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Take the 2011 MSP salary survey

Ever wonder how your salary stacks up against other MSPs in the country, or even in your area?

Briefings on Credentialing (BOC) is conducting an online salary survey to collect data on the latest salary trends among MSPs. Click here to fill out the short 15-question survey. A summary of the results will be published online at the Credentialing Resource Center blog, and BOC subscribers will receive and in-depth look at the results in their April 2011 issue.

After you complete the survey, enter your name to win a credentialing book of your choice. The winner will receive one complimentary HCPro credentialing and privileging book, excluding Core Privileges for Physicians.

The survey closes on February 11.

Ageism or activism?

A January 24, 2011 article in The New York Times, “As Doctors Age, Worries About Their Ability Grow” raises a poignant issue: physicians’ mental and technical abilities may decline as they age.  Physicians are well acquainted with the effects of aging as it relates to their patients, but they are less aware of the affect of aging on themselves.  The article mentions a 2005 study that found that the rate of disciplinary action by a state medical board was 6.6% for physicians out of medical school more than 40 years compared with 1.3% for physicians out only 10 years. A 2006 study found higher mortality rates for complicated surgeries when the surgeon was more than 60 years old.  Obviously physicians can become impaired at a young age, or remain at the top of their game well past 70, but should the medical staff be more proactive? Should we protect our colleagues and patients by more aggressively evaluating the aging physician for mental and physical impairments? Should the medical staff bylaws, rules, regulations, or policies address special conditions for the aging practitioner that includes a provision for fitness-for-work evaluations? Ours do.

New York Times shines light on the aging physician issue for the general public

Here at HCPro, we’ve been discussing the issue of aging practitioners for years and offering our customers tips, strategies, and policies to help them usher aging yet valued physicians into retirement. However, the general public may not be as acutely aware of the issue as our customers are. Many mistakenly think that there are foolproof mechanisms in every hospital to protect them from doctors who are no longer competent to practice, reports a January 25 article in The New York Times. Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, senior consultant with The Greeley Company, a division of HCPro, Inc., in Danvers, MA, was quoted in The New York Times article. He emphasizes the need to screen aging physicians early to allow them to modify their practices and enter retirement with dignity, rather than having their licenses taken away after an embarrassing or deadly event.

Did the ABIM overreach?

Months ago, the American Board of Internal Medicine proposed sanctioning 139 physicians for passing along and receiving test questions from a test preparation company. While many physicians feared the sanctions would cost them their jobs, it now appears dozens of the physicians cited won’t be held for sanctions the ABIM initially sought.

Drew Wachler, an attorney representing 40 physicians, says the ABIM has allowed his clients to resume their careers, by shifting course, in part. Still, he says, he hopes ABIM will revise its procedures, and that remains to be seen.

Via Joe Cantlupe, HealthLeaders Media.

Video: Online medical staff training demo

HCPro released the online medical staff training library that users can use at home or the office, basically anywhere with an Internet connection. A few of you still had questions about how it works. It’s not a DVD or CD. It’s not an audio conference. It’s the next best thing to going to a live conference.

Well, you’ll just have to see for yourself on how it works. Click below to view the navigation demo.

For more information on this product, click here.

What’s on your to-do list? Discharge planning improvement should be

Yes, it’s almost the end of January, and I shamefully still have my Christmas tree up and my luggage all over my living room floor. Why? My to-do lists seem endless.

I have two lists—one for personal life, full of items, such as pay bills and write thank-you cards, and one for work life, a long list of people I need to e-mail or calls to make.

As with most people’s, the to-do list seems to grow by the minute. Today’s Hospitalist featured an article on uncovering the cause of hospitalists’ readmission rates, in other words, a must for the to-do list.

Board certification poll

Suicidal surgeons – Erasing the stigma

A January article in the Archives of Surgery titled “Suicidal Ideation Among American Surgeons” (Arch Surg. 2011; 146[1]:54-62)  reports that 501 of 7,905 survey respondents (6.3%) experienced suicidal ideation in the previous 12 months. This anonymous survey was conducted in June 2008. The rate of suicidal ideation among this population of surgeons was 1.5 to 3.0 times higher than the general population. Only 26% of those with recent suicidal ideation sought psychiatric/psychological help. Sixty percent of the physicians were reluctant to seek help because they were concerned that doing so could affect their medical licenses. 

