations to help you graciously get out of things you don’t have the time, the attention, or the enthusiasm for.

  1. Stop, drop, and listen to your gut. Even the smallest decision requires some soul searching. When you are presented with a choice, it’s important to stop what you’re doing, drop any distractions, and listen to what your inner guide is telling you to do. We all know at an instinctive level what we have the emotion, expertise, and energy to commit to, yet we often ignore that voice. From now on, pause for a moment to do a comparison of the rewards versus the repercussions of saying yes to yet another obligation.
  2. Ask yourself a question. No matter how enticing an opportunity may seem, participating in it is of no use to you if it doesn’t come with some degree of personal merit. While it may sound selfish, the only question that really matters when making a decision is, “Will doing this add value to my life?” That value may be emotional, financial, moral, or altruistic. Not pondering this question can skew your priorities and leave you battling to find balance.
  3. Buy some time. Snap decisions usually won’t serve your best interests. In fact, they can be detrimental to your reputation, especially when you constantly change your mind and need to back track. Many people spontaneously say yes simply to avoid the perceived awkwardness of saying no. When you reply to an invitation with a statement like, “I need some time to think about this. I’ll get back to you tomorrow with my answer,” you’ll be free to consider the consequences of committing.
  4. Stop apologizing. Do you trip over apologies every time you say no? Stop it! There’s no need to feel bad about making a decision that serves your greater good. “Sorry, I can’t make it. I’m so busy. Sorry! Did I say I’m sorry?” can be replaced with, “Thank you for inviting me. I’m unable to attend,” or, “I appreciate being included. I’m not in a position to participate.” If you feel compelled to give a reason for your unavailability, make it concise and conclusive by saying something like, “I have other commitments I need to honor.”
  5. Say it like you mean it. Confidence is the key. While some people, like author Anne Lamott, consider the monosyllabic word no to be a complete sentence, you can soften its blow by using three word responses to requests you’re unable to accept. For example, decline invitations by combining the three words no, thank, and you. Or, if someone specifically asks, “Are you available to spearhead this committee?” you can link the word no with the words I’m and not. Whatever you do, don’t say, “I wish I could, but …” unless you truly mean it. Many people will take that as the opening they need to continue to push you to change your mind.

Our daily decisions either limit or liberate us. And, as challenging as it can be to turn people, opportunities, and adventures down, remember this: Saying no to something you’re not primed for will always leave you open to say yes to something you’re passionate about.


Source: physicianpractice.com

Reducing Re-admissions with Care Transition Planning

Nearly one in five Medicare patients returns to the hospital within thirty days of discharge. With more than three quarters of these re-hospitalizations the result of preventable circumstances, providers have scrambled to identify areas of improvement. Recent research has shown that nearly a third of physicians blame hurried or incomplete hand-off procedures for an adverse event during hospitalization.

There are four major issues that often lead to readmissions:

  1. Lack of communication among providers and between the provider and the patient.
  2. Poor reconciliation of multiple drug regimens.
  3. Inability to exchange health information in a timely, electronic manner.
  4. Failure to educate patients about self-care programs to follow at home.

Research confirms that by working in a concerted, collaborative effort, providers can significantly improve care and reduce re-hospitalization by following these guidelines:

  1. Compare medication plans
  2. Communicate critical information
  3. Teach patients how to manage their own care

“Traditionally, doctors are trained in medical school to interview a patient and write daily summaries of the care plan but though vital to patient care, they rarely receive communication or handoff training,” said lead author Amy J. Starmer, MD, MPH, from the Division of General Pediatrics at Boston Children’s Hospital.  When trained in the use of a mnemonic device and EHR tool to help prompt more thorough communication, physicians were able to cut the number of preventable adverse events in half and significantly reduce medical errors. Instituting uniform procedures for common issues such as medication reconciliation and self-management for patients after discharge were effective in keeping patients out of the hospital.


Source: EHRintelligence



Six Ways to Foster an Environment of Patient-Centered Care

Building strong relationships with patients that take into account their needs, desires, quirks, and questions can be a daunting proposition. The Patient Experience Council (PXC) at The Sullivan Institute has released a set of guiding principles to aid healthcare organizations as they transition to a service-oriented mentality. These principles reinforce the notion that patients are the owners of their own health, and must be encouraged to create partnerships with healthcare providers in order to achieve the goals of the Triple Aim: reduced costs, improved quality, and a better patient experience.

