Physician Leadership-What should We Expect?

 

Kevin Pho MD in his blog KevinMD  has a guest post by Stephen C. Schimpff, MD who asks   “What should we expect of a physician leader today? “ 

Dr.Schimpff’s bio is very impressive, and perhaps the  most interesting feature is that he is now ‘retired’.  When I first started to  read Dr. Schimpff’s blog post I thought to myself.  ‘Who has time to lead, when one is fully engaged in the daily care of patients, administration, meetings, lectures, CME and the business of your medical practice (s)?’  . Very few indeed !

It is not enough for us to talk to ourselves, go to medical society meetings and trump the latest talking point from organized medicine.

Today we have a new means of leadership, the ultimate tool of democracy, a leader in revolutionary thought and a means of aggregating opinion, visible to all. Social Media, whether it is Facebook, Google +, Twitter Tumblr, Stumpleupon, or whatever.

I have a weekly Google + Hangout on Wednesday evenings at 6PM. Frequently there are several MDs, HIT  people, and a number of Googlers unrelated to health, but with many questions, and I am asked questions that surprise me. I take for granted everyone knows details of the impending Health Reform. Well, they do not. The questions are good ones, and it is a chance for me to give my own opinion, and knowledge with the filtering of organized medicine.

There is another option for Health Reform, and I have my own special forces team working on the mission.

del.icio.us Tags: google hangout,health reform,secret agent,physician leaders,kevinmd

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A New Blogroll

 

Health train Express felt it was a good time to review what some think are the best medical blogs.

Some view blogging as passé and moribund since social media seems to have surpassed blogging as a medium.  I disagree. I find social media as a way of driving traffic to my blogs. 

There are several sources, and without further ado, here they are:

Sponsored by Lenovo and Epocrates

Top Ten Clinical Medicine Blogs from blogs.com

Ten Top Healthcare Blogs (Medical Billing and Coding)

Life in the FastLane.com’

Meducation (Technology)

Top Health & Medical Bloggers (& Their Twitter Names

This list should keep you busy. Each of them brings something else to the table.  I found Top Health & Medical Bloggers and their twitter names the most interesting. This list should allow us to expand our social media networking.

I am wondering if my international readers would like to comment here or twitter me @glevin1 with their regional ‘Hot Blogs’ ?

Our next Google Hangout will be on

September 14, 2011

6 PM PDT

Invites will be sent out during this coming week. Watch for it on twitter, G+, or by email. Put Gary Levin in  your circles on G+ to be sure your Google Hangout Invitation arrives.

del.icio.us Tags: google hangout,top health blogs

 

 

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Primary Care Reimbursement

Quote of the Day:
God looks at the clean hands, not the full ones.
--Publilius Syrus

A hot button topic for primary care doctors has been about the imbalance of  RVUs allotted for patient visits to a primary care doctor, and the lack of procedure codes. Unlike specialists who have a potpourri of procedures, codes, modifiers to up regulate their fees (all legal and proper), the PCPs are left with  few to chose from.

One fear that specialists verbalize is that the ‘Medicare pie’ is only so big, and CMS is not going to increase it, so that if PCP gets more specialists will get less.

This is a strategic move on the part of CMS and HHS. It has always been this way, and that is why specialists want to continue to control the RVU process. Divide and conquer weakens our voices.

 

My opinion is that specialists must support their PCP referral base. If we do not then

1. Your referral base will disappear if your PCPs get wind of  your opposition

2. It is foolhardy to enjoy the fruits of medicine no matter what specialty you are in, while other MDs are suffering from disparate incomes. Any health reform must equilibrate the work/reimbursement ratios.

3. PCPs now must have at least three years of postgraduate training, unlike years ago when one year of postgraduate training made one qualified to practice general medicine

In addition to that the AMA has the copyright to CPT coding, something that every physician uses everyday. In fact that is one reason why only 165,000 licensed MDs belong to the venerable AMA.

The AAFP has begun a campaign to change the system. An article in the Wall Street Journal by Anna Wilde Matthews elaborates,

“Primary-care physicians are pressing the agency that oversees Medicare to change a payment system they say places a higher value on work done by specialists.

The American Academy of Family Physicians has sent a letter demanding changes to a committee that plays a key role in Medicare's process for setting physician payments. The academy wants the panel to add more members representing primary-care groups, among other adjustments.

The academy also has set up a task force to propose new methods for calculating Medicare reimbursement for many of the services provided by primary-care doctors.”

In an article published in 2005 by the Dean’s Newsletter at Stanford School of Medicine, the issues about CPT codes and RVUs points out the added complexity of valuing CPT codes.

Stanford University uses a “Funds Flow Work Group” . If ACOs come to pass, this may be the model for distributing income allotted to physicians. No matter what it is going to be a very interesting and challenging time.

del.icio.us Tags: primary care,specialty care,cpt,rvu,Stanford,aafp,ama

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Health Hangout Number 2

MARK YOUR CALENDAR----TODAY at  6 PM PDT    9PM EDT

The Second International Google+ Health Hangout Session will be held on Sept 7^th Wednesday at 6PM PDT 9PM EDT. You can find it by going to my stream at Gary Levin and look for the “I am hanging out “ Click on the “Join the Hangout tab”

For those of you who are not familiar with 'Hangouts” there is a video tutorial at:

Google + Video Tutorial Other information can be found at: www.google.com/+/ or just Google “The Google + Project “ .

