Tag: doctors

The Role of Every Doctor in Improving the Opioid Crisis

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The opioid crisis is ongoing, and every doctor has a role in providing excellent care for patients and preventing opioid overuse and misuse. While some people seem to think that the solution lies in never prescribing opioids, in reality, some patients are struggling with life-threatening illnesses and in need of palliative care that makes them an appropriate solution. Every physician must now walk a fine line between managing pain and prescribing in a manner that encourages addiction.

Changes in the Opioid Crisis

It’s unsurprising that there is a renewed interest in creating policies to limit prescriptions of opioids in the wake of rising deaths from overdoses. According to the CDC, overdoses from prescription medication are a leading factor in the 16-year increase in opioid overdose deaths. From 1999 to 2010, the amount of prescription opioids sold to hospitals, practices and pharmacies nearly quadrupled without an overall increase in the amount of pain that patients reported.

CDC Guidelines

The CDC released aggressive clinical practice guidelines that suggest limiting initial opioid prescriptions to 3 days unless it is a situation where there is active cancer, a need for palliative care or end-of-life care. The guidelines also caution prescriptions that contain more than 90 morphine milligram equivalents every day due to the increased risk of overdose and lateral efficacy of a stronger prescription.

The CDC’s clinical reminders are a launching point for your practice to serve as a resource for patients and prevent opioid addiction in your community. Some of the reminders include:

  • Start with low dosages
  • When opioids are prescribed for acute pain, prescribe no more than needed
  • Never prescribe extended-release opioids for acute pain
  • Always discuss benefits and risks and availability of non-opioid treatments with patients before prescribing or continuing a prescription

Assessing the Risk and Harm at Your Practice

When you are working with patients who are receiving one prescription for opioids or renewing a prescription, you should always make assessing risk and addressing potential harm a priority. To properly consider risk and harms:

  • Evaluate each patient’s risk factors for opioid-related side effects and hazards
  • Check the prescription drug monitoring program for prescriptions from other providers or high dosages
  • Avoid prescribing benzodiazepine and opioids concurrently
  • Use urine drug testing to identify undisclosed use or the presence of prescribed substances
  • Arrange treatment for opioid use disorder if a patient is in need

Help Impact the Opioid Crisis with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Is Addressing Social Determinants of Health Vital to Patient Success?

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There’s a lot of buzz around the social determinants of health in the healthcare community, and for many good reasons. The social determinants of health have been found to be critical in promoting optimal patient health, limiting disease and improving healthcare quality. 

What Are the Social Determinants of Health?

Social determinants of health are nonmedical things that affect a patient’s health outcomes and overall health. They can include where a patient is born, where someone lives, what job they have, their age and a wide range of other factors that all shape their daily life and health. These social determinants have a serious effect. One analysis of studies measured adult deaths attributed to social factors and discovered that in 2000, over 245,000 deaths could be attributed to low education, 176,000 to racial segregation, 162,000 to low social support, 133,000 to individual-level poverty and 119,000 to income level equality. For comparison, the number of deaths that could be linked to low social support was nearly identical to the number of deaths from lung cancer.  

The Reality in the United States

Currently, the United States is ranked among the 10 richest countries in the world per capita. However, place of birth is more strongly correlated with life expectancy than genetics. There is no one way to improve these statistics without the work of policymakers, physicians, communities and individuals. Community health partnerships are one effective way to address social determinants of health and support your community.

Getting Involved

How can your workers better address needs like transportation or access to healthy food? One family practice in Columbus, OH partnered with the Mid-Ohio Food Bank to pilot a health initiative for patients with diabetes. While the practice thought almost no patients were living with food insecurity, a whopping 43% of patients surveyed had trouble finding healthy food to eat. The practice added a mini food bank inside and offered participating diabetes patients fresh produce (from the food bank), recipes, cutting boards, peelers and a brief nutrition class. In the first 4 months of the program for 40 patients, 12 patients had reduced A1C levels and the majority of patients indicated positive results. Even more promising? Physician satisfaction increased and burnout levels decreased. While this isn’t feasible for every practice, it’s great food for thought for yours.

