|
Physician Spotlight: Dr. Stuart Royal
Birmingham and in particular, Children's Hospital of Birmingham, never had a more loyal friend and advocate than Dr. Stuart Royal. Even though the 56-year-old pediatric radiologist has been recruited by world-renowned hospitals in larger cities, his hometown ties and desire to remain at Children's are strong. But he doesn't in the least feel as if he's sacrificed any opportunities by staying.
"I'm proud of Birmingham," Royal declares. "I think that most people don't know what we have here, but this is a city of world-class hospitals."
A second-generation physician, Royal came naturally to his desire to care for children. He saw his pediatrician father, Arnold Royal, care for young patients until the elder Royal was 79 years old. And the younger Royal seems destined to follow in his father's footsteps in terms of longevity.
By June Mathews - Posted: Tuesday, June 6, 2006 2:01 pm |
Architect's rendering of new Southwest Alabama Medical Center in Thomasville. |
|
Rural Hospital in Thomasville Set to Triple in Size
The year was 1963. The Beatles topped record charts with "I Want to Hold Your Hand." President John F. Kennedy was assassinated in a Dallas motorcade. Martin Luther King gave his "I Have a Dream" speech in Washington, DC. The average American earned $4,743 a year.
Closer to home that same year, the south Alabama city of Thomasville made local headlines when a brand-new hospital, the Thomasville Infirmary, opened for business. Like many rural hospitals around the country, the facility has worked hard just to stay afloat in the decades since, as the healthcare industry saw historic changes: Medicare, Medicaid, HMOs, magnetic resonance imaging, and computer-assisted tomography, to name only a few.
By Dale Short - Posted: Tuesday, June 6, 2006 1:59 pm |
Dr. William J.Weiner, FAANUniversity of Maryland School of Medicine in Baltimore. |
|
Parkinson's Experts Outline New Guidelines for Therapy, Diagnosis
Working to give people suffering from Parkinson's disease better odds at fighting the ailment while leading a fulfilling life, a group of experts has come up with new guidelines for diagnosing and treating the disorder.
The American Academy of Neurology wants to educate physicians on Parkinson's, a disease characterized by the steady loss of dopamine in the brain. A loss of dopamine leads to symptoms like shaking, stiffness, shuffling walk, slowness of movements, balance problems, small or cramped handwriting, loss of facial expression, and soft, muffled speech.
One of the tragedies of Parkinson's is that it is misdiagnosed in 5-to-10 percent of all cases. And autopsies determine that one in five people diagnosed with Parkinson's actually have another affliction.
By Tracy Staton - Posted: Tuesday, June 6, 2006 1:56 pm |
New 64-slice CT scanners, like this one at UAB, scan very quickly and at high resolution, allowing CT scans of the beating heart, among other benefits. |
|
Faster, More Powerful Imaging Available in Birmingham
Birmingham area hospitals and imaging centers are offering some of the newest, most powerful imaging technology available, allowing new diagnostic and treatment options for area physicians.
In MRI, several hospitals in the area, including UAB, St. Vincent's and Princeton, have recently added 3-tesla machines. The tesla number refers to the field strength of the magnet. Just a couple years ago, 1.5-tesla machines were considered high-field.
"The higher the field strength, the stronger the signal available," explains Dr. Martin L. Schwartz, musculoskeletal radiologist, Radiology Associates of Birmingham and a clinical professor of radiology at UAB. "MRI quality is based on a signal-to-noise ratio. The higher the signal and the lower the noise, the better quality image. The 3-T gives you that added quality, but it also allows faster scan times, and it gives you the capability to image areas, particularly small joints, much better than we've had the ability to in the past. The patient can have a higher quality scan in a shorter period of time."
By Deborah Lockridge - Posted: Tuesday, June 6, 2006 1:46 pm |
May 2006
Posted: Monday, June 5, 2006 4:25 pm |
May 2006
Posted: Monday, June 5, 2006 4:24 pm |
Building Bones Should Begin Early
Roughly 10 million Americans over age 50 have osteoporosis, and another 34 million have low bone mass which puts them at risk for osteoporosis, fractures and related complications later in life, according to the National Osteoporosis Foundation. By 2020, those numbers are expected to rise to about 14 million individuals over 50 with osteoporosis and another 47 million with low bone mass, and the number of hip fractures in the United States could double or triple.
Today, even with such a widespread problem, 70 percent of the nation's women with osteoporosis go undiagnosed and untreated. "It's due to a lack of knowledge and awareness among the public and healthcare professionals," said Dr. David Gams, an ob/gyn at Brookwood Medical Center. "It's a huge problem, because 30 million women in the U.S. are at risk, along with 13 million men."
The surgeon general's report, "Bone Health and Osteoporosis," said studies have found low usage rates for testing and treatment among the high-risk population, including bone mineral density testing, calcium and vitamin D supplementation and antiresorptive therapy. "Most physicians do not discuss osteoporosis with patients even after a fracture," the report states. "Even when physicians do suggest therapy, it often does not conform to evidence-based recommendations."
By Ann B. DeBellis - Posted: Monday, May 1, 2006 3:24 pm |
Breastfeeding Is Good for Mom, Too
Discussions about breastfeeding commonly refer to the benefits an infant receives from its mother's milk. But significant data now demonstrates the numerous benefits for mom as well. As a result, the issue of breastfeeding is high on both international and United States health care agendas, according to the American Academy of Pediatrics (AAP), and it is a topic to be addressed as we celebrate National Women's Health Week May 14-20.
The American College of Obstetricians and Gynecologists cites the following benefits for breastfeeding mothers:
- Reduces risk of breast cancer.
- Reduces risk of uterine and ovarian cancer.
- Lessens osteoporosis.
- Reduces risk of diabetes.
- Benefits child spacing.
- Promotes emotional health.
- Promotes postpartum weight loss.
By Ann B. DeBellis - Posted: Monday, May 1, 2006 3:20 pm |
Does Sex Matter? When It Comes to Medical Research, Yes
"A woman's body is the key to her fate. … Her physical, social and psychological fulfillment all depend on one crucial test: her ability to attract a suitable male and to hold his interest over many years." Those were the words of Dr. Robert Wilson, a noted New York gynecologist, in his now-controversial 1966 tome "Feminine Forever."
Yes, times have changed, but not quickly enough when it comes to the need for medicine and medical research that takes into account the biological differences between men and women. "Most of the research studies that were being done prior to 1990 were done on the male model. Then the results were applied to women with the assumption that there was no difference. Of course, as time has proven, there are many differences biologically between men and women in terms of diagnosis, the screening tests that are needed, prevention techniques, treatment options and symptoms of diseases," explains L. Jo Parrish, vice president of institutional advancement for the Washington, D.C.-based Society for Women's Health Research.
Parrish adds that medicine's tendency to conduct research using males "was even true with the animal model. Even the mice and the rats typically were males. So almost even from the bench-level research, the female model wasn't being used." She says that before 1990, most medical research done on women tended to deal with reproductive health.
By Sharon H. Fitzgerald - Posted: Monday, May 1, 2006 3:17 pm |
Virginia Ladd, AARDA President & Executive Director |
|
Women Battle Autoimmune Diseases Three Times More than Men
Last month, at the first national conference in Washington, D.C. of the American Autoimmune Related Diseases Association (AARDA), experts across the country in several different specialty fields agreed on two things … there's still much they don't know and much that typical Americans also don't know about autoimmune diseases but should.
"Looking strictly at the numbers, autoimmune disease is right up there with cancer and heart disease as a major health issue in this country," says Virginia Ladd, AARDA president and executive director. "Yet we have a Roper survey and other key measures that clearly indicate that autoimmune disease is not receiving the recognition it deserves – to the detriment of the health and quality of life of the tens of millions of Americans and their families who cope with these illnesses every day."
By Sharon H. Fitzgerald - Posted: Monday, May 1, 2006 3:12 pm |
Managing Menopause
As a woman ages, she begins to notice signs of menopause as estrogen levels start to decrease with the cessation of ovarian function. Her monthly cycle becomes erratic, hot flashes and vaginal dryness may occur, and she may start to notice extra weight around her middle. As true menopause occurs, these symptoms – along with sleeping difficulties and mood swings – may intensify and become major issues for 50 percent of all women, according to Dr. Jimmy Sparks, an ob/gyn with Sparks & Favor at Brookwood.
"We define menopause as permanent cessation of menses associated with a loss of ovarian activity," Sparks said. "Physicians can confirm the diagnosis by testing for an increase in both the follicle stimulating hormone and the lutenizing hormone levels. When both are elevated, it indicates a decrease in ovarian activity."
By Ann B. DeBellis - Posted: Monday, May 1, 2006 3:08 pm |
Southern Medical Association Celebrates Centennial Year
When the Southern Medical Association (SMA) convenes its Annual Scientific Assembly this October in Charlotte, N.C., it will be doing so in honor of its Centennial Celebration. For a century, SMA has been offering physicians and others in the medical professions information, education and services that promote the highest standards of medicine.
"We provide a complete armamentarium of practice management with resources for professional development, business development and financial management," said SMA's Executive Vice-President Ed Waldron.
"But I think the most important thing about the SMA is that we're an apolitical organization. We do not spend any time lobbying at the local or national level. Our goals are to provide a platform for total practice performance."
By June Mathews - Posted: Monday, May 1, 2006 3:05 pm |
Dan Sullivan |
|
Stroke Program Certification Effort Aims at Eliminating Lethal Mistakes
When someone suffers a stroke, the type of treatment they get in the first few hours can be absolutely crucial to their ability to survive or recover. But stroke treatment at a host of United States hospitals has lagged behind clearly outlined standards of excellence.
Out of more than 4,000 hospitals in the country, only about 200 have a certified stroke center, says Dan Sullivan, a doctor and lawyer who runs the Sullivan Group, which specializes in consulting with providers on patient safety, error reduction and risk management.
"That's not a lot," says Sullivan. "We need more, and we need to do a better job of taking care of stroke."
The absence of JCAHO-certified primary stroke centers has helped foster confusion about therapies like thrombolytic agents that caused widespread complications a few years ago, says Sullivan. Researchers discovered that the complications were often caused by a failure to follow clearly established protocols. The agents needed to be given to patients within the first three hours of a stroke – not four – and providers were failing to check glucose levels as required.
By John Carroll - Posted: Monday, May 1, 2006 3:00 pm |
Cost of Charity Soars as Complaints Mount
Hospitals provided a record amount of charity care last year, according to a new, in-depth report from a major accounting agency, but received little thanks for the work. Instead, aggressive bill collection practices, inconsistent accounting practices and a "broken" healthcare pricing system all conspired to give hospitals a painfully public black eye for charity care.
Meanwhile, a separate national report notes that physicians are providing less charity care than ever, even as the demand for it grows to alarming new heights.
Add it all up, says PricewaterhouseCoopers Health Research Institute, and the hospital bill on charity care for poor and uninsured Americans skyrocketed from $20.7 billion in 2004 to $27 billion last year.
