Archive for April, 2019

SURVEY: Prior Authorization Obstacles Unnecessarily Delay Patient Access to Cancer Treatments

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SURVEY: Prior Authorization Obstacles Unnecessarily Delay Patient Access to Cancer Treatments

ARLINGTON, Va., April 25, 2019 — Restrictive prior authorization practices cause unnecessary delays and interference in care decisions for cancer patients, according to a new survey of nearly 700 radiation oncologists — physicians who treat cancer patients using radiation– released today by the American Society for Radiation Oncology (ASTRO).

Nearly all radiation oncologists (93%) said that their patients are delayed from life-saving treatments, and a third (31%) said the average delay lasts longer than five days – a full week of standard radiation treatments. These delays cause added stress and anxiety to patients already concerned about their health, and they are cause for alarm given research linking each week of delay in starting cancer therapy with a 1.2% to 3.2% increased risk of death.

In addition to prevalent treatment delays, the ASTRO physician survey illuminates other ways prior authorization negatively impacts patient outcomes and takes physicians away from caring for their patients:

Added Patient Stress

  • More than 7 in 10 radiation oncologists (73%) said their patients regularly express concern to them about the delay caused by prior authorization.
  • More than 3 in 10 radiation oncologists (32%) have been forced to use a different therapy for a substantial number of their patients (>10%) due to prior authorizations delays.

Unnecessary Delay Tactics

  • Nearly two-thirds of radiation oncologists (62%) said most denials they receive from prior authorization review are overturned on appeal.
  • Radiation oncology benefit management companies (ROBMs) required 85% of radiation oncologists to generate multiple treatment plans, which require physicians and medical physicists to spend several hours developing alternatives to their recommended course of treatment.
  • More than 4 in 10 respondents (44%) said their peer-reviews typically are not conducted by a licensed radiation oncologist.

Wasting Physician Time

  • Nearly one in five radiation oncologists (17%) said they lose more than 10% of time that they could be caring for their patients focused instead on dealing with prior authorization issues. An additional 39% spend 5-10% of their average workday on prior authorization.
  • More than 4 in 10 radiation oncologists (44%) needed prior authorization for at least half of their treatment recommendations. An additional third (37%) needed it for at least a quarter of their cases.
  • Many radiation oncologists (63%) had to hire additional staff in the last year to manage the prior authorization process.

Disproportionate Impact on Patients at Community-Based Clinics

  • Patients treated at community-based, private practices experience longer delays than those seen at academic centers. For example, average treatment delays lasting longer than a week were reported by 34% of private practitioners vs. 28% of academic physicians (p=0.005).
  • Radiation oncologists in private practice are almost twice as likely to spend more than 10% of their day focused on prior authorization, compared to physicians at academic centers (23% vs. 13%, p=0.003)

“This survey makes clear that restrictive prior authorization practices can cause unnecessary, stressful and potentially life-threatening delays for cancer patients,” said Paul Harari, MD, FASTRO, Chair of the ASTRO Board of Directors and professor and Chairman of human oncology at the University of Wisconsin-Madison. “While the system may have been designed as a path to streamline and strengthen health care, it is in fact frequently harmful to patients receiving radiation therapy. In its current form, prior authorization causes immense anxiety and wastes precious time for cancer patients.”

“Radiation oncology and cancer patients have been particularly hard hit by prior authorization’s unnecessary burden and interference in care decisions,” said Vivek Kavadi, MD, Vice Chair of ASTRO’s Payer Relations Subcommittee and a radiation oncologist at Texas Oncology. “Radiation oncologists increasingly are restricted from exercising our clinical judgment in what is in the best interest of the patient, yet we are held accountable for the outcomes of treatments where decisions have been taken out of our hands.”

In the 2018 annual ASTRO member survey, radiation oncologists named prior authorization as the greatest challenge facing the field. The burden was especially prominent among private practitioners in community-based settings, where the majority of cancer patients receive care.

