MedWorm: Pediatricians

Me voy.

Ad libitum — Fri, 03 Feb 2012 14:05:00 +0100

http://www.youtube.com/watch?v=onkn2LXPYy4Me voydejando todo lo que te di,me voy dejando la vida aqui,me voy llorando en calma.Me voy,estoy borracho y voy a decir,que nunca pude ser lo que fui,que estoy pagando un karma.Pero no quiero que olvidesque yo te segui hasta el mar,y una cancion fue el amorque nunca hicimos.Me voy por que nunca viste que la luna era mi almacuando yo...... te la regalabaMe voy, te ame con todo pero no hay mas,mi corazon tiene que parar,me voy para salvarme.Me voy,si en tus bolsillos ya no hay lugar,para el amor que te quise dar,no volveré a besarte.Pero no quiero que olvides que yo te segui hasta el mar,y una cancion fue el amorque nunca hicimos.Me voy por que nunca viste que la luna era mi almacuando yo...... te la regalaba.Te la regalaba, te la regalaba.Yo te di...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Why is Measuring Sick to Well Ratio Important for your Pediatric Practice?

Pediatric Inc — Wed, 01 Feb 2012 15:00:06 +0100

Simply put, measuring wellness-to-sick ratio estimates the focus a practice has on preventive care. And how can this info help your practice? Data shows that practices that have fewer sick visits to well visits tend to be practices with better financial outcomes. But there are other reasons why measuring sick to well ratios are beneficial to your practice. Practice Management extraodinaire Chip Hart from PCC has some really good reasons as to why measuring this number is good for your practice. Chip says that “with the massive fluctuations in sick visit demand (look at the 2010 flu season and look at now), consistent well visit placement is crucial to business stability.” Chip also adds that well visits establish a practice’s value more than runny noses and sore throats. ...

Post #28 Respiratory Syncytial Virus (RSV) - Dispelling Some Myths

A Pediatrician's Blog — Sat, 28 Jan 2012 19:17:00 +0100

One of the common fear-inducing germs that moms ask me about during the wintertime is the Respiratory Syncytial Virus commonly known as RSV. Most moms correctly recognize the germ as a potentially devastating illness, however there are some common misconceptions about the germ that I would like to clarify.Probably the most common misconception is that RSV is dangerous; while RSV can be dangerous it typically is not. RSV is one of many known viruses which causes the common cold (there are over 200). The majority of people who acquire RSV will go on to have typical cold symptoms including cough, runny nose, and possibly fever. Most people will recover within a few weeks without any long term complications. However, the very first time a human being catches RSV, there is a higher probability ...

Steve Eblin Named CEO of Randolph Hospital . . . Just So We're Clear On Where Dr. Johnson Stands

Dr.J's HouseCalls — Thu, 26 Jan 2012 03:53:00 +0100

Just this morning, someone asked me if I had heard anything new about "the search" for the new CEO of Randolph Hospital (in the wake of Bob Morrison's departure). And I told them that, while I had not heard anything, I had no doubt whatsoever that the "search" was a ruse, and that Steven E. Eblin, Randolph's longtime VP of Corporate Planning & Development, and President of Randolph Medical Associates . . . the man who recruited me home to Asheboro . . . then broke every promise he ever made to me . . . and then fired me for saving a critically-ill newborn baby's life . . . would get the job.Now, what happened to me happened back in the heady, high-flying, non-profiteering days of Bill & Hillary's village . . . and on Bob Morrison's watch as&...

Practice Makeover E-Book: 101 Ways to Transform You Practice (Updated)

Pediatric Inc — Wed, 25 Jan 2012 15:00:28 +0100

Last summer, I was asked to give a talk at the Physician’s Computer Company Practice Management Conference. Around the same time, I was starting to write a blog post that talked about 101 things to do in your office. I wasn’t sure how to title it yet. PCC’s theme for the conference was “Change” so I decided to title the talk 101 ways to transform your practice and expand the post I was working on into an hour talk. But I also wanted to do something different with my slides. When I go to conferences, I usually ignore people’s slides. Why? Because most people use their slides as a teleprompter. Second, I usually can’t read and listen at the same time so I prefer to listen (surprisingly, I can text, read and respond to email while listening although my wife doesn’t agree). I a...

Who Opposes Healthcare? Children of Course

Pediatric Inc — Tue, 24 Jan 2012 21:30:24 +0100

I’m happy to see that in this country, we have media outlets that are digging around to find the real truth. Not the fake truth – like some of those other outlets do – but the REAL truth. Now it all makes sense. Enjoy! (Source: Pediatric Inc)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

What is the Benefit of an EMR in a Medical Practice?

Pediatric Inc — Wed, 18 Jan 2012 15:00:26 +0100

Today, I have another guest post. This time it’s from Dr. Suzanne Berman MD, FAAP. Dr. Berman is also a contributor to Survivor Pediatrics. In this post, she gives insight into the real benefit of having a EMR. For example, many docs believe that a EMR will help them chart faster. But as Dr. Berman points out, that is not always true. The real benefit of an EMR isn’t being able to put data in/chart faster – this is great if you can do it but not everyone can point/click/type faster than they can check boxes– …the real benefit of an EMR is getting practice-wide data quickly OUT of it. When docs test drive EMRs, they want to see “How do I put in the vitals? How do I issue an Rx?” As far as getting data out, they want to see patient-specific, single-patient data: “S...

Thing.

Ad libitum — Thu, 12 Jan 2012 17:46:00 +0100

Pequeñas cosas que hacen nuestro día a día,detalles que nos arman una existencia dulce y placentera,momentos que se contabilizan como eternos cuando somos felices.Simpleza echa vida,vida echa instantes. (Source: Ad libitum)

Insurance Contract Negotiations: 15 Tips From a Pro

Pediatric Inc — Wed, 11 Jan 2012 15:00:55 +0100

Today’s guest blog post comes from David Horowitz MD. Dr. Horowitz responded to a question on SOAPM regarding how to go about negotiating with a payer. I thought his advice was practical, to the point and very useful, so I asked him if he had an issue with me posting his response. He graciously agreed to share his comments with readers of PediatricInc. By the way, this is not an unusual response on SOAPM. Most comments are this good. Enjoy… I have done the contract negotiations for my practice for 20+ years. In those dark ages, before Internet and AAP resources, there was no primer for doing this. One of my partners recently asked how she could get up to speed on this, looking to the point where I might retire – which is not anytime soon. So I started thinking about a few es...

Alba.

Ad libitum — Tue, 10 Jan 2012 22:35:00 +0100

El camino no había sido recorrido en vanoEra símbolo de algo más inmenso,más efímero,sutil y volatil.Un camino largo y destruido,cubierto por la arena,pues los años quisieron borrar hasta el último rastro.Y en el fondo lo olvidaste,¿Para qué era que avanzabas?¿A quién estás ansioso de encontrar?Sí quien querías que te acompañara,te abandono casi en la cima.No era preciso llegar.Y retrocediste,la cuesta abajo era más fácil,y quizás hasta podrías encontrara quien perdista al querer llegar.Quizás...quizás, fue mejor que te detuvieras.Fue mejor que miraras arriba de nuevo,que no necesitabas regresar,que querías avanzar.Y dejaste todo atrás,a las luz de un amanecer,respiraste ese aire puro...... y volviste a nacer. (Source: Ad libitum)

Tightrope

Ad libitum — Mon, 09 Jan 2012 21:46:00 +0100

Con el suspiro de tu voz,clavándose en mis pensamientos,déjame...déjame sentirte,déjame jugar con tus caricias,quiero acabar con tu inexistencia,destrozar tu voluntady hacerla mía,quiero morir en esa pielque tantas noches de olvido reclamé,pedí,supliqué,quiero...con esos besos casi corrompidos por la malicia,que fueron míos,fueron...y aún en la más oscura hora,mis recuerdos no dejan de perseguirte,de buscarte,de tomarte entre ideas...se que no fue,mío nunca fue,aquel suspiro cargado de ansiada insistencia,lo sé,pero lo amoldé,sé que mío lo quise hacer,aunque ahora se haya ido,y digas que nunca lo haya visto,que si me mirabasera imposible detenerte,que si yo te tocabaera inútil detenerme...ahora se ha ido,simplemente a volado,al otro lado del cielo,lejos,siempre lejos. (...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Should I Open a Medical Practice in This Environment?

Pediatric Inc — Wed, 04 Jan 2012 15:00:41 +0100

In the past few months I’ve been asked a couple of times what advice I would give to someone that is opening a practice from scratch. And in the same conversation I’m asked, do you think, considering everything that is going on now, if it is a good idea to open a medical practice. My short answer is, go for it! My long answer is, well, more complicated. First, I think it is important to assess one’s priorities and determine the true motivation for opening up the practice. Motivation – or the reason why – is very important because if one opens the clinic for the wrong reasons, failure is often the consequence. Here is why… during the journey of opening one’s own medical practice, one will no doubt be challenged, get burned out and perhaps even question if this ...

PediatricInc: Top 10 Post of 2011

Pediatric Inc — Fri, 30 Dec 2011 15:00:52 +0100

In case you missed them, here are the top 10 post for 2011. Is Your Front Desk a Command Center? Top 11 Pediatric Facebook Pages Patient Collection Letters, What is Your Approach? Medical Practice Advertisement Tip #3, How To Save $80,000 How Social Media Can Transform Your Medical Practice Can Costco and Your Medical Practice Have Something in Common? Does Your Medical Practice Have a Problem with Bad Debt? Here is a Solution Ten Hidden Cost When Implementing an EMR Seven Reasons Why Medical Practices Have Yet to Adopt EMRs The list is ranked by total traffic. Funny what people find more interesting. Usually, my top 10 are not the same. Here are some of my favorites: What Can A Practice Learn from Bon Jovi? 10 Practice Management Reports You Haven’t Thought of Can a Medical Practice ...

The Secret to Getting Referrals

Pediatric Inc — Mon, 26 Dec 2011 16:30:35 +0100

Have you seen those signs in doctor’s offices that read, “The best compliment you can give us is a referral?” Some say this is a great way to get referrals. Simply asking for one. I’ve also heard “healthcare marketing professionals” suggest that doctors ought to spend time in the community networking with other physicians like OB/GYNs, neighboring schools, daycares or any other person that can send a patient our way. At Salud Pediatrics, we’ve done all kinds of things… for example, we’ve sent out letters to OBs, we’ve stopped by to say hello at daycares and also dropped off a few business cards at the local pharmacy. But I wonder… are all these suggestions the right approach? Is doing all those things the best way to get referrals? Let’s think about thisR...