By Tracy Staton - Posted: Monday, May 1, 2006 2:55 pm |
Dan Michael, MD, examines an X-Ray of a patient with a verterbal ompression facture. |
|
Birmingham Surgeons Use Innovative Treatment for Compression Fractures
Osteoporosis causes over 700,000 spinal fractures in the United States each year. Vertebral compression fractures (VCF) can result in kyphosis or dowager's hump, a debilitating condition characterized by chronic pain and increased mortality risk. Now, some Birmingham surgeons are getting results in the repair of VCFs using an innovative procedure called balloon kyphoplasty.
"This is so much better and safer than our previous treatment options," says Dan Michael, MD. In years past, physicians relied on bracing, combined with pain medication. There were several drawbacks. The narcotics could be addictive and hard for elderly patients to tolerate. And, says Michael, who practices orthopedics at St. Vincent's, "we couldn't reduce the fractures with bracing. People stayed bent over. The only way to restore height was with major surgery. We'd have to put a rod in there and pry it open, which most people didn't want."
By Steve Spencer - Posted: Monday, May 1, 2006 2:51 pm |
Drug Counterfeiters Gear up to Meet Growing Demand
Government probes have been helping to shine a harsh light on the growing global traffic in counterfeit drugs.
One group of federal investigators inspecting doses of what was being sold as the cancer drug Procrit® found that patients were getting non-sterile tap water. In another case, agents found that drugs marked as Zyprexa® – a powerful medication used to treat schizophrenia – were actually aspirin. And more recently, United States Customs agents have been garnering headlines for their work seizing fake batches of Tamiflu® at the country's borders.
With the price of branded drugs rising at a double-digit pace every year, regulators and the pharma industry have grown increasingly sensitive to the proliferating signs that counterfeiting operations have been growing by leaps and bounds.
According to the World Health Organization, about 10 percent of all pharmaceuticals on the market today are counterfeit, representing a market worth tens of billions of dollars. Estimates on the counterfeit trade in the United States are lower, but the FDA nevertheless estimates that counterfeits are used to fill 35 million prescriptions each year.
By John Carroll - Posted: Monday, May 1, 2006 2:46 pm |
Dr. Steven Nissen, Cleveland Clinic |
|
New Plaque Study Highlights Power of Crestor
In what many cardiologists are describing as a groundbreaking new study, researchers determined that high doses of the statin Crestor® actually reduce the level of plaque that is responsible for hardening arteries.
Over the course of 24 months, 349 patients took 40 milligrams of Crestor (rosuvastatin) a day. At the end of that time, patients taking the statin experienced an average reduction of "bad" low-density lipoprotein (LDLs) of 53 percent and an increase of 15 percent in "good" cholesterol, high-density lipoprotein (HDLs). Most remarkably, patients also experienced a reduction of 7 percent to 9 percent of arterial plaque.
"I think this is actually the first study ever to show that a statin actually reduced the atherosclerotic burden," said Dr. David Zhao, director of the cardiac catheterization lab and head of interventional cardiology at Vanderbilt University Medical Center. "In the past, many studies demonstrated you could slow progression of the atherosclerotic process, but never showed regression. I think it will have a very significant impact in terms of preventing coronary artery disease. Potentially, someone can slowly regress back."
By John Carroll - Posted: Monday, May 1, 2006 2:43 pm |
OPHTHALMOLOGY NEWS ROUNDUP
- New, smaller instruments allow suture-less incisions for vitreous surgery (surgery in the back part of the eye), allowing for faster recovery. Incisions about half the size of the 1 mm ones that have previously been required are so small they essentially self-seal. "Sutures on the external part of the eye really cause a lot of irritation of the retina and prolong the recovery time," says Dr. C. Douglas Witherspoon, founding partner of Retina Specialists of Alabama. "So any kind of instrumentation that can eliminate suturing externally on the eye is a big advantage."
- Witherspoon and his partner, Dr. Robert Morris, have developed two new surgical techniques.
- Hydraulic thrombotomy is used to treat retinal vascular occlusion, a common cause of blindness in young and middle-aged adults. The surgery involves inserting a needle into the retinal vein that delivers a pulse of saline to flush out the offending thrombus. This is followed by injection of a clot-buster drug to help prevent subsequent clot re-formation. "The procedure's still fairly early in development, but the results are really quite promising so far," Witherspoon says. "There hasn't been any good treatment for central retinal vein occlusion in the past, so this is something that can be very valuable."
Posted: Monday, May 1, 2006 2:39 pm |
A scene as it might be viewed by a person with glaucoma. |
|
Vision on Both Ends of the Spectrum
The field of ophthalmology has undergone rapid changes and advancements over the past decade. From a better understanding of genetic triggers for eye disease to new treatment options to improve patients' visual acuity, ophthalmic researchers are bringing renewed hope to those whose sight is compromised.
Millions of Americans currently have lost or are in jeopardy of losing the most basic of all the senses – their vision. A 2004 meta-analysis study funded by the National Eye Institute and conducted by the Eye Disease Prevalence Research Group looks at current and projected prevalence data for four major diseases – age-related macular degeneration, cataracts, diabetic retinopathy and glaucoma. The data was published in the April 2004 edition of the Archives of Ophthalmology (http://archopht.ama-assn.org).
"Blindness or low vision affects 3.3 million Americans age 40 and over, or one in 28, according to study authors," reported the NEI. "This figure is projected to reach 5.5 million by the year 2020."
By CINDY SANDERS - Posted: Monday, May 1, 2006 2:29 pm |
Drugs Offer New Hope For Macular Problems
New drugs are offering hope to patients with macular problems that previously were largely untreatable.
Anti-VEGF (vascular endothelial growth factor) drugs, which have been successful in helping treat colon and other cancers, appear to have great potential in ophthalmology.
When injected inside the eye, these drugs inhibit the growth of abnormal blood vessels and cause regression of existing ones, explains Dr. C. Douglas Witherspoon, founding partner of Retina Specialists of Alabama. This has been particularly helpful in treating age-related macular degeneration. "Prior to this, the treatment that's been available has primarily been laser treatment," Witherspoon says. "That's effective if certain conditions are present." But if the abnormal blood vessels caused by macular degeneration are located in the center of the eye, the laser treatment can damage the healthy tissue needed for vision along with the blood vessels.
By Deborah Lockridge - Posted: Monday, May 1, 2006 2:25 pm |
Dr. Sheila Dunn, Quality America |
|
How Safe Are You from Disgruntled Patients?
Just before St. Patrick's Day, a disgruntled patient walked into the office of Mountain Kidney Associates in Asheville, North Carolina. Patiently, John David Beavers waited until he was called back to the office of Dr. Brian Ling. When the two were alone together, Beavers fired two shots, killing Ling six days after the death of his son Michael Beavers, 25, a patient of Ling's.
The tragedy brings to the forefront an issue all healthcare providers are concerned about: How safe are you from disgruntled patients?
"An alarming number of medical workers complain about violence in my seminars," said Dr. Sheila Dunn, CEO of Quality America, an OSHA-compliance healthcare consulting firm. "When I ask if they've been verbally abused, usually everyone in my audiences raises their hand. When I ask if a patient has tried to injure them, about 25 percent do. The third question I'll ask is 'How many of you have ever had a patient pull a weapon on you?' and generally maybe seven or eight out of 200 will raise their hand."
By LYNNE JETER - Posted: Monday, May 1, 2006 2:21 pm |
Samford University Provost Dr. Brad Green and Dean Nena Sanders joined 14 faculty members from the Ida V. Moffett School of Nursing for the Centers of Excellence awards presentation in October. |
|
Moffett School of Nursing Named National Center of Excellence
The first nursing program in the state of Alabama to achieve accreditation by the National League for Nursing (NLN) in 1955 has again received recognition by the same organization. The Ida V. Moffett School of Nursing (IVMSON) at Samford University is one of only four nursing programs in the nation to be named a Center of Excellence in Nursing Education for 2005-2008, joining Excelsior College in Albany, New York; the University of Louisiana at Lafayette; and the University of North Carolina at Greensboro. Samford's program was cited for excellence in creating environments that promote student learning and professional development.
"This award gives distinction to the unique environment we have created where student learning and professional development is enhanced," said Dean Nena Sanders. "We are a learning organization, so not only do our students learn the skills to be a nurse, they learn how to learn. By becoming a lifelong learner, our students can sustain that learning throughout their nursing careers." Sanders added that students also engage in professional development throughout their education at IVMSON. "That enables them to be more engaged when they assume the role of a nursing professional," she said.
By Ann B. DeBellis - Posted: Monday, May 1, 2006 2:15 pm |
Physician Spotlight: Dr. Joyce Koppang
Mother's Day is a special time for all moms, but for Dr. Joyce Koppang, the surprises and joys of the day are multiplied several times over. Koppang, a cardiologist at Heart South Cardiovascular Associates in Alabaster, is also the mother of six kids: Peter, 12; Reneé, 11; Sean, 9; Nicole, 8; Christina, 6; and Ashley, 4.
"When I was growing up, I always wanted a large family and a career," says Koppang. "I feel very fortunate to have both."
Her ability to successfully lead such an active – and occasionally frenzied – life, says Koppang, can be attributed in large part to the willingness of her husband of 16 years, Brian Johnsen, to take on the role of a semi-Mr. Mom while pursuing his own work from home. Johnsen, who holds a Ph.D. in engineering, is in the process of obtaining a patent for a soccer device. He also coaches two soccer teams.
By June Mathews - Posted: Monday, May 1, 2006 2:13 pm |
Dr. Steven Schroeder- University of California, San Francisco |
|
QIOs Start to Modernize in the Wake of Harsh Complaints
For years, Medicare patients who had a beef with the government health program were directed straight to one of a host of Quality Improvement Organizations, private contractors set up as nonprofit groups.
But a recent report of the Institute of Medicine says the $300 million annual expense of operating 53 QIOs has delivered few real benefits for patients. Too many conflicts exist between the QIOs and the hospitals and physicians they're expected to oversee in terms of patient care and quality. Additionally, too few Medicare patients have ever heard of the network; and of those who have tried to use the system, only a small number of the people who leveled a complaint have ever been able to resolve them.
By Tracy Staton and John Carroll - Posted: Monday, May 1, 2006 2:08 pm |
AQAF Works for ''Transformational Change'' in Healthcare
As AQAF embarks on its Eighth Scope of Work over the next three years for the Centers for Medicare & Medicaid Services (CMS), the organization is undertaking some initiatives to help providers achieve "transformational change" in healthcare. With CMS challenging AQAF and all quality improvement organizations "to achieve more than they have ever done before," a couple of strategies could have far-reaching implications in improving the quality of healthcare and how that care is recorded.
One of the most important aspects of quality healthcare is the communication between physician and patient. As more diverse people and cultures move into our state, that diversity impacts the healthcare system. As a result, CMS is asking healthcare providers to become more culturally aware as they provide care to their patients. "Often, patients don't adhere to a doctor's instructions because they don't understand them or they don't understand how to take their medications," said Sandra Richardson, who leads the cultural initiative "Better Communication Better Care" for AQAF. "The importance of knowing how to properly treat patients from various cultures, religions and ethnicities can literally mean the difference between life and death," Richardson said. "Misdiagnoses and other medical errors account for between $17 billion to $29 billion in healthcare costs annually."