The findings from ASTRO’s new physician survey align with recent reports from the American Medical Association (AMA), American Cancer Society Cancer Action Network (ACS CAN) and others, demonstrating the pervasiveness of prior authorization obstacles throughout the American health care system.

ASTRO recently signed onto a letter with the AMA and other medical societies calling for CMS to require Medicare Advantage plans to align their prior authorization requirements with a Consensus Statement on Improving the Prior Authorization Process authored jointly by leading provider and payer organizations.

Survey Methodology

An online survey was sent by email to all 3,882 U.S. based, practicing radiation oncologists in ASTRO’s member database, and 620 physicians completed the survey online. Invitations were sent in December 2018, with one email reminder in January 2019, and the survey closed in February 2019. ASTRO staff also administered paper surveys at the ASTRO Annual Meeting in October 2018 and collected 53 responses. Findings reflect the combined total of 673 radiation oncologist responses. For more information about respondent demographics, view the executive summary.

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ABOUT ASTRO

The American Society for Radiation Oncology (ASTRO) is the world’s largest radiation oncology society, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. The Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals,International Journal of Radiation Oncology • Biology • Physics, Practical Radiation Oncology andAdvances in Radiation Oncology; developed and maintains an extensive patient website, RT Answers; and created the nonprofit foundation Radiation Oncology Institute. To learn more about ASTRO, visit our website, sign up to receive our news and follow us on our blog, Facebook, Twitterand LinkedIn.

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Critical Errors in Inhaler Technique Common in Children with Asthma

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Critical Errors in Inhaler Technique Common in Children with Asthma

In the first study to evaluate inhaler technique in children hospitalized for asthma – the group at highest risk for complications and death from asthma – researchers found that nearly half of participants demonstrated improper inhaler use, which means they routinely were not taking in the full dose of medication. Adolescents most commonly displayed critical errors in inhaler technique. They also often skipped using a spacer, which is a device that is recommended for use with an inhaler to help the right amount of asthma medication reach the lungs. Findings were published in the Journal of Hospital Medicine.

“We know that asthma can be well managed in the majority of patients and using your inhaler correctly is a key factor in managing asthma,” says lead author Waheeda Samady, M.D., hospitalist at Ann & Robert H. Lurie Children’s Hospital of Chicago, and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Improper inhaler technique can contribute to children having uncontrolled asthma and needing to come to the hospital for their asthma. Our study suggests that as healthcare providers we can do a better job showing patients and families the correct inhaler and spacer technique, and checking it frequently to ensure they master it.”

Out of 113 study participants, 2-16 years of age, 42 percent missed at least one critical step in their inhaler technique. Researchers found that 18 percent did not use a spacer device with their inhaler and that these patients were mostly older.

“We see that our adolescent patients, who are transitioning to independent medication management, still need close monitoring to make sure they use their inhaler and spacer appropriately to achieve optimal asthma control,” says Dr. Samady. “Teens may feel that using a spacer is only for younger children, but using a spacer is recommended for adults as well.”

Previous studies have shown that adding a spacer device to an inhaler increases the amount of asthma medication a person takes in from 34 percent to 83 percent.

“Children with asthma can lead full lives if they receive the right medication at the appropriate dose, which is why correct inhaler technique is so crucial,” says Dr. Samady.

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Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 212,000 children from 49 states and 51 countries.

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Meet Our New Officers

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Meet Our New Officers

Aruna Arora, M.D.
President-Elect

Dr. Arora originally planned to follow her father into medicine as a pediatrician after watching him treat his patients and seeing his dedication to the children and their families. She, too, wanted to make a difference in the daily lives of people. But, when she was in medical school, her fascination with the brain and cognitive development changed her mind and her specialty to neurology.