Another Christmas Thought: Thank You For The Card

Dr.J's HouseCalls — Mon, 26 Dec 2011 14:57:00 +0100

You know who you are.And I hope you know how much it means;) (Source: Dr.J's HouseCalls)

A Christmas Thought: Feed The Birds

Dr.J's HouseCalls — Sun, 25 Dec 2011 05:30:00 +0100

There was a very good opinion piece on CNN this Christmas Eve morning entitiled, "When Bedford Falls Becomes Pottersville". Over the years, I've watched my hometown slowly turn into Pottersville and I don't like it.I have it on very good authority that "Feed the Birds", from 1964's "Mary Poppins" was Walt Disney's favorite song/sequence out of all of the Disney films. It's also mine.It's about charity and doing the right thing, even when charity and doing the right thing isn't easy - giving even when you don't have much yourself . . . acting for good even when it hurts.It's not a bad message to ponder at Christmas. Alas, it's also a message that Asheboro's "non-profit" medical sector totally did not get ...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Sheep&woLf

Ad libitum — Wed, 21 Dec 2011 04:42:00 +0100

http://www.youtube.com/watch?v=UBVfqPkTHOc&feature=topicsEs de esas veces,donde simplemente me quedo mirando la pantalla,viendo titilar el cursor en la espera de un par de versos,con los que pueda quizás,enamorarte un poco más.Pero no consigo enumerar rimas,ni puedo llenarme de poemas,ni hacer poesía,de aquello que hace tiempo,provocaste en mi,Has tomado mi inspiración y la has echo trizas,has puesto entre tus manos la arcilla de mi arte,y la has moldeado de forma diferente,le has puesto sabor, música y letras nuevas.No te apoderaste de mi vida,me uniste a la tuya,te hiciste vida conmigo,con todo.Es por eso que no siempre hay palabras adecuadas,cuando se trata de expresarte todo lo que siento,es por eso que un par de frases inventadas se vuelven aire,si trato de decirte...que cont...

howL

Ad libitum — Tue, 20 Dec 2011 18:58:00 +0100

Aulla, pero asegúrate que esa Luna sea tuya.Cortesía de http://karlohumor.blogspot.com/ (Source: Ad libitum)

How To Take Care of Your Most Valuable Assets

Pediatric Inc — Mon, 19 Dec 2011 15:00:25 +0100

Organizations often talk about how their employees are the company’s strongest assets. Which is absolutely true. But very few actually take the time to ensure that their most valuable assets have what they need to perform their best. We believe they have what they need; we think they are comfortable; we assume they are happy, but how do we really know? We have a small group in our office that has been with us for a long time and for the most part, I have always assumed I have a good understanding of how they feel about their jobs, their coworkers and the company in general. But then I realized, I’ve always assumed. Never have I asked direct questions about how they truly feel about me (as their leader, boss, or manager) or the medical practice. So I decided to change that. I dra...

Iza las velas, ízalas José ♪

Ad libitum — Mon, 12 Dec 2011 23:00:00 +0100

http://www.youtube.com/watch?v=pW-Njfe6zcg Soy un gran pirata,y navego por aquellos maresme arrastro por sus islas,donde mi sombra ha dejadoun muerto vigilante,para los tesoros que me he guardado.Soy un gran pirata,entre puertos he vividoy callejuelas me he educado,con espadas he aprendidola virtud del más astuto.Soy un gran pirata,victorioso y supremo,temido por mis hombres,envidiado por los nobles,acechado por corsariosy a ninguno he olvidado.Soy un gran pirata,que en las noches un buen ron,me lleva a la morada,de mi exilio, mi mujer y mi canción. (Source: Ad libitum)

How Long Before Your Practice Runs Out of Money?

Pediatric Inc — Mon, 12 Dec 2011 15:16:27 +0100

Let’s say your practice saw the last patient today for ever. After that last one, no more patients will come see you again. How long before your practice runs out of money? A month; a day; 3 months? This is a very important question to answer. Why? Because it helps us have a perspective on the business and when and how to start making decisions. In the How The Mighty Fall: And Why Some Companies Never Give In Jim Collins talks about how companies start to fall apart way before they actually fall apart. Like a disease that starts to affect the body before symptoms are visible, many companies start the decline before the leadership even is able to make a diagnosis. And often times, by the time the leadership realizes there is a problem, it is often too late. Imagine not having a gauge in...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

The Last Full Measure Of Service: What Makes A Man Or Woman "Right" Enough For The Courier Tribune?

Dr.J's HouseCalls — Sat, 10 Dec 2011 14:27:00 +0100

Note to Readers: This Post Has Been Updated.I had planned to let my post on the disintegration of the Merce Clinic (which speaks volumes about Randolph Hospital CEO, Bob Morrison's, true legacy . . . and the abject failure of "non-profit" medicine in Asheboro) stand for a while, and return to break. But then . . .Lance Corporal Jacob Levy, a native of Ramseur, graduate of Eastern Randolph High School, and of Lumbee Indian descent, was shot in the head while on patrol in Afghanistan on Wednesday. He has done prior combat tours there - and in Pakistan - and had volunteered to go back. The Marine was stabilized in the field, and has been on life support in Germany since that time.He serves with the son of my good friend, Buzz Arm...

Love is.

Ad libitum — Fri, 09 Dec 2011 16:25:00 +0100

"Amar es enamorarse de la misma persona todos los días"Cortesía de: http://donserapio.blogspot.com/ (Source: Ad libitum)

Free RBRVS Calculator For Your Medical Practice

Pediatric Inc — Fri, 09 Dec 2011 00:11:05 +0100

My friends over at Pedsource just published a free RBRVS Calculator based on 2012 data. According to the post, the data is using an annual conversion factor of $24.60. They caution that this number will change sometime between today (12/8/11) and March, 2012. Because the AMA doesn’t let anyone provide a free RVU calculator that includes CPT codes due to their CPT copyrights (booo, booo), the great folks at Pedsource (yaaay, yaaay) created this tool for those of us who have a CPT license that allows for a use such as this. In theory, that should mean any practice that submits insurance claims. What is this tool good for? The tool allows you to choose your CMS-driven location, set a Medicare Multiplier, and then, on a code-by-code basis, determine your pricing level. Basically, you can us...

The Quality Of Merce In Asheboro, North Carolina

Dr.J's HouseCalls — Thu, 08 Dec 2011 03:51:00 +0100

12/8 Note to Readers: This post has been updated. And I'm pulling no punches.I'm on a blogging break . . . for reasons restated in my last post (on Bob Morrison's real legacy) . . . but some recent developments scream for commentary.Both the Courier Tribune and the Randolph Guide have "in-depth" stories on the disintegration of Asheboro's once-noble endeavor, the Merce Clinic.The Clinic, started in 1992, by doctors with charitable intentions donating their time to the town's most indigent, is now "at death's door" (a strange choice of words for newspaper reporters otherwise desperately poo-pooing Forbes Magazine's 2008 "diagnosis" that listed Asheboro as one of the nation's "Top-Ten Dying Towns") . . . and clinic administrators/board memb...

Beast.

Ad libitum — Wed, 07 Dec 2011 06:42:00 +0100

http://www.youtube.com/watch?v=sF3aZyNDF1QTe levantas sobre tus cuatro patasy alzas el lomo con lentitud,tu pelaje se eriza, se encrispa,disfrutas de la respiración agitada,golpeteando y bombardeando tu sistema.Aprietas los colmillos y comienzas a gruñir,tus ojos fijos sobre lo que necesitas destruir,sobre lo quieres despedazar,mordisco a mordisco, no tienes que pensar.Quieres dejarlo salir,quieres que esa bestia se apodere de ti,y te deje ser...el animal que siempre ha vivido en ti. (Source: Ad libitum)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

En tierra de cosas perdidas.

Ad libitum — Tue, 06 Dec 2011 20:10:00 +0100

Recuerdo, al abrir mi primer blog, haber hecho un análisis del porque tenía el nombre de: "Aritmética de los Sonidos y las Letras", un punto interesante, puesto que no soy de asignarle títulos a las cosas sin que haya alguna explicación de por medio.Y es por ello que empezamos hablando de cosas perdidas, ya que al extraviar esta información, también se extravió en parte el concepto que le daba sentido al título de mi Blog.El blog en cuestión ya no existe.Podría llamarse un acto inconciente, tal vez, puesto que cuando sucedió ni yo misma era capaz de medir la magnitud de lo que representaba haber desaparecido mi cuenta original de gmail.O tal vez podría denominarlo un "infantilismo" de mi parte.Lo conciente si fue el haber tenido la intención de borrar aquella cuenta,&nbs...

If You Had to Layoff Your Staff, How Would You Do It?

Pediatric Inc — Tue, 06 Dec 2011 12:00:42 +0100

If you had to downsize your practice, how would you do it? How would you decided who goes and who stays? Of course, we want to be as fair as possible, but how do you define fair? Some will consider it fair to fire the newer employees first, while others will argue that employees that have been there the longest generally cost more or have gotten comfortable in their roles. Jeanne Marconi, a pediatrician in Norwalk, CT weighed in on this difficult topic the other day on SOAPM. I thought she had some very good practical advice, so I asked her if I could share it with the readers of this blog. She agreed. Here is what she had to say: Develop a rating scale of all departments. Decide what 5 stars means and choose and REWARD the 5 star employees. Only keep 4 star employees if you BELIEVE they ...

Does Your Medical Practice Allow Anybody To Post Links and Comments on Your Facebook Page?

Pediatric Inc — Tue, 29 Nov 2011 13:00:13 +0100

The short answer is yes. We do! Why? Because we think allowing patient to post links and commenting on our practice’s Facebook page helps us achieve these four things: It encourages communication It allows us to address issues that we would otherwise have a hard time addressing. Other patients will benefit by reading the discussions. We get an opportunity to show how we handle different situations. Not long ago, we had a parent post a link to our practice Facebook page. The link was to a questionable blog post. The blog post discussed how a lead scientist at Merck claimed that the HPV vaccine was essentially ineffective. The parent wanted to know if we had any thoughts as a practice on the blog post and the claims it made. Had we not allowed comments and or links on our Facebook page, ...

Concierge Practice From a Pediatric Perspective

Pediatric Inc — Tue, 22 Nov 2011 20:18:17 +0100

Today’s guest post comes by Jill Fahy. Jill does a fantastic job of reporting from the pediatric front lines. In this article, she talks about the concierge model, but from a pediatric perspective. We always read about concierge practices, but hardly ever do we hear the issue addressed from a pediatric practice management perspective. I think the article provides very good insight into this growing trend. I hope you do too. __________________________________________________________________________________________ Two years ago, Jessica Lucia, a mother of three young boys, was invited by her pediatrician, Dr. Gayle Smith, to join Dr. Smith’s new solo practice – Partners In Pediatrics. The decision – an enthusiastic ‘yes’ – should have been easy to make, said Lucia, refe...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

The Randolph Guide On Bob Morrison's Legacy: "A Small Town Doesn't Mean Slim Pickins" (Subtitled: "I Wonder What Mary Thinks?")

Dr.J's HouseCalls — Fri, 18 Nov 2011 02:00:00 +0100

More and more these days, I hear from Asheboro folk who, for one reason or another, have just discovered my blog. "You GO, Girl!!!", seems to be the prevailing theme (apart from disappointment that I went on an extended break just as they found me) . . . especially from world-weary contemporaries who were raised in Asheboro, but could not count themselves amongst the mill-town's well-named, well-connected or financially-padded. Most of them left the town behind in the dust as soon as they could.And those giving the high-fives concur that one of the biggest reasons our hometown is on life-support now has much to do with the peculiar brand "journalism" practiced for well-over-a-decade by the Courier Tribune.Indeed, this ...

Easiest Way to Save Money For Your Medical Practice

Pediatric Inc — Wed, 16 Nov 2011 15:00:32 +0100

One of the easiest and fastest way to save money for your practice, is joining a GPO. However, I’m amazed of how many medical practices don’t know what GPOs are, much less belong to one. If you don’t know what they are or what they do, I’d suggest to look into them. To help you get started, I asked Paresh Patel, National Sales Manager for a large GPO here inChicagoto answer a few questions for readers of this blog. Hopefully, you’ll get a better understanding of GPOs, what is the purpose of such organizations, and how they can help medical practices save money. First thing first first… What is a GPO and what does it do? A Group Purchasing Organization (GPO) leverages the purchasing power of a large group of separate entities to obtain contractual discounts from suppl...

Small or Big: What is the future of small private practices?

Pediatric Inc — Sun, 13 Nov 2011 12:00:29 +0100

Many experts and pundits are predicting that the downward pressure we are seeing in healthcare will claim small independent private physicians first. Those that are not affiliated or belong to a hospital or large healthcare network will not survive, say the pundits. The argument is that these small practices will not be able to withstand the financial and administrative pressures of the new healthcare landscape. Others very eloquently argue that if we don’t band together soon, and form larger groups, they will not have a seat at the table when the time comes, therefore forcing them to accept a deal that may not be in their best interest in the future. It is like jumping on a large tanker to survive a huge storm or last longer at sea without returning to port. Which is a good strategy, I ...

