U.S. physicians are torn over what the government should do to make healthcare more available and affordable, they're like-minded about one perceived scourge: the insurance industry, the Philadelphia Inquirer reports. A national survey of physicians found that most favored expanding health coverage to the uninsured through a government-sponsored program. Another survey found 70% of Massachusetts doctors support that state's three-year-old reform law, which increased public options, and created a government-regulated health insurance exchange.
Ninety-nine percent of hospital board chairmen think their hospital fares at least as well as a typical hospital on standard quality measures. Among the chairmen of hospitals that perform worst, 100% say their hospital performs at least as well as a typical hospital. The figures are from a survey published in the journal Health Affairs, based on responses from 722 people who chair the boards of nonprofit hospitals.
There have been major changes happening at medical schools across the United States as graduate schools try to catch up with the changing medical landscape, the Washington Post reports. The schools are now trying to prepare students for a world where mainstream doctors adopt holistic or alternative techniques, where doctors' offices portray themselves as "medical homes" offering "patient-centered" care, where primary-care physicians are increasingly in demand, and, where the system of paying for healthcare is likely to undergo a major upheaval, the Post reports. Catering to these needs, medical experts say, could help future doctors offer preventive care first, reactionary second.
With the House's passage of a sweeping healthcare overhaul, the advertising battle over reform has been pushed into a new phase as competing groups have taken to the airwaves to thank or punish Democrats for their votes, reports the Washington Post. There has already been more than $150 million spent this year on television ads related to the healthcare debate, according to the Campaign Media Analysis Group. As of Nov. 6, about $63 million had been spent on ads favoring Democrats' reform plans and $52 million on ads opposed, according to the analysis group.
The concept of "doing today's work today" through open access or same-day scheduling has been well known in practice management circles for years, and most practices that have tried it can vouch that adopting this technique increases patient, staff, and physician satisfaction, and decreases no-shows and wasted work.
Despite the rave reviews, open access—reserving a number of appointment slots for same-day appointments—is not wildly popular in practice.
One reason: "To doctors, volume is money. And they look at gaps in the schedule and almost panic," says Dawn Blazier, office manager at My Family Doctor, PC, in Brodheadsville, PA, where she's been using open access scheduling since 2004. "But at the end of the week, you're seeing just as many patients, but the stress is taken out of the schedule."
Further, traditional schedules often leave staff members spending significant time trying to squeeze in patients who need to be seen quickly, says Christine Ingram, a senior consultant with The Coker Group in Alpharetta, GA. For some practices, every day is a struggle to decide how to fit every patient into the schedule. And when this can't be done, patients go unseen and unsatisfied, she adds.
Despite the benefits, open access can go awry if not planned and executed properly. Here are six steps to help ensure open access success:
1. Educate and obtain buy-in. Make sure you have educated your staff and physicians on the reasons for adopting the new scheduling system, says Ingram. Start by clearing up misconceptions, particularly the idea that you'll be giving up control of the schedule.
"Believe it or not, you'll have a more predictable schedule, even though it's not people that you see on paper. Plus, physicians more often get to see their own patients. Patients don't have to see someone who just happens to have an open emergency slot," she says.
What many physicians and staff members may not realize is that open access is fully customizable to each practice's needs. Not all physicians need to use the system, nor do all physicians need to reserve the same amount of open access time. And it's perfectly acceptable—essential, even—to make changes throughout the year due to seasonal volume differences as well as trial and error, Blazier says.
2. Determine the scope of open access that is right for your practice. "Do your homework first," Blazier says. This means keeping a phone log of the number of calls the practice gets each day and the type of appointments requested, and watching trends develop for a few weeks, keeping in mind seasonal variability. "You're going to have to adjust, but you don't want to add 10 hours a week of open access when you only needed six," she says.
Meanwhile, take the time to conduct a quick operations check to ensure you aren't performing redundant front-end processes, such as collecting the same information at more than one time or place. This step will automatically improve the efficiency of your practice and clear the way for a smooth transition to open access, Ingram says.
Also understand that open access may not work for every physician or practice. For example, this type of scheduling is best suited to primary care or specialties that aren't heavily referral based. A doctor who does a lot of surgical consults, on the other hand, is probably not a good fit, Ingram says.
3. Simplify your scheduling codes (reasons for visit). Settle on no more than three to four standard codes, Ingram says. You may also want to standardize the length of each visit, no matter what visit type, she adds.
4. Work down your backlog before going live. If your practice is very busy, it may take some time to reduce your patient backlog before you can add same-day slots to your schedule. Some practices hasten this process by temporarily adding physician hours and shifts. This work-intense phase is the most challenging part of the implementation for many practices, Ingram says, but it pays off once your scheduling becomes virtually stress free.
5. Be flexible, but disciplined. Although you will find the need to make changes as you go along (e.g., more slots for back-to-school physicals and a slower implementation period for certain physicians), resist the urge to fill open access slots with anything but same-day calls. "The tendency is, ‘Oh, this patient needs to get in for a routine visit, and here's an empty [open access] slot for tomorrow,' " Blazier says. "At first, we struggled to keep these slots off-limits, but now we don't even look at them. If we do prebook an appointment, we're always sorry. If someone wants to call the next day, we're happy to put them in, but we won't prebook appointments that are reserved for same-day."
6. Track your success. Periodically check in with physicians, staff members, and patients to gauge how the schedule is working and determine whether you need to make any tweaks. Also monitor whether you see a drop in no shows and patient complaints.
It can take time to find the right mix of prescheduled and open access and work out the kinks, Blazier says, adding that it's well worth the effort. "I've been in the practice office for over 21 years, and to me, [open access] is the best way to schedule. I would never want to go back to an environment to have to squeeze in patients and double book," she says.
"The patients are absolutely thrilled," Blazier adds. "They're kind of trained by now that if they call in the morning, they're almost guaranteed an appointment that day. And that gives them peace of mind that they can pick up the phone and get what they want. And when we can give them what they want, it really makes for a nice relationship."
TeamStaff, Inc., a healthcare and administrative staffing services provider, has announced that CEO Rick J. Filippelli will step down, effective Jan. 30, 2010.