“While taking care of patients with ALS can be challenging at times, there is nothing quite like helping a patient and family understand their own humanity. Helping someone whose life has been dramatically altered appealed to my original goal of helping people in their daily lives. I still remember the first time I performed an EMG on a patient with an initial complaint of a poor golf swing and diagnosed him with ALS. His journey over the next few years to death was humbling,” Dr. Arora said.

This year, Dr. Arora steps into the role of President-Elect on the Association’s Board of Censors with renewed vigor to make a difference for her colleagues in Madison County and beyond. Her desire to give back to her community is a guiding light for her every day.

“Understanding access to care issues or specific health care needs of certain populations can help with the care of individual patients. My membership and interest in the Medical Association is focused on figuring out how we can take a group of like-minded people and develop a coherent strategy that can potentially impact the health care of all Alabamians,” she said.

 

Amanda J. Williams, M.D.
Vice President

Dr. Williams is originally from Tallahassee, Fla. She received her medical doctorate from the University of South Florida and trained at University of Pittsburgh Medical Center’s Western Psychiatric Institute and Clinic, one of the largest and most reputable psychiatry residency programs in the country. There she was the chief resident of inpatient services and completed a one-year fellowship in Community Mental Health. She is now an esteemed board-certified psychiatrist in Montgomery, Ala.

She primarily treats adults with disorders of mood, anxiety, psychosis and personality, along with those struggling with addiction, past trauma, intellectual disabilities, and memory difficulties. She is a strong advocate for individuals suffering from mental illness and absolutely loves helping individuals find genuine wellness.

This is Dr. Williams’ second term on the board, and she is looking forward to lending her experience as a physician to her role as vice president.

“I’m honored and excited to have this opportunity within the Medical Association,” she said. “The practice of medicine faces many challenges right now, and I’m eager to take part in creating solutions in Alabama.”

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Centreville Physician Named President of the Medical Association

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Centreville Physician Named President of the Medical Association

BIRMINGHAM – Long-time Centreville physician, John S. Meigs Jr., M.D., was named president of the Medical Association of the State of Alabama during the Association’s Annual Meeting and Business Session last week. Dr. Meigs also serves on the board for the Alabama Board of Medical Examiners.

“The Association welcomes Dr. Meigs’ continued service on the Board of Censors as president,” Executive Director Mark Jackson said. “His medical experience, as well as his civic-mindedness and sense of compassion brings a strong perspective to the Board. It is a genuine pleasure to work with such a leader in the medical community.”

Dr. Meigs received his medical degree from the University of South Alabama and completed his internship and residency in family medicine with UAB/Selma Family Practice Residency Program.

He is a Diplomate with the American Board of Family Medicine. He is also a past president and former board chair of the Alabama Academy of Family Physicians; a Fellow, former Speaker, a past president and immediate past board chair with the American Academy of Family Physicians, and member of the American Medical Association. With the Medical Association, Dr. Meigs has served as a Delegate, Counselor, Life Counselor, Speaker of the House of Delegates, Board of Censors and on numerous committees. From 2009 to 2018 he served on the State Committee of Public Health and was their Chair his last four years.

In 2014, Dr. Meigs received the high honor of being elected to the Alabama Healthcare Hall of Fame, which recognizes those persons who have made outstanding contributions to or rendered exemplary service for health care in the State of Alabama.

Dedicated to giving back to his community, Dr. Meigs has served as a clinical professor at The University of Alabama College of Community and Health Science and a clinical professor at the University of Alabama-Birmingham School of Medicine. He is currently a member of the clinical faculty of the Cahaba Family Medicine Residency Program in Centreville. Additionally, he was named 2004 Bibb County Citizen of the Year by the Kiwanis Club. He has also served as President of Distinguished Young Women of Bibb County and is an active member of Brent Baptist Church where he serves as Moderator and as a deacon.

Dr. Meigs has been a member of the Bibb County Medical Society and the Medical Association since 1982.  He has been on the active medical staff of Bibb Medical Center since 1982.  His practice of Family Medicine continues with Bibb Medical Associates in Centreville.

