In 2007, 56% of American adults sought information about a personal health concern, up from 38% in 2001, according to a study by the Center for Studying Health System Change. Use of all information sources rose substantially, with Internet information seeking doubling to 32% during the six-year period. Consumers across all categories of age, education, income, race/ethnicity and health status increased their information seeking significantly, but education level remained the key factor in explaining how likely people are to seek health information, according to the study.
The Centers for Medicare & Medicaid Services has announced that all physician groups participating in the Physician Group Practice Demonstration improved the quality of care delivered to patients with congestive heart failure, coronary artery disease, and diabetes mellitus during performance year two of the demonstration.
The 10 groups earned $16.7 million in incentive payments under the demonstration that rewards healthcare providers for improving health outcomes and coordinating the overall healthcare needs of Medicare patients assigned to the groups, according to a CMS release.
It is crucial to know the characteristics of your practice's service area. Start by asking basic questions about the service area, including the following:
Is the population growing or declining?
What trends are you seeing with respect to the average age, sex, household income, race/ethnicity mix, education levels, and length of residence?
Describe the work force: Is there a predominant employer?
What is the mix of retail, manufacturing, governmental, and service occupations?
What potential effect will environmental factors have on the community's physical and mental health?
Who are your competitors? How many similar physician practices serve the same population?
What is the distribution of primary care versus specialty care physicians in the service area?
Do consumers out-migrate from the service area for specialty care, and if so, why?
How do consumers/patients differentiate physician care delivered at your medical practice from what is offered at competitor practices?
What attributes do they value that can be leveraged to build awareness, preference, and, ultimately, utilization of your group's service offerings?
How do consumers perceive the physician group?
Is there anything truly distinctive and meaningful about the group, and if so, how is this being communicated to the marketplace?
What sources do consumers rely upon to get information about physicians and the group's clinical offerings?
How do consumers make their choices about where to go for care (e.g., health plan, employer, word of mouth, etc.)?
From where does the practice draw 80% of its referred patients?
Much of this information is available through secondary market research, which refers to already existing information obtained from external sources, such as the Medical Group Management Association, the U.S. Census Bureau, and local and state medical associations. It also includes internally generated data, such as relative value units, current procedural terminology codes, and patients' ZIP codes.
Unlike hospitals, which have access to standardized inpatient market share reports, most medical groups don't have a lot of detailed information about their market share and must rely on estimates. The National Ambulatory Medical Care Survey publishes physician visits by specialty every two years. However, this information is specific to regions of the country and not to local area marketplaces.
There also are proprietary outpatient modeling software packages that estimate office visits using claims-based data. These may be a better solution, depending on your needs. The important thing is to recognize trends and to know what is happening in the practice service area. Choose the method that best helps you do this.
When dealing with issues related to health, life, and death on a daily basis, it's almost impossible to avoid controversy. From abortion to assisted suicide, physicians are caught in the middle of plenty of heated moral debates.
The latest comes out of California and pits the First Amendment against anti-discrimination laws. The California Supreme Court ruled this week against physicians who refused to perform an intrauterine insemination on a lesbian because of her sexual orientation. The OB/GYN defendant claimed that her religious views prevented her from performing the procedure and argued that the First Amendment right to freedom of religion protected her from prosecution.
Not so, according to the court. The judges ruled that it was a civil rights issue, no different than if the physician had refused to treat a patient because of race or ethnicity.
Physicians have come down on both sides of the issue. While many applaud the ruling because it reinforces the notion from the Hippocratic Oath that doctors should focus on the good of the patient, some have expressed concern about government entities telling them who and what to treat.
This case was fairly clear cut—California law includes sexual orientation in its civil rights protections. But there is a lot of gray area at the intersection of religion and medicine. What if a physician refuses to provide emergency contraceptives because of religious beliefs? What if a doctor objects to the use of stem cells? At issue is the proper balance between a physician's individual liberty and his or her obligation to a patient (particularly when receiving government funds).
Scholars and lawmakers have grappled with that balance for years, so providing an answer right now is a bit above my pay grade. But let's shrink the scope a little and consider the dynamics of a medical group or hospital.
Leaders have to deal with similar problems of balancing individual autonomy and group accountability. Suppose you are partners with or employing a physician who refuses to perform certain procedures. Should your group give the physician the autonomy to make his or her own decisions or attempt to set a policy and intervene?
If an individual physician's decision affects overall business or leads to a damaging lawsuit, it becomes everyone's problem. In fact, the California case escalated not because of a single physician, but because the overall medical group refused to provide treatment and advised the patient to find another doctor outside the group. The court's most conservative justice said in a separate concurring opinion that an individual doctor could protect against liability by referring patients to other doctors in their practice who did not share their religious objections.
If the group had been prepared with a physician willing to treat the patient or had a policy for dealing with the issue, it might have never gone to court.
These topics are not easy to address, particularly in a close-knit practice. But they become a lot more difficult to deal with after your reputation has been tarnished or a lawsuit has been filed.
Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at ebakhtiari@healthleadersmedia.com.
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After 15 months of negotiations and three strikes, union-represented registered nurses and two California hospitals affiliated with Sutter Health have reached tentative agreements on new contracts. Nurses at Alta Bates Summit Medical Center and Marin General Hospital will now vote on whether to ratify the accord, which their negotiating teams have recommended. The nurses did not get a master contract with all Sutter Health affiliates, which was their priority. But they said the tentative agreement was reached on "pivotal patient protections issues."
For months, the cost and availability of healthcare were daily fodder in the debate over which Democratic candidate would do a better job as president. But now healthcare has taken a backseat to the economy, the price of gas, and the war in Iraq as the top issues in the Presidential campaign.