Address the Social Determinants of Health with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Preventing Physician Fatigue at Your Medical Practice

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As we covered in our last blog, preventing physician fatigue needs to be a major priority for every medical practice. When providers are under constant pressure to perform, not only are they at risk of developing stress-related health issues, but employees and patients can also suffer increased stress and dissatisfaction. Thankfully, there are a number of strategies currently being used by many medical practices to get to work preventing physician fatigue.

How Your Practice Can Work to Prevent Physician Fatigue

  1. Make wellness for your employees a top priority at your medical practice. Remember that physician burnout isn’t just a problem for the doctors experiencing it, but also the patients and employees who may bear the brunt of it.
  2. Create a wellness position at your practice or a collaborative committee. Your wellness chairperson or champion should be someone who can help to survey employees for burnout and troubleshoot initiatives to prevent physician fatigue. These employees can also work to make employees aware of all of the wellness resources available and model positive anti-burnout activities, like leaving the office on time or stopping during lunch for a short meditation session.
  3. Survey your employees on a yearly basis to see what employees are doing to keep themselves in good physical, mental and emotional health. Use the results to identify potential workplace wellness initiatives and get a look at where your medical practice is succeeding and where you could stand to improve.
  4. This might seem obvious, but if you complete a workplace wellness survey, you should also use the results to make positive changes in your workplace. Whether it’s redesigning the way that daily workflow occurs or developing new and better ways for employees to communicate, these changes will show employees that you are listening and that you care about their experience enough to change.
  5. Once you have made some changes, you should repeat the survey to see how things have changed. Are you doing your job when it comes to preventing physician fatigue? Checking back in allows you to also see if there are new areas where you could stand to improve.
  6. Don’t call out employees or embarrass anyone in the office with survey findings. Instead, you should be supportive and continue to emphasize improvement. Just like physician fatigue doesn’t happen overnight, counteracting burnout doesn’t happen in one day either. 

Preventing Physician Fatigue with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

The Real Cost of Physician Fatigue

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According to a number of recent studies, physician fatigue is no longer a marginal problem, but instead an epidemic sweeping through hospitals and medical practices. Physician burnout has a far-reaching impact on physicians themselves, patients and the finances of every healthcare facility.

Physician Fatigue 101

Physician fatigue is used to refer to doctors experiencing emotional exhaustion, a decreased feeling of success and pride at work, cynicism, exhaustion, depersonalization of patients and a lack of empathy. Burnout can be subtle and affect any healthcare practitioner.

There are four core factors that increase stress levels and the likelihood of physicians specifically experiencing burnout and fatigue.

  1. Time: Doctors are under a great deal of pressure to do a lot of tasks in a short amount of time and document the entire process.
  2. Chaos: Physicians experience disorder on a regular basis, even in organized offices that sometimes lack resources or a streamlined workflow.
  3. Lack of Control: Feeling a persistent lack of control over the tasks performed, work conditions and environment can increase fatigue.
  4. Competing Demands: When doctors are constantly pulled in two different directions, like needing to increase the number of patients but also spend more valuable time with each patient, it can also contribute to burnout.

It has been directly linked to:

  • Physician alcohol and drug abuse
  • Decreased patient satisfaction and care quality
  • Higher malpractice risk
  • Higher turnover
  • Physician suicide

With physician fatigue being a potentially fatal disorder, it’s vital that your practice takes it seriously.

On Patients

Burnout can compromise patient care and patient experience. When anyone experiences high levels of stress for long periods of time, their memory, attention and decision-making will be affected. In a career where skilled, competent and timely decision-making is so important, the consequences of physician fatigue can be deadly for patients.

On Practices

To demonstrate the devastating impact of physician fatigue can be demonstrated in one study by the American Medical Association. This found that in a healthcare system with 500 doctors and the average national rate of burnout (54%), a whopping $12 million a year would need to be spent only to replace the physicians that were lost. That figure does not factor in decreased productivity, financial ramifications of mistakes and more.