 

Meet the 2019-2020 Board Officers and Board of Censors

  • John S. Meigs, Jr., M.D., President
  • Aruna Thotakura Arora, M.D., President-Elect
  • Jefferson Underwood, III, M.D., Immediate Past President
  • Amanda Williams, M.D., Vice President
  • Alexis T. Mason, M.D., Secretary-Treasurer
  • Julia L. Boothe, M.D., Speaker
  • Thomas James Weida, M.D., Vice-Speaker
  • Mark H. LeQuire, M.D., Board Chairman, At-Large Place No. 1
  • Michael T. Flanagan, M.D., Board Vice Chairman, 2nd District Censor
  • Max Rogers, M.D., 1st District Censor
  • Gary F. Leung, M.D., 3rd District Censor
  • Dick Owens, M.D., 4th District Censor
  • Patrick J. O’Neill, M.D., 5th District Censor
  • Eli L. Brown, M.D., 6th District Censor
  • Jane A. Weida, M.D., FAAFP, 7th District Censor
  • Beverly F. Jordan, M.D., At-Large Place No. 2
  • Hernando D. Carter, M.D., At-Large Place No. 3
  • Gregory Wayne Ayers, M.D., At-Large Place No. 4
  • William Jay Suggs, At-Large Place No. 5
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Four Medical Students Receive Scholarships during 2019 Annual Meeting

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Four Medical Students Receive Scholarships during 2019 Annual Meeting

BIRMINGHAM – This year four medical students received scholarship awards totaling up to $8,000 during the 2019 Annual Meeting of the Medical Foundation of Alabama. The AMASA Medical Student Scholarship Fund was established in 2012 by the Alliance to the Medical Association of the State of Alabama in partnership with the Medical Foundation of Alabama to assist rising senior medical students with the financial responsibilities that inevitably accompany their senior year of medical school. Meet the recipients:

Davis C. Diamond, University of South Alabama College of Medicine

Davis, a native of Georgia, said he has always had a strong connection with the State of Alabama since the majority of his family lives here. In fact, the decision to attend college at The University of Alabama came quite naturally considering his parents met at the college. While he is looking forward to pursuing his chosen specialty of dermatology, no matter where his residency may take him, he and his wife are looking forward to returning to Alabama to work and raise a family.

In the future, Davis hopes to join an academic or clinical practice focusing on complex medical dermatology with an additional career goal to be involved in ongoing research regarding the topics of melanoma, atopic dermatitis and dermatologic manifestations of rheumatologic disease. He has already had the opportunity to participate in a drug development lab for melanoma treatment and hopes to pursue similar endeavors in his career. Davis would also like to continue to mentor and teach as he has during his years in medical school.

Alexandra M. Fry, University of Alabama Birmingham School of Medicine

Armed with a minor in Spanish, Alexandra has been able to continue to improve her medical Spanish vocabulary by volunteering as a translator in the Equal Access Birmingham Clinic. Her passion for the Spanish culture has blossomed into future goals of using her voice to better connect with patients and with a more diverse population to improve the existing health care inequality. Last summer, she traveled to Buenos Aires, Argentina, to perform medical research on Chagas Disease giving her true insights in understanding the grassroots of medical study by immersing herself in another culture.

Alexandra is also interested in pursuing a new medical specialty with Physical Medicine and Rehabilitation. Understanding how our population is becoming older, and this specialty combines internal medicine, neurology and physical therapy, Alexandra said she is excited to conduct more research in this field of study.

Christopher A. Johnson, University of Alabama Birmingham School of Medicine

For Christopher, a native of Dothan, medicine was not the family specialty. Unlike his peers who were raised in families of physicians and expected to follow in the family business, Christopher was raised in a family of musicians. His father was a music minister in Birmingham and his mother a music teacher in Dothan who worked three jobs to ensure he and his three sisters had every opportunity life had to offer. Instead, he was surrounded by “some of the best men who also happened to be physicians” who invested in him personally and academically. He credits these role models for shaping him into the “man I am today and the physician I am striving to become. I am not inspired to carry on the legacy of these men in my career as a physician and hope to bless the next generation with the same encouragement and guidance I was fortunate enough to receive.”