By Ann B. DeBellis - Posted: Monday, May 1, 2006 2:05 pm |
Therapist Jennifer Bell, MS, OTR/L, works with a patient on a closed circuit television for reading at the UAB Center for Low Vision Rehabilitation. |
|
UAB'S Low Vision Center Treats Whole Person
Ask anyone who works at a low vision center, such as the University of Alabama-Birmingham Center for Low Vision Rehabilitation, and they can tell you from experience that their services are important to helping people with serious vision problems. But because there have not yet been any scientific studies proving it, reimbursement for treatment can sometimes be a problem.
"If someone has a stroke, they automatically get rehab," says Dawn DeCarlo, OD, MS, director of the UAB Center for Low Vision Rehabilitation and associate professor of ophthalmology. "If they didn't, it would be considered malpractice. But a person can become legally blind and they're not really owed anything. I think that model is changing. Having scientific evidence that these things work will enable policies to be changed."
By Deborah Lockridge - Posted: Monday, May 1, 2006 2:03 pm |
April 2006
Posted: Thursday, April 27, 2006 2:51 pm |
April 2006
Posted: Thursday, April 27, 2006 2:50 pm |
To URL or Not to URL
The Internet is rewriting the rules of business in almost every industry. Healthcare is no exception.
Primary care givers, doctors and nurses, however, have been slow to adapt to the new reality, perhaps assuming that a Web site is not a necessity for great patient care.
Doctors and nursing provide hands-on services, of course, but a major part of the job is communication. For some patients, it's the only service. However in many medical practices, time to communicate is at a premium. And for a growing number of people, the Web is rapidly becoming their prime source of information.
In other words, if patients don't get it from the source, they'll likely go to the Web.
So, despite the title of this article, for doctors and nurses, it's not a question of whether, but of when.
Physician surveys generally find that only around 30 to 40 percent of doctors have their own Web site … nurses, almost none.
by Richard W. Oliver - Posted: Monday, April 3, 2006 4:19 pm |
R. Bruce Josten, executive vice president of government affairs for the United States Chamber of Commerce. |
|
Wal-Mart Promises Reform as the Retailer Braves Storm of Insurance Bills
With 48,000 workers, Wal-Mart easily breezes into the top slot of Pennsylvania's list of top 10 employers.
But the world's largest retailer also easily qualifies for another top spot it's less likely to claim bragging rights about. Of those workers, 7,577 – or about one in six, according to an analysis by the Philadelphia Inquirer –receive assistance, the highest number of employees from any private employer in the state.
Those kinds of numbers – repeated in headlines in states all across the country – have proven to be a public relations nightmare for Wal-Mart. As low-wage Wal-Mart employees turn to public assistance for medical care, a host of labor unions and community activists have seized on healthcare coverage as the Achilles' heel of the world's most profitable corporation. And unless it's able to fight off its dogged pursuers, the fight promises to cost the company dearly on the bottom line.
By Tracy Staton - Posted: Monday, April 3, 2006 4:15 pm |
Researchers Link Hospital IT Investments to Better Returns
As hospitals and physicians have steadily upped the ante on their investments in healthcare IT, there's always been a nagging doubt about just how much real value they were gaining in the transaction. True, a host of reports could point to the link between cutting edge technology and better care and improved patient safety, but the providers never really knew what – if any – hard financial return on investment was being achieved.
The absence of a demonstrable bottom line has proven to be a consistent deterrent for some providers still sitting on the IT fence. But a group of researchers feel that by looking at the numbers of a large lineup of hospitals in one region, they have helped expose the silver lining that is attached to the IT budget.
By John Carroll - Posted: Monday, April 3, 2006 4:11 pm |
— Dr. Peter H.R. Green |
|
Celiac Disease
When it comes to diagnosing celiac disease, doctors have to become detectives.
With its broad range of symptoms, celiac is a master of disguise … first pretending to be one condition, then another.
In February, Collins Books released a definitive new guide to exploring this under diagnosed autoimmune disorder. "Celiac Disease: A Hidden Epidemic," by co-authors Dr. Peter H.R. Green and Rory Jones, offers the dual perspective of patient and doctor. While written for a consumer audience, there is much the professional can gain from the book considering the pervasive lack of awareness about this disease in the American culture.
Green, professor of clinical medicine at Columbia University College of Physicians and Surgeons and director of the Celiac Disease Center at Columbia, says that ultimately celiac isn't hard to diagnose … a simple blood test will put you on the right track … it just isn't considered.
By Cindy Sanders - Posted: Monday, April 3, 2006 4:07 pm |
Few Alabama Hospitals Fit Niche for Critical Access Designation
A program initiated by the federal government to help struggling rural hospitals has not been widely used in Alabama. The Critical Access Hospital program, well-entrenched in other states, doesn't seem a good fit for most of Alabama's rural healthcare facilities.
In 1997 the Medicare Rural Hospital Flexibility Program introduced a program offering rural hospitals an opportunity to be designated as Critical Access Hospitals. The program's goal was to boost rural acute care hospitals by increasing Medicare reimbursement to cost plus one percent for facilities that qualified. Hospitals qualified for the program by meeting size, services, length of stay and proximity specifications.
However, the program has not been as advantageous to hospitals in Alabama as in surrounding states.
"It's all in the demographics," said Jane Knight, vice president of member relations for the Alabama Hospital Association. She said the program's specifications have not suited Alabama's hospitals as well as those of other states.
"At first, we thought there might be five or ten hospitals that would participate," Knight said. "But the bed count and length of stay are limiting factors."
by Jean M. McLean - Posted: Monday, April 3, 2006 4:03 pm |
Allergy Academy Defines Sinusitis and Its Treatment
Just reading the litany of symptoms is enough to make you sick – stuffy nose, post-nasal drainage, discolored mucus from the nose, facial pain and pressure, a toothache, cough, loss of smell, bad breath, headache and fatigue. Those are most, though not all, the woes caused by sinusitis, one of the most often diagnosed diseases in the United States.
But when physicians diagnose sinusitis, are they all singing from the same page of the hymnal? Not necessarily, according to the American Academy of Allergy, Asthma & Immunology. That's why the academy late last year released an updated practice parameter with an agreed-upon definition of sinusitis and new recommendations for diagnosis and management of the disease.
One of the reviewers of this new parameter was Dr. Brian A. Smart, allergist at the Asthma and Allergy Center of DuPage Medical Group in Glen Ellyn, Ill. An active member of AAAAI, Smart explains that sinusitis is "a very active field of research right now. Not so recently, we used to think of it as a problem of sinus infections only. More recently, we've come to realize that sinus infections are for many people a secondary process that comes from the primary process." And the primary process, quite simply, is inflammation of the sinus linings. The inflammation is usually caused by inadequate draining due to allergy, infection or obstruction.
By Sharon H. Fitzgerald - Posted: Monday, April 3, 2006 3:59 pm |
— Dr. Frank Virant |
|
Nuts Still Top the List of American Food Allergens
When Canadian coroner Michel Miron announced last month that the death of a 15-year-old Quebec girl allergic to peanuts was not the result of kissing her boyfriend, who earlier had eaten a peanut snack, Miron said he hoped to quell the "phobia" surrounding the tragic incident. Indeed, the worldwide media coverage surrounding Christina Desforges' November 2005 death, probably due to her asthma, illustrated how much medical science still does not know about food allergies – and how much the general public fears unpredictable allergic reactions.
Food allergy symptoms can "unfortunately be quite variable," says Dr. Frank Virant, an allergist with Northwestern Asthma & Allergy Center in Seattle, Wash. They can range from a little redness and irritation around the mouth to a swelling of the mouth and throat, vomiting and diarrhea, hives, wheezing, a rapid drop in blood pressure and even death.
By Sharon H. Fitzgerald - Posted: Monday, April 3, 2006 3:54 pm |
Stinging Insect Sensitivity a Hot Topic for Summer
With the advent of warmer weather, patients with stinging insect sensitivity must be more alert, and physicians may need to be more aware of the latest guidelines for treatment.
Dr. Susann Kircher, Allergy & Asthma Center of Birmingham, has served on the Insect Hypersensitivity Committee of the American College of Allergy, Asthma and Immunology for three years now. The committee provides recommendations to the association's board of regents and monitors and implements programs in the area of insect allergies and hypersensitivity.
Kircher says that allergy shots for stinging insects are particularly effective. "Usually I strongly recommend it; patients can be 97 percent cured for venom anaphylaxis. It's one of the few times I'll actually say I think we should do allergy shots."
By Marti Webb Slay - Posted: Monday, April 3, 2006 3:51 pm |
Asthma Drugs: The Air Has Not Cleared Yet About Usage Issues
A relatively new asthma drug, Xolair®, is proving to be quite effective, if expensive, for allergic asthmatics. At the same time, a new FDA warning raises questions about the use of long-acting beta-agonists (LABAs) as an asthma treatment. Local allergists share insights about the use of these medications.
Alabama Allergy & Asthma Center did some of the initial clinical trials on Xolair, an injectable medication that's used for allergic asthma. "One of the Catch-22s of people with asthma is they clearly have allergic triggers to their asthma, but their asthma is too unstable to actually go on allergy shots, which they would benefit from tremendously because that's the root of it," explains Dr. Clara Chung."Your asthma must be in control to be on allergy shots."
She says Xolair, which blocks IgE and fights all allergies nonspecifically, is "a remarkable drug. It works very quickly so you don't have to have the buildup process. It's been a miraculous drug for a lot of moderately severe to severe asthmatics."
by Marti Webb Slay - Posted: Monday, April 3, 2006 3:46 pm |
— ACP President Dr. C. Anderson Hedberg, FACP. |
|
ACP Warns of Pending Primary Care Crisis
Each year the American College of Physicians holds a media conference at the National Press Club in Washington, D.C. Typically, the organization covers a variety of topics pertaining to internal medicine. But not this year.
"We made this a single-issue press conference … it's a crisis," says ACP President Dr. C. Anderson Hedberg, FACP, of the growing concern over the future of primary care practitioners.
Currently, says the board-certified internist, the organization's membership is split about 50/50 between general internists and those in subspecialties. However, those percentages are not expected to hold up in the future. Hedberg says long hours and low reimbursement rates in the field of general internal medicine are driving young doctors toward specialties.
"The number of medical students choosing primary care internal medicine has dropped dramatically," Hedberg states. "In 1998, approximately 54 percent of our internal medicine residents chose that track. By 2005, it had dropped to 13 percent."
He points out that doctors are like everyone else, they want to have families and a life outside their practice. Young interns see the high patient loads and low reimbursement rates and opt for more lucrative specialties.
Dr. Floyd Buras, president of the Louisiana State Medical Society, agrees. "Medicaid pays about $37 for an office visit." But an ear, nose and throat doctor makes $1,000 for taking out someone's tonsils, and can do five of those surgeries in one morning. A primary care physician has to see more than 100 patients, which takes a week and a half, to make the same amount of money.
by Cindy Sanders with Ted Griggs - Posted: Monday, April 3, 2006 3:39 pm |
Jennifer Miller, JD, MGMA |
|
Desperately Seeking Simplicity
It's the very first step in the reimbursement food chain … being credentialed by public and private payers.