We Can’t Provide If We Are In Need

Pediatric Inc — Wed, 09 Nov 2011 19:59:48 +0100

I’ve had an opportunity to give my “101 ways to transform your practice“ talk a couple of times and one of the points that gets the most interest from attendees, is our collection efforts. Specifically some of the techniques we use to get people to pay us. So I wanted to highlight for you today, some of those techniques we use. Fundamentally, the collection efforts begins before you’ve provided the service. And the administrative task is to ensure we will get paid before anything else. Now, there are circumstances where a child is ill and needs immediate attention. I’m not talking about those special circumstances. The well-being of children comes above all else. Having said that, the well-being of children depends on our financial well-being. In other words… ̷...

Audrey Armfield

Dr.J's HouseCalls — Tue, 08 Nov 2011 17:17:00 +0100

My pal-from-high-school and online-knight-in-shining-armor, Buzz-Armfield-of-the-Asheboro-Armfields-who-gave-one-million-dollars-to-the-Randolph-Hospital-Cancer-Center lost his Mother on Sunday morning. She had suffered a massive stroke two weeks prior.I never met Mrs. Armfield, Sr. But, based on her son's vivid descriptions (Buzz is nothing if not a gifted story-teller), I imagined her to be a feisty, independent, albeit old-school Southern dame. Like many of Asheboro's "right people", she referred to me as "that woman" (Buzzy was apologetic), and it made me smile. I took no offense. Many older folk in Asheboro are a product of the mill-town environment and their time.Audrey Seltz Armfield's obituary can be found here. ...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

The Murray Verdict

Dr.J's HouseCalls — Mon, 07 Nov 2011 22:58:00 +0100

There is no question - NONE - that Conrad Murray was guilty of malpractice in the death of Michael Jackson. Medically speaking, the things he admitted to doing were imcomprehensibly reckless and stupid - truly inexcusable. He deserves to loose his medical license (what many of the fans-prancing-around-the-Courthouse-declaring-the-world-is-safer-because-it's-minus-another-bad-doctor don't seem to understand, is that he can probably, at some point in the not too distant future, get it back). But for a while, after more & more evidence surfaced showcasing Jackson's addictions (that made Elvis look like a rank amateur), I struggled with the notion that Murray was criminally negligent . . . given that Jackson's beyond-wacked-out worl...

Survey To Identify Delays in VFC vs. Private Shipments

Pediatric Inc — Sun, 06 Nov 2011 18:40:33 +0100

If your pediatric practice participates in the VFC program, you are aware that VFC generally ships their vaccine later than one’s private vaccines. As many of us know, this delay becomes a burden during the flu season. For example, in our practice, we often receive our private flu shipment a month, sometimes nearly two months, before VFC vaccines. I always thought this was an Illinois issue, but apparently, the delay happens all over the States. There have been variable delivery times with large lags in VFC vs. private stock in recent years. Thus the AAP Immunization Program is conducting a survey on when practices received their influenza vaccine- private and VFC. I think this is great because the survey helps pinpoint the problem areas. The AAP was the only one to collect this informa...

Looking For Some Puss This Weekend . . .

Dr.J's HouseCalls — Fri, 28 Oct 2011 14:27:00 +0100

LOL! Made you look.Puss-In-Boots, silly. Where is your mind? (Source: Dr.J's HouseCalls)

Why "That Woman" Loves Mr. Armfield-of-the-Asheboro-Armfields . . . and Jeff Sykes

Dr.J's HouseCalls — Sun, 23 Oct 2011 15:45:00 +0100

This post was composed a month ago. I forgot about it, and almost deleted it. But then, President Obama, in the wake of Quaddafi's demise, announced that the war in Iraq is "over".I'm not so civilized as to pretend that my more bloodthirsty human instincts were very satisfied by actually seeing a picture of the dying/dead despot (as I would have liked to have seen Osama Bin Laden). And I have no problem with the way he went out.As for the "end" of the war, I had the same initial reaction/thoughts as Billy Jones. The next step is to down-scale the military. What are all of those out-of-work soldiers going to do in this economy?(You'll forgive me if I have no more faith in Obama's "jobs bill" than I had in his notions of healthcare "reform".)Movin...

10 Practice Management Reports That you Haven’t Thought Of.

Pediatric Inc — Sun, 23 Oct 2011 11:00:48 +0100

There is a very common phrase in the business world that says, you can’t improve what you don’t measure. As with any business, there are many different things one can measure at our pediatric practices. So how does one know where to begin? Some things are easy to identify. For example, we tend to measure accounts receivables, productivity by provider, expenses, maybe even accounts receivables by insurance company. I also like to document and measure patient seen by month, days worked by provider, gross billings, and net receivables. I also have graphs that compare all those numbers to our goals. But are there other metrics we ought to look at that will help us improve our practice? Chip Hart, practice management extraordinaire (I’m not saying that sarcastically) had some thoughts on ...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Is Strength Training Safe in Young Children?

Dr Nabong's Pediatric Blogs — Fri, 21 Oct 2011 17:05:00 +0100

There are more than 40 million children in the United States who participate in different sports every year. This is encouraged for health reasons. Helps them become stronger and hopefully prevents obesity. But is strength training or resistance training safe for young children.The American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness is supportive of strength training as an adjunct to sports participation and it does not advocate the sport of competitive weight lifting for the skeletally immature child.Benefits of weight training:increased muscular strength and enduranceprevention of injuriesenhancement of bone metabolismimprovements in self-esteem, self-confidence and body imageA literature review by Faigenbaum and colleagues indicates that resistance training, when...

Post #27 Proper Swaddling of Babies to Prevent Hip Dysplasia

A Pediatrician's Blog — Wed, 19 Oct 2011 14:19:00 +0100

In ten years of pediatrics I have only had a handful of cases of hip dysplasia. Hip dysplasia is when the hip joint (a ball and socket joint) does not develop appropriately and can lead to dislocation and improper development which in turn can lead to mobility issues in the future. Mostly, I have seen this occur in breech babies (legs are in funny positions in the womb), females (hip anatomy makes it have a higher propensity for issues than males), first born babies (the womb is tightest in the first pregnancy leaving less room for the baby and his/her hips), and low amniotic fluid (less room in the womb). Recent evidence indicates that improper swaddling may contribute to hip dysplasia. Like other parts of the baby, the hip continues to develop and mature even after the baby is born. Prop...

How did you hear about us?

Pediatric Inc — Wed, 19 Oct 2011 11:00:47 +0100

We ask this question all the time when new patients come to visit us. You know what are the two top answers? My friend/sister/co-worker/neighbor comes here and you guys come highly recommended… We found you on the web, saw the site, read your reviews online, and your Facebook page and thought this was a great place to come. The first top answer is of course word-of-mouth. We all know that WOM is the best form of advertising and one should try to foster it as much as we can. Nothing new to report here. But the second response, what is that? I’d say it is the next best thing to WOM, which is a Positive Digital Trail. Why is PDT important to our practice? Because as many parents (especially first time parents) are finding us through our online digital presence as they are through word-o...

Horse-sh*t, Mr. President!

Dr.J's HouseCalls — Tue, 18 Oct 2011 20:09:00 +0100

From The Weekly Standard, our President, on the "Occupy Wall Street" movement:The most important thing we can do right now is those of us in leadership letting people know that we understand their struggles and we are on their side, and that we want to set up a system in which hard work, responsibility, doing what you’re supposed to do, is rewarded . . . and that people who are irresponsible, who are reckless, who don’t feel a sense of obligation to their communities and their companies and their workers that those folks aren’t rewarded.Honestly, after fourteen years trying to get the corporate bullies running Randolph Hospital to play fair (and now watching Bob Morrison ride off into the sunset with his pockets full of non-profit dollars - and without answering ...

Top 11 Pediatric Facebook Pages

Pediatric Inc — Sun, 16 Oct 2011 11:00:02 +0100

Does your practice have a Facebook page? If you don’t, have you wondered what your practice can do with a Facebook page? Why would you need one anyway? Have you wondered what other pediatricians are doing with their Facebook pages? I’ve put together a list of my Top Facebook favorites pediatric pages (I was going to make it top 10, but I couldn’t decide which one to drop). These pages will give you a good starting point. And for those that already have Facebook pages, I’m sure you’ll find great ideas that you can incorporate on your. There is no need to reinvent the wheel. Instead, check out what others are doing and tweak these strategies to make them your own! Editorial note – these are not in any particular order. 1 Nicholasville Pediatrics Facebook’s page does ...

On The Retirement Of Randolph Hospital's Bob Morrison

Dr.J's HouseCalls — Fri, 14 Oct 2011 13:45:00 +0100

Confirming rumors that have been swirling for a while now, Randolph Hospital's $700,000 man, Bob Morrison,(Questions? Check the hospital's IRS "2008" 990's as posted at Guidestar - page 30 - the link takes several moments to load) has announced his retirement. No effective date was given. I'd say it cannot come soon enough, but given what I'm working on, I'd be lying. And I don't lie nearly as well as Bob.In the part of the press release that one can actually read online in Bob's own personal local newsletter (excuse me, Asheboro's always fawning, slobbering Courier Tribune) . . . right before the article dives below a paywall . . . Morrison states his part in was "small" and "the heavy lifting done by others". Ergo...

Customer Service, It Is All In The Little Things

Pediatric Inc — Wed, 12 Oct 2011 11:00:36 +0100

Photo Credit - RexFeatures.com Yesterday, as parent was walking out, he says to the staff member that was helping him check out “Oh, wow! Look at that. You guys got new cards.” Then, the parent got a little embarrassed for his excitement over a business card and in an apologetic voice said “I guess it is the little things that impress me the most.” My office is next door to the checkout counter, so I often hear the conversations that happen during the check out process. But this one in particular put a smile on my face. Not because the parent liked our new business cards (which by the way, they are pretty cool), but because he confirmed something that I’ve been preaching for a very, very long time; which is, success in delivering an excellent customer service experience lies in ...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

On "Occupying Asheboro" . . . And Rumors Of My Death

Dr.J's HouseCalls — Tue, 11 Oct 2011 18:13:00 +0100

Still on an extended break (which will continue indefinitely) and still working on a project that, if I can make it happen, will (before it's all said and done) ruffle more than a few "right" feathers in Asheboro, North Carolina.In the meantime, thought I'd comment on something I got in my Inbox last week - from Mary Kay Henry, President of the SEIU (Service Employees International Union). I'm not exactly sure how I got on Ms. Henry's e-mail list, but I'm certain it has something to with leaving no stone unturned as one ex-public service Pediatrician fought tooth-and-nail for going-on fourteen years for some small resemblance of fair play and justice in North Carolina . . . after getting fired for saving a newborn baby'...

Lice Can Be Lousy!

Dr. Shu Says — Sat, 08 Oct 2011 23:34:00 +0100

(Source: Dr. Shu Says)

Staff Not Cooperating? Maybe It’s Time to Look at Your Own Behavior

Pediatric Inc — Wed, 05 Oct 2011 11:00:56 +0100

My family and I like to watch the Dog Whisperer. The Dog Whisperer is a reality television series that follows Cesar Millan as he works in the field of dog rehabilitation. For those that haven’t seen it, the program shows Cesar being invited to a home to train dogs that have behavioral problems such as aggression, fear, obsessive behaviors among others. It is interesting to see how Cesar is able to bring balance to the dogs behavior. But more compelling is the dog owners’ transformation. Even thought the show is about dogs, it is really more about humans. As one author put it, Cesar showed [the owners] that their own unconscious issues were being manifested by the dogs. Aggression in the dog may have been covering for some weakness in the owner. By helping the owner become “calm,...

How much does it cost to see a patient in your medical office?

Pediatric Inc — Sun, 02 Oct 2011 11:00:44 +0100

If y0u were to ask the average business owner, how much does it cost to make widgets, my guess is that 9 out of 10 would know exactly what that figure is. On the other hand, if you were to ask a doctor who owns the her practice, how much is it costing you to see each patient, I’d argue 9 out of 10 wouldn’t know. Now, I’m making huge assumptions of course, my I think the point is valid. Doctor’s offices do a very poor job of understanding basic business principles, such as, figuring out their cost. Figuring out cost can get complicated… and there is certainly a lot of ways of doing it. But I tend to think that there is elegance is simplicity. Gather the total number of encounters. Next, gather all your expenses. Then, you divide the two Expenses – 850,000 Encounters – 10,000 ...