Christopher hopes to pursue a career in family medicine with a fellowship in sports medicine. In the past two-and-a-half years, he has completed his pre-clinical work, begun his clinical rotations in Montgomery and married. Now, he is looking forward to using these opportunities to better the world around him.

Jeremy K. Prince, Edward Via College of Osteopathic Medicine – Auburn

Jeremy, a native of Aliceville, said he believes “a career in family medicine is the best avenue because family physicians have the ability to be deeply involved in the community.” And, the community is very important to Jeremy, who has traveled across Alabama and witnessed firsthand how our state’s health care issues have taken a severe toll on our citizens.

One of Jeremy’s mentors at VCOM said Jeremy’s positive attitude and leadership skills make him a true professional and role model for his classmates, and his ability to encourage and support others has created a positive force in the school and the community at large.

Donations to the Scholarship Program can be sent to AMASA Treasurer Mary Beth Lloyd, 5949 Crestwood Circle, Birmingham, AL 35212. Donations may now be made directly to the AMASA Scholarship Fund from retirement accounts.

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Underwood Minority Scholarship Award Announced

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Underwood Minority Scholarship Award Announced

MONTGOMERY — The Underwood Minority Scholarship Award was officially announced during the Association’s 2019 Annual Meeting and Business Session. Named for long-time Montgomery physician and the Medical Association’s 152nd President Jefferson Underwood III, M.D., the Underwood Minority Scholarship Award is for African-American individuals underrepresented in Alabama’s medical schools and the state’s physician workforce.

Dr. Underwood became the first African-American male to serve as President of the Association in 2018-2019. He previously served the Association as President-Elect, Secretary-Treasurer and Vice President. He is also a member of the Montgomery County Medical Society, in which he also served on the Board of Trustees and as President.

  • Applicants must be African American.
  • Students already attending medical and osteopathic school or who have been accepted are eligible.
  • One scholarship will be awarded annually.
  • Fundraising efforts will be the responsibility of the Medical Foundation of Alabama
  • The scholarship presentation will take place at the Medical Association’s Annual Meeting.
  • The Board of Medical Scholarship Awards will make recommendations to the Medical Association for potential recipients.
  • 2020 scholarship applications will become available in Fall 2019.

For more information, contact Mark Jackson at mjackson@alamedical.org.

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STUDY: Opioid Epidemic May Have Cost U.S. Governments $37.8 Billion in Tax Revenue

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STUDY: Opioid Epidemic May Have Cost U.S. Governments $37.8 Billion in Tax Revenue

UNIVERSITY PARK, Pa. — The opioid epidemic may have cost U.S. state and federal governments up to $37.8 billion in lost tax revenue due to opioid-related employment loss, according to Penn State researchers. Additionally, the researchers found that Pennsylvania was one of the states with the most lost revenue, with approximately $638.2 million lost to income and sales tax. The study looked at data between 2000 and 2016.

Joel Segel, assistant professor of Health Policy and Administration, said that the results — recently published in the journal Medical Care — could help governments that are hoping to make up for lost revenue.

“This is a cost that was maybe not thought about as explicitly before, and a cost that governments could potentially try to recoup,” Segel said. “Instead of focusing on the cost of treating people with opioid use disorder, you could think about it in terms of a potential benefit to getting people healthy, back on their feet, and back in the workforce.”

Previous research estimated that in 2016 there were nearly 2.1 million Americans with an opioid use disorder, and approximately 64,000 deaths were the result of an opioid overdose. According to the National Institute on Drug Abuse, there were 2,235 opioid-related overdose deaths­­­ in Pennsylvania alone.