Unfortunately, it is also a step rife with complexity, redundancy and sometimes seemingly endless delays.
Jennifer Miller, JD, external relations liaison in the government affairs division of the Medical Group Management Association, says there are two key issues tied to credentialing: 1) the timeliness of the process and 2) the administrative burden.
MGMA has recently joined forces with the American Academy of Family Physicians and the American Health Information Management Association to form the Healthcare Administrative Simplification Coalition. As a group, HASC is looking at a number of issues that needlessly complicate the practice of medicine.
By Cindy Sanders - Posted: Monday, April 3, 2006 3:35 pm |
Dr. Dennis Boulware, senior associate dean for medical education at UAB, examines a patient. |
|
Reimbursement Issues Leading To Shortage Of Primary Care Physicians
"Primary care, the backbone of the nation's healthcare system, is at grave risk of collapse due to a dysfunctional financing and delivery system."
That's the first line of a recent report from the American College of Physicians, which predicts that unless reforms take place in reimbursement and other areas, "within a few years, there will not be enough primary care physicians to take care of an aging population with increasing incidences of chronic diseases."
Very few young physicians are going into primary care, the ACP reports, and 35 percent of physicians nationwide are over the age of 55, nearing retirement age. In 2003, only 19 percent of first-year medical residents planned to pursue careers in general medicine. Among third-year internal medicine residents, only 27 percent planned to practice general internal medicine – compared to 54 percent in 1998.
By Deborah Lockridge - Posted: Monday, April 3, 2006 3:30 pm |
(L-R): Tommy Waddell, President of Red Mountain Imaging; Lisa Beard, Executive Director of MGMA, Alan Bailey and Jonathon Ledbetter of Red Mountain Imaging at the recent MGMA spring conference. |
|
Alabama MGMA Among Top In Nation
Alabama is thinly populated. The city of Chicago boasts more inhabitants than our entire state. Yet Alabama is the home of the second largest Medical Group Management Association in the nation. The Alabama MGMA has more members than the MGMA chapters in California, New York, and Texas, to name a few. How has such a robust organization developed here?
An obvious ingredient in this success is leadership. Active members have served on committees and worked as officers. And the association is blessed with an energetic executive director, Lisa Beard. Since she arrived in 1995, the Alabama MGMA has grown from 300 to over 700 members. "It's really been a great, steady growth," Beard says. "I can't say that any one thing has contributed to it. I think we're just providing what our members need."
Members trust the Alabama MGMA to defend their interests. Recently, the association worked with MASA (Medical Association of the State of Alabama) to help physician practices avoid a potential financial loss. Earlier in the year, Medicaid had incorrectly coded certain procedures. After discovering the error, Medicaid wanted to recoup the funds, even though physicians had already been paid. Donna Wood, past MGMA president, and Cary Kuhlmann of MASA worked tirelessly, ultimately convincing Medicaid to rescind the repayment request. This was a huge help to MGMA members. One administrator told Lisa Beard that it saved his practice $15,000.
By Steve Spencer - Posted: Monday, April 3, 2006 3:27 pm |
Physician Spotlight: Bruce W. Brown, MD
In November 2000, Dr. Bruce Brown took a break. After 10 years in a busy internal medicine practice in Beaumont, Tex., Brown wanted to spend more time with his family. He was also suffering job burnout and needed time for some soul-searching.
"I wasn't even sure I still wanted to be a doctor," he says.
But 18 months and a healing dose of Caribbean sun and sand later, Brown was ready to return to medicine. His priorities, however, had changed. With no desire to return to the pace of his previous practice, Brown had spent part of his sabbatical considering the merits of a hospitalist practice. Thus the seed for Hospital Care Associates, PC, was planted.
The need for hospitalists, says Brown, has risen over the past few years due to crackdowns in insurance reimbursements. As a result, some primary care doctors are opting for the cost efficiency of office-only practices; others are choosing to specialize since medical insurance pays more for procedures than office visits. These changes in the delivery of medical care have left a gap in routine hospital care, one that hospitals have recognized and are seeking to fill with hospitalists.
By June Mathews - Posted: Monday, April 3, 2006 3:21 pm |
Generic Drug Backlog Sparks a Fight Over User Fees
WellPoint has employed every strategy in its pharmaceutical armory to prod its members toward low-cost generic drugs. The country's largest managed care organization has negotiated lower prices, issued alerts to members and offered free trial periods to make sure that they heard loud and clear that generics would cost them less and do them just as much good as any branded drug that they may hear about on television.
It's been rewarded by one of the highest loyalty rates to generics in the country. WellPoint's members will choose a copycat generic over a branded equivalent 96.7 percent of the time. And the organization can convert a majority of its members to a new generic drug in the space of weeks.
Those efforts, multiplied by those of a host of managed care companies and public health programs, have had a major impact on drug costs. Overall, the Centers for Medicaid and Medicare Services fingered increased use of generic drugs as one of the key factors in the lower growth rate on drug spending recorded in 2004.
By John Carroll - Posted: Monday, April 3, 2006 3:18 pm |
Frank Tobin, CPA and vice president, MediSYS. |
|
Coding Key to Making Reimbursement Work for You
There's a vicious cycle going on in physician's offices, says Frank Tobin, CPA and vice president of local medical billing and information technology firm MediSYS. Doctors try to see more patients to make up for stagnant reimbursement rates. "When physicians have 20 people in the waiting room, they tend to not make as complete a note as they might otherwise. Because of that, they feel compelled to make the coding less than it would be otherwise, therefore they receive less reimbursement, they try to see more patients to make up for it, and they're under even more time pressure."
Not only are reimbursement levels stagnant, Tobin says, but the whole reimbursement process is harder than it used to be, requiring more documentation.
"The degree of difficulty in submitting a claim today and having it paid must be 30 or 40 percent more difficult than it was five years ago," he says. "You have to have extra staff people, and you have to have more sophisticated staff people. There are a lot of things that can be done with software to help, but in the end, you or your staff still has to fish out the necessary information that five years ago wasn't necessary."
By Deborah Lockridge - Posted: Monday, April 3, 2006 3:14 pm |
Dr. Kenneth G. Varley, medical director of Southern Pain Specialists, is pictured with the new iDXA system. |
|
No Bare Bones Approach to Pain
Southern Pain Specialists is the first in the South to acquire a new bone mineral density system that will help detect, diagnose and monitor treatment of osteoporosis.
According to a 2004 United States Surgeon General's report, 10 million Americans over the age of 50 have osteoporosis, while another 34 million are at risk for developing the disease. Each year, approximately 1.5 million bone fractures are attributable to osteoporosis. But early detection and treatment, which can include diet as well as medication, can slow the progress of osteoporosis and avoid fractures.
"We want to help primary care physicians identify those patients at risk," says Dr. Kenneth G. Varley, medical director of Southern Pain Specialists.
By Deborah Lockridge - Posted: Monday, April 3, 2006 3:10 pm |
Despite Cuts, Doctors Still Taking New Medicare Patients
Despite Medicare reimbursement cuts and a chorus of complaints from physician groups, doctors are still accepting Medicare patients at the same rate, according to a study by the Center for Studying Health System Change. But doctors say that without a reimbursement fix, it's only a matter of time until doctors start closing their doors to new Medicare beneficiaries.
Almost 73 percent of doctors said they were accepting new Medicare patients in 2004 and 2005, up slightly from 71 percent in 2001; among family physicians, the increase was even greater, to 65.3 percent from 61.7 percent. This is in spite of a 5.4 percent cut in reimbursements that took place in 2002; that rate cut was largely reversed by increases in reimbursements from 2003-2005, the Center said.
"Despite fluctuations in both Medicare physician payment and access during the past 10 years, Medicare beneficiaries' access to physicians remains high and is on par with physician access for privately insured patients, even though Medicare payment rates average about 20 percent less than private insurance rates," said HSC senior researcher Peter J. Cunningham, PhD, coauthor of the study along with HSC health research analyst Andrea Staiti and Paul B. Ginsburg.
By Tracy Staton - Posted: Friday, March 3, 2006 4:39 pm |
IT Budgets Swell as New Technology Continues to Gain Adherents
In the healthcare world, 2006 may mark a watershed year for investing in information technology.
Looking over the landscape of healthcare budgets, the influential accounting firm PriceWaterhouseCoopers' Health Research Institute concluded that the healthcare industry will devote five percent of its collective budget this year to new technology that will improve care, speed collections and spur the flow of data needed to track individual and institutional performance standards. That marks a major buildup in spending for an industry that has historically reserved only two to three percent of its budget for IT and that years ago gained a reputation as a stubborn shirker in the technology revolution.
The investment that has already been made has been paying off handsomely, says the accounting firm.
"Patient safety was rated as the most important benefit of increased information technology integration among hospital executives surveyed by PwC," said the accounting firm. "The research found that digitally advanced hospitals have better quality. They have seen a large drop in average length of stay and a large increase in operating revenues. These hospitals also ranked higher on seven of 10 process measures in the treatment of … heart attack, heart failure and pneumonia.
By John Carroll - Posted: Friday, March 3, 2006 4:35 pm |
The Case for Quality
Some things are just intuitively known.
For example, without surveys or research or data, most involved with the healthcare industry are fully aware of the value of nurses. Without them, we certainly couldn't run our country's clinics and practices and hospitals. And a skilled nursing facility would be … well, just an unskilled facility.
However, in the day-to-day operations world of diminishing reimbursements, rising costs and a seemingly unlimited list of capital requests, the spreadsheet value of adding more nurses or changing staff ratios isn't as immediately clear.
Can you make a business case for quality?
That was the simple question asked by a team of nationally renowned researchers1 who have spent the last several years looking at a host of issues associated with the nursing field. Their latest study, which looks specifically at nurse staffing mixes in hospitals, was published as part of a multi-part series in the January/February 2006 issue of the journal Health Affairs.
By Cindy Sanders - Posted: Friday, March 3, 2006 4:27 pm |
Mark Leahey |
|
Congress Taking Close New Look at Reprocessed Medical Devices
Congressmen Tom Davis and Henry Waxman are pulling out their magnifying glasses to examine reprocessed medical devices.
As chairman and ranking member of the House Committee on Government Reform, the two men have asked the Government Accountability Office to investigate the safety of reprocessing and reusing medical devices designated by their manufacturers as "single-use." They also want the GAO to determine whether the FDA is regulating the reprocessing business adequately.
"In addition, we would like GAO to examine how the safety and oversight of reprocessed devices compares to the safety and oversight of single-use devices," the letter states.
Meanwhile, the congressmen requested from the FDA a list of information about the industry and the FDA's oversight of it. In a letter addressed to Acting Commissioner Andrew von Eschenbach, Davis and Waxman asked for information about reported problems with both reprocessed and new single-use devices, and about any regulatory actions the agency has taken against reprocessors, among other things.
