The Value of Toenails

(note: NOT Dr. Tom’s actual toes)   When I’m asked to evaluate a practice’s Medicare Advantage performance, one of the first questions I ask of the primes is if they personally trim their patient’s toenails.   In a fee-for-service production-based model, doing so makes no sense . . . there are far greater returns on your time in referring trims to the podiatrist or a supervised NP/PA and seeing 1-2 more patients instead.   And if...

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Good Medicine and Good Business

“Good medicine is good business, but good business is not good medicine.”     This generally accepted aphorism is why your organization is diversifying.     It’s using the cash flow of its healthcare lines to invest in other allied sectors that offer steady, safer returns but still allow it to stay within the confines of its corporate mission statement.     Real Estate. Medical Equipment. Insurance and Financing.     Diversion of assets into...

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The Patient’s Guide to MACRA—and a Healthcare Revolution

What the heck is MACRA?   And why is it about to transform my healthcare?   Right now, you must be thinking, “Boring!, why do I need to know this?”   Because no matter how you pay for your healthcare, MACRA will change the face of your world.   MACRA stands for the Medicare and CHIPS Reauthorization Act.   It’s a law passed in 2015 to “fix” Medicare.   And boy, did it need fixing....

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Clinicians – Excel in the Corporate World

  So you’ve decided to practice medicine as an employee of a large organization.   It’ll be unlike anything you’ve ever done before.   Sure, your residency was provided within a large organization—but you were a trainee. You were protected.   Even if your life experience covers working in a large business, you’ve never played the key role that you will now—clinician, the driver of revenue and cost.   No, working as an important employee...

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Success Codes Nutrition 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....

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Boss Management

    Much burnout prevention training runs along the line of learning to handle your boss.   The idea goes that your relationship with your boss is 90% of your job satisfaction.   If the boss is happy, then you’re happy.   Utilitarian submission—that’s the implied strategy.   And female clinicians, with their social programming for pleasing, are especially vulnerable.   As a clinician, if you’re employed where your boss is 90% of your job satisfaction,...

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The Innovation Explosion

  Bill Bernbach is the father of modern advertising.   Ask any marketer—all of today’s advertising reflects his influence.  Heard of “minimalism with an emotional connection”? You see it in the marketing for Apple, Nike and Spanx. That’s him. He first used it to transform a car conceived by Adolph Hitler into the best selling automobile of his time.   How did he do it?   He didn’t do it himself.   In 1962, he...

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Who Owns Your Doctor?

    There’s something new under the sun.   Insurers are buying up doctor’s practices.   This is not necessarily a bad thing, but you need to know about it.   In the past, it was the large healthcare delivery organizations (HDOs) that bought up clinician practices.   Looking to apply basic business principles to the delivery of healthcare,  HDOs believed that employing doctors by buying up their practices allowed them to do better financially.  ...

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Tools of Persuasion—Smile

  Most clinicians are now paid based on the actions of patients, not themselves.         Congratulations, you’re no longer practicing the art of medicine, you’re in the business of influence.         It’s ironic. The electronic health record was introduced to ease the collection and analysis of patient care data.  Improved outcomes through meeting metrics.         But at the same time, clinician behaviors resulting from the introduction...

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Success Codes-Ostomy 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....

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