Posted on November 30, 2017 by Tom Davis

The Specialist Advantage

Procedure-dependent specialists are sensing the instability of their referral streams as they see primary care services fragment. Though clearly illegal, primes are being subtley coerced by their employers into keeping their specialty referrals inside their own health systems. Without a robust primary care workforce within their organization, specialists are forced to rely on outside marketing to bring in patients directly. And I’ve yet to meet one specialist division that’s satisfied it...

Posted on November 29, 2017 by Tom Davis

Get The Medical Care You Deserve

As a teen, I bussed tables at a fancy restaurant. I loved flirting with the old ladies (my age now), troubleshooting the room and getting paid to hustle. I guess that’s why I used to love family medicine before I became an “employed physician.” Unfortunately, I also saw the dark side. The mouse in the lettuce, the dropped food getting plated and the cooks having sex in the cooler. Then one day,...

Posted on November 28, 2017 by Tom Davis

Abundance

You need a mindset of abundance. The scarcity mindset sees limited resources from which the individual must get their share. Things are being done “to” them. They are not in control The abundance mindset sees only the opportunity to constantly innovate, creating the opportunity to generate an infinite amount of resources. And as innovation succeeds, it creates a sense of mastery. To succeed in a value-based, risk-sharing environment, you must develop...

Posted on November 27, 2017 by Tom Davis

Success Codes-Pulmonary Medicine 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 terminologies 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....

Posted on November 24, 2017 by Tom Davis

Professional Expense Accounts

For clinicians and clinicians-to-be Imagine going to your Medical Director and saying, “As I work here day-to-day, I can see that burnout is going to be a real concern. I really want to stay for the long term. Since our organization doesn’t have a prevention program, I found one with CME . . . and I want to pay for it out of my professional expenses account.” “Sounds like a good idea.” ...

Posted on November 23, 2017 by Tom Davis

But I Didn’t Do Anything Wrong!

I was sitting there looking at a $40,000 clawback. And I didn’t do anything wrong. The insurance company was under pressure to increase its recovery rates under its internal audit systems, so as to prevent a more intrusive examination from the outside. So they applied the latest documentation regulations to documentation on visits performed 4 years old—long before those regulations had been created, let alone approved. If I appealed, I...

Posted on November 22, 2017 by Tom Davis

Dr Jen

Mrs. Dr. Tom is cursed with chronic pain, so she needs a good clinician to help her deal and get through the bad days. And she just got off the phone with hers—-Dr Jen. She was on the phone with her for over an hour. An hour! It didn’t cost her one extra nickel. Dr Jen’s practice is run on a “Direct Primary Care” model. For a monthly fee,...

Posted on November 21, 2017 by Tom Davis

The Congratulations Test

Many of my clients are clinicians looking for a change, and I help them along their journey. Many are scared—the unknown, the uncertain always gives one pause. So I prep them with the “Congratulations Test.” When it becomes known you are leaving your organization, if more than three fellow co-workers spontaneously come up to you and offer “Congratulations,” then you know you made the right decision. So far every client...

Posted on November 20, 2017 by Tom Davis

Success Codes—Diabetic Neuropathy 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....

Posted on November 17, 2017 by Tom Davis

Simplicity Works

Fear complexity. Complexity makes your system fragile to constant regulatory change. Complexity generates costs that eat away at your gross. Complexity creates distractions, serving itself at the expense of labor that generates actual value. But complexity is very difficult to avoid. It’s sexy. It makes you look important. It supports authority. The greatest challenge I have with my clients is overcoming complexity. Creating a recognition that complexity is an...