  1. Clearly define roles for the care team and the patient: Patients should be educated about their responsibilities and accountability for their own health, but providers must also learn to adapt to their new role as coaches and partners, not just the writers of prescriptions or the givers of bad news.  Providers and patients must both clearly communicate their roles throughout the relationship wherever the patient touches the continuum of care.
  2. Conducting assessments of skills and competencies: Some patients are more able to take responsibility for themselves than others, and providers must establish a baseline of engagement, health literacy, and decision-making abilities before diving into a complicated care plan.  Providers must also match their skills and expertise with the level and type of services being provided in order to reduce the opportunities for misdiagnosis, mistreatment, or patient harm.
  3. Putting patients in the driver’s seat: The patient is ultimately responsible for making final decisions about his or her health, and providers should not force their opinions onto the patient.  Choices should be framed in a neutral manner with the support and expertise of the clinician providing a strong foundation for informed decision-making.
  4. Providing patients with access to their data: Patients must have the right and ability to access their personal health information, establish restrictions on who can view and edit their data, and decide how their data should be used.
  5. Ensuring data accuracy: Patient data must be as current and accurate as possible, and should be in a format that is easy and intuitive for the patient to understand.  Providers should ensure that patients have the opportunity to ask questions about their data or make corrections to applicable information in order to ensure accuracy and veracity.
  6. Adhering to privacy and security: Healthcare providers have the responsibility to ensure that patient data is stored and transmitted securely.  Only authorized, authenticated persons may access patient information, and providers must adhere both to HIPAA regulations and to patient access preferences across the care continuum.

By adhering to these guidelines, providers can foster better relationships with patients who feel more in control of their own care.  Healthcare organizations may see a significant return on their investment through better engagement, improved performance, lowered costs, and fewer health emergencies from responsible, accountable patients.


Source: EHRIntelligence.com

Stolen and Lost Devices are Putting Personal Healthcare Information at Risk

Amid a rising tide of compliance pressures, employee mobility, and high black-market values for personal identifiable information (PII) and personal healthcare information (PHI), security and risk professionals at healthcare organizations are dealing with staggering amounts of endpoint-related data loss and exposure when compared with other industries. However, many healthcare organizations struggle with low security budgets, and only about half secure their endpoint data through technologies such as full disk encryption or file-level encryption today.

By all accounts, we’re approaching a new order of integration between technology and medicine. Real time medical diagnostic data obtained from our mobile phones will soon be integrated directly into our electronic medical records where clinicians can use the data to make more accurate (and potentially dynamic) treatment plans. However, with all of this new patient data being collected by insurance payers, medical providers, and third-party services, there are many dangers presented when security and risk (S&R) pros don’t adequately protect PHI. Unfortunately, there are a number of systemic challenges that hinder these efforts to protect PHI, such as:

  • Unclear regulations surrounding endpoint data protection.
  • Perception within management that healthcare data is not an attractive target for hackers.
  • Modest security budgets.

Physicians will return from medical conferences wanting to try the latest clinical apps, information workers tasked with processing sensitive health insurance data will use consumer cloud storage tools to increase their productivity, and medical researchers will take patient data home with them on their personal laptops to save themselves from long hours in the lab. Whatever their role, healthcare professionals are not immune to the workforce mobility trends affecting all other industries.

As healthcare organizations gather and process greater amounts of PHI, data security initiatives become exponentially more important. S&R leaders must work to create awareness and understanding of the associated responsibilities and risks at the highest levels of the organization.

These radical new changes will create new challenges and responsibilities for already overburdened security organizations. However, there are several things S&R professionals can do to prepare for this transformation today:

  1. Move your controls closer to the data itself. Security pros apply most controls at the very edges of the network. However, if attackers penetrate your perimeter, they will have full and unrestricted access to your data.
  2. Look to new solutions for cloud visibility and data protection. Encrypt data before it goes into the cloud.
  3. Discover where the data is located, diligently control access, and watch user behavior. Always remember that every byte of data could contain information about patients. To protect this sensitive data, your first line of defense is to discover and identify where this data is located, and limit data access to only those individuals whose job function requires it.
  4. Focus on behavioral changes, not simply security awareness, for data security and privacy. Technology controls are important, but employee awareness and behaviors are another critical aspect of data protection.


