Physicians Practice - March 2008 - (Page 14)

LETTERS “No matter how much money one makes, there is always someone making more. I believe that at some point it makes no sense to try to keep up with the Joneses, particularly if the Joneses are insane!” ENOUGH IS ENOUGH? PAY DEBATE CONTINUES I want to compliment you on your October editorial “How Much Is Enough?” Recently, I talked to a solo practitioner in the suburbs of Chicago. He said he was looking for a partner because he felt overwhelmed — he had clinic from 8 a.m. to 5 p.m., and then rounds at three hospitals until 11 most evenings, and was on call every other weekend at those hospitals. I asked why he didn’t simply shorten his clinic or remove one of the hospitals from his coverage, and he said, “Well, how can I possibly make $250,000 a year if I don’t do this? I have to in order to make a decent living!” That attitude is surprisingly common. I recently read a book called “Green with Envy” by Shira Boss that refers to the philosophy of that physician and also discusses what you mentioned in passing — that no matter how much money one makes, there is always someone making more. I believe that at some point it makes no sense to try to keep up with the Joneses, particularly if the Joneses are insane! Personally, I’d rather make a little less money and have a life. I’m surprised, though, how few physicians agree with me. I don’t know if it’s a work ethic thing or greed, or some combination of both. I do know that the more a person makes, the more their lifestyle simply conforms to that income, and then that pursuit becomes addictive. Worse, at some point, it becomes dangerous, both to the physician and that physician’s patients. —Marc Wasserman, MD Chicago In “How Much Is Enough,” you brieﬂy mention the costs that many of us incur going through the process of medical school and residency, but do not note that this debt almost always is at the six-ﬁgure mark. I’ve paid on my consolidated loans for four years and have made little to no progress decreasing the amount owed, since most of each payment goes toward interest on those six ﬁgures. How many years will I have to work to pay this off before I can even start to think about retirement? I actually avoid calculating this out because it is too painful a thought. I don’t take costly vacations, I didn’t buy an expensive house, I don’t have expensive or new cars, and I don’t have a boat or a second home or any other luxury items. I plan to keep my nose to the grindstone and take any excess income to pay off my student loans. Even with this rather restricted budget it will take me a very long time to pay them off given the magnitude of the debt. I am already working at absolute maximum capacity in my schedule. I work 12-hour days most of the time, and I certainly am not being “purposefully less productive.” Do I deserve a decent income? I think the answer is yes. I sacriﬁced long and hard to make it through training, even working a second job while in residency to support my family and make my mortgage payments while on a meager resident salary, and I still cannot enjoy my life as a physician because this debt is looming over my head. Am I bitter about it? Yes. Would I have chosen a different career had I known this would happen? Probably. OUR MISSION Helping physicians manage their practices more efﬁciently, leading to improved patient care. P U B L I S H I N G S TA F F VICE PRESIDENT & GROUP PUBLISHER Ken Karpay kkarpay@physicianspractice.com GENERAL MANAGER Katherine Hermann khermann@physicianspractice.com EDITORIAL EXECUTIVE EDITOR Bob Keaveney bkeaveney@physicianspractice.com SENIOR EDITOR, PRACTICE MANAGEMENT Pamela L. Moore, PhD pmoore@physicianspractice.com