Medical Billing Behind the Scenes

Pediatric Inc — Wed, 28 Sep 2011 11:00:25 +0100

I wrote the blog post below on the Survivor Pediatrics blog titled “What I wish parents Knew about Medical Billing”. I didn’t post it here on PediatricInc because placing it here would have been like preaching to the choir. To my surprise, the post has gotten a lot of attention and I’ve received a lot of great feedback from people in the healthcare industry (those that actually live this day by day) as well as non-clinical or non-medical people. So I decided to post a summary here on PediatricInc, not to tell you all what you already know, but rather to enlist you in sharing this message with your community, your audience and your parents. Below is a summary, but you can check out the entire article by visiting the other pedia-tastic blog Survivor Pediatrics. CODING — A LOT OF WH...

CDC Says "Take 3" Actions to Fight the Flu

Dr Nabong's Pediatric Blogs — Tue, 27 Sep 2011 17:14:00 +0100

This is the time of year that we urge everyone to take steps to fight the flu!Sign and Symptoms of the flufever, cough, sore throat, runny or stuffy nosebody aches, headache, chills and fatiguemay have vomiting and diarrheasome may have respiratory symptoms without the fever#1 Get the flu vaccinethe 2011-2012 vaccine will protect against influenza B, H1N1 and the H3N2 viruseveryone 6 months and older should get the flu vaccinevaccination of high risk persons (i.e. asthma, heart disease, kidney disease) is important to decrease the severity of their flu illnessvaccination of health care workers and other people who take care of infants younger than 6 months of age is recommended to have the flu vaccine#2 Stop the spread of germswash your hands with soap and water of an alcohol-based hand ru...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

How Social Media Can Transform Your Medical Practice

Pediatric Inc — Sun, 25 Sep 2011 11:00:10 +0100

Written by Natasha Burgert MD Last summer, I joined millions of others in the deluge of social media. I committed one year of effort to see if social would enhance or distract from my pediatric practice. That was my goal, just one year. At that time, I wanted to dip my foot in the pool, and see if it made any ripples. The unexpected consequence was how much social media has changed my medical practice, and me. Ripples have returned as tidal waves. My practice has seen tangible, real valuable benefits. I have been intellectually challenged, and have professionally grown. For my practice: Increasing new patient traffic is creating revenue for our group.I average 1 new patient family per week who came because of our social media presence. I know this because they tell me, “I am here to see...

Does Your Practice Employ a Certified Professional Coder?

Pediatric Inc — Wed, 21 Sep 2011 11:00:53 +0100

Written by Jill Fahy When practice managers ask Donelle Holle whether they should have a Certified Pediatric Coder (CPC) on staff, the veteran pediatric coding and reimbursement consultant usually responds with a few questions of her own. “It depends on the office, it depends on how big they are, it depends on what they need,” said Holle. Certified Professional Coders have been formally recognized, through the successful completion of a standardized exam, as having the skills and knowledge to review and code services, procedures and diagnoses on medical claims in physician-office or other health care provider setting. CPCs, according to the American Academy of Professional Coders (AAPC), have a thorough understanding of medical coding rules and regulations related to compliance and rei...

Does Your Practice Need a Mission?

Pediatric Inc — Sun, 18 Sep 2011 11:00:07 +0100

Creating a mission is one of the first steps to transforming your practice. Why? Because if you don’t know where you are going you will probably end up somewhere else. We embarked on creating a mission (after already being in practice for 7 years, so it is not too late to create one) recently. I will admit that I wasn’t too thrilled to create one for the practice. In my experience company missions were posted on a wall but nobody paid any attention to. However, I knew that if we didn’t know what port we were sailing to, no wind was going to be favorable. Thus, we worked very hard on our mission. We looked deep down to determine what we wanted to “stand” for during the next 7 years. Joanna, as a pediatrician, wanted to make sure our clinic was doing its best to help ea...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Tratando

Ad libitum — Sun, 18 Sep 2011 04:35:00 +0100

Quiero escribirteun día como hoydos simplesy llanas palabras.Quiero narrarteen solo cinco letrasmis intentos inútilesde matar mi alma.De no creer ni de soñar,el pensar en ti un solo día más.Arrancarme de raízde este cruel infiernoy de una pesadillatriste y sin final.¿Sientes qué es difícilsaber lo que pido?¿Quieres entenderlo que pienso en verdad? Todo lo que trato Es quererte sin más nada Amarte sin medida Más de lo que esperaba¿O es que crees acaso...que de amor ya no se nada? (Source: Ad libitum)

Those Who Can, Do. Those Who Can't, Blog.

Dr.J's HouseCalls — Fri, 16 Sep 2011 23:50:00 +0100

9/17 Author's note: This post has been edited/expanded upon after a Flu shot and a good night's sleep.A number of people have asked me when I'm planning to resume regular blogging. A few are a tad torqued-off that I've been gone for so long.The simple answer is that what was originally conceived as an ordinary summer break will likely extend well into October. Paraphrasing an old adage I despise (about teaching):Those who can, do. Those who can't blog.Watching what's been going on the Greensboro blogosphere over the last several months . . . this after being cyber-stalked-and-brazenly-libeled online (with some of Blogsboro's "finest" sneering, spitting and snickering as it was being done) . . . I am more convinced of that than eve...

101 Ways to Transform Your Practice

Pediatric Inc — Wed, 14 Sep 2011 11:00:56 +0100

This past summer, I had the opportunity to give a talk at PCC’s Practice Management Conference. The topic we choose to discuss was, 101 ways to transform your practice. The talk received good feedback and I hope to do it again some time. But for now, I wanted to share with you what were the 101 ways different ways to transform your practice. Enjoy! (By the way, for the talk, I didn’t actually go through every single one of these. I create a workbook and handed it out with an explanation of each of these items. If you are interested in the workbook, Sign up to receive updates (Get Updates on the site) every time I post a new blog post and tell me you did so by going here) Be comfortable with change Define a mission Create a company charter Go out and fail; and fail often Embra...

Does Your Practice Need a Practice Management Consultant?

Pediatric Inc — Sun, 11 Sep 2011 11:00:56 +0100

Sometimes, it is hard to answer that question. I know it is hard for me sometimes. Therefore, to make the decision easier for those of us that are managers of practices ourselves, I decided to create a little graph. By the way… if you don’t know what SOAPM is, click here and here. The MGMA? Click here. Hope this helps… (Source: Pediatric Inc)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Craving Quiet

Dr.J's HouseCalls — Sun, 11 Sep 2011 01:11:00 +0100

Apart from a PBS Frontline piece entitled "Faith and Doubt at Ground Zero", I've deliberately avoided the 9/11 memorial programs and retrospectives that have flooded the airways and the ether over the last several days. To be sure, one day . . . someday, I will make the pilgrimages to New York and Pennsylvania. Respect will be paid. But tomorrow, I think the TV will be off.We all have our memories of that day. We all process them differently. For my own part, I'm not entirely sure what makes 9/11/2011 any different from 9/10, or 9/12, or any other day since that awful, surreal morning.For 9/11/2001 still affects the lives of every American on a daily basis . . . and will continue to do so until long after all of our lives...

Why Your Practice Should be On Google Places

Pediatric Inc — Wed, 07 Sep 2011 11:00:18 +0100

According to a Pew Internet study, 87% of adults use search engines (mostly Google) to find information. And an increasingly amount of those searches are for local stores and establishments. Seventy-three percent of all online activity is related to local content, according to data released by Google. One of the ways to take control of your listings on search engines is to sign up for a free service by Google called Google Places. This free tool allows you to not only list your medical practice, but also list how it appears online. You can add a map of your location, your services, photos, health insurance plans you currently take or anything else that helps you stand out from other practices in your area. Here is a great video that explains how this service works. In addition to the list...

All in the Family: When Spouses Work Together in the Office

Pediatric Inc — Sun, 04 Sep 2011 11:00:12 +0100

Today’s guest post comes via Jill Fahy. Jill is a marketing writer for a pediatric software company. She wrote this piece about spouses working together. This of course touches home. For those that don’t know, Joanna, my wife is the senior doctor and owner of our medical practice. I manage the practice. How do we make it work? Well, Joanna does all the heavy lifting taking care of children and I just pay a few bills here and there. Actually, it does take some work. And Jill’s post has some very good examples from other physician’s offices that are managed by spouses. Enjoy Jill’s post. Doctors Teri Perryman and Michael Kaplan are pediatricians whose practices, in many respects, are very different. Dr. Perryman has been a solo practitioner in Texas since 1998....

Post #26 Flu Shot Update 2011

A Pediatrician's Blog — Sat, 03 Sep 2011 08:10:00 +0100

Flu viruses are always changing. Each year, experts study thousands of flu virus samples from around the world to figure out which viruses are making people sick and how these viruses are changing. With this information, they forecast which three viruses are most likely to make the most people sick during the next flu season. These strains are then used to make the flu vaccine for the next flu season. This year’s three flu strains included in the vaccine remain the same as last year’s vaccine: * A/California/7/2009 (H1N1)-like virus * A/Perth/16/2009 (H3N2)-like virus * B/Brisbane/60/2008-like virus) As noted above, this year's seasonal flu vaccine will again include the Novel 2009 H1N1 flu strand (A.K.A. A/California/7/2009 (H1N1)-like virus) which was used during the global pande...

Aftermath

Dr.J's HouseCalls — Fri, 02 Sep 2011 14:02:00 +0100

The little far-Northeastern North Carolina town where I work was battered for well over 24 hours (from late last Friday night until the wee hours of Sunday morning) with sheets of rain and screaming wind. Irene's eye passed just to our East, so we saw no relief during the onslaught. If anything, apart from when the eyewall was passing, the back-end of the storm seemed far worse than the front (I think that was about the shift in wind direction).Trees are down everywhere. We had what I would categorize as mild-to-moderate flooding for this part of the world (the weathermen have joked that we're no longer in a drought). At least one local bridge is out. Local farmers took a massive hit - particularly those growing corn, co...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Pharma Reps, Friends or Foes?

Pediatric Inc — Sun, 28 Aug 2011 11:00:00 +0100

From a practice management perspective, I find my visits with the reps very valuable. Besides the obvious, which is they bring info about their product, here are my 5 reasons why I think pharma reps are valuable to a practice. Many reps have a pulse on the market, so to speak. I always ask the Prevnar guy, how’s business going? If he tells me sales have dropped in his area, I know not too many newborns have been born lately. If he tells me that the practice down the street isn’t busy, and either are we, I know it isn’t just us. Reps can be great recruiters… we found our last employee thanks to one of the reps. Many reps have valuable first hand knowledge. For example, today we had the Merck rep came by (yes, the food they brought was delicious). One of the things they were pr...

Hurricane Irene: North Carolina Is Ready

Dr.J's HouseCalls — Fri, 26 Aug 2011 13:11:00 +0100

I would like to think that if there is ever hurricane named Mary, she will be a Category Five storm whose eye mows through the core of Raleigh, takes out the legislative building, and then curves around to wreak havoc on the District of Columbia . . . and later on, Martha's Vineyard.Pause for wistful smile.As it stands now, on Saturday afternoon, a massive Category 2-3 storm bearing the name of my Mother will making landfall somewhere on the coast of Eastern North Carolina. Since the big screw in Asheboro, and despite all the bumps/boulders in the road, I've always had the sense that I was where I was supposed to be in any given moment in time - and that there were things to accomplish - even if that thing was only healing a broken heart. Eastern N...