Reduce Physician Fatigue with Vetters Enterprises

Let us help you eliminate the chaos in your office and reduce stress levels with our services in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Give us a call at (443) 352-0088.

The 4 Most Common Reasons Your Practice’s Claims Are Bouncing

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Billing can be time-consuming, tedious and frustrating to say the least. It can be even more frustrating when the medical claims that you worked so hard to submit are bounced right back. What are the most common reasons that a medical practice’s claims are bouncing back after submission?

Minor Errors

Just like it’s easy to miss a comma in an email or mistype a word, it’s also very easy to make minor errors in medical claims. Reimbursements are often denied or delayed due to seemingly-small mistakes, like forgetting to include a plan ID number or mixing up a letter. Because front desks are already so busy and overwhelmed, mistakes can fall through the cracks. One winning solution to this is using a professional outsourced claims processing service that will review claims before submission and look just for errors. The time saved from going through a resubmission is much less than time spent reviewing claims.

Missing Information

Another common reason that claims are bouncing is insufficient information. You always need to submit documentation to back up claims, and you should always supply each insurance provider the information that is requested to process payment in an expedient manner. Again, it is much easier to put the effort into properly gathering everything beforehand instead of needing to go back in the future to find the right documentation.

Skipping Authorization

If you needed authorization before a procedure was performed and it was not secured, you shouldn’t be too surprised that a claim bounced back your way. You should verify whether or not prior authorization is needed before you schedule the procedure. When it is time to bill, ensure that you also include the prior authorization number on the submitted claim. While prior authorizations can seem like an annoying extra step, they are vital to ensuring that claims receive approval in a prompt manner.

Changes on the Patient End

One of the most common reasons for claim denial isn’t necessarily your practice’s fault at all. Claims are often denied because a patient’s coverage has changed, the plan or payer has been changed or coverage has been terminated altogether. Even if you think everything is the same as the last time you spoke with a patient, you should always ask to confirm insurance information and see an insurance card at each appointment.

Trust the Experts at Vetters Enterprises for your Billing Needs

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

When You Should Call Your Patients Instead of Emailing

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Technology has changed the entire healthcare landscape, and for many doctors, it has also transformed the way that they speak with their patients. Instead of communicating by telephone and letter being the only options, emailing and texting are now on the table. Do you know when you should call your patients instead of emailing or texting?

Why Do Doctors Email?

A growing number of doctors use email for most regular communications, as it can increase practice efficiency and prevent playing phone tag. Doctors also like being able to make themselves available for patient questions and concerns around the clock through email. Email communication can also be perfectly sufficient for quick messages requesting appointments, rescheduling or requesting prescription refills. However, there are HIPAA violations that can come to play over email that aren’t as possible elsewhere.

When Emailing Is Inappropriate

As with any other technology product, there are both upsides and downsides to emailing instead of calling your patients. Beyond potential murky water with HIPAA guidelines, there are many situations where emailing can lead to unnecessary stress and confusion:

  • Discussing issues before completing a physical examination of the patient could lead to misdiagnosis.
  • Email messages can be misinterpreted by the patient receiving them. If the misinterpretation leads to damage, you could be held liable.
  • Anyone who is not the patient could open the email and read sensitive information.

If there is a chance that any of the above scenarios could occur, you should call your patients instead. Remember that the tone of your voice can have a huge effect on the message that a patient receives, and written words are not ideal for conveying tone.

If You Do Email

When it is appropriate to email instead of calling your patients, use the following best practices:

  • Use email messages to supplement your existing patient relationship, send reminders and offer general health tips.
  • Only use email if you have a firewall-protected server and both you and the patient are using encryption technology. Most standard email does not meet HIPAA requirements.
  • Educate your patients about when it is appropriate to email the office instead of calling.

Learn When to Call Your Patients with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

How the 2018 Flu Epidemic Can Prepare Your Practice for the 2019 Season

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The 2018 flu epidemic caused a frenzy across practices, the internet and communities throughout the United States. While many flu seasons over the past few decades have been unremarkable, the 2018 flu epidemic was notable for the severity of the virus and the deaths that occurred as a result. As in any field, it’s important to learn from the past to improve the future. The 2018 flu epidemic has many lessons to offer the average practice.