The results of this study beg several critical questions. One is why are so many of our brethren suicidal? I’m sure we can spout a myriad of reasons for this; however, a potentially bigger issue is why are they afraid to seek help? Physicians are pretty good at denying their own medical illnesses and shortcomings – is this a denial issue? Or is it that in the current system, admitting we have an illness may lead to a loss of our livelihood and profession? 

One of the functions of licensing boards is to protect the public. Sixty percent of the physicians surveyed who indicated they had experienced suicidal ideation perceived that licensing boards might take action against their license due to their illness.  These physicians were not viewing the boards as advocates of the public but rather as adversaries of the physicians.  Are the licensing boards cracking the whip, or are medical staffs not adequately advocating for physicians through their physician wellness committees? Is our helping profession failing to help our own? Maybe it is time for us to remove the stigma of mental illness and just address all illnesses with similar care, compassion, and support, regardless of whether the patient is a physician. What do you think?

From second-class citizens to one of the gang: Hospital welcomes non-physician providers to the medical staff

It wasn’t long ago that PAs, NPs, and CRNAs could lose their privileges in a jiffy if the chief of staff of Adventist hospital decided it was necessary; there was no due process, hearing, or appeal rights, reports the Journal of the American Academy of Physician Assistants. A recent change to the hospital’s bylaws now allows non-physician providers full medical staff membership. This includes due process, committee voting membership, and the ability to participate in the peer review of physicians. Stephen Hanson, MPA, PA-C, says that this is a step in the right direction, not only for recognizing PAs as valuable members of the patient care team, but also in improving relationships between physician and non-physician providers.

Increasing numbers of physicians without hospital privileges causing distress in Canada

Every physician who decides to give up hospital privileges causes patients to be “orphaned,” says Dr. David Broderick of Northumberland Hills Hospital in Ontario. Broderick estimates that about one-third of the community’s physicians don’t take on hospital work, and of the two-thirds that do, few take the orphaned patients left behind by those who choose to practice solely in their offices, reports Northumberland Today. This trend may lead to understaffed emergency departments and a potential decline in the quality of patient care. Broderick relayed to his hospital’s board the story of a physician who returned his recruitment bonus to opt for a less-stressful lifestyle practicing in the office. 

Do patients really understand the physician-hospital relationship?

A man who underwent a cardiac procedure at Middle Tennessee Medical Center claims that the staff at MTMC refused to let him see his regular cardiologist during his stay, reports The Tennessean. The patient’s cardiologist, however, had only consulting privileges at MTMC since she moved her practice 40 miles away. According to the article, “They just plain, flat-out, bald-faced lied to me,” the patient said of the MTMC staff.

After being discharged, the patient spoke to his regular cardiologist who said that she regularly visits her patients whenever they are admitted to the hospital even though she only has consulting privileges. Some claim that this miscommunication was an intentional ploy by MTMC to gain more business, but barring any questionable behavior, this story begs the question of whether patients really understand the relationship between physicians and hospitals.

Patients may not understand that they can’t pick a hospital out of a hat and expect their physician to be able to treat them there, but do physicians explain that? Do they explicitly say to patients, “If you ever have an emergency, go to XYZ hospital because I can treat you there. I can’t treat you at ABC Hospital because I don’t have privileges there.” This may be less of an issue in rural areas where there may only be one hospital, but here in Massachusetts where you can’t throw a rock without hitting a hospital, it may be thoroughly confusing for patients who simply want to see the physician with whom they have a relationship. Patients are increasingly asked to take charge of their healthcare, so if they are going to be in the driver’s seat, physicians need to teach them the rules of the road.

When it’s over, it’s over

January is the month of looking forward and back and a good time to review the topic of employment transitions. Clinicians enjoy almost total job security, but management is a different story. Hospitalist programs are called upon to deliver ever-higher levels of clinical quality and patient satisfaction, but program directors have few tools to deliver on these mandates and must get good work from inexperienced physicians placed under high stress. Judging by the number of directorship opportunities being advertised for established programs, a lot of directors have trouble delivering on the mandates. It will probably get worse as the government squeezes hospital revenues harder and harder; I’ll have more about that next month. The rest of this piece will discuss what to do when a job ends.