Earthquake Virgin No More

Dr.J's HouseCalls — Tue, 23 Aug 2011 19:03:00 +0100

At work down East. Busy day. Babies raining down from the sky. The hospital/its staff are beginning to batten-down the hatches for a hurricane named Irene later this week. I was minding my own business in the nursery, when the building began to rumble and the baby warmers started to sway. The Freaky Mennonite was freaking. It took a few seconds to realize that it wasn't those pesky nursery ghosts messing with us - but that I was experiencing my first earthquake (or at least the first one I've identified as an earthquake while it was happening).And it was TOTALLY cool!I have dutifully appraised the USGS of my experience in an online questionnaire. Still trying to raise my Aunt in Virginia, who apparently ...

"A Small Town's Mean Streak": Mesquite, Nevada Has NOTHING On Asheboro & Greensboro, North Carolina

Dr.J's HouseCalls — Mon, 22 Aug 2011 15:55:00 +0100

This morning, my good friend, Buzz-Armfield-of-the-Asheboro-Armfields-who-gave-one-million-dollars-to-the-Randolph-Hospital-Cancer-Center forwarded a CNN story that I actually had already seen and archived for commentary later. Like the heart-breaking story of Kimberly Hiatt a few months back, CNN's piece showcased a good woman's suicide, after an honest mistake snowballed into the destruction of a life (well, actually two lives, because this woman took the man she loved with her). In this case, CNN opined that Donna Fairchild's death-by-her-own-hand showcased "a small town's mean streak".Her death apparently also brought about a huge back-lash against her tormentors, and fostered in real change for the town. But, of ...

Does your practice need a business manager?

Pediatric Inc — Mon, 22 Aug 2011 11:00:51 +0100

When we first opened our practice, we knew we needed to hire an office manager to handle paying the bills, managing the staff’s time of and buying all the office supplies. But we didn’t anticipate that we’d need a business manager. Soon after we opened, it was apparent that the practice needed a business manager – not an office manager – but a business manager. Medical practices are relatively complex businesses. And they generate a lot of cash when you compare them to other small businesses. Thus, a practice should have a “qualified” business manager that manages the practice for physicians in order to run the business efficiently. In my experience, I’ve seen physicians give this position to nurses and in some cases, medical assistants with a knack for organization. Howeve...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

To Invest or Not to Invest in the Medical Practice

Pediatric Inc — Mon, 15 Aug 2011 11:00:31 +0100

Successful practices invest time and money to grow and improve. This includes sending staff for training (and paying them for the time), keeping current with information technology, purchasing new equipment and making building or office improvements. A practice that is afraid to take financial risks rarely thrives. I know, we need to keep expenses under control. And I agree. But buying an inexpensive fax or copy machine may be easier on your bank account, but if it can’t handle the workload, it will cost you in the long run both in terms of time and staff frustration. Being a penny-pincher when making capital equipment purchases is a mistake. It is important that employees have the proper tools to do their jobs. As well as assess the cost/ benefit analysis which should include more t...

How Twitter Can Help Pediatricians Extend and Amplify Their Influence and Trust

Pediatric Inc — Sat, 13 Aug 2011 11:00:03 +0100

I know for some, this may be difficult to see, but Twitter has huge potential for pediatricians. How so? The platform is an opportunity for pediatrician to lead and influence in a way that was not possible before. Twitter is not so much about what the practice or the doctor gets out of it, but it is about the opportunity it affords doctors to give to others and make an impact. Pediatricians sit on a lot of information. But they don’t ever get a chance to be on TV, the radio, write a book or a magazine column (most don’t even have a blog) to share, influence, teach and guide. But pediatricians still have a lot of influence. They are trusted sources of information. Twitter provides an unprecedented opportunity for doctors to extend and amplify their influence and trust. With Twitter...

Naps for Kids

Dr. Shu Says — Fri, 12 Aug 2011 00:31:00 +0100

My latest interview on CNN.com: (Source: Dr. Shu Says)

The Need To Screed

Dr.J's HouseCalls — Wed, 10 Aug 2011 00:46:00 +0100

Lately, I've fielded several inquiries about when I'll resume regular blogging. A man I met this past weekend actually wanted my autograph. Apparently, I have fans . . . a surprisingly large following amongst the common folk of Asheboro . . . the consensus being that I tell it like it is . . . especially when it comes to our sad/sorry/suck-up excuse for a newspaper . . . and all of the "right people" who ran my hometown into the ground as they stuffed their own pockets . . . . . . Bob Morrison being first in line in terms of screwing-over his employees while he collects his very phat paycheck. And he's gotten away with it mostly because no one on Randolph Hospital's Board of Directors has a working set of testicles - or a spine...

Exit Interviews Before They Exit

Pediatric Inc — Sun, 07 Aug 2011 13:46:28 +0100

Exit interviews are done when an employee is leaving the organization. The intent of the interview is for the employer to gather data for improving working conditions and retaining employees. Theoretically, I understand why one would want to do exit interview. But I don’t understand why one would wait until the employee is leaving to ask their opinion. Seems to me that at that point, it is too late. Asking employees exit interview type questions while employees are working at your practice can also be a good tool to gather employees’ feedback on their work experience in and effort to improve working conditions and retain employees. Examples of exit interview type questions that can help one get a sense of how employee perceive working at your practice. For example: What is most satisfy...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Primitive to Paperless in 6 Weeks

Pediatric Inc — Mon, 01 Aug 2011 14:00:42 +0100

Today’s post comes from Dr. Bill Adams. Dr. Adams is a pediatrician and he works at Triangle Pediatrics in Cary North Carolina. His office recently went live with an EMR. He wrote a really nice summary, so I asked him if I could publish it on the blog. He agreed, so I wanted to share it with you. Setup: EMR Live 6/7/11 7 providers, up to 65 years old, with 18 staff support, one location 31,230 charts gone (Two rooms), National Scanning,Inc., review of that company to follow. Office Practicum EMR and PM Eprescribing and Instamed claims processing implemented Dell T610 Dual Core server,and backup server 13 Lenovo X220T I5 laptop/tablets (all day, no recharge, Gorilla glass, pen/touch/keyboard) Standard DSL (No T1) Well, we’ll just have to see how this goes. Of course we are certain...

For your next employee meeting, ask this question

Pediatric Inc — Mon, 25 Jul 2011 14:00:58 +0100

If you owned the medical practice, what would you do differently? I think this is a powerful question. Why? Because I think it is an elegant way to find ways to improve the practice. I also think the question helps us as managers gain insight into areas of the practice that we may not be completely aware of. Moreover, asking the staff for their input on how they would change things if they were in charge is in a way suggesting, I value your input your expertise and your knowledge and I’m eager to learn from you. For me the, the question also helps understand my employees better. Some suggestions are selfish; others are very insightful and discerning. And it also helps me delegate. If someone is really passionate about something or think their idea would really improve on it, I like to g...

The Doctor Who Lived

Dr.J's HouseCalls — Wed, 20 Jul 2011 12:40:00 +0100

I was home last weekend - although lately, I've thought of Asheboro less and less as "home". The YaYas bought tickets to see the Harry Potter grand finale (see it in 3D), and we had a fine time watching good witches and wizards vanquish the bad.J.K.Rowling's story is nothing if not about how ordinary people "sort" in the face of corruption and evil in their midst . . . how some rise to the occasion while others sell themselves short - and out. It's packed with very good lessons for children to absorb/digest, and Ms. Rowling earned her kabillion dollars/pounds.After the movie, someone commented to me that when it came to medicine (and law/journalism) in Asheboro, there were a lot of parallels between my experience and Harry's&nbs...

Rethink Home Trampolines

Dr. Shu Says — Tue, 19 Jul 2011 13:35:00 +0100

Think before you get one for your backyard! My interview with Beth Galvin from Fox 5 Atlanta. Health Watch: Trampoline Safety: MyFoxATLANTA.comBottom line: Trampolines are safest under the supervision of a coach or trainer in a gym. If you must have a home trampoline, stay in the middle, only allow one child to jump at a time, and avoid jumping off the trampoline. (Source: Dr. Shu Says)

Comfortable With The Old?

Pediatric Inc — Mon, 18 Jul 2011 11:00:49 +0100

Most people are more comfortable with old problems than with new solutions. That is a problem. Those that can’t change their minds can’t change anything. Having a genuine reason to transform your practice is the catalyst that will help one do so. Before you start the process, ask these to questions: Is there something to can improve in your practice? If no, then forget it Do you want to change your practice in anyway? If not, forget it. If a practice does not realize there are problems and/or do not want to change them, it is really hard or even impossible to transform a practice. Fundamentally, we must become the change we want to see. If not, then the transformation cannot begin. (Source: Pediatric Inc)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Summer Camp Safety--Are Your Kids Ready?

Dr. Shu Says — Thu, 14 Jul 2011 14:39:00 +0100

My recent interview on CNN.com. (Source: Dr. Shu Says)

Do You Need to Hire Pediatrics Practice Management Consultant?

Pediatric Inc — Tue, 12 Jul 2011 11:00:45 +0100

Written By Chip Hart I will never forget the scene. I was the lonely consultant in the dark and shag-carpeted basement “conference room” of a large pediatric practice and was giving them a stern lecture about their pricing. The practice hadn’t updated its prices in years and was undoubtedly losing money. Lots of it. After my explanation of RVUs and why 105% of Medicare wouldn’t cut it, the senior partner – well, the loudest one, anyway – looked me in the eye and said, “OK, that sounds smart, let’s just raise our prices.” It was the response I was hoping to get. The youngest and newest partner jumped in quickly, “What?! How can you listen to this guy?” Uh oh, I thought. His voice cracked, “…I’ve been telling you this same information for almos...

Do You Need to Hire Practice Management Consultant?

Pediatric Inc — Tue, 12 Jul 2011 11:00:45 +0100

Sandhills Update: Bob Morrison And Brooke Schmidly Don't Just Fly Over The Cuckoo's Nest, They Mow It Down

Dr.J's HouseCalls — Fri, 08 Jul 2011 04:00:00 +0100

In speaking with lawyers and others familiar with the North Carolina's legal system over the last few months, I've heard a lot of opinions. But the one that is shared by virtually everyone is that legally speaking, Randolph County is a different world. Down is up. Right is left. And there ain't no light in any of the crevices.There's a reason Randolph Hospital made it a contractual obligation for employed physicians filing any lawsuits relevant to their employment to do so in Randolph County.The game is fixed to protect Asheboro's big dawgs.I've never been more sure of that than I am now. We'll get to that.I got a phone call on July 4th. A friend back home was positively giddy . . . having just read a SCATHING letter-to-the-Courier-Tribune's Ed...

Medical Practices Need to Change Too

Pediatric Inc — Wed, 06 Jul 2011 13:00:05 +0100

We don’t change a whole lot in the private practice world. Why is that? The truth is change creates opportunities. Change allows us to find new ways to adapt, create, and meet the challenges of our private practice healthcare world. Change also keeps us on top of our game. A few years ago, we had a very large, well established practice open up shop right next door. We were literally door to door with them. We were so upset; for a little while. Then we started thinking of ways we needed to stay at the top of our game. We brainstormed on ways we could improve on our customer service; we looked at expanding our hours. We asked questions, such as, could we remain open while the practice next door was closed? Was their anything we could add to our services that could differentiate oursel...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Independence - Get Some!

Liddle Kidz Infant and Pediatric Massage Blog — Wed, 06 Jul 2011 12:20:00 +0100

Independence is defined as the quality or state of being independent. Essentially, not dependent.Having just celebrated the 4th of July, which we know is celebrated in honor of our freedom and independence. On this day, I always think about independence and how honored I feel to have found massage therapy to create my own independence. Yes, it seems odd to celebrate massage therapy on the 4th, but if you think about it, massage therapy can be your vehicle to true independence. How Massage Therapy Can Create Independence:1 - create your own freedom You can schedule your massage sessions, workshops and bodywork clients at times when it is convenient for you, while at the same time honoring their time as a client. Yes, we’ve heard the mantra “the client is always right”, and this is tr...