By Tracy Staton - Posted: Friday, March 3, 2006 4:23 pm |
Dr. Daniel Mirelman, MD |
|
New Procedure Offers Less-Invasive Treatment For Bowel Incontinence
As many as one out of 13 adults in the United States suffers from a condition that may leave them home-bound, and a local surgical practice is the first in the Birmingham area to offer a new, minimally invasive treatment.
Bowel or fecal incontinence, the involuntary leakage of stool or gas from the anal canal, affects up to eight percent of the population. Yet two-thirds of patients do not seek medical attention because they're embarrassed or they don't think treatments are available.
While there are surgical procedures to correct abnormalities in the rectal sphincter muscle, they are invasive and are often accompanied by significant pain and long recovery times. When conservative therapies such as dietary changes, exercise and medications do not work, there is a new minimally invasive medical procedure, called the Secca® Procedure. It has been available locally at Birmingham Surgical, PC, for about six months.
by Deborah Lockridge - Posted: Friday, March 3, 2006 4:19 pm |
Dr. Mark Deierhoi |
|
New Developments in Kidney Transplantation
New developments in kidney transplantation are making the procedure available to more patients and improving the rejection rates and donor recovery.
A clinical trial that is still underway could improve rejection rates while sparing the long-term use of steroids.
"One of the drugs with the most long-term negative effects in patients is prednisone," explains Dr. Mark Deierhoi, professor of surgery and director of renal transplantation at UAB. "That has been a problem for patients for a long time in transplantation. Most protocols include prednisone as a part of the regimen. Patients have problems with bone disease and cataracts and post-transplant diabetes, wound healing problems and things like that. If we can avoid the use of steroids, then some of these chronic long-term complications will be lessened significantly."
By Marti Webb Slay - Posted: Friday, March 3, 2006 4:16 pm |
Early Referral Key to Avoiding Dialysis and Transplantation
When considering the overwhelming prevalence of kidney disease, nephrologists and transplant surgeons alike agree that early referral is key to slowing the progression of renal disease and possibly avoiding the need for dialysis and transplantation altogether.
"There are 350,000 dialysis patients in the country now," explains Dr. Tom Ozbirn, partner with Nephrology Associates. "There's ten times that many patients who have chronic kidney disease that are potential dialysis patients. Transplant is the best option, but unfortunately, there are thousands of people on the list waiting for a kidney – over 2,400 people on the list at UAB alone. They do 300 transplants per year. We are now putting people on the transplant list that we know are going to die before they're called. It's a catastrophic thing.
By Marti Webb Slay - Posted: Friday, March 3, 2006 4:09 pm |
Speaking Out about the Silent Disease
Chronic Kidney Disease, or CKD, is often referred to as the "silent disease" because it tends to stay quiet until it reaches more advanced stages. However, by utilizing clinical knowledge, healthcare providers can often "hear" the early warning signs of CKD even when they are just a whisper.
Nearly three years ago the National Kidney Foundation launched its Kidney Learning System, directly targeting healthcare providers and ultimately their patients. At its heart, the goal of KLS, which is focused on prevention, early identification and intervention strategies, clinical applications and improved outcomes, is to simply get everyone on the same page.
In theory, this should be a relatively easy task. In practical application, there is still a great deal of room for improvement.
Dr. Leslie Spry, spokesperson for the National Kidney Foundation, says identifying patients by their chronic kidney disease stage is one of the best ways to facilitate a common language between general practitioners and nephrologists.
By Cindy Sanders - Posted: Friday, March 3, 2006 4:07 pm |
Dr. Alan Hawxby |
|
Incompatible Kidney Donation Now a Possibility
Generally, organ donations require the donor and recipient to have compatible blood and tissue types, but new technologies are now available to overcome those barriers, opening up kidney transplants to a larger group.
The first of two new programs now available at UAB is a donor swap. "You can have a patient who is blood group A with a B donor," explains Dr. Alan Hawxby, assistant professor of surgery, Division of Transplantation at UAB. "What we can do is to find another pair who is a B with an A donor and do a paired donation. So the A recipient gets an A donor kidney, and the B recipient gets the B donor kidney. Now we have software to help us make these matches."
All four patients are put to sleep at the same time and operated on simultaneously. "That way, none of them can back out," says Hawxby.
By Marti Webb Slay - Posted: Friday, March 3, 2006 4:01 pm |
The Right Pension Plan Can Save You Money
To amass financial wealth needed for a comfortable retirement and to protect those assets from potential litigation, physicians are encouraged to maximize contributions in qualified retirement plans. But many doctors don't fund these plans as well as they could, says Bryan Luquire, Senior Vice President and Regional Trust Executive for BancorpSouth. "Plan design issues, lack of guidance, time crunches and misunderstanding all can lead to a retirement plan that may not produce the income necessary to retire in the manner that a physician desires," he said.
Luquire and his associates help these medical professionals look at the "big picture" of their financial situations. "We help them review their current retirement plan and look at different options based on the demographics of the practice," he said.
Those options are numerous, but Luquire said new comparability plans, also known as cross-tested plans, are replacing traditional profit-sharing and 401(k) plans because they make it possible for certain employees, like physician owners in small practices, to establish a qualified profit-sharing plan in which an employee's age, service and position in the practice are considered when allocating contributions.
By Ann B. DeBellis - Posted: Friday, March 3, 2006 3:57 pm |
Jim Rogers and "Hot Commodities"
After growing up in Demopolis, Alabama and attending Yale on scholarship, Jim Rogers began a career on Wall Street, where he co-founded the Quantum Fund in the 1970s, an investment partnership that gained over 4,000 percent, while the S&P 500 rose less than 50 percent. Rogers retired at age 37 and began traveling the world, chronicling his journeys in several books, 'Investment Biker' and 'Adventure Capitalist.' His most recent book is called 'Hot Commodities.' Rogers can be seen several times a week, talking finance with Neil Cavuto of FOX News. Recently, Rogers was generous enough to spend some time with the Birmingham Medical News, outlining his thoughts on investing.
Over the years, you've been extremely successful in all types of investments, from commodities to stocks in countries around the world. How do you find you investment ideas?
Posted: Friday, March 3, 2006 3:54 pm |
Jim Stroud: Warren, Averett, Kimbrough & Marino |
|
Preparing a Practice for Retirement
Assuming a physician has done what is needed to prepare personally for retirement, he next must prepare the medical practice for his departure. "A physician should think of planning for his practice as a legacy," said Jim Stroud, a member of Birmingham CPA firm Warren, Averett, Kimbrough & Marino, LLC. "What are you going to leave behind for your staff, your patients, the hospital and the community?"
According to the American Medical Association, physician groups that coordinate succession planning before anyone is ready to retire can have a smooth transition for the retiring physician and the practice. A good succession plan will include policies for decreasing a physician's activity in the practice, such as cutting his or her call schedule, and how to structure a retirement buyout or compensation plan.
By Ann B. DeBellis - Posted: Friday, March 3, 2006 3:47 pm |
Physician Spotlight: Tom N. Edwards, MD
Dr. Tom Edwards has found a new mission. Because he has a heart for the undeserved, Edwards has poured much of his personal and professional time and efforts into helping those with limited abilities help themselves.
A former medical missionary, Edwards and his family spent ten years helping plant churches in Abidjan, Ivory Coast, Africa, in conjunction with the Presbyterian Church of America's Mission to the World. When Edwards, his wife, Connie, and their three children returned to the United States in 1999, he knew that the end of one mission only meant the beginning of another.
"I love being a missionary, and I have a wonderful wife who allows me to do that," Edwards says. "I've always loved serving the underserved. I really enjoyed working in Africa because I enjoy ministering to their physical and spiritual needs together."
In his early years of practicing medicine, Edwards had worked in the East Lake community at the old East End Hospital. When the hospital moved to its current location near Huffman in 1985, Edwards, of course, moved with it, working there until he went to Africa in 1989.
By June Mathews - Posted: Friday, March 3, 2006 3:40 pm |
Planning for a Successful Financial Future
When it comes to ensuring a secure financial future, physicians don't always take time to think about their financial health. However, most financial advisors agree that doctors have gotten the message about the importance of planning for their retirement and beyond.
Lee Riley of First American Bank agrees. "My wife is a doctor and I think that in the last 10 years doctors have become more educated about financial planning opportunities and what they need to do," he said. "For the most part, the medical community realizes they have the income to get financial services, and doctors are doing a better job of saving for retirement because there are more people out there to support them."
By Ann B. DeBellis - Posted: Friday, March 3, 2006 3:38 pm |
Pharmacists May Seek More Help to Handle Part D Fallout
For pharmacist Tim Tucker, who runs City Drug Company Pharmacy in the small town of Huntingdon, Tennessee, (population 5,000) one word can neatly summarize the long-anticipated arrival of the Medicare Part D drug benefit: nightmare.
"Community pharmacists, bearing the brunt of implementing the new benefit, discovered that the 'choice' Congress required in the new benefit led to a cumbersome number of plans, yielding chaos," the pharmacist, a trustee of the American Pharmacists Association, recently told members of Congress. "Some of these plans were well prepared to implement the benefit. Many were not. Simple steps were unnecessarily challenging. For the last few weeks, my pharmacy has been more of an eligibility verification center and insurance navigator than a healthcare facility."
By John Carroll - Posted: Friday, March 3, 2006 3:35 pm |
Physician Ownership Could Return Carraway To Its Roots
Everything old is new again. That may be the message for hospitals struggling in competitive medical markets like Birmingham. A return to physician-owned general hospitals could be a natural extension of a nationwide trend in smaller physician-owned facilities. However, just as before, it's unlikely to become the norm.
"Physicians have owned hospitals for a couple of generations," said Jay Weatherly, partner and co-founder of Salient Health Ventures. "It's not that new, but it's not prevalent." Weatherly's firm facilitates collaboration between physicians and hospitals, including joint ventures.
Some observers believe the recent trend of physician ownership of specialty hospitals is expanding to general facilities. That expansion may come despite some fears of physician-owner referrals diverting patients from community facilities. Though questions remain, struggling hospitals in need of greater capital and better physician support are considering physicians as educated investors.
by Jean M. McLean and Steve Spencer - Posted: Friday, March 3, 2006 3:33 pm |
New Study May Help Make Angioplasty An Outpatient Procedure
For years now, angioplasty plus stenting to clear clogged arteries has required patients to stay in the hospital for as much as two or three days before doctors felt they could safely return home. But an extensive new clinical study suggests that a single dose of a new blood thinner may make angioplasty an outpatient procedure for many heart patients.
The study analyzed the responses of 1,005 patients. One group received a dose of the antiplatelet drug abciximab and was discharged four to six hours after the procedure. The second group also received a dose plus infusion and stayed overnight. A third group with predetermined complications also stayed hospitalized overnight after receiving a dose plus infusion of the antiplatelet drug.
"We propose a practice with more comfort for the patients, less risk of complications and greater cost-savings due to shorter hospitalizations," said Olivier Bertrand, MD, PhD, assistant professor, faculty of medicine, Laval University in Quebec City, Canada and interventional cardiologist at Laval Hospital. Bertrand unveiled his trial results at a conference put on by the American Heart Association in Dallas. Eli-Lilly and Bristol-MyersSquibb/sanofi-aventis, which make and market the drug in the study, funded Bertrand's trial.
