The following are some conflict-reducing techniques outlined during Physician Health Services' seminar "Managing Workplace Conflict: Improving Personal Effectiveness" held in November 2008.
The techniques provide an overview of how to effectively reduce conflict in a healthcare setting by outlining how both sides can handle the problem to reach a peaceful conclusion:
Review the facts:
How does your story differ from the other side's?
Where do your data come from?
Know your assumptions
Realize it takes two to tango
Use honesty
Inquire, inquire Delay discussion when necessary
Handle emotions with care:
Is there too much emotion or too little?
Don't counterpunch
Know when to back off
Sense when your temper is rising and practice self-calming
Work with meanings:
Reframe the problem
Brainstorm possible solutions
Define mutually acceptable outcomes
See and express the problem as a neutral consultant might
Show respect
Adapted from Physician Health Services' seminar "Managing Workplace Conflict: Improving Personal Effectiveness." This article originally ran in the February 2009 issue ofThe Doctor's Office, a HealthLeaders Media publication.
With a stroke of his pen, President Barack Obama on Tuesday effectively eliminated physicians' biggest barrier to widespread EHR adoption.
For years physicians have cited the costs of implementation as a rationale for delaying adoption—including in our own Industry Survey—and considering the average initial investment somewhere in the $30,000 range, it has been a legitimate obstacle for most practices.
Not anymore. The American Recovery and Investment Act sets aside $19 billion to support healthcare IT, including up to $42,000 for each individual provider.
Here's how it gets doled out: Physicians who are "meaningful" EHR users can receive up to $18,000 if they are eligible in 2011 or 2012 ($15,000 or less if the first year is after that). Payment ceilings drop to $12,000 in year two, $8,000 in year three, $4,000 in year four, and $2,000 in year five. Payment limitations are 25% higher for eligible providers in areas designated as health professional shortage areas, and the incentives do not apply to hospital-based physicians.
Physicians wanted federal help with the healthcare IT costs, and here it is. Problem solved?
Not quite. It's better to think of EHR adoption as a starting point than a finish line, says David C. Kibbe, MD, MBA, senior advisor for the American Academy of Family Physicians and chair of the ASTM International E31Technical Committee on Healthcare Informatics. The real goal should be to improve quality and coordination of healthcare, not just to outfit every physician with new technology. The stimulus package's ultimate effectiveness depends on how some of the details in the provisions are executed in relation to that long-term goal.
For instance, the range of products eligible for incentive payments will make a significant difference. "One of the keys to the bill's success is to make sure that new and innovative products are allowed to participate in this marketplace and that the monies are spent toward some of those innovations, which I think will lower costs," says Kibbe.
Many of the traditional products, including those endorsed by the Certification Commission for Health Information Technology, have been experimental and difficult to integrate. If the scope is too narrow, physicians' concerns about interoperability and effectiveness, which have previously been overshadowed by cost concerns, could reinstall some hesitancy.
The details will be up in the air, however, until President Obama appoints a Secretary of Health and Human Services and other key players, such as the newly-created Office of the National Coordinator for Health Information Technology.
But time is of the essence. The bill is designed to make physicians act relatively quickly—in 2015, physicians without a meaningful EHR will receive only 99% of payments for professional services. The next year, another percentage point is shaved off, and another after that.
Physicians have been taking a wait-and-see approach long enough. The money is on the way; it's time to start shopping.
Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at ebakhtiari@healthleadersmedia.com.
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A typical primary care physician who treats elderly Medicare patients must coordinate care with 229 other physicians working in 117 different practices, according to a study by researchers at the Center for Studying Health System Change, Memorial Sloan-Kettering Cancer Center, and the Dana-Farber Cancer Institute. "The logistical challenges to care coordination are daunting given the fragmentation of care and the large number of peers that physicians must interact with when treating Medicare patients," said Hoangmai H. Pham, MD, MPH, the study's lead author and an HSC senior health researcher.
In Canada, the economic crisis is forcing some physicians to delay retirement plans or work longer hours than they had planned, according to this blog posting. According to Manfred Purtzki, a Vancouver financial adviser, the average physician-held portfolio has shrunk by approximately 30% in the last year, the blogger notes.
Gov. Kathleen Sebelius of Kansas is emerging as President Obama's top choice for secretary of health and human services, advisers said. Should she be nominated, Sebelius would bring eight years of experience as her state's insurance commissioner as well as six years as a governor running a state Medicaid program. But with President Obama about to begin a drive to expand health coverage, her strongest asset may be her record of navigating partisan politics as a Democrat in one of the country's most Republican states.
The Washington State Medical Association, which represents more than 9,000 physicians, is fighting a bill that would require doctors to screen vulnerable patients for a potentially deadly germ called MRSA. The number of hospital patients infected with MRSA has skyrocketed in Washington, but the medical association opposes any attempt by lawmakers to dictate how doctors attack the pathogen, said spokeswoman Jennifer Hanscom. The bill's sponsor, Rep. Tom Campbell, R-Roy, said the evidence is clear that doctors and hospitals have repeatedly failed to protect patients from the antibiotic-resistant germ MRSA.