Communicate Clearly with Patients

Communicating with patients and employees is critical for triaging potential flu patients before they ever come in for an appointment. Doctor’s office and emergency room visits are not necessary for the majority of people experienced mild flu-like symptoms. Your practice should educate patients early on what symptoms are cause for concern and what symptoms do not mean they need to head right into the office. This limits both unnecessary strains on your resources and prevents exposure in your waiting room. If you can, include the most worrying symptoms that should lead to medical care (trouble breathing, chest pain, confusion, dizziness, etc.) in a brochure or email blast that you send out to patients.

Offer Protection Tools in Your Practice

When patients with flu-like symptoms arrive in your office, provide them with tissues and surgical masks. Always have hand sanitizer available for any visitor to your practice. If possible, keep patients with influenza symptoms away from other patients. If it isn’t possible to maintain more than one waiting room, mark off a specific area or prioritize patients with flu symptoms when filling exam rooms. This stops the spread of flu inside of your practice and makes patients visiting for unrelated reasons feel more comfortable coming in.

Educate About the Flu Vaccine

One of the key hallmarks of the 2018 flu epidemic was many patients ignoring the influenza vaccine because of perceived ineffectiveness or other concerns about vaccines. When visiting with patients, take time to explain why flu vaccines are important, even when the past year’s vaccine was perceived as a “failure” in some circles. Answer questions with respect, and understand that patients are often undereducated or misinformed on the subject of flu vaccinations. Start promoting the vaccine’s availability early in the year and reach out to patients who haven’t been vaccinated by the start of flu season to make it clear that it isn’t too late.

Flu Epidemic Guidance for Your Practice from Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Ending the Revolving Door of Patients at Your Practice

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A general practice with a revolving door of patients is one that always seems to be losing patients at the same rate that they are attracting them. New patients are showing up for appointments, but most of them vanish off to never be seen again. While it’s tempting to invest most of your marketing efforts towards attracting new patients, without making an attempt to keep the old ones, you’ll end up with a revolving door of patients.

Why Are Patients Leaving?

One survey of patients who chose to leave their medical practice of choice found that patients have 4 core reasons for putting their medical care in someone else’s hands:

  1. Feeling neglected
  2. Poor communication or misinformation
  3. Feeling rushed
  4. Lack of detail or description for procedures, tests and results

At the heart of all 4 of those things is that sometimes, doctors do not have enough time to satisfy patient needs fully. What does that mean? You should go above and beyond to provide patients with additional resources and also distribute the patient retention responsibility throughout your practice. It isn’t just the doctor who is responsible for keeping patients. Instead, it’s also the receptionists, nurses, technicians and more.

Educate

Invest in resources that can educate your patients. While you might not have time to explain a procedure to a patient in one visit thoroughly, you could show a video, offer them literature or direct them to a page on your website. When patients know where to find the information that they need, they will be much more likely to seek it out and sate their curiosity.

Ask and Reassess

Regular patient surveys are another great way to see how you’re doing and make changes to suit the needs of your patients better. In some cases, patients value the opportunity to express themselves more than actual changes taking place! Make it clear that you care about your patients, their health and their experience at your practice and you will be much closer to retaining them.

Follow Up

When a patient leaves that means that they’re gone forever, right? No! If a patient leaves your practice, despite your efforts to retain them, you should place a follow-up call to see why they chose to do so. Many patients are willing to give you valuable insight on why they left, which could help you pull more patients out of the revolving door of patients.

Additional Retention Tips

  • Ensure that patients are informed of when their next appointment is.
  • Reward patient loyalty.
  • Send appointment reminders.
  • Make scheduling as easy as possible.
  • Keep track of important patient information, like birthdays and contact information.

Practice Guidance for Your Practice from Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

What PCPs Should Know About Asking for a Hospice Consult as a PCP

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Once you’ve determined that hospice care might be the best course of treatment for one of your patients, it’s time to formulate a plan to discuss hospice care and arrange for a hospice consult. Making that recommendation can be easier said than done, especially since hospice care has many connotations that go along with it. What do you need to know about hospice care for your patients?