By Tracy Staton - Posted: Wednesday, February 8, 2006 2:48 pm |
Survey: High Deductibles Often Steer Patients Away From Care
Those high-deductible and consumer-directed health plans may be all the rage in the insurance industry, but researchers say they ultimately may pose a threat to people's health.
A new survey from the Employee Benefit Research Institute and the Commonwealth Fund concludes that members of high-deductible health plans – which can carry minimum deductibles of $1,000 for individuals and $2,000 for families while tied to tax-sheltered savings plans – are discouraging many of the sickest citizens in our country to avoid doctors' offices when they need them the most.
By John Carroll - Posted: Wednesday, February 8, 2006 2:44 pm |
How is Alabama Dealing with Soaring Medicaid Costs?
As healthcare costs go up and the number of uninsured Americans rises, Medicaid funding is an ongoing concern, especially for providers such as nursing homes and teaching hospitals who have a large number of Medicaid patients.
States now spend more on Medicaid than they do on elementary and secondary education, according to a report released last month by the State Coverage Initiatives program, which provides technical support to help states broaden health insurance coverage. The states spent 21.9 percent of their revenue on Medicaid in fiscal year 2004, while elementary and secondary education made up about 21.5 percent of states' budgets. At the same time, says the group, states have been aggressive in containing Medicaid costs.
Every year, state Medicaid advocates must fight proposed cuts in the budget.
"I've been doing this for 25 years, and there hasn't been a year when it has not been an issue," says Carol Herrmann-Steckel, commissioner of the Alabama Medicaid Agency.
By Deborah Lockridge - Posted: Wednesday, February 8, 2006 2:38 pm |
Elias Zerhouni, NIH Director |
|
NIH Outlines Ambitious Plans To Produce Cancer Genome Atlas
The National Institutes of Health is planning to spend upwards of a billion dollars to deploy the latest technology in the hunt for molecular signposts that will play a key role in diagnosing and treating all forms of cancer.
In what is billed as the largest genetic research program since the human genome project outlined our genetic code, NIH Director Elias Zerhouni proclaimed the Cancer Genome Atlas initiative as the beginning of a new era in the treatment of cancer – a disease that will strike one half of all Americans at some point in their lives.
"Thanks to the tools and technologies developed by the human genome project and recent advances in using genetic information to improve cancer diagnosis and treatment, it is now possible to envision a systematic effort to map the changes in the human genetic blueprint associated with all known forms of cancer," said Zerhouni.
By Tracy Staton - Posted: Wednesday, February 8, 2006 2:34 pm |
William D. Johnston, PhD. Inhibitex CEO |
|
Inhibitex Designing New Therapy To Fight Deadly MRSA
A new and more virulent form of antibiotic-resistant staph infection has spread beyond its traditional setting in U.S. hospitals and has begun appearing with increasing – and lethal -- frequency in communities around the country.
Methicillin-resistant Staphylococcus aureus infections in the community now account for 12 percent of all staph cases, according to the Centers for Disease Control in Atlanta. MRSA is significantly more lethal than the staph infections that have grown ever more commonplace in hospitals. The CDC now estimates that 89.4 million Americans carry Staph aureus in their nasal passages, and a whopping 2.3 million carry MRSA.
One recently published study linked MRSA infections to the recent death of three Chicago children. Fourteen cases of skin-eating MRSA infections have appeared in the Los Angeles area. And hospitals in the Nashville area have reported a troubling surge in MRSA cases.
By John Carroll - Posted: Wednesday, February 8, 2006 2:30 pm |
Dr. Anu V. Rao |
|
Women Need More Aggressive Management of Cardiac Risk Factors
Heart disease has been the leading cause of death in women since 1912, but today doctors still underestimate women's heart risk, according to a study published in the February 2005 issue of Circulation: Journal of the American Heart Association. In fact, the study found that less than one in five physicians recognized that more women die of heart disease each year than men.
As a result of doctors' misperception that a woman's risk is lower than a man's, women are less likely to receive recommendations from their physicians for preventive therapies such as cholesterol-lowering drugs, aspirin therapy and cardiac rehabilitation to protect them against heart attacks and death. This is a mindset that must change, said Anu V. Rao, MD, FACC, Director of the Women's Cardiovascular Center for CardioVascular Associates, P.C. at Brookwood Medical Center in Birmingham. "Heart disease kills almost twice as many women each year than all cancers combined," Rao pointed out. "Women still need to be concerned about breast cancer, but they also need to be aware of their total body."
Rao said what women do early in life can prevent problems later, and doctors need to treat cholesterol and hypertension more aggressively in their female patients. "The good cholesterol norm for women is higher than for men, but doctors need to manage the bad cholesterol as well. You can't ignore the bad just because the good is okay," Rao said.
By Ann B. DeBellis - Posted: Wednesday, February 8, 2006 2:22 pm |
Cardiac rehab patients enjoy Montclair's updated facility. Martha Bryant (right), coordinator of the program, and her staff of registered nurses monitor patients and provide education on diet, nutrition, and lifestyle modifications. |
|
New Montclair Facility Helps Cardiac Rehab Patients in Recovery
The American Heart Association says physicians should aggressively encourage patients to exercise and follow cardiac rehabilitation protocols to prevent recurrent heart attacks; however, these programs are underused in the United States with only 10 to 20 percent of eligible patients participating.
In the revision of the association's 1994 scientific statement, research findings show that average cardiac death was 26 percent lower in rehab patients who received exercise training. There were also 21 percent fewer non-fatal heart attacks, 13 percent fewer bypass surgeries and 19 percent fewer angioplasties in the exercise-trained people.
While exercise plays a major role in cardiac rehab, Martha Bryant, oordinator for cardiac rehab and pulmonary management for Baptist Medical Center Montclair, said education is equally as important as physical activity. "We educate our patients about why physical activity is safe and beneficial and why it will continue to help them as they recover," Bryant said. She and the other registered nurses also provide guidance about diet and nutrition.
Montclair's rehab facility recently relocated to Professional Office Building 860. Patients are enjoying the renovated area and new exercise equipment in a glass-enclosed room which provides lots of light and allows patients to enjoy the outside scenery. A new Quinton Cardiac Monitoring System helps Bryant and her staff monitor each patient's progress and keep the physician updated. "As a patient progresses in the program, we inform the physician of what we do here and how the patient responds," Bryant said.
By Ann B. DeBellis - Posted: Wednesday, February 8, 2006 2:18 pm |
Cardiology Grand Rounds
The American Heart Association's "Top 10 Research Advances for 2005" list (see related story) is just the tip of the iceberg when it comes to what's new in the field. Below is another small sampling of recent discoveries and studies that will hopefully add to our medical arsenal in the fight against heart disease and stroke.
- At the American Heart Association's annual scientific sessions in Dallas in mid-November, Johns Hopkins scientists presented their latest findings on creating a biologic pacemaker. In guinea pig experiments, the scientists fused common connective tissue cells taken from lungs with heart muscle cells to create a safe and effective biological pacemaker whose cells can fire on their own and naturally regulate the muscle's rhythmic beat.
"This work with fibroblasts could pave the way to an alternative to implanted electronic pacemakers," says Dr. Eduardo Marbán, professor and chief of cardiology at Hopkins and its Heart Institute. "Such a 'biopacemaker' is a potentially important option for patients at too high a risk for infection or who are physically too small to accommodate mechanical pacemakers."
By Cindy Sanders - Posted: Wednesday, February 8, 2006 2:14 pm |
AHA Unveils Top Research Advances in 2005
It seems as if almost every week a groundbreaking study is released with implications on the management, prevention or treatment of cardiovascular disease. From rapid discoveries tied to our ever-increasing understanding of the human genome to evidence-based reconfirmation of what many physicians are already putting into practice, each of these reports adds to our body of knowledge as we seek to understand America's number one killer.
As part of its year-end report, the American Heart Association creates an annual "top 10" list highlighting some of the most significant research advances during the past calendar year. The recently released 2005 list covers a broad spectrum from a smoking cessation drug to cell recycling to MI risk from prehypertension.
Dr. Robert Eckel, president of the American Heart Association, says, "The importance of the top 10 is that it covers a breadth of topics. It's a nice mix of basic science and clinical medicine."
By Cindy Sanders - Posted: Wednesday, February 8, 2006 2:10 pm |
Diona Holcombe, Registered Respiratory Therapist. |
|
Local 'Heroes'
In January, the Birmingham Regional Council of the Alabama Hospital Association hosted a reception honoring five Birmingham-area hospital employees for their dedication to the healthcare industry. The reception was one of seven regional awards presentations being held as part of the association's annual statewide Health Care Heroes contest, which culminates with a banquet in February where one overall winner from each region will be recognized.
In January, the Birmingham Regional Council of the Alabama Hospital Association hosted a reception honoring five Birmingham-area hospital employees for their dedication to the healthcare industry. The reception was one of seven regional awards presentations being held as part of the association's annual statewide Health Care Heroes contest, which culminates with a banquet in February where one overall winner from each region will be recognized.
Diona Holcombe, Registered Respiratory Therapist
The youngest honoree was Diona Holcombe, a respiratory therapist at UAB Hospital. Just five years into her career, Holcombe has managed to make a memorable impression on her colleagues. She is described as a caring team member who is always willing to take on extra work when needed. She has even invited out of town coworkers to stay at her home.
"Diona is an exceptional clinician and often gives patients what they need most, which is that extra touch by stopping and listening to them and giving their family members the reassurance they need," said Robert Cofield in his nomination of Holcombe.
Holcombe has been active as a volunteer, serving as a counselor at Camp WheezeAway for children with asthma. After Hurricane Katrina, she traveled with a critical care transport team to New Orleans, where the team evacuated 26 infants from a hospital and helped move people from hurricane-stricken areas.
by Steve Spencer - Posted: Wednesday, February 8, 2006 1:58 pm |
Before You Begin
Architects, much like physicians, are opting more and more to hone their expertise by focusing on a specialty design field. Within this movement, healthcare design has emerged as a major specialty area.
It takes a significant body of knowledge to meet the multitude of requirements posed by building a hospital or other medical facility from an understanding of regulatory compliance and special structural needs for large pieces of equipment to a deep insight into staff and departmental functions and patient flow.
For that reason, many healthcare providers and administrators find it beneficial to work with design and building professionals that have experience within the medical construction industry. Architect Frank Pitts, who serves as the president of the American College of Healthcare Architects, the first specialty board certification group within the architecture profession, notes that it is quite common to work with a healthcare architecture specialist and a local generalist design firm.
Pitts suggests doing some homework before you begin your own project such as visiting hospitals or practices that have done similar projects, asking what worked and what didn't, and finding out what architects were involved.