No Justice For Caylee: In The Good Ole USA, Kids & Fetuses Don't Matter At All

Dr.J's HouseCalls — Wed, 06 Jul 2011 03:14:00 +0100

I've not followed the Casey Anthony investigation or trial at all. And that's been hard to do.How the disappearance and murder of one little girl has grabbed the headlines for so long . . . when there are so many children out there who are neglected and physically/mentally/sexually brutalized and murdered every single day . . . is something I've not been able to wrap my head around. Why does the media latch on to what and who it does?How many children/families still alive/still suffering could have been helped with even a small portion of the air time devoted to a murder trial presented as entertainment . . . the ultimate in "reality TV"?I can't deny that, without a conscious effort to avoid following the case, it would have been easy for me ...

Independence Day 2011: What Happens When Social Media's Leading Physician Voice (Kevin M.D. Of MedPage Today) Gets Tangled Up In That Veil He Can't Ever Seem To Pull Completely Back

Dr.J's HouseCalls — Tue, 05 Jul 2011 03:59:00 +0100

Last Independence Day weekend, I put up a post on the ridiculous/time-consuming/expensive requirements now imposed upon Pediatricians who want to remain (key word, REMAIN) Board-certified. I updated the post in December. They're good posts and I'd encourage anyone who hasn't to read them. The American Board of Pediatrics and medicine's other specialty-Boards have long been behaving like a bunch of Ivy League Fascists and somebody needs to call them on it.Once you've jumped through all the hoops to become a Board-certified physician (the medical school, the residency, the two-day proctored exam, the oral exam in some specialties), that should be IT. I'll happily do all the American-Academy-of-Pediatrics-approved Conti...

Premature Graying in Children?

Dr. Shu Says — Mon, 04 Jul 2011 20:52:00 +0100

A stray gray in a young child is usually nothing to worry about but if it becomes a pattern, best to get it checked out. My QA on CNN.com. (Source: Dr. Shu Says)

How do I find time for Social Medial?

Pediatric Inc — Tue, 28 Jun 2011 13:00:53 +0100

As a primary care internist, I work 10-12 hours per day, plus 6 hours on Saturday, and sometimes on Sunday. And I still am behind in my work. Pediatricians are probably just as busy. How could your docs find time to write articulate and well thought out blogs? This is a question I got from a reader of the blog. Below is my response. YOU HAVE TO LIKE IT FIRST Fundamentally, if you don’t like it, you won’t find the time. Thus, in order to find the time, you have to want to engage in social media; you have to appreciate it. You have to like it, enjoy it and find pleasure roaming the web, reading interesting articles, sharing, communicating, networking etc. If you don’t enjoy it, it will be a chore and you’ll soon get bored and move on. MOTIVATION IS KEY For years, I ...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Her Name was Kimberly Hiatt - And She Was A Good Nurse

Dr.J's HouseCalls — Tue, 28 Jun 2011 00:41:00 +0100

6/28 Author's Update: After sleeping on it, this post has been edited several times through the course of the morning, and slightly expounded upon. As I've re-read and played with the text this morning - adding links as the whim arose, I realize that it sounds incredibly bitter.And I just don't care.A nursing colleague of mine pointed me to this story on MSNBC today - about a Seattle Pediatric Critical Care nurse who was fired after making a medication mistake that may (or may not) have contributed to the death of a medically-fragile baby. She accidentally gave a cardiac patient ten times the normal dose of calcium chloride, and the infant died five days later.The nurse reported her mistake immediately....

Post #25 Pediatrics is Priceless

A Pediatrician's Blog — Mon, 27 Jun 2011 04:46:00 +0100

An extra blue scrub top is tucked away in the lower right cabinet of the nurse's station. Every so often, after being sprayed with bodily fluid, I have to make a midday swap of my work clothes. However, it's a small price to pay to be a part of children's lives; one day the baby who spits up on your shoulder will be the same kid who runs down the hall screaming your name and clings to your leg with the dexterity of a koala. What makes pediatrics so rewarding is the long-term relationships that you build with children and their families who every day make you feel like a small hero.Practicing general pediatrics often feels like searching for a needle in a haystack. Hidden in a sea of upper respiratory infections, reflux, eczema, and diaper rashes is a cystic fibrosis diagnosis, for example,...

"The Majestic"

Dr.J's HouseCalls — Sun, 26 Jun 2011 21:46:00 +0100

This afternoon, on-call in the middle of far-Eastern nowhere, I caught a movie on TV that I had never seen before.It's called "The Majestic" starring Jim Carrey.I'm not a huge fan of a lot Carrey's early comedy work . . . I don't do "Dumb and Dumber" . . . but he is a tremendously-gifted dramatic actor, and he hit this one out of the park.The movie, very sweet in a totally hokey way, had a happy ending - as most movies with good intentions and noble messages do. But despite the warm fuzzies that wafted out of the rafters of the renovated small-town theater at movie's end, "The Majestic" made me very sad.For alas, in real life, the "good" guys and gals of courage and conviction - ordinary folks standing on principle . . . don't al...

Asheboro N.C., My Hometown, As A "Retirement Community": Does Anyone Else Smell A Rat Named Keith?

Dr.J's HouseCalls — Tue, 21 Jun 2011 22:11:00 +0100

A friend sent me a ditty by Mary Anderson published in the Courier Tribune last week - about Asheboro & Randolph County exploring the possibility of being certified as a "retirement community" by the N.C. Department of Commerce.It was timely, because I was travelling last week, and at a rest stop I hit before crossing the state line into the Commonwealth of Virginia (my personal preference for retirement), out of sheer curiosity, I picked up a publication on retirement communities in North Carolina. It seems that seniors like places like Wilmington, Asheville, Chapel Hill and even my old stomping ground of Winston-Salem . . . places with diversity and culture (arts/entertainment/good eats) and superior medical care (yeah, I know, I told a ...

To Be Paid or Not to Be Paid

Pediatric Inc — Tue, 21 Jun 2011 14:00:40 +0100

A pediatrician wouldn’t dismiss a parent’s hardship that hinders a child’s health because they know that the well-being of the child has a direct correlation to the well-being of the parents. If the parents aren’t doing well (financially, emotionally, physically, etc), the child will have a hard time doing well as well. Thus, in order to appropriately provide care to patients, the parent issues need to be addressed first. Not doing so could be considered negligent. This concept is no different in a “private” medical practice; whereas the wellbeing of the child is in direct correlation to the wellbeing of the practice’s welfare. However many pediatricians don’t seem to grasp the concept that there is a direct correlation between the financial health of a practice and the wel...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Look Before You Lock

Dr. Shu Says — Tue, 21 Jun 2011 12:30:00 +0100

Dozens of kids die each year from being left in a hot car. The inside temperature of a car can go up as much as 20 degrees F in 10 minutes and 50 degrees in 1 to 2 hours. A body temperature of 104 causes heat exhaustion and one of 107 can be deadly. My interview with Fox 5 Atlanta:Dangers Lurk for Kids in Hot Cars: MyFoxATLANTA.com (Source: Dr. Shu Says)

Tylenol will only be available in 1 formulation

Dr Nabong's Pediatric Blogs — Thu, 16 Jun 2011 18:24:00 +0100

The FDA(Food Drug Administration) have passed a guideline recently that the Tylenol/Acetaminophen formulation will just be present in 1 concentration. This will help our parents avoid a lot of confusion The 80mg/0.8ml will be discontinued. This results in overdosage of tylenol and improper dosing. The only formulation that this will be available at would be 160mg/ml they will be including a measuring device inside the box so we can appropriately measure the amount an infant needs.Tylenol/Acetaminophen concentration (60mg/5ml)Dosage chart based on weight6-11 lbs 1/4 tsp (1.25ml)12-17 lbs 1/2 tsp (2.5ml)18-23 lbs 3/4 tsp (3.75ml)24-35 lbs 1 tsp (5 ml)36-47 lbs 1.5 tsp (7.5ml)48-59 lbs 2 tsp60-71 lbs 2.5 tsp72-95 lbs 3 tsp>96 lbs 4 tsp (Source: Dr Nabong's Pediatric Blogs)

Bob Morrison, Randolph Hospital And Mental Health: "Dead In The Water"

Dr.J's HouseCalls — Wed, 15 Jun 2011 14:17:00 +0100

I think my summer break may wind up being more about popping up about once a week or so to comment on stuff that I just cannot let pass without commentary, and then diving back under cover. A friend sent me such a story today.It's from the Courier Tribune, so I can't link it, and must summarize.Randolph Hospital's over-$700,000 year man, Robert Morrison . . . the guy who let his minions run a homegrown Pediatrician out-out-on-a-rail for saving a baby's life - and then sued her for telling the truth - and then swindled her in civil Court of fair restitution for the horrible things he put her through - by (among other things) lying repeatedly under Oath about the "confidentiality" of his books and salaries (see the sidebar, folks) . . . appeared ...

No Margin; No Mission

Pediatric Inc — Tue, 14 Jun 2011 13:00:05 +0100

The private medical practice world is constantly changing. Not to mention unpredictable as lawmakers settle on health care reform. Private medical practice’s are faced with an increasingly larger uninsured and under insured population, State Medicaid cuts, increasing capital needs, and labor shortages. That’s why… Having an enthusiastic, intense, dedicated and even fanatical outlooks on your financial management is now more important than ever. Remember, you are business and as such, you must align your responsibilities in an effort to remain competitive. Without a strong financial foundation, your practice will undoubtedly fail thus not being able to care for anyone. To compete in this new, value-driven, fast-paced aggressive market, healthcare providers must carefully r...

Speak Your Mind or Keep Quiet?

Dr. Shu Says — Tue, 14 Jun 2011 02:58:00 +0100

When it comes to other people's kids, it can be hard to know whether to butt in or leave things alone. My blog post on CNN.com: http://thechart.blogs.cnn.com/2011/06/13/monday-613-kids-at-risk-say-something-or-bite-your-tongue/ (Source: Dr. Shu Says)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Just When You Think You're Out, Those Dancing (Randolph County) Stars Pull You Back In

Dr.J's HouseCalls — Thu, 09 Jun 2011 18:31:00 +0100

Inspired by my stunningly beautiful, incredibly brave, totally-fricking amazing friend, Charlene, I thought I was out in May. But then former North "Senator", Johnny Reid Edwards, was indicted. So I came out to play. And then I went back on break.But this morning, my well-named pal, Buzz Armfield-of-the-Armfields (not to be confused with Ed-Cone-of-those-Cone-Health-Cones) called at an ungodly hour to tell me that the front page of the N&R's "Life" section featured a full-page article on Randolph County's "Dancing With The Stars". And the article boasted a 3/4 page picture of my ex-attorney, Steve Schmidly.Dancing.Regular Housecalls readers know that liquor-loving "Schmid" was the Asheboro-based-legal-eagle who "represented me" in my legal da...

15 Reasons why you should go to PCC’s 2011 Pediatric Practice Management & Coding Conference

Pediatric Inc — Tue, 07 Jun 2011 11:00:32 +0100

This summer, PCC will have their annual pediatric practice management & coding conference. This year, the conference is extra special for me because I’ve been asked to be a speaker. PCC usually has the top speakers give classes at their event. So I’m so excited and pleased to have been chosen to speak at this year’s event. My talk is titled 101 ways to transform your medical practice. I’ll be talking about some of the changes we need to make in our medical office to meet the demand of this new, value-driven, high volume-low-margin healthcare environment we face. If you’ve never been , I think you should consider going. It is truly one of the best pediatric specific conferences in the country. In an effort to convince you, I’ve put together a list 15 reasons you should go. ...

Johnny Reid (Edwards) I Knew Exactly What Ye Were

Dr.J's HouseCalls — Mon, 06 Jun 2011 02:23:00 +0100

You-all knew that there was only one thing that could pull me out of Housecall's summer break.As opposed to wasting any more time on Mr. Edwards than I already have, I think that simply melding and modifying/expounding upon some comments I've left on several of the Raleigh N&O's articles this week will shortly (well, shortly for me) and succinctly sum it up:I've read the indictment (having copied it off - along with the arrest warrant to consider for framing), and it seems a fairly straightforward case to make to a jury stacked with ordinary people who don't have millions to pay big-gun attorneys . . . and who don't have old bunnies sitting around willing to pay their bills when the rabbit dies (I must confess the bit about the bun...