What Is Hospice Care?

Whenever someone is facing a life-limiting illness, the goal of their medical care should be a team-oriented approach to care, pain management, emotional support and spiritual support that is customized to the patient. In surveys, many caregivers and families of terminally ill patients indicate that they would have liked information about hospice care when the diagnosis was labeled as terminal, not later in the process. While communicating this might not be comfortable, you should keep this in mind.

Delivering Bad News

One of the best methods for delivering bad news in the medical field is SPIKES. SPIKES represents a 6-stage process: set up, perception, invitation, knowledge, emotion and summary.

  • Set Up: Choose the right environment for the discussion and ensure medical consensus beforehand.
  • Perception: Ask the patient what they know about the illness and any information they already know. Ask the patient what matters most to them and what their wishes are. You should also ask if the patient has heard of hospice care and what they know about it.
  • Invitation: Ask the patient if it’s okay if you share information about hospice care with them.
  • Knowledge: Provide the patient with information before the hospice consult. Let the patient know that hospice can help them meet their goals of staying at home instead of going to the hospital, pain management and emotional support. Also, let the patient know what hospice care provides.
  • Emotion: Express sympathy for the patient. For example, “I know this isn’t good news to hear,” or “I’m sorry that I have to be the one to tell you this.”
  • Summary: When patients get a lot of information at once, it can be hard for them to process things. At the end of the conversation, ask the patient what they understood. You should also state clearly your recommendation that the patient have a hospice consult so they understand what the next step should be.

Recommending a Hospice Consult

You should determine whether or not a patient is eligible for hospice care. Medicare mandates that patients have a life expectancy of 6 months or less if the illness runs the expected course. You must be able to certify the terminal diagnosis and prognosis or re-certify them. To obtain a hospice consult, you must request it from a hospice service provider. The provider will evaluate the patient, determine eligibility and establish a care plan.

Practice Guidance for Your Practice from Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Breaking Down GDPR and What It Could Mean for US Physicians

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There’s a high chance that if you subscribe to 200 mailing lists, you’ve received what feels like 1,000 emails informing you about privacy policy changes. All of these emails are coming in the wake of the European privacy laws called the General Data Protection Regulations (GDPR). What do you need to know about these laws, even if you’re only treating patients in the United States?

Who Is Affected by GDPR?

Any business that is established in the European Union and any business that handles the personal information of “data subjects” in the European Union, regardless of where they live and their citizenship, is subject. If a doctor works or is based in the EU and has a website that collects any personal data, like a name, email address, phone number of IP address (even through Google Analytics), they are required to comply. Doctors in the UK must follow these new regulations, but US doctors are exempt…for now. There’s a good chance that over the course of the next few years, the United States will put similar regulations into place.

What Happens if Doctors Don’t Comply?

Anyone who doesn’t comply with these new laws can be subject to fines up to 20 million pounds or 4% of the worldwide turnover for the past 12 months depending on which is greater. These steep fines probably won’t be levied against small practices, but instead against any businesses that receive the most complaints. It’s a good idea to practice keeping patient data safe now, instead of running into nasty surprises in the future.

What Should You Do for GDPR?

If GDPR-type regulations go into place in the United States, here’s what you need to know!

  • Personal data includes names, phone numbers, emails, questions, comments, IP addresses and digital data. Even if you do nothing with personal data but store it, you must still comply.
  • You should audit the personal data that you’ve already collected and note where it is from and who it is shared with. Once you do that, you should document the legal basis for the processing of data and send an email to all existing list members to notify them of your privacy policy.
  • When collecting personal data in the future, you must add opt-in wording to all of your forms. It should include the affirmation of “explicit, affirmative and granular consent.” Patients should have no doubt that they are granting their consent and not simply have an automatically-selected box. You should also make your privacy policy so that it is written in plain, easy-to-understand English.
  • Update your cookie policy or add one.
  • Make sure that all of your data processors are GDPR-compliant.

Protect Patient Information with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.