MANAGING EDITOR Abigail Beckel abeckel@physicianspractice.com SENIOR EDITOR, PROJECTS Laurie Hyland Robertson lchrobertson@physicianspractice.com ASSOCIATE EDITOR Barbara A. Gabriel, MA bgabriel@physicianspractice.com MANAGING EDITOR, PROJECTS Alyson Siclare asiclare@physicianspractice.com SENIOR WRITER Shirley Grace, MA sgrace@physicianspractice.com EDITORIAL ASSISTANT Erica Lukenich elukenich@physicianspractice.com CONTRIBUTING WRITERS Robert Anthony, Jerry Arnett, MD, Bill Dacey, Susan Kreimer, Suz Redfearn, Shelly K. Schwartz PROJECT MANAGER Amanda Norbury TECHNOLOGY ANALYST Alka Chander DESIGN GROUP CREATIVE DIRECTOR Nancy Bitteker ASSOCIATE ART DIRECTOR Bill Ellis H O S P I TA L S T R AT E G I E S DIRECTOR, HOSPITAL STRATEGIES Steve Gottshall sgottshall@physicianspractice.com 773 880 HOSPITAL RELATIONS STRATEGIST Shelley Schoenfeld sschoenfeld@physicianspractice.com 732 393 HOSPITAL RELATIONS STRATEGIST Lori Brenner lbrenner@physicianspractice.com 715 384 HOSPITAL RELATIONS STRATEGIST Tom Reavis tom.reavis@cmpmedica.com 602 790 8484 9696 6711 2652 B U S I N E S S A D V E R T I S I N G S T R AT E G I E S DIRECTOR, BUSINESS ADVERTISING STRATEGIES, WEST Eric Temple-Morris etemple@physicianspractice.com 503 203 1060 BUSINESS ADVERTISING STRATEGIST, EAST Pamela Peterson ppeterson@physicianspractice.com 973 228 1226 BUSINESS ADVERTISING STRATEGIST, MIDWEST, SOUTH Seth Geller sgeller@physicianspractice.com 443 543 5131 BUSINESS ADVERTISING COORDINATOR Samantha Williamson samantha.williamson@cmpmedica.com 503 203 1059 PHARMACEUTICAL ADVERTISING SALES Jill Bresnick 203 662 6533 JBresnick@cmp.com BUSINESS SERVICES VICE PRESIDENT/RESEARCH, MARKETING AND CIRCULATION Beatrix Eriksen MARKETING DIRECTOR Lynne Kirk Hammar CLIENT RELATIONS MANAGER Lindsay Moe CLIENT RELATIONS SPECIALIST Beth Zacharias MARKETING MANAGER Amy Tubman GROUP DIRECTOR OF MANUFACTURING AND PRODUCTION Steve Sanborn GROUP PRODUCTION MANAGER Carlos Yanez PRODUCTION ASSISTANT Naddya Chavez BUSINESS DEVELOPMENT COORDINATOR Ann Marie Patrick CLASSIFIED ADVERTISING SALES Valley Forge Publishing Group 800 983 7737 HEADQUARTERS: 5523 Research Park Drive, Suite 210 Baltimore, Maryland 21228 Phone: 443 543 5100; Toll Free: 800 781 2211 Fax: 443 543 5170; E-mail: info@physicianspractice.com Web: www.PhysiciansPractice.com TO SUBSCRIBE TO PHYSICIANS PRACTICE: Call 203 662 6551 PHYSICIANS PRACTICE® (ISSN 1072-2912), published by CMP Healthcare Media LLC, is distributed to more than 280,000 U.S. physicians. Copyright © 2008 by CMP Healthcare Media LLC. Single copies $10; annual subscription $56. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publishers. Send address changes to: Physicians Practice, c/o CMPMedica, 330 Boston Post Road, Darien, CT 06820; or send by email to wdingle@cmp.com. 14 | PHYSICIANS PRACTICE | MARCH 2008 WWW.PHYSICIANSPRACTICE.COM http://www.PhysiciansPractice.com http://WWW.PHYSICIANSPRACTICE.COM

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

Physicians Practice - March 2008 Contents The Bigger Picture: Try a Little Tenderness Second Opinion Letters Physicians Practice Pearls: The Value of First Impressions Noteworthy Cover Story: Your Complete Guide to Patient Service Billings & Collections: Rules to Code By The Administrators Desk: Selecting an EMR Technology: Learn to Love Your Nerd Ask The Experts Coding The Guide The Tech Doctor: All About Blogs The Great Practice Makeover: When Bad Things Happen to Good Practices Start It Up - NEW! The Law: Audits 101 In Practice: Do As I Say... Pretty Please? Healthonomics: Handling the Changes Wrought by Medicare D Classifieds Advertiser Index

Physicians Practice - March 2008

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