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The Polarized Hospital-Physician Relationship
Elyas Bakhtiari, Managing Editor

The traditional voluntary medical staff model that characterized hospital-physician relations for decades is now fading. That much we know. However, what the new relationship between physicians and hospitals will look like when the dust settles remains to be seen. [Read More]
  Sept. 18, 2008

 
Editor's Picks
Hospitals cautious in helping doctors buy EMRs
Despite regulatory changes that have opened the door to hospital-physician collaboration on EMR purchases, hospitals have been slow to move forward, according to a report released today from the Center for Studying Health System Change. Hospital leaders have expressed interest in supporting physician adoption to improve quality and physician alignment, but most haven't felt enough competitive pressure to act quickly. The authors conclude that larger metropolitan communities might see phased rollouts soon, but in any given community "only a small proportion of physicians are likely to be affected, at least in the next few years." [Read More]
What's the best way to pay doctors?
Many of healthcare's current problems hinge on the answer to that question. In this week's New England Journal of Medicine, Meredith Rosenthal, PhD, takes a look at some current experiments in payment reform, including the medical home, episode-based payments, and the Medicare Physician Group Practice Demonstration. Her conclusion, however, is that prospects for reform are based more on politics than economics. "Given that the two major goals of reform are to constrain spending growth and to move money from more intensive to less intensive settings—from doctors who carry endoscopes and scalpels to primary care physicians, for example—there will be substantial resistance to even the best-designed plans," she writes. [Read More]
Defensive medicine gets offensive
Benjamin Brewer, MD, writes in the Wall Street Journal about feeling compelled to order a CT scan for a testy patient, not because he was worried about internal injuries, but because he feared missing something on the dissatisfied patient and being sued. Defensive medicine is certainly something most doctors are familiar with, and Brewer estimates it accounts for 10% of unnecessary healthcare costs. Finding a solution is a challenge, however. Better physician-patient relationships would help, but that's its own problem. [Read More]
The making of a turf war?
"Virtual" colonoscopies may be able to identify 90% of polyps or cancers, according to a study in this week's New England Journal of Medicine. Good news for those looking for a less, well, invasive way to screen for colon cancer. But here's the rub: Colonoscopies have been very profitable for gastroenterologists, and there may be a little inter-specialty friction if/when radiologists can achieve similar results. Hospitals or multispecialty groups looking to invest in the technology down the road had better have a plan for dealing with some upset physicians. [Read More]
Business Rx
Eight tips for converting to open-access scheduling
In recent years many practices have successfully reduced patient frustration through "open access" scheduling. But there is no easy recipe for converting to open access scheduling. Practice leaders need to tailor this kind of system to their unique circumstances. [Read More]
Physician News
Eye on partnership of doctors, heart research group
Minneapolis Star Tribune - September 15, 2008
ER patients often left confused after visits
New York Times - September 15, 2008
Small patients, big consequences in medical errors
New York Times - September 15, 2008
Physician executive group appoints new CEO
Tampa Bay Business Journal - September 17, 2008

From HealthLeaders Magazine
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HealthLeaders February 2008
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PhysicianLeaders Forum

Informed Consent: More Than a Signature: Attorney Alan G. Williams, author of Physician, Protect Thyself: 7 Simple Ways NOT to Get Sued for Medical Malpractice, discusses the importance of informed consent and offers tips for improving the patient education process. [Read More]
Audio Feature

ICD-10 Woes: Robert Tennant, senior policy advisor with MGMA, discusses the CMS proposed timeline for implementing the ICD-10 code set and explains the administrative burden it could place on medical practices. he gave to Congress on the nation's looming physician shortage. [Listen Now]
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