Segel said that while previous studies have looked at the cost of the opioid epidemic in terms of substance abuse treatment and other medical costs, he and the other researchers were interested in exploring other costs that may not have been captured before.

“We wanted to take a systematic approach to how we could think about some of the tax revenue that is lost if someone is unable to work due to opioid use,” Segel said. “This could be an important consideration for either state or federal budgets.”

The researchers used data from the National Survey on Drug Use and Health, as well as information from a previous study that estimated declines in the labor force due to the opioid epidemic. They used the TAXSIM calculator from the National Bureau of Economic Research to estimate losses in tax revenue.

After analyzing the data, the researchers found that from 2000 to 2016, there was an estimated decline of 1.6 million participants in the labor force, with about 68,000 of those in Pennsylvania. There were about 180,000 overdose deaths, with approximately 6,100 occurring in Pennsylvania.

Additionally, the researchers estimated losses of $11.8 billion to state governments and $26 billion to the federal government in tax revenue due to reductions in the labor force. For state governments, this included lost sales tax and income tax revenue. Losses to the federal government were entirely due to lost income tax revenue.

Segel said the results help show the value of treating people with opioid use disorder and should be considered when treatment programs are being considered and evaluated.

“The state of Pennsylvania has been developing some innovative programs, and our results are something to consider as these programs are being considered for implementation,” Segel said. “Not only are treatment programs beneficial to the individual and to society, but if you’re thinking about the total cost of these treatment programs, future earnings from tax revenue could help offset a piece of that.”

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Penn State has made a multi-year investment in bringing together researchers from many fields to address the challenges of substance abuse in Pennsylvania and beyond.

Dennis P. Scanlon, distinguished professor of health policy and administration and director of the Center for Health Care Policy Research; Yunfeng Shi, assistant professor of health policy and administration; and John R. Moran, associate professor of health policy and administration, all with Penn State, also participated in this work.

This work was supported by the Commonwealth of Pennsylvania under the project “Estimation of Societal Costs to States Due to the Opioid Epidemic,” and part of larger work supported under a Strategic Planning Implementation award from the Penn State Office of the Provost, “Integrated Data Systems Solutions for Health Equity.”

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The Painful Reality of Ransomware and How to Protect Against It

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The Painful Reality of Ransomware and How to Protect Against It

Imagine if in a split second you were unable to access all of your patients’ health care records. A cruel ransomware attack had locked you out of your computer system, and in order to regain your precious data you needed to pay a cybercriminal’s demand in bitcoin.

Unfortunately by the time you finish reading this article several businesses in the U.S. will experience this dreadful reality. Most commonly the disaster will occur when an infected email attachment is opened and spreads through a network.

Health care providers have a significantly higher risk of being targeted by ransomware. The reason for this is simple: you possess a large amount of data that is valuable to cybercriminals. In addition, hackers know you need to access medical records, digital x-rays, and test results to provide medical services to your patients. This, they hope, will motivate you to meet their demands to get your protected health information back.

A sudden disruption to a business proves to be a strong impetus. Nearly three-quarters of businesses infected by ransomware pay up to recover their data. Studies show, however, that less than half of them receive the necessary decryption key to unlock their data. The good news is there’s a simple, secure solution to avoid going through this painful scenario.

DETERMINE YOUR HIPAA RISK

Ironclad Data Protection

Many practices don’t have the expertise, time or resources to deal with a ransomware attack. Many feel confident that their IT service provider has addressed security and backup needs in the event of a disaster. As a leading provider of HIPAA compliance software, we know several cases where a practice’s IT provider has not properly backed up their system. This can put you in the unenviable position of having to deal with unsavory cybercriminals. Here’s how our OfficeSafe software protects your data with the most secure online backup storage service available, and alleviates worries about a ransomware attack.

