Physicians Practice - January 2008 - (Page 40)

ADDING ANCILLARIES an increased incidence of rejected claims. Physicians, meanwhile, who are struggling to squeeze more patients into an already hectic schedule, may be more likely to make incorrect diagnoses, prescribe assume that physicians (and their staff), scrambling to supplement their income, may experience their own brand of burnout due to increased workloads, which could affect patient safety. Terry McGeeney, president and chief executive of TransforMED, a practice redesign initiative of the American Academy of Family Physicians, agrees that patient safety must remain the industry’s foremost goal. “As long as providers function within their skill level, safety should not be an issue,” he says. “But on the other hand, you should always receive adequate training and perform enough procedures to keep current. If you only do ﬁve vasectomies a year, for example, it may not be in the best interest of your patients to continue doing them.” TOO FAR AFIELD? DOUBLE JEOPARDY It’s no great leap to assume that physicians, scrambling to supplement their income, may experience their own brand of burnout due to increased workloads, which could affect patient safety. That has Nancy Davenport-Ennis concerned. The chief executive of Patient Advocate Foundation in Newport News, Virg., says the diversiﬁcation of patient services can be a signiﬁcant positive — as long as doctors keep their eyes on the ball. “Practices that are going to diversify services need to use standards and quality metrics set through quality assurance and accreditation programs and use enhanced provider reporting to increase transparency in all those areas to ensure quality care,” she says. “We encourage practices to have a broad array of ancillary services all directly related to therapeutic intervention and quality of life.” That means offering ancillaries that don’t necessarily beneﬁt the bottom line. “We would be concerned, for example, with fulltime oncology practices that had no nurses available to take weekend or evening calls, leaving a message for patients to call or visit the local hospital instead,” says Davenport-Ennis. “For us, not providing that ancillary service can become a matter of life and death because the community hospital may not have immediate access to the patient’s adverse event being addressed at one o’clock in the morning.” the wrong medicine, or overlook negative lab results. “If you’re using existing staff to perform new services, there’s not only an increased chance for errors, but you’ll likely experience internal operating problems, including patient processing delays.” Fabrizio says. “You have to ask yourself if you can perform this service and maintain the same quality of care.” While little data exists on the underlying cause of medical errors in doctor’s ofﬁces, the effect of fatigue on hospital nurses and physicians is well documented. The landmark 1999 Institute of Medicine report, titled, “To Err is Human,” estimates that up to 98,000 people die in U.S. hospitals each year as a result of medical errors. Sleep deprivation was among the list of contributing factors, along with antiquated paper records systems and systematic problems within the healthcare ﬁeld. Hospitals, of course, are staffed around the clock, which necessitates shift work from sleep-deprived doctors and nurses. They are also more likely to juggle an onslaught of emergency patients at once. Both of these can contribute to human error. But it’s no great leap to 40 | PHYSICIANS PRACTICE | JANUARY 2008 As physicians reinvent their roles as healthcare providers, there are also a number of ethical concerns to consider. Some in the medical community, for example, believe doctors are getting dangerously close to performing procedures way outside their scopes of practice. “All kinds of different physicians have gotten involved in Botox injections, for example, to try to keep their practices alive where they themselves might be skeptical about the medical value of what they are doing,” says David Dale, president of READ MORE ABOUT IT! Visit this article online at PhysiciansPractice.com to: • Learn more about adding ancillaries smartly by typing “Adding Ancillaries” in our Search Article box. secrets of better-performing practices by reading the November 2007 cover story “Learning From the Best.” Click the “Articles” link and scroll down to the November issue. say about adding intravenous medication administration to your practice by typing “scope of practice” in our Q&A section’s search box. • Arm yourself with the success • Read what the experts have to WWW.PHYSICIANSPRACTICE.COM http://PhysiciansPractice.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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