Influence and Persuasion—The New Clinical Skills You MUST Know

For Clinicians and clinicians-to-be   He was pretty bland as insurance execs go—-but more than any other he burned my soul.   A decade ago when reviewing the first “pay-for-performance” plan our practice was going to have to swallow, he educated us on our metrics reporting. Fully 88% of those between 50 and 75 years old who actually had colons and had not had colon cancer were going to have to have a colonoscopy or...

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Success Codes—Diabetic Hyperglycemia

Time for another edition of my wildly popular “Success Codes” series. If you haven’t already, you may want to review my world-class, yet humbly simple (yes, really) explanation of RAF scoring—it’ll help you understand some of the shorthand terminology below. It’s the only one on the web written by a PCP who’s been in the trenches blocking and tackling since Medicare Advantage first arrived on the scene 20+ years ago—and done so with incredible results.  ...

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Exclusive Rights in Your Employment Contracts

For Clinicians and Clinicians-to-be Many organizations that try to hire you will demand exclusive rights to your medical license.   No moonlighting, no second job—nothing without their permission.   Now I’ve been using this space for months to point out the various scams and red flags organizations use to try to get you to sign on the dotted line.   This isn’t one of them.   Exclusive service clauses are neither unusual or unreasonable in...

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Watson, Your Workforce and You

  Recently IBM’s Watson was able to correctly analyze a pathology specimen and put a name to a patient’s cancer, a diagnosis which had previously stumped a group of highly trained physicians.   The patient received the appropriate chemotherapy and did well.   Watson reportedly learned from the experience, enabling the program to make the same diagnosis more easily in later simulations.   The history of automation teaches that this is not a harbinger of...

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Don’t Ignore Those Letters From Your Insurance Company

For PatientsIf you get a letter from your Medicare Advantage insurer this open enrollment period, make sure you’ve opened it.   This is the time of year when insurers send you letters about how your benefits will change come the first of the year. Some of those changes could be huge—-you really want to know about them.   The problem is, the one critical letter from your actual insurer is buried under a pile of...

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Clinician or Cog?

For clinicians and clinicians-to-be It was a dark and stormy night—really!   After working with one too many organizations unwilling to align incentives with their primes, I wrote the following piece out of frustration and sadness.   My editor told me it was too “dark” to publish, but the message is vital, burnout too common and patient dissatisfaction too high not to share.   Here goes:   If you’re an employed clinician and your organization...

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Success Codes—Diabetic Angiopathy Edition

Time for another edition of my wildly popular “Success Codes” series. If you haven’t already, you may want to review my world-class, yet humbly simple (yes, really) explanation of RAF scoring—it’ll help you understand some of the shorthand terminology below. It’s the only one on the web written by a PCP who’s been in the trenches blocking and tackling since Medicare Advantage first arrived on the scene 20+ years ago—and done so with incredible results.  ...

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Citizenship

For clinicians and clinicians-to-beHow can you tell shorthand what the worldview a prospective employer is?   If their compensation component includes a  “citizenship” component—-run.   Just run.   These components usually consist of attaining compliance with certain corporate activities—meeting attendance, mandatory training, filling out surveys, community service.  Failure to attain the desired level of engagement results in financial penalties, revenue withheld that you already worked to generate.   These “citizenship components” are always coercive—and speak...

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The True Cost of Defensive Medicine

For clinicians and clinicians-to-be   It’s difficult to discern how much practicing defensive medicine adds to the overall cost of care.   Big or small, it’s not nothing.   Empirically, practicing defensive medicine may or may not decrease the risk of getting sued—but it sure feels like it does.   And not practicing defensive medicine feels like assuming a greater risk while caring for the patient.   Getting sued is 6-8 years of living hell....

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Finding Your Insurance Home

For Patients   You simply must have a Medicare “insurance home”.       A place you can contact to troubleshoot your Medicare insurance problems.       A place of protection from all those predators and frauds out there.       A place where you feel confident your interests are going to be put first.       A place where you feel safe.       How do you find your insurance home?  ...

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