We provide a HIPAA compliant data backup solution with 256-bit encryption and SQL database restoration. This makes backing up and restoring your practice’s crucial data easy. In the event of a ransomware attack, you’ll have ten days of data backup, enabling your practice to easily find a clean data backup set. This is critically important. If your practice doesn’t have the capability to reinstate your data to multiple restore points in the past, you don’t have a sufficient disaster recovery solution.

OfficeSafe’s centralized management portal is designed for healthcare service providers and goes beyond file-and-folder backups, delivering a secure hybrid local and cloud solution. With our point-to-point encryption, you can use your existing email address to send messages via Gmail and other popular email client services. OfficeSafe also includes an emergency planning tool that helps members of your team expedite their response to unexpected situations.

The HIPAA Security Rule mandates that ransomware on your computer system or on that of a business associate must be reported to the government, as well as to the affected patients. If more than 500 records have been breached, you need to alert the media. The only caveat to this rule is if you can prove there’s a low probability that your protected health information has been compromised. Don’t let an unexpected incident cripple your business and tarnish your practice’s reputation.

Call us today at (800) 588-0254 or find out how we can work alongside your IT team to provide your business with full data protection in the event of a disaster.

DOWNLOAD YOUR HIPAA CHECKLIST TODAY
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Etowah County’s Physicians Who Care with Seth Spotnitz, M.D., and Matt Lovato, M.D.

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Etowah County’s Physicians Who Care with Seth Spotnitz, M.D., and Matt Lovato, M.D.

DECATUR ─ Part of the job of being a physician is to advocate on behalf of the patient. For the physicians in Etowah County who comprise the nonprofit organization known as Physicians Who Care, this isn’t just part of their job…it’s their mission.

Physicians Who Care of Northeast Alabama was founded in 1988 as a grassroots patients’ rights advocacy group. Originally, PWC was one of five physician-led patient-advocacy groups in the nation led by a national organization in response to the managed care practices of the time, according to PWC President Seth Spotnitz, M.D.

“When we first started there were groups in Los Angeles, St. Louis, Philadelphia and Detroit working to stand up for our patients,” Dr. Spotnitz said. “The national organization lasted about 10 years. They did a good job of lobbying in Washington and publishing some articles regarding national health care, but they dissolved around 2000 after the patients’ rights legislation passed. The other groups began to fade away, not seeing the need for local advocacy for patient advocates, but we did. We kept going. Since then we’ve been working in the community to improve relations with the population by doing numerous activities fundraisers.”

The Physicians Who Care of Northeast Alabama stay busy in their community. From publishing a directory as a service to the citizens of Etowah County to hosting a 5K Run/Walk each April with proceeds going to the Etowah County Cancer Foundation, the physician members of PWC work hard outside their normal business days to take care of others in their community.

One of the popular events hosted by the group is the A-Day physicals for county student-athletes. In order for students to be able to participate in school sports, they must have a physical in the spring. In 2018, the PWC physician volunteers saw 371 student-athletes during the A-Day physicals. Unfortunately, according to President-Elect Matt Lovato, M.D., this one day may be the only day a student sees a physician, so he wanted to make it count by reshaping how the group sees the students.

“We did it to where we were doing things a little bit more comprehensively. You can allow students to play sports with a pretty limited exam,” Dr. Lovato explained, “but we knew, with some of these kids, they would use this sports medical exam as a substitute for any checkup with their regular doctor. We went from doing the limited exams to doing a complete exam which made it possible for the physicians to detect more issues that we wouldn’t necessarily on a lesser exam. We can now detect things that allow us to let these students and their parents know they need to follow up with their family physicians. There’s always the possibility of catching something that could be life-threatening during one of these exams, but we haven’t yet found anything that the students and their parents weren’t already aware of, but doing more comprehensive exams allows us the opportunity to make sure these patients are healthy.”

PWC has given back to the community in so many ways during the years. From providing projecting microscopes for all the high schools in the county to hosting Thanksgiving dinners for residents who are less fortunate to raising money to help the chamber of commerce build office space, when the community calls, PWC always answers.