You can also twitter me @glevin1. On the morning of the hangout I you will receive invites to all those in my “health hangout circle” and/or professional connections. If you follow my stream you will see a green “Join” tab. Clicking on it will bring you to the hangout. For those of you not on Google + I will send an email invite on Thursday AM at 9AM PDT and 12PM EDT.

Hangouts are limited to ten participants. If there are more than ten I will ask five in the hangout to leave every ten minutes to allow others to join. The Hangout will open 10 minutes before the listed times.

Google + has not been officially launched and is still considered in 'beta'.

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Google + And Health Train Express

 

Readers may have noticed my posts here have trailed off a bit. Rest assured I am well and not burned out on blogging. I have been immersed in social media. I have always had a small presence on twitter and Facebook, however I have been seduced and carried away by a  new love…Google +. Google + has a particular feature that I think can and will revolutionize the way physicians can interact in groups of up to ten.

The big ‘G’ has finally  struck it big once again. After many fits of spurts and stops, including investments and acquisitions in many  other smaller enterprises (which seemed to go nowhere) in reality it was all foundational and a learning experience for Google.

The list for the intrepid Google is on this Infographic   

Google learned much from these “failed whales”. In reality the investment paid off big time, not in immediately on their books, however Google plus despite what naysayers opine is going to be big time. They gained knowledge in the areas of streaming video and conferencing.   Users will not abandon Facebook or Twitter because each of those serves other purposes. Although this market niche is dominated by FB and Twitter, there are other players such as Linkedin which play an important role especially for professionals in health and business.

My particular enthusiasm is regarding the role of Google + Hangouts. The potential for physician conferencing for education, consulting, and even patient group education by physicians or assistants is there. It is already to be used, if physicians can be brought to the table. Perhaps as physicians become more comfortable with EMR and HIT they will accept Google + Hangouts more readily. 

Physicians seem to like ancillary HIT, ie, that not involved in the direct physician-patient interaction. Health 2.0, mobile apps, and tablets have gained a strong foothold. The entrance of the tablet PC is making a significant impact in the clinical setting for physicians.

Health Train Express is establishing a weekly “Hangout” on Wednesday of each week.  An agenda will be published here on the blog each week on Monday preceding the video conference.  Each week will be focused on different interests. This coming Wednesday will be organizational and I will need some help in choosing topics ranging from HIE, Health 2.0, Mobile apps, EMR, Incentives, Algorithms in Diagnosis and Treatment, Social Media and many more. 

Hope to see you there on this coming September 7th 2011 at 6PM PDT and 9PM EDT.

del.icio.us Tags: google +,google hangout,Health 2.0,emr,hie,hit,physicians,tablet pc,social media

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Health Hangout Post-mortem

Part I

The first hangout was shared by only a few of the best ‘hangers’. It was on short notice, however the time of the ‘H’ will better be placed in the evening after hours…Not many working stiffs (docs), not cadavers can take time to ‘hang’ right after lunch. Steve Eisenberg MD (oncology superior) from Poway Ca and I were ‘hanging’ when his nurse interrupted him for a phone call. He never quite made it back.

Be forewarned…hanging may interrupt and alter your office productivity. Also when leaving the room, mute your video and audio.  All the health care techs,, nurses and wannabees will come up to the screen to see who you are.

The next hangout will be in the evening, TBA.

So, if you  are a physician and want to ‘poo-poo’ social media, you do so at your own risk.

Here are some examples of what Social Media means to your patients.

Inventing Breakthroughs Day (800x450) from C3N Project on Vimeo.

Social Media Summit Scholarship Essay

MyIBD app for Crohn’s and Ulcerative Colitis

Social Media Summit Scholarship Essay - Jill Plevinsky

Social Media Summit Scholarship Essay – Corey Daniel King

Social Media Summit Scholarship Essay - Jim Pantelas

C3N - the Collaborative Chronic Care Network from Lybba on Vimeo.

When Patients Band Together

 

Tendon Surgery Facilitated by Social Media

 

The Top 10 Ways To Keep Social Media From Driving You Totally Nuts

 

del.icio.us Tags: C3N,social media,chronic care network,Health Hangout

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Hanging out on the Health Train

August 31, 2011   

Google + Hangout today at 1PM PDT, 4PM EDT.

Good Morning. Today I am hosting the first Hangout on Google + for Health Professionals, Physicians, and Health Information Professionals. Date: August 31, 2011: Time: 1PM PDT, 4PM EDT. Place: Google Hangouts. Search for Gary Levin and Click on the Green “Join” tab. Invites will be sent out at 12:30 PM today. The Hangout room will open at 12:50, sign in early since there are only 9 spots in addition to mine. The Agenda will be organizational. the Hangout and topics to be discussed and a forward looking schedule for the next six months.

Some possible topics: EMR Incentives, EMR adoption, ROIs are there any ? Experiences of Early Adopters. Thoughts on Diagnostic and Treatment Algorithms. Use of tablet PCs.

 

Or look for the  Join This Hangout   tab on my profile page on the right by searching for  Gary Levin in the search box on the main stream page of Google +. Sign in early, check your mic and video.

 

del.icio.us Tags: Hangout,Google +,Health Train,EMR,HIT

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