Source: ehrintelligence.com

How Practices Can Improve Patient Payment Collections

How Practices Can Improve Patient Payment Collections

4 basic steps that may help practices do a better job collecting from patients:

  1. For new or infrequent patients, ask them to complete a package of materials before their appointment. Access can be provided online before the patient’s visit or the materials can be sent by mail or e-mail for the patient to complete before the visit. The approach taken depends on the practice’s technological capabilities and permission provided by the patient. Successful collection requires complete and accurate patient information.
  2. As discussed in previous blogs, a practice must be upfront about getting paid for its services! It should be made clear to patients immediately that they are expected to cover co-pays and known deductibles at time of service. Patients unwilling or unable to pay should be rescheduled; except in the event of an emergency. Having clear policies that are shared with patients can help a practice collect more fees upfront. Accepting credit cards can also make payment of fees more convenient for patients who prefer this option.
  3. As discussed in previous blogs, a practice must be upfront about getting paid for its services! It should be made clear to patients immediately that they are expected to cover co-pays and known deductibles at time of service. Patients unwilling or unable to pay should be rescheduled; provided, in the event of an emergency I would recommend the patient be seen. Having clear policies that are shared with patients can help a practice collect more fees upfront. Accepting credit cards can also make payment of fees more convenient for patients who prefer this option.
  4. Don’t wait too long to try to collect! In the first year, the probability of a practice collecting a past due account drops by 10 percent every 30 days. This means that the longer a practice waits, the less likely it is to collect.  Make sure you have an effective policy that combines letters and calls to patients and then send the bill to collection as soon as you complete the process. Make sure you work with an agency that lets you approve whether you want a patient to be sued and always use an agency that is licensed and has a reputation for acting lawfully and professionally. Don’t forget that a signed Business Associate Agreement is needed with any agency you choose.

There is no perfect way to collect patient payments, but every practice should have an effective policy, and it should tweak that policy until it gets the best results. Most practices will agree that leaving money on the table is simply not an option anymore!


Source: physicianspractice.com

Top 6 Practice Management Challenges Facing Physicians in 2015

Top 6 Practice Management Challenges Facing Physicians in 2015

Physicians still face mountains of red tape in the upcoming year

Challenge 1: Administrative burdens – A Kaiser study, from 2012, estimated that the nation’s physicians spend more than 868 million hours annually on prior authorization activities. Payers say prior authorizations hold down costs, improve treatment efficacy and ensure patient safety. To physicians, however, they are an obstacle to providing the best care for their patients.

Challenge 2: Independence vs. Employment – For some physicians, joining a large hospital system offers a haven from the rising administrative burdens of staying independent and from competitive pressures that can drive a small practice into insolvency. But joining a hospital system is not a panacea for the challenges facing physicians.

Challenge 3: Payers dictating healthcare – Physicians have to deal with a range of audits tied to meaningful use and other programs. The federal government can audit Medicare patients’ charts, while individual states can audit records for Medicaid patients, since they fund Medicaid, up to 10 years after a patient’s treatment, notes Tatiana Melnik, JD, an attorney specializing in technology and healthcare IT in Tampa, Florida.

Challenge 4: Patients dictating healthcare -Balancing the desire to practice quality medicine with the need to obtain positive feedback from patients promises to be a growing challenge for primary care physicians (PCPs) in 2015 and the years beyond.

Challenge 5: Staff retention – As more payers gravitate toward value-based payment models and increased emphasis is placed on effective team-based medicine, maintaining staff will be critical to practice success. Ask any consultant, and they will tell you that a practice is only as good as its employees.

Challenge 6: Avoiding liability – As a way to avoid potential liability, some physicians report practicing defensive medicine. Erring on the side of caution, physicians order more diagnostic procedures than might be necessary to head off litigation.

Source: medicaleconomics.modernmedicine.com

Multitasking: More Harm than Good

Multitasking: More Harm than Good in Medical Practices

More often than we care to acknowledge, in the office and at home, we invite more than we can handle.  As individuals, throughout society, we are trained to believe that the ability to multitask is a great attribute. Unfortunately, that’s a big mistake. Here’s why, and how to avoid multitasking in the future.

First things first: We are trained to believe that tackling multiple items at once is efficient and productive. But the fastest and easiest way to handle multiple tasks is actually to identify the most important task, second most important, third most important, and so on.  Then tackle the first and finish it all the way, move on to the second and complete it, then move all the way down the list. Ignore the temptation to multitask.