Today, the growing healthcare construction industry encompasses a number of subspecialties ranging from architects to engineers to planning firms to interior designers. Below are a few online resources to help you in the early phases of planning and decision-making.
by Cindy Sanders - Posted: Wednesday, February 8, 2006 1:54 pm |
UAB is building a new radiation oncology building to replace a 30-year-old facility. |
|
Birmingham-Area Healthcare Projects
Here are some of the interesting construction and renovation projects under way in the Birmingham area:
Cooper Green Hospital: M.J. Harris, Inc. is starting on a long-awaited renovation of Jefferson County's Cooper Green Hospital. Last year, Cooper Green won approval from a state board to proceed with a $28 million to $34 million renovation. In addition to getting the hospital up to current safety codes, the first stage of renovation will involve building a glass façade and courtyard on the front of the hospital.
Hazelrig-Salter Radiation Oncology Facility: The UAB Comprehensive Cancer Center will break ground this spring on a 50,000-square-feet, two-story building and an adjacent green space to be called "The Park of Hope." The facility, to be located on 18th Street South at 6th Avenue, will provide both treatment and administrative space for the radiation oncology department. It will replace UAB's 30-year-old radiation facility located in the Lurleen B. Wallace Tumor Institute. UAB recently received a $5 million gift from Mountain Brook businessman W. Cobb Hazelrig to help build the facility. Completion is expected in 2007.
Posted: Wednesday, February 8, 2006 1:50 pm |
George Pressler: ACHA, AIA, FHFI, president of Planning Decision Resources, Inc. |
|
Building on a Plan
When you are bursting at the seams or excited that the funding has come through for a new project, the natural inclination is to rush out and begin building.
While you've probably spent hours and hours thinking about a new OR filled with today's latest technology or a vastly improved step-down unit with a bit of breathing room, have you really thought about how the two work together? What should your new or renovated facility look like 10 years from now? How do you get there from here? And what does any of this have to do with your corporate mission statement?
Award-winning design begins long before an architect ever sketches a single line. In the excitement of a new building project, it's all too easy to put the cart before the horse. However, architects who specialize in healthcare design are quick to say that the "horse" … a facility's mission and vision for the delivery of care … is the real driver and therefore must be the first thing considered.
Before launching a project, Frank Pitts, FACHA, AIA, president of the American College of Healthcare Architects, says, "It's a great opportunity to think about your vision because failing to do that you're going to build a building that either embodies the architect's assumption or perpetuates the model the architect and clinicians see in place today."
By Cindy Sanders - Posted: Wednesday, February 8, 2006 1:46 pm |
Mystique Resorbable Graft Containment plating system. |
|
Local Doctors Use New Implant in Spine Surgery
Every now and then along comes a medical innovation that makes physicians wonder how they ever managed without it. This particular innovation, a surgical implant that supports the spine as it heals after surgery, is now being used in Birmingham. Two local neurosurgeons using this device are Dr. William C. Woodall at Baptist Medical Center Montclair and Dr. R. Cem Cezayirli at Baptist Princeton. They are utilizing this implant to support the spine and are especially impressed that it is reabsorbed by the body over time.
Instead of using a metal plate to provide strength while healing occurs, doctors are using the new cervical plate called Mystique. Developed by Medtronic Sofamor Danek, the new Mystique Resorbable Graft Containment plating system is the first of its kind for spinal surgery to treat cervical degenerative disease. It is unique because it is reabsorbed by the body in one to three years, while providing the support and strength needed for spinal disc fusion to occur. As the plate dissolves, its by-products, carbon dioxide and water, are released through the lungs.
The Mystique plate is used in a surgical procedure called anterior cervical discectomy and fusion, or ACDF. When surgery is needed to relieve nerve or spinal cord compression, often caused by a herniated disc, the surgeon will make a small incision in the front of the neck to reach the cervical spine. The disc is removed and the space is filled with bone graft, which enables two vertebrae to fuse together. The Mystique plate is used for stabilizing the weak bony tissue around the fusion while it heals.
By Joyce A. Norman - Posted: Wednesday, February 8, 2006 1:40 pm |
BlueCross to Implement New Diagnostic Imaging Rules
In a sweeping move to decrease "inappropriate" medical imaging in Alabama, BlueCross BlueShield of Alabama recently announced significant and expansive changes regarding CT, MRI and PET imaging. The rules, in the form of a new radiology program, are in response to what BlueCross sees as unchecked and increasing imaging utilization brought about by non-radiologist physician ownership of imaging equipment. According to information cited to by BlueCross, so-called self-referring physicians order two to eight times as many scans as other doctors.
It is undisputed that medical imaging, such as MRI, CT and PET scanning, is one of the health care industry's fastest-growing sectors. According to a May 2005 article in the Wall Street Journal, scanning costs for Medicare rose at three times the rate of other medical services from 1999 to 2002, with a further 16 percent increase in 2003. Capital spending on diagnostic imaging equipment is a $100 billion a year industry. A March 2005 article in the Birmingham Business Journal discussed the opening of Alabama's 86th accredited diagnostic imaging facility, a number which has certainly increased in just the last few months. There are also countless physician practices offering diagnostic imaging. One must wonder, however, whether the rise in imaging services and utilization is due to the ordering of inappropriate diagnostic studies or the fact that each year imaging technology is proven more useful in diagnosing an ever increasing array of medical conditions.
Posted: Wednesday, February 8, 2006 1:39 pm |
Physician Spotlight: Dr. Susana Bowling
Dr. Susana Bowling fears that in today's impersonal world, some of the beauty of practicing medicine has been lost. Her goal is to recapture it.
A neurologist by profession, Bowling is an artist at heart. A talented painter, she has produced works that have appeared in local galleries and that have in a couple of instances been sold to raise money for charity.
"I learned to paint by copying the masters," she says, "and I've been drawing ever since I could hold a pen. I remember my grandmother telling my mother, 'This girl is going to be an artist.'"
But Bowling doesn't feel her profession and her artistic nature are mutually exclusive. In fact, she believes her practice of neurology is enhanced by her ability to see things with the right, or creative, side of her brain.
"Art has a lot to do with neurology," she says. "Both involve imaging and in both, you are working with your hands."
And even if her flair for art hadn't already enhanced Bowling's practice of medicine, it has surely enhanced the place where she works. The walls of the Alabama Neurological Institute (ANI) on the Brookwood Medical Center campus are filled with her paintings.
by June Mathews - Posted: Tuesday, February 7, 2006 4:38 pm |
Dean Samet, Director of Smith, Seckman, Reid, Inc. |
|
Surprise! JCAHO Calling
Who's in the lobby to do what?!!!!
Don't let this be your reaction when you hear that the JCAHO survey team has shown up unannounced to inspect your hospital facility for re-accreditation. Beginning last month, the Joint Commission has switched to surprise surveys for the first time in its history.
While some of you may question whether or not the Geneva Convention would classify this as torture, the real reason behind the move is of a much more noble nature.
"The purpose of this is to help the organization maintain continuous compliance along with utilizing the Joint Commission standards as good management tools and providing good patient care and safety," explains Dean Samet, director of regulatory compliance services for Smith Seckman Reid, Inc., an engineering firm serving the healthcare industry.
by Cindy Sanders - Posted: Tuesday, February 7, 2006 4:36 pm |
Dr. John McBrayer, right, uses a 64-slice CT scanner to evaluate a patient's cardiac health. |
|
Research Advances Offer Hope in Battle against Heart Disease
Increased survival rates for patients with drug-eluting stents and a study that extended the range of patients that might benefit from prophylactic implantable defibrillators were among the American Heart Association's top 10 research advances for 2005. While there have been numerous advances in the field of cardiology, Dr. John McBrayer, an interventional cardiologist with Heart South Cardiovascular Group, PC in Birmingham, said he thinks the drug-coated stents are one of the most significant.
Bare metal stents have been used for more than 10 years, but McBrayer said that while these stents opened a blocked artery after angioplasty, restenosis often recurred. Approved by the U.S. Food and Drug Administration for use in 2003, the drug-eluting stent slowly releases a medication that significantly reduces the rate of re-blockage that occurs with bare stents and angioplasty procedures. American Heart Association studies show that after three years the rate of major adverse cardiac events (including death, heart attack and repeat procedures) in patients treated with drug-eluting stents was half the rate of those treated with bare metal stents.
By Ann B. DeBellis - Posted: Tuesday, February 7, 2006 4:31 pm |
This five-story medical office building and surgery center will connect with UAB Medical West in Bessemer. |
|
Healthcare Building Boom Reflects Trends
As the practice of medicine changes, so do medical facilities. A boom in healthcare construction reflects trends toward private rooms, sophisticated diagnostics equipment and changes in ER procedures.
Over the past five years, hospitals nationwide have spent nearly $100 billion in inflation-adjusted dollars building new facilities, according to the U.S. Census Bureau. That's up 47 percent from the previous five years.
New hospitals, however, don't mean more beds. The overall number of hospital beds is falling nationwide. Instead, hospitals are replacing semiprivate rooms with private rooms. Today's private rooms are larger than old semiprivate rooms and are often designed to accommodate visiting family members.
"The semiprivate rooms have been converted to private rooms, and now there are not enough rooms in which to admit patients," says Joe Bynum, managing principle with The Ritchie Organization, a Birmingham architectural firm.
By Deborah Lockridge - Posted: Tuesday, February 7, 2006 4:29 pm |
BlueCross BlueShield of Alabama is the state's largest insurance carrier. |
|
Why Do Reimbursements Cause Friction Between Insurers and Healthcare Providers?
When UAB Health System and UnitedHealthcare parted ways late last year, the split highlighted the ongoing tension between insurance carriers and healthcare providers over reimbursement rates.
Last fall, UAB gave the insurance company 90 days notice that without higher reimbursement rates, it was terminating its contract. Negotiations did not result in a compromise, and the contract terminated at the end of November.
"We could not accept on behalf of our customers an off-cycle, unpredictable increase in the neighborhood of 60 percent," says David Lewis, chief executive officer of UnitedHealthcare's Gulf States region. "When we sought to renegotiate, we were unable to get UAB to come off those numbers."
UAB, on the other hand, did not regard the requested increase as "exorbitant," as UHC had described it in a letter to customers.
By Deborah Lockridge - Posted: Friday, January 6, 2006 4:36 pm |
Dr. Douglas Kamerow |
|
An Ounce of Prevention to Cure Pounds
Obesity has become a national epidemic. With nearly 30 percent of the adult American population defined as obese (a body mass index of 30 or more) and 65 percent considered overweight or obese, it is a problem that impacts every state, every race and every socioeconomic level.
Furthermore, the onslaught of co-morbid conditions attached to obesity — diabetes, hypertension, heart disease, arthritis — not to mention the increased risk for even more diseases including many forms of cancer, means that weight gain has a far-reaching impact on Americans' health and the nation's healthcare system.
Overweight and obesity are not just adult problems, however. Prevalence rates in youth have also been steadily rising. To combat the current problem and work to stem the tide, both the Institute of Medicine (IOM) and the American Academy of Pediatrics (AAP) have formed study groups.
By Cindy Sanders - Posted: Friday, January 6, 2006 4:32 pm |
Dr. Les Miles performs weight loss surgery at Medical Center East. |
|
Severely Obese Find Success through Weight Loss Surgery
Severely obese individuals typically don't have trouble losing weight. Keeping off the pounds is the problem. "These people are experts at weight loss," said Dr. Les Miles, a general surgeon at Medical Center East. "They can tell you about the times they lost 80 pounds and 100 pounds, but they just can't keep the weight off."