I just joined Twitter. Now, who do I follow?

Pediatric Inc — Wed, 01 Jun 2011 14:00:38 +0100

Image via CrunchBase The other day on SOAPM a doc mentioned that he had joined Twitter but he wasn’t sure who to follow. So he asked the group who we followed and which Twitter users did we find especially helpful. He also asked if any of us that successfully marketed this service to patients. I replied with my list of the people I thought this particular doc would benefit from. My list to him mostly included other doctors (I tend to follow people from many different industries). Doctor Cliff Wu had an interesting reply. I emailed Dr. Wu and asked his permission to publish his response. I thought it gave a great perspective from a front-line, busy as heck pediatrician using Twitter. I added the embedded links. One of the easy things to do actually is to take a few of these accounts, suc...

Be the Change!

Liddle Kidz Infant and Pediatric Massage Blog — Mon, 30 May 2011 15:46:00 +0100

I was driving in the rainy streets of Chicago a couple of days ago, flipping through radio stations when I paused to hear the next song. It was John Mayer’s “Waiting on the World to Change.” In that moment, driving along, those lyrics really resonated with me. I got to thinking . . .why are people waiting on the world change? Why are we not doing what we can, to change the things we can? Mahatma Gandhi said “Be the change you wish to see in the world.” I agree with this! So, how do you start? It can be something that appears so little, such as coming through security at the airport. I was just in Chicago Midway Airport and I saw a mom was struggling to put her shoes back on and get everything stuffed back into her bags. Her little daughter struggled to get her bag off of the secu...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Cataracts

Dr Nabong's Pediatric Blogs — Wed, 25 May 2011 22:23:00 +0100

A cataract is basically any kind of opacity on the lens which can be significant if it blocks the central vision resulting in amblyopia in children if not treated early. It can be present in some instances but if this is just at the periphery and does not cause obstruction they just watch it. Many cataracts are hereditary usually unassociated with other diseases and the most common mode of inheritance is autosomal dominant. Autosoma recessive pattern of inheritance also occurs but less frequently.Source: Behrman et al: Nelson Textbook of Pediatrics 15th edition (Source: Dr Nabong's Pediatric Blogs)

How Your Medical Practice Can Hedge Against Loss of Visits

Pediatric Inc — Wed, 25 May 2011 15:36:46 +0100

One of the numbers that I check regularly month after month is number of patients seen. One of the advantages of tracking these numbers is that they are a good forecasting tool. Studying the numbers and anticipating things like the flu season gave me a real good idea of how many patients to expect in the coming months. For example, the numbers tell me when traditionally we don’t see that many patients. Then, instead of freaking out why our office is seeing fewer patients during July, I remain calm knowing that historically July is generally slow. Over the years, I became in-tuned with our practice’s patients seasonality trends. If we were less busy, I wouldn’t worry because I knew things would eventually pick up. In fact, I knew to the month when things would start moving. And over t...

Fast Facts on Influenza from the CDC 2010-2011

Dr Nabong's Pediatric Blogs — Tue, 24 May 2011 18:51:00 +0100

A total of 3,306 new cases of influenza confirmed duringinfluenza season week 6.Influenza A accounted for 78.6% of the influenza casesInfluenza B accounted for 21.4%2011-2011 35 pediatric deaths (Source: Dr Nabong's Pediatric Blogs)

FDA approves meningococcal vaccine for infants

Dr Nabong's Pediatric Blogs — Mon, 23 May 2011 23:27:00 +0100

The FDA has approved the use of the meningococcal vaccine for infants. Menactra was approved to prevent N. meningitidis for use in infants. The approval is for a 2 dose series to be administered 3 months apart. It is not yet officially included in the immunization schedule but we are definitely looking forward to its inclusion. (Source: Dr Nabong's Pediatric Blogs)

Measles spreading in Europe

Dr Nabong's Pediatric Blogs — Mon, 23 May 2011 23:21:00 +0100

The WHO(World Health Organization) reported that there are approximately 6,500 cases of measle that have been report in 30 counties in the European Region in 2011. They have been attempting to immunize children at 9 months of age to prevent the spread of the disease. in lieu of this we can not but emphasize the importance of the MMR(measles-mumps-rubella) vaccine. It has been shown that the disease is still out there and is spreading. Vaccinate your child with the MMR vaccine at 1 year and 4 years. (Source: Dr Nabong's Pediatric Blogs)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Benzocaine products can cause Methemoglobinemia

Dr Nabong's Pediatric Blogs — Mon, 23 May 2011 23:02:00 +0100

The Food and Drug Administration(FDA) alerted health care personnel on April 7, 2011 that benzocaine gels and liquids have been associated with a rare but fatal condition, methemoglobinemia, in which the amount of oxygen carried through the bloodstream is greatly reduced.This occurs more in children younger than 2 years of age who have been treated for teething with the benzocaine gel. Babies usually teeth between 4-6 months of age and I usually advise the parents to start rubbing the gums first, use a cold washcloth to rub the gums, refrigerated teething rings, Acetaminophen for pain and rarely use the Orajel or Anbesol( I always tell my patient's parents to use it very sparingly if they have to) because of this rare condition.watch for signs of pale, gray or blue skin, lips and nail beds...

Allergic Rhinitis

Dr Nabong's Pediatric Blogs — Mon, 23 May 2011 22:19:00 +0100

Once the beautiful Palo Verde trees start to bloom with those pretty yellow flowers then you will start noticing that there would be a lot of individuals starting to sneeze, have sore throats, itchy eyes, nasal congestion and coughing. Fever is not usually a part of this syndrome. Usually when fever happens there is a secondary bacterial infection that happens. Ear infection, sinusitis. There can also be a secondary to viral infection, pharyngitis. You would notice that they would have dark circles under their eyes (allergic shiners) and there is a line across their nose(nasal crease). This happens when they try to wipe their noses using the palms of their hands in an upward motion called the allergic salute. They would also complain of itchy eyes resulting in redness but with a clear disc...

Have Your Cake and Sleep Too?

Dr. Shu Says — Sat, 21 May 2011 22:39:00 +0100

(Source: Dr. Shu Says)

How can you become a change agent in your medical practice?

Pediatric Inc — Wed, 18 May 2011 15:23:27 +0100

The other day I was catching up with a friend of mine. He was telling me that he was a bit frustrated at work because the people he works with aren’t as efficient as he’d like them to be. He went on to say that management wasn’t open to making improvements, listen to new ideas or open to change. I told him that he was describing a classic leadership (you don’t have to be in charge to be a leader) problem; which is, getting people to change. It seems that whether you’re on the employee side or the employer, fundamentally, if you’re a leader, you’re always in this predicament. I shared with him that despite running our own business, we still face the “change” challenge; except this time around, it comes directly from our employees. They resist change sometimes. On my way ho...

The Great Housecalls Summer Sign-Off: Taking Back Tomorrow

Dr.J's HouseCalls — Tue, 17 May 2011 14:03:00 +0100

You know, for a couple of weeks, I've been working on this uber-big, long-winded, summer sign-off . . . using the commentary of a U.S. Attorney in Greensboro (as Community One brass waived a criminal indictment in a Ponzi scheme) to do it.Asheboro's mill town kings - running the hometown bank aground - had "turned a blind eye" to very ugly things going on right under their noses, you see. Why yes, they could . . . help RIP YOU OFF. The "reporters" at the Courier Tribune had the stones to feign surprise, and print something-that-wasn't-news-to-most-of-us (i.e. crooks-in-suits ran the local bank) as news. And the oh-so-heroic U.S. Attorney's office stepped in to make Community One pay back pennies-on-the-dollar to the hapless victims. Ooo-rah!My point was going ...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

What can your medical practice learn from watching the show Iron Chef?

Pediatric Inc — Wed, 11 May 2011 14:00:18 +0100

I enjoy watching Iron Chef America. I am amazed that the Food Channel can create a show about cooking that is exciting, competitive, informative, nail biting and fun all in a single show. Theoretically, a competitive cooking show sounds boring. What is fun and exciting about that? But Iron Chef makes you root for a guy to pull out a lobster from the boiling water so he can plate it in time, while the other guy is running franticly chopping things up ’til the last minute all while the commentator gives a play, by play and insights as to the ingredients and technique of each chef. For those that haven’t seen the show, it consist of two chef (one is the iron chef and the other is the challenger) trying to make several dishes in an hour with a secret ingredient that is revealed to them...

My Friend: The Stunningly-Beautiful, Totally-Fricking-Amazing, Nurse Charlene

Dr.J's HouseCalls — Wed, 11 May 2011 04:25:00 +0100

One of the best things about getting kicked out of your hometown by non-profiteering liars-and-thieves are the people you meet on medicine's yellow-brick-road. I most certainly would not trade some of the friends-I-never-would-have-met-had-I-not-saved-the-life-and-blown-that-whistle for sixteen peaceful/uneventful years in Asheboro working for the losers running Randolph Medical Associates & Randolph Hospital.Before we get started talking about my stunningly-beautiful, totally-fricking-amazing friend, Charlene, I have a new "Freaky Mennonite" update. (For the record, I have dutifully confessed all of my more bloodthirsty/less-than-Christian urges regarding Osama Bin Laden to the Freaky Mennonite. . . we've discussed them philosop...

Thank You, Thank You Very Much!

Dr.J's HouseCalls — Mon, 09 May 2011 18:08:00 +0100

As the water rises in Memphis (mind still blown), at least we know they'll still have Blue Christmases:"I want to say this: Graceland is safe. And we would charge hell with a water pistol to keep it that way, and I'd be willing to lead the charge," said Bob Nations Jr., director of the Shelby County Emergency Management Agency.Best quote I've heard in a long time. Right behind you, Mr. Nations. And thank you. Thank you very much. (Source: Dr.J's HouseCalls)

A River Runs Through It

Dr.J's HouseCalls — Mon, 09 May 2011 04:33:00 +0100

A lot has happened in the past week, and I'm still working on that last post before the great summer sign-off. But between the job and the gorgeous weather the keyboard's charms are lost.I've worked in two big cities in my life - one was New Orleans, and the other was Memphis. And on both occasions, my Daddy told me to have my fun and GET OUT. If a decent hurricane directly hit, the levees in New Orleans would not hold. "It will be the biggest mess you've ever seen". And the Mississippi would flood again.And so it has. This blows my mind.Meanwhile, clean-up here in Eastern NC continues. It got knocked out of the headlines fairly quickly - by the even nastier storms the next week - and then a royal wedding - and then a bullet run...

Should Your Baby Still Be Taking That Bottle?

Dr. Shu Says — Thu, 05 May 2011 19:52:00 +0100

A new study reports that babies who continue to take a bottle until 2 years of age are more likely to be obese at age 5 1/2. To avoid cavities, the American Academy of Pediatrics Dentistry recommends switching from a bottle to a cup by 12 to 14 months.http://yourlife.usatoday.com/parenting-family/babies/story/2011/05/Study-links-baby-bottle-use-to-obesity/46813132/1 (Source: Dr. Shu Says)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Medical Practice: 7 reasons why you may want to use social media

Pediatric Inc — Thu, 05 May 2011 14:57:21 +0100

“Twitter? I don’t have time for that, besides, my life is boring; nobody wants to hear about my boring life.” This is a common response when I talk to people about social media. One of the reasons I think many have a hard time persuading docs to adopt social media, is because docs don’t understand what they can do with social media or how they can use it for their practice. For the most part, people consider Twitter and Facebook a time waster. A place where one writes what they had for dinner or post pictures of how cute little Timmy looks in his swim trunks. And the truth is, there is a lot of that. But there is also another side that can be much more meaningful and useful. For starters, social media democratizes information. Moreover, it gives the ability to go...