“One of our major accomplishments I’m most proud of is that we are responsible for the rehabilitation hospital here in town,” Dr. Spotnitz said. “We wanted and needed a rehab hospital here, so we contacted various hospitals. At the time HealthSouth seemed to be the best fit. The PWC went to the CON Commission and were able to give them the right to build here. Now it’s called Encompass, but it was a great achievement for us. We all pulled together to get them here for our patients.”

For Dr. Spotnitz, the need for local advocacy is real, and Etowah County has the power from within to fill that need. The physicians themselves have managed to propel Physicians Who Care forward for years now, and they have no plans to stop.

“We know there are organizations fighting for medicine on a national level, so that’s not our focus here,” Dr. Spotnitz said. “We have to do what we can here in our little area of the country. The bottom line is that we do all this because we believe the physician is to be the patient’s advocate right here where we can do the most good.”

If you would like to know more about Physicians Who Care and the group’s charitable work in Etowah County, check out the website at http://physicianswho.care/

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Could Employee Engagement be a Cultural Decision?

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Could Employee Engagement be a Cultural Decision?

As the Baby Boomers retire and Millennials join the workforce, managers find themselves with a new challenge in engaging the staff. The baby boomers did not mind following strict rules, nor did they require a daily pat on the back. Most employees need more than just a task list. They need to feel valued, informed and engaged. Physician leaders and administrators can engage the staff more effectively if they are modeling a positive culture based on a mission statement, values and communicating goals. Behavior modeling creates a sense of trust and engagement in the staff that improves morale and retention. High turnover in a medical practice is stressful for everyone; the remaining staff must take on more work and re-train staff over, and over again. High staff turnover is costly – the time to interview, onboard staff and train staff reduces productivity, and it is a definite sign there is something wrong at the leadership level.

Most physicians are experiencing “burnout” due to challenges in health care and increasing patient volume. In past years, a group practice was led by a physician who was interested in the business of medicine; the others in the group simply supported the ideals of the lead physician. Physician and administrator relationships are the basis for building a positive culture. The physicians and the administrator should meet often. All physicians should be involved in business decisions and develop leadership styles to enhance a positive culture. New physicians have skills in technical aspects of practice management and can serve as a champion to guide new projects. An administrator skilled in communication and empowerment can engage staff and grow leaders. Practice administrators learn what motivates each employee, and they can influence the entire team by assuring conflict is avoided or resolved. An effective administrator assures the office is running smoothly and leads by example. The administrator is a coach in every sense; he or she impacts the physician leaders, the staff and the patients. An effective administrator seeks opportunities to build morale by celebrating work milestones, birthdays, or even organizing a company picnic.

Engaged employees contribute to the organization’s effectiveness. An engaged employee feels passionate about the job and is loyal to the practice. If an employee is emotionally committed to the practice, he or she is more committed to the goals of the practice. A workplace that encourages idea sharing and personal value will give leaders and employees a sense of purpose and belonging, which leads to empowerment. An engaged employee will be an advocate for the practice, they speak positively about their work and encourage others to be a part of the organization. As we invest in our employees and overall culture, we raise the level of expertise and strength. As the team grows stronger, the projects are successful and seamless because the administrator and the physicians can work at a higher level.

A positive culture shows in every aspect of the practice; the efficiency and cheerfulness of the staff and the overall experience of the patient. I spoke recently during a group staff meeting on patient satisfaction. We discussed body language, a patient can detect when a staff member does not care or is not happy with their job. The patient experience relies upon an engaged staff member. We discussed companies who have an exceptionally positive culture that is ‘’caught” not “taught.” A positive culture starts at the top and trickles down to everyone!

Article contributed by Tammie Lunceford, Healthcare and Dental Consultant, Warren Averett Healthcare Consulting Group. Warren Averett is an official Gold Partner with the Medical Association.

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