Letter from the Editor-in-Chief

Posted On August 28, 2017 By In Letter from the Editor-in-Chief

Do the MACRA’ena?

Corny titles aside, MACRA/MIPS is creating a great deal of uncertainty and anxiety among physician practices, and urgent care centers are no exception. I have seen a lot of urgent care news sources, including this journal, referencing the latest updates from CMS (or recent articles published by other organizations), but urgent care-specific analysis is in short supply. I frequently hear colleagues say, “Medicare is such a small percent of my business, it’s just not worth the hassle.” Or is it? As with most government programs, complying with the rules indeedRead More
“Grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.” I’m not usually one to quote religious text, but this excerpt from the Serenity Prayer resonates. Perhaps the most pointed and overwhelming challenge facing physicians today is the loss of control over our profession. The last three decades have seen dramatic erosion of the status, ownership, and independence of physicians. The root cause is multifactorial to be sure, with influence from powerful special interests across multipleRead More
CQI – Continuous Quality Improvement: The process by which an organization identifies a problem, plans action to address the problem, implements the plan, and reviews the results for effectiveness.       In healthcare, we commit to CQI in order to affect outcomes; we focus on systems and process and how inefficiencies and lack of integration lead to undesirable outcomes. We scrutinize and identify a problem and propose a plan to change the process to improve outcomes. Here’s a very simple example: A universally accepted clinical quality goal is to reduce theRead More
In my previous column, I discussed the challenging issue of patient satisfaction and the provider behaviors that can contribute to poor service experiences. In this month’s editorial, I will pivot the discussion to the patient profiles and behaviors that can trigger negative interactions and poor service reviews. While most of us understand the importance of “customer service” in healthcare, we do not always dedicate ourselves to understanding the common traps and landmines that lead to service failures. As such, we allow ourselves to be baited into the same disruptive encountersRead More
Patient satisfaction surveys have driven a contentious wedge between management and clinical teams. While management is tasked with ensuring the practice is addressing patient needs and evolving consumer demands, providers are far more concerned with doing the right thing clinically (satisfaction be damned). However, with patient expectations changing, access to care improving, and practice economics eroding, we have to find a way to bridge this issue or we will quickly find ourselves locked in counterproductive bickering while others run off with our patients. Remember, the aging urgent care value propositionRead More
It’s tax time again and that got me thinking. And thinking got me angry. And angry got me belligerent. And belligerent got me nowhere. So, I went back to thinking about it, and here’s my take: Taxes are the contributions we make to society and the government so that it functions reasonably well, preserves our fragile democracy, and supports those who need our help. Yet, as a physician in a primary care specialty, like many of you, I can’t help but feel resentful this time of year. I’m “taxed out,”Read More
Clinical practice guidelines have been gaining interest, along with a little ire, over the last decade. Fueled by Medicare reform, the Affordable Care Act, Meaningful Use, and value-based reimbursement models, clinical practice guideline development has been envisioned as a critical way to achieve consistent care quality in a cost-effective and evidence-based way. This is nothing new of course. I remember memorizing the U.S. Preventive Services Task Force Screening Guidelines in residency in preparation for boards. I recall with fascination the lectures in medical school describing how screening guidelines are developed,Read More
Much has been written of late regarding physician burnout. And why not? The rates of burnout are astronomical and the consequences are scary. Consider these statistics: Medscape Physician Lifestyle Report 2015 notes that almost half of physicians report experiencing burnout. The Physicians Foundation’s 2014 Survey of America’s Physicians reveals that physicians are far more likely to burn out than professionals in any other line of work, and that only 40% of physicians over 46 years of age describe their professional morale to be even somewhat positive. By far, the mostRead More