What's On The Bottom Of The Ocean (With Osama)?

Dr.J's HouseCalls — Thu, 05 May 2011 00:37:00 +0100

Well, maybe three more posts.This is exactly what the Federal and state governments did to primary care physicians. Notice that lawyers just quit and let the poor & underserved rot. (Source: Dr.J's HouseCalls)

Dear Mr. President . . .

Dr.J's HouseCalls — Wed, 04 May 2011 22:32:00 +0100

Well, it appears I have two more posts left in me.I believe deeply in my bones that President Obama made the wrong decision today. But we'll leave it to someone else (maybe a MSM media outlet . . . yeah, I know . . . that's REALLY "crazy talk!") to sue the government under the Freedom of Information Act. However, wanting to do something more than "vote" in dueling unscientific Fox News and MSMBC polls, I did contact the White House this afternoon and let them know where I stand:This is the second time I've contacted the Obama White House.The first time was shortly after the President took office - before "Rahming" through his RIDICULOUS/EXPENSIVE healthcare "reform" legislation (that didn't fix much of ANYTHING that needs to be...

Redux With A Purpose: One Woman's Experience At Randolph Hospital's "Armfield" Cancer Center

Dr.J's HouseCalls — Tue, 03 May 2011 17:25:00 +0100

I had planned for Sunday's post on Ginger Hunt to stay front and center on Housecalls for at least several days before I put up the-post-that-it-bumped, and then took a long summer break from blogging. I've been really struggling with some decisions about how to proceed with the rest of my life - about what is important and what is not. It's amazing how much difference one day and one event can have on your life and outlook.Osama Bin Laden is dead. A wave of emotions are still pouring over me - one could say like water in a mighty stream. Alas, as hard as I've tried over the years, I've never been able to achieve the "quiet". Over the last 24 hours, apart from Dubya's statement that, "No Matter How Long It Takes, Justice WILL Be Done", cutt...

"No Matter How Long It Takes, Justice WILL Be Done"

Dr.J's HouseCalls — Mon, 02 May 2011 13:12:00 +0100

I woke up this morning to the news that Osama Bin Laden is dead. Ding dong.I'm going with my first two thoughts on this (and making no apologies for them): (1) As SWEET as this is, there is no such thing as closure (or real peace). And (2) A bullet in the head, burial at sea (like some kind of war hero), and "Islamic tradition" was too good for that EVIL piece-of-shit. But if that's what we have to settle for, I want video footage and pictures of the corpse - to counter the images of people jumping from The Towers - choosing to splatter on the pavement rather than burn alive. "Islamic tradition", Mr. President? You're KIDDING me, right?Oh, and for a whole lotta reasons, I'm REALLY DOWN with W's sentiment on this. No matter how lo...

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

One Woman's Experience At Randolph Hospital's "Armfield" Cancer Center

Dr.J's HouseCalls — Sun, 01 May 2011 13:20:00 +0100

Author's Note/Addendum: Henry "Buzz" Armfield attempted a comment on this post that was blocked due to length. I am including what he forwarded me as an addendum at the end of this post.I'm working on a post that was originally planned to go up today . . expanding on the plight of Community One and how "the right people" in our mill town are EXPERTS at "turning a blind eye" (I hear that, as of this week, they will have one less place to meet and plot their evil) . . . and I had not planned to put anything else up for a while.But last night, I got a call from Sir Buzz Armfield-of-the-Asheboro-Armfields-who-gave-one-million-dollars-to-have-the-family-name-emblazoned-on-the-wall-beside-the-front-door-of-Randolph-Hospital's-Cancer-...

Edwardian Sexcapades - Right Under The Royal Kiss

Dr.J's HouseCalls — Sat, 30 Apr 2011 13:53:00 +0100

Johnny Reid made the DRUDGE REPORT last night . . . he's right under the royal kiss.I agree with commenters over at the News & Observer. Edwards and his mistress/videographer/baby-mama brought this lawsuit. Depositions are public record. What makes him so special? Tell you what, indict the loser already, use the tape as evidence, and see how fast he cops a plea.Here's another thought: If you're a candidate for the Presidency and you want to protect your privacy, don't make a sex tape for your minions to lug around for you - or find. (Source: Dr.J's HouseCalls)

God Save The Queen

Dr.J's HouseCalls — Sat, 30 Apr 2011 00:58:00 +0100

One of the great regrets of my life so far is that I did not get to see the inside of Westminster Abbey when Mama and I did our grand tour of Great Britain in 2005. As our focus was on Ireland, we only had one day in London and could not fit a visit in. Of course, this gives me a reason to go back. There was much discussion of the Royal wedding at work today amongst the girls - with everyone agreeing they would not want to be Kate Middleton, except for the day. Being fond of hats, I was particularly enamoured of the truly MAD hats and the fascisnators - especially Princess Beatrice's very unique (being kind) headpiece, apparently inspired by Lovecraft's Cthulhu.As we reviewed the footage on CNN and MSN and You ...

What are You Eating?

Liddle Kidz Infant and Pediatric Massage Blog — Fri, 29 Apr 2011 14:05:00 +0100

You Are What You EatPut down your Coke and start reading. Yes, everyone has the day when cheesecake or cold pizza seems like the best breakfast option. I am no exception, and cheesecake is my favorite, but I also know that if we don’t take good care of ourselves now we will pay for it in the future. So, ask your self, “What are we doing to our kids?”According the CDC, Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. The prevalence of obesity among adolescents aged 12 to 19 years increased from 5.0% to 18.1%.In order for our kids to succeed in life, they need to have a good start.Michelle Obama promotes the "Let's Move!" campaign to target childhood obesity. It is a g...

On Fairy Tales

Dr.J's HouseCalls — Fri, 29 Apr 2011 11:38:00 +0100

In stark contrast to the marriage of Charles and Diana, and although I had originally planned to do so, the Queen-of-the-Yas did not get up at an ungodly hour to watch Kate Middleton become a Princess.I don't believe in fairy tales anymore. It's sad. But to be expected. We girls grow up. Besides, there's always CNN and People Magazine if you need a fix of fantasy.Kate's dress and veil were simply lovely - all very grown up and modern in comparison to those of another Princess in whose shadow she walks. I don't think she'll walk there for long. Well done. (Source: Dr.J's HouseCalls)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Do you need a social media policy for your medical practice?

Pediatric Inc — Wed, 27 Apr 2011 15:00:38 +0100

I don’t think you really need one. And here is why. Social media is merely a communication tools just like a telephone. We don’t have a phone policy in place for employees yet I would assume they already know what is appropriate and what is not when talking with patients or parents on the phone. Thus we don’t need a document to tell employees how to act online. A well written employee manual ought to be enough to set the proper guidelines. Michael Hyatt, wrote a fantastic post about this issue: he highlights 5 reasons why you don’t need one. He says that 1) your people can be trusted; 2) social media are just one more way to communicate; 3) more rules only make your company more bureaucratic; 4) formal policies only discourage people from participating and finally; 5) Y...

FNB/Community One Update: Banking Mayberry Style

Dr.J's HouseCalls — Wed, 27 Apr 2011 13:12:00 +0100

Drum roll please. Once again, the Greensboro N&R has scooped the Courier Tribune (so much for Diane Winemuller's emphasis on the "hyper-local"): In what appears to be a Mayberry-style shot-gun marriage arranged by Paw (the Feds) to keep an eye on (and prop up) two bad sisters, Community One Bank has merged with Granite Bank (of Granite Falls, N.C.) - bringing in outside management - with the Carlyle Group and Oak Hill Capital pouring 155 million dollars into the joint venture.If you read carefully, you'll note that Bank of Granite stock is worth MORE than Community One/FNB. But between the two floundering banks, the stock prices still add up to less than one dollar per share.Late Afternoon Update: It gets even better....

Social Media and Kids

Dr. Shu Says — Wed, 27 Apr 2011 02:33:00 +0100

My interview with Tacoma Perry on Fox 5 Atlanta. Bottom line--moderation and monitor!Doctors: Social Media Causing Rise in Injuries: MyFoxATLANTA.com (Source: Dr. Shu Says)

Mr. Mayor "Re-Vitalize" Asheboro All You Like. But Perhaps God Might Be More Likely To Hear Your Prayers If You Didn't Lie To The Public Or Re-write History.

Dr.J's HouseCalls — Tue, 26 Apr 2011 03:25:00 +0100

Regular readers of Housecalls will remember that I was not exactly thrilled when Asheboro City leaders appeared as "honored guests" during an eleven o'clock service at Asheboro's First Baptist Church back in February - kicking off a campaign (for lack of a better word) of prayer, coinciding with the season of Lent, to ask God to heal our city.While I don't doubt, for one second, the sincerity of FBC's real church-people - or the Power of God - the hypocrisy exuded by those standing on FBC's stage ranked right up there with the Courier Tribune's Annette Jordan sanctimoniously lecturing anyone on the importance of the public's access to public records.As I've said before, when it comes to forgiveness and atonement, I ...

Happy Easter

Dr.J's HouseCalls — Sun, 24 Apr 2011 20:05:00 +0100

(Source: Dr.J's HouseCalls)

MedWorm Message: Register forMedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Journalistic PMS (Peggy Morrison Syndrome)

Dr.J's HouseCalls — Sun, 24 Apr 2011 02:45:00 +0100

Related to this Housecalls post and this one, in his latest editorial in the Courier, Ray Criscoe does his best John Robinson impersonation, and offered us his (sorry) excuses for the emphasis he chose not to place in the immediate aftermath of tornadoes that decimated entire communities in the Eastern part of our state last Saturday.Ray explains that it's all about the "hyper-local". That's what sells newspapers (as if he would know).It reminds me of Peggy Morrison's whine after local sympathy for North Carolina's far-Eastern victims of Hurricane Floyd threatened local United Way coffers. This is the woman whose husband made over 700,000 in 2008 as the CEO of "non-profit" Randolph Hospital.Charity has served them well.Of course, if the n...

"Lest Anyone Doubt The Story Of Mary Johnson . . ."

Dr.J's HouseCalls — Sat, 23 Apr 2011 23:00:00 +0100

Catching up, fellow doctor-blogger, Joe Guarino, no doubt furrowed some brows amongst the local "Coneheads" when he posted this ditty last Friday on a physician survey out of Texas.Seventeen percent of physicians report cases in which physicians lost employment, contracts, or hospital privileges because they raised issues about hospital regulatory compliance or patient care quality.I'm not very surprised by the findings - or the numbers. In fact, based on my own experience - and all of the ugly I have seen in my years on-the-road, I would expect those numbers to be higher in North Carolina - where the big/non-profit hospitals rule broad swipes of the economic landscape. It's rare for medical badness to make headlines - and usual...

Chili Champs vs. Deadly Tornados: A Letter To The Editor Of The Courier Tribune

Dr.J's HouseCalls — Sat, 23 Apr 2011 13:38:00 +0100

I've been spring cleaning this week - actually making up for a couple of missed springs - and blogging has been on the back-burner. It actually hurts to type this as my fingers are raw from scrubbing floors and washing walls.A few days ago, a friend of mine forwarded me a Letter-To-The-Editor of the Courier Tribune - it was on behalf of a friend of his who had (good) reason (as you will shortly see) to believe it would not be printed. The letter mirrored the sentiments I expressed last Sunday about what passed for local news reporting in the wake of a swarm of unusually-powerful-for-these-parts tornadoes that turned large portions of the Eastern part of our state into a hellish version of Oz.At least this time (as oppo...

The Force Was Strong With Her

Dr.J's HouseCalls — Wed, 20 Apr 2011 12:40:00 +0100

I've never had to kill a post before, but yesterday's musings on a young lady at a Disney park who willingly surrendered to the Dark Side of the Force seemed to be eating my blog from within - something about the embedded code to the video.It's too bad. I'm still chuckling over the video. (Source: Dr.J's HouseCalls)