It’s almost as if juggling projects, switching gears unnecessarily or abruptly, or leaving a job unfinished to start a new project gives you the opportunity to say to other people, “Hey, look at me! Look how involved I am! Look at how busy I am! I’m great at multitasking.” A multitasker, however, can’t compete with others who tackle their to-do list one item at a time.

When you are working on a new task, brainstorming, engaging in first-time thinking, or doing creative work, it’s important to focus your complete and undivided attention to that one task. To dissipate your attention, in that case, means you are not going to do the best job.

Here are a few tips to reduce the temptation to multitask:

  • Give yourself five to ten minute stretches to focus on the task at hand
  • Safeguard your immediate environment to avoid interruptions
  • Acknowledge yourself whenever you stick to one task and finish it
  • Repeat all the above at least once a day, knowing that the more you can do these activities the better!



EHR Wish List

EHR Wish List

A number of articles recently decry the impact of EHRs on physician’s happiness and satisfaction. While there are only a few physicians out there who still contend the superiority (in terms of completeness, safety, and connectedness) of the paper chart to the EHR, most physicians concede the necessity of EHR, with only a few grumbles and complaints. Many still wonder why Google and Amazon both surpass the EHR in terms of connectedness, ease of use, and all-around technological goodness. For any EHR technologists or engineers out there, here is a list of wants and must-haves, for an “in-the-trenches” practicing physician:

  1. Help me recognize my patients. I cannot easily remember the names and faces of thousands of patients. I forget who they are married to, what they do for a living, and even our last conversation. It would be great if the EHR featured the same type of technology that allows those pop-ups when I am on my computer that are personalized to the last thing I was shopping for online.
  2. Allow me to communicate better with pharmacies. I have no way to “cancel” or “discontinue” a medication through the pharmacy other than picking up the phone and calling. This leads to medication errors and confusion all around. If TripIt, my travel app, can search my e-mail inbox and remind me of the details of an upcoming trip, why is the EHR unable to sync with the pharmacies and adjust the medication list in real-time?
  3. Reduce the need for my wet signature. If money can be moved electronically in vast sums with reasonable security, why can’t I electronically prescribe controlled substances? Surely it is easier to forge a paper prescription than an electronically generated secure fax.
  4. Allow for more than just plug and click technology for online scheduling of appointments. At my salon, I can choose from several dozen different services online — from facials to massages — with a dozen different therapists and aestheticians, and get the correct appointment for the correct “procedure” reliably. Plus, I get a text message alerting me to the appointment!
  5. Integrate more smart-software that supports my clinical decision making. My EHR has perfected the warnings that indicate a potential interaction if I prescribe an antibiotic to a patient with blue dye #5 allergy, which is almost never clinically relevant, but rarely will help me problem solve with decision trees and algorithms. In order to remain relevant, EHRs must redesign how they function to support physicians in their professional endeavors, the way technology supports us in the rest of our life.


Source: physicianspractice.com

Patient Portals

Patient Portals

One in three patients confirmed they have access to a patient portal, however, thirty-three percent of patients simply don’t know anything about the possibility of online engagement at all.  When asked by Software Advice about their online interactions with providers, those patients who have attempted to use portal systems generally expressed frustration, confusion, and annoyance with both the technology and the people behind it. Far from providing convenience and reassurance to patients, portals seem to be falling short of consumer expectations and providers may be partly responsible.

  • Thirty-four percent of patients said their top frustration with portals was unresponsive staff who didn’t communicate effectively, leaving patients to abandon the computer and pick up the phone.
  • Twenty-two percent also cited automated emails as a chief complaint, calling them impersonal and annoying.
  • Patients were also dissatisfied with the interfaces that patient portals present.  A third stated that it was difficult and confusing to find the information they wanted.
  • Eleven percent found that their records were stuffed with medical jargon when they did manage to locate their data.

The survey suggests that providers should spend more time explaining the benefits of portals to their patients, and pay special attention to educating patients about the availability of online access to their data.  When choosing a portal, providers may wish to focus on simple interfaces that can provide consumers, especially the elderly, with a user-friendly experience.  As healthcare organizations adapt to the increasing levels of patient engagement required by the EHR Incentive Programs, they may also wish to educate staff members about effective communication strategies and timely, helpful responses to patient inquiries that arrive through the portal systems.

Source: ehrintelligence