Along with the excess pounds, these individuals usually deal with obesity-related health problems such as severe sleep apnea, diabetes or heart disease. In the past, they had no other option but diet and exercise but the development of bariatric surgical procedures has given these people hope for a longer and brighter future. "Obesity studies show that people with a body mass index (BMI) over 40 don't lose weight and sustain the loss," Miles said, "but we're seeing results in long-term studies that show bariatric surgical patients are losing slightly more than half of their excess weight and it's staying off."
By Ann B. DeBellis - Posted: Friday, January 6, 2006 4:29 pm |
UAB Pediatrician Dr. Frank Franklin, Medical Director of the Children's Center for Weight Management. |
|
Identifying Weight Problems Early is Critical in the Fight Against Obesity
Childhood obesity has become the most prevalent pediatric nutritional problem in the U.S. Almost 16 percent of American children and teens are overweight, according to the Centers for Disease Control, and this prevalence for adolescents has almost tripled over the past 20 years. "This is a serious issue," said pediatrician Frank A. Franklin, MD, PhD, medical director of the Children's Center for Weight Management at Children's Hospital, "but it's a problem that can be recognized early and addressed."
Children whose body mass indexes (BMI) are at or above the 95th percentile are considered overweight, Franklin said. Those with a BMI at or above the 85th percentile but below the 95th are at risk for being overweight. If the child has an obese parent, the risk doubles. "Excess weight in childhood is frequently a precursor to adult obesity. The array of associated physical disorders and emotional problems that often accompany obesity can persist, and frequently worsen, throughout life," he said. "Moreover, the probability of adult obesity increases as overweight children age. Fifty percent of children who are overweight at age six will become overweight adults; by adolescence, the probability escalates to 80 percent."
By Ann B. DeBellis - Posted: Friday, January 6, 2006 4:25 pm |
A closed circuit reading machine, like this one at the Liz Moore Low Vision Center, helps enlarge print so patients with macular degeneration can read again. |
|
Macular Degeneration: Casting an Eye on New Treatment Options
As America's population ages, age-related macular degeneration becomes more and more of an important medical issue.
"The statistics are startling," says Dr. Elmar Lawaczeck, an ophthalmologist with the Brookwood Eye Institute. "In the population 70-plus years of age, about 30 percent will have some degree of macular degeneration. In the population 80-plus, it's 50 percent; 90-plus, it's 80 percent."
The macula is a small area in the retina at the back of the eye that allows a person to see fine details clearly and perform activities such as reading and driving. When the macula does not function correctly, central vision can be affected by blurriness, dark areas or distortion.
There are many kinds of macular problems, but the most common is age-related macular degeneration, or AMD. It may be "dry" or "wet." The dry version is caused by aging and thinning of the tissues of the macula, and vision loss is usually gradual. This is the most common kind of AMD, and there is no treatment.
By Deborah Lockridge - Posted: Friday, January 6, 2006 4:24 pm |
Giving Your Practice the Same Attention as Your Car
Your Lexus … your Volvo … or your Caravan … it really doesn't matter what you drive, everyone knows the occasional tune-up is an important step toward keeping your vehicle in top running condition.
Preventative maintenance often stops little problems from becoming big ones. Certainly physicians are familiar with this notion, which is as true for your health as it is for your car. Why then does the concept seem so foreign to so many when applied to their practice?
Surely your practice deserves the same consideration as your car to ensure that the source of your livelihood and that of your employees remains viable. With looming reimbursement cuts, making sure you are running at maximum efficiency has never been so important.
By Cindy Sanders - Posted: Friday, January 6, 2006 4:21 pm |
Area 180, will soon be making its mark on the Christian music world with a new album. Band members include (l-r) Gary Davis, Dr. Dave Wilhelm, Haley Rutledge, Chris Wilhelm, Kevin Kilpatrick, Libby Richardson and Wendy West. |
|
David B. Wilhelm: He Touches Many through His Music, Words, and Medicine
As a physician, Dave Wilhelm wants to help people maintain healthy bodies and minds. As a musician and writer, he wants to help them maintain healthy souls.
A founding member of a local Christian band called Area 180 and the author of three inspirational books, Wilhelm recognizes the value of using his talents to reach people. He also recognizes that reaching people often requires non-traditional means.
For example, Wilhelm and his fellow band members are using musical instruments in a normally non-instrumental Church of Christ setting to help them share their faith. One Tuesday night a month, Area 180 hosts a time of praise and worship at the Homewood Church of Christ Family Center. The gatherings feature some of the group's original songs along with a selection of well-known favorites. Mixed in with the music are moments of Bible reading and sharing.
"Church in general can't be like it was 30 or 40 years ago," Wilhelm says. "We understand the traditions and heritage, but we also see the need for expressing ourselves in a different manner. Many people don't fit the mold of traditional church, and we're reaching across those boundaries."
By June Mathews - Posted: Friday, January 6, 2006 4:18 pm |
Scott Serota, CEO of the BCBS Association. |
|
Blues Create A Healthcare Bank
The big push to spread acceptance of consumer-directed health plans is spurring the Blue Cross Blue Shield Association to start a unique new bank for members of the Blues.
Dubbed Blue Healthcare Bank, the institution is designed to provide the kind of financial support consumers will need when they sign up with a consumer-directed health plan, a health savings account, a health reimbursement arrangement or a flexible spending account from any of the BCBS companies scattered throughout the country.
Increasingly, consumers are expected to put up a larger share of their own funds to pay for their insurance. And the Blue Healthcare Bank gives them a way to manage their health funds to maximum advantage. Consumers and companies can deposit money into the accounts. A checkbook or debit card will be available to pay for specific health expenses, which will also make it easier to handle tax-sheltered funds and budget their share of deductibles.
By John Carroll - Posted: Friday, January 6, 2006 4:07 pm |
Healthcare Providers Can Help Reduce Alabama Waistlines
According to officials with the Centers for Disease Control, an estimated 365,000 people die each year from health problems related to obesity, a public health issue that is growing rapidly in the U.S. But while obesity is a national concern, nowhere are waistlines expanding as rapidly as they are in the state of Alabama.
In the 2005 report "F as in Fat: How Obesity Policies are Failing in America" by Trust for America's Health (TFAH), Alabama is rated the second most obese state, with Mississippi ranking number one. While Mississippians took the top spot away from Alabama this year, Alabama still exhibited the largest overall increase in obesity. Obese Alabamians increased 1.5 percentage points to 27.7 percent.
Obesity is defined by a body mass index (BMI) of 30 or above. Overweight is a BMI of 25 to 29.9. When you combine both groups, 63 percent of Alabama adults need to lose weight. So why is Alabama so fat? TFAH says obesity is primarily the result of poor nutrition and lack of physical exercise. Jose Fernandez, PhD, assistant professor at UAB's Department of Nutrition Sciences, said genetics also play a role, with African American women and Mexican American men having the greatest propensity for obesity.
By Ann B. DeBellis - Posted: Friday, January 6, 2006 4:04 pm |
Declining Reimbursements Present Challenges as Practice Costs Rise
In an environment where rising operating costs collide with declining reimbursements, practice managers face significant challenges. The endless struggle to maintain revenue while managing overhead and providing quality care requires effort and imagination.
The difficulty is compounded by the fact that fixed costs comprise the bulk of most practices' overhead. One of the larger components of fixed costs is real estate. Increasingly, medical practices are choosing to sell office buildings in order to reduce real estate costs. "We've acquired quite a few properties from large physician groups," say Rance Sanders of The Sanders Trust. "Usually, equity has built up in the property. By selling the building and leasing it back, they can increase cash on the balance sheet, reduce debt, and lower their monthly operating costs."
By Steve Spencer - Posted: Friday, January 6, 2006 4:01 pm |
Wanda Hooper |
|
Avian Flu Fears Leave Local Providers With Few Options
In the small Gulf Coast community where Dr. Ralph Kahler practices, questions about avian flu are a regular part of the job. As a local infectious disease expert, he has a lot of people turning to him for answers.
And he doesn't have a lot of reassuring answers to offer."I really don't see anything that we could do on the local level," says Dr. Kahler. "We're really dependent on the federal government and the Centers for Disease Control, vaccine and drug makers."
Local doctors would do everything they could, he adds, disseminating any vaccines that could be available and providing supportive care for anyone affected, but that's "about all we can do. Tamiflu has been used. But if a true pandemic comes, it will disappear in short order."
By John Carroll - Posted: Tuesday, December 13, 2005 5:04 pm |
P4P Plan Delivers Only Small Gains In Quality Metrics
A group of researchers tested the theory that paying doctors for performance would improve healthcare quality and discovered that in one of the most ambitious projects, most of the pay-for-performance money already goes to the best doctors, with only marginal gains in quality to show for the money.
The number of health plans that have adopted P4P plans has been growing rapidly, notes Harvard School of Public Health Assistant Professor of Health Economics and Policy Meredith B. Rosenthal, the lead author of the study that appeared in the October 12 issue of the Journal of the American Medical Association. But they're making the adoption of the plans a leap of faith, believing they will spur quality improvements without any data to back up their assumptions.
BY TRACY STATON - Posted: Tuesday, December 13, 2005 5:02 pm |
Dr. William F. Jessee, FACMPE, president and CEO of MGMA |
|
MGMA CEO Outlines Strategic Plan at Annual Meeting
At the end of October, practice managers from around the country gathered in Nashville for the annual meeting of the Medical Group Management Association. Dr. William F. Jessee, FACMPE, president and CEO of MGMA and its certification body, the American College of Medical Practice Executives, delivered his annual report highlighting accomplishments and concerns impacting the membership.
Additionally, the physician outlined the six components of the recently completed strategic plan and unveiled the new, unified mission statement for MGMA and ACMPE, which simply states the association will be driven to continually improve the performance of medical group practice professionals and the organizations they represent. Straightforward in content, Jessee said the short mission statement had become the launching pad for all other efforts.
"That mission drives our every effort to make a better future than we have today," he said. "It is the beacon from which we built the strategic plan."
By Cindy Sanders - Posted: Tuesday, December 13, 2005 4:59 pm |
Patients Are People, Too
Despite the increasing specialization in medicine, some doctors are advocating an approach to care that focuses on the entire patient rather than on a single section of the body or biological process that needs to be fixed. While this concept may not technically meet the criteria of alternative or complementary medicine, viewing a patient as an entire person can still require a shift in the traditional approach taught in medical school.
"If you go back to the history of medicine, René Descartes established this dualism between mind and body, and it brought into our time a mechanistic approach to the body, where doctors would treat the body like a mechanical object," explains Dr. Mark Stafford, associate professor in the department of medicine at UAB. "What we've learned in recent years is that there's an intimate connection between the brain and the body."
By Marti Webb Slay - Posted: Tuesday, December 13, 2005 4:56 pm |
| |
|
| Google Ad Blocks |
|
| Add our RSS Feed |
|
| |
|
