MedWorm: Solo Practices

EMR use still low at solo and small practices

American Medical News - BUSINESS — Thu, 11 Mar 2010 12:59:41 +0100

But adoption rates at practices with more than 10 physicians have grown significantly since 2009. (Source: American Medical News - BUSINESS)

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Bundled payments might cut hospital costs without reducing quality of care

Wash Post Health — Tue, 09 Mar 2010 05:00:00 +0100

A decade and a half ago, when I started my solo practice, I would say to my routine HIV patients, "Let's see you back in three months." I was eager to fill clinic slots; also, because of my lack of experience, I felt safer seeing my patients more often. (Source: Wash Post Health)

Bundled Payments Might Cut Hospital Costs Without Reducing Quality of Care

RWJF News Digest - Quality/Equality — Tue, 09 Mar 2010 05:00:00 +0100

A decade and a half ago, when I started my solo practice, I would say to my routine HIV patients, "Let's see you back in three months." (Source: RWJF News Digest - Quality/Equality)

Bundled payments might cut hospital costs without reducing quality of care

washingtonpost.com - Health — Tue, 09 Mar 2010 05:00:00 +0100

HIMSS: Fully functional EMR can equal more patients, more revenues

Cardiovascular Business News — Wed, 03 Mar 2010 21:24:39 +0100

ATLANTA – During an education session this afternoon at HIMSS10, Gregory Oliver, DO, primary physician at Oliver Family Healthcare, shared his insight into how to implement a fully functional EMR in a solo practice and raise profits by 25 percent annually through efficiency and the laddering of technologies. (Source: Cardiovascular Business News)

HIMSS: Fully functional EMR can equal more patients, more revenues

CMIO.net: The News Weekly for Health IT Executives — Wed, 03 Mar 2010 21:24:39 +0100

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HIMSS: Fully functional EMR can equal more patients, more revenues

Health Imaging News — Wed, 03 Mar 2010 21:24:39 +0100

HIMSS: Fully functional EMR can equal more patients, more revenues

Health Imaging News — Wed, 03 Mar 2010 21:24:39 +0100

Private Practice of Prosthodontists: Current Conditions of Practice in the United States

Journal of Prosthodontics — Thu, 25 Feb 2010 00:00:00 +0100

Conclusion: In 2007, prosthodontists in private practice paid out about $1.4 billion in practice expenses to provide $2.2 billion dollars in prosthodontic care. Based on survey results from 2007 and the previous 6 years, specialization in prosthodontic care continues to be an economically attractive and productive healthcare profession in the United States. (Source: Journal of Prosthodontics)

Physician's Focus: Many Small Practices Evolve in Direction of Boutique Medicine

Modern Medicine — Thu, 25 Feb 2010 00:00:00 +0100

A growing number of physicians dedicated to keeping the small practice model alive are succeeding with innovations like the cash-only practice, concierge medicine, the open-access office, and the micropractice. Independence seems to be the main attraction, as a solo practice--or even a group of 2, 3, or 4 physicians—makes it easier for doctors to be their own boss, set their own hours, choose their own staff, and be the captain (at least partially) of their own destinies. (Source: Modern Medicine)

Pathways Between Marriage and Parenting for Wives and Husbands: The Role of Coparenting

Family Process — Thu, 11 Feb 2010 00:00:00 +0100

This study used model-fitting analyses to include both wives and husbands in a test of these two alternative models of the role of coparenting in the family system. Our data suggested that both the traditional indirect model (marital health to coparenting to parenting practices), and the alternative predictor model where coparenting alliance directly and simultaneously predicts marital health and parenting practices, fit for both spouses. This suggests that dynamic and multiple roles may be played by coparenting in the overall family system, and raises important practical implications for family clinicians. A medida que las investigaciones sobre sistemas familiares se han expandido, también lo han hecho las investigaciones de cómo los compañeros conyugales comparten la crianza de sus hi...

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International health policy survey in 11 countries: assessment of non-response bias in the Norwegian sample

BMC Health Services Research — Wed, 10 Feb 2010 00:00:00 +0100

The objective of this study was to assess the effects of non-response in the Norwegian part of the Commonwealth Fund international health policy survey in 2009. Methods: As part of an international health policy survey in 2009 a cross-sectional survey was conducted in Norway among a representative sample of Norwegian general practitioners. 1 400 randomly selected GPs were sent a postal questionnaire including questions about the Norwegian health care system, the quality of the GPs' own practice and the cooperation with specialist health care. The survey included three postal reminders and a telephone follow-up of postal non-respondents. The main outcome measures were increase in response rate for each reminder, the effects of demographic and practice variables on response, the effects of n...

Suboptimal quality of type 2 diabetes care discovered through electronic feedback led to increased nurse–GP cooperation. A qualitative study

Primary Care Diabetes — Fri, 22 Jan 2010 00:00:00 +0100

Conclusion: EFS used at an overall level provided an overview of the diabetes population which made GPs aware of the need to improve the quality of diabetes care. The EFS influenced partnership practices, but not solo practices, to hire nurses and allocate parts of diabetes care to them. The findings are important in the interpretation of the effect of EFS. (Source: Primary Care Diabetes)

Care management tools for patients with chronic conditions not always used

American Medical News - PROFESSION — Thu, 07 Jan 2010 13:03:32 +0100

Solo and smaller group practices are the least likely to have the staff and other resources needed to use those tools, a recent study says. (Source: American Medical News - PROFESSION)

Better Now Than Later: Get Involved in Reimbursement Issues

Clinical Neurology News — Fri, 01 Jan 2010 00:00:00 +0100

DR. JONES is cochair of the AAN's Government Regulatory Committee and has a solo private practice in Bristol, R.I. As many are now aware, there are a variety of changes to the Medicare fee payment schedule for 2010. (Source: Clinical Neurology News)

Z - Score an Important Clue to Diagnosis of Co-Morbidities and Fracture Risk

Journal of Clinical Densitometry — Fri, 01 Jan 2010 00:00:00 +0100

This study reviews the presence of low Z - scores and relevance to diagnosis, risk of fracture and therapeutic implications for evaluation of patients in a solo rheumatology practice. (Source: Journal of Clinical Densitometry)

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Book: Declarations of a Dinosaur

Sound Medicine — Sun, 20 Dec 2009 00:00:00 +0100

Reports on Primary Health Care topics are sponsored by Wishard Health Services. Lucy Hornstein, MD, is a member of dying breed: the solo practicing family doctor. Today she chats with Sound Medicine's Dr. David Crabb about her book, Declarations of a Dinosaur. Dr. Hornstein offers up rules she's learned treating patients. And she muses about the uncertain future of the family practice docto.... (Source: Sound Medicine)

Rural surgery: the Australian experience.

The Surgical Clinics of North America — Tue, 01 Dec 2009 00:00:00 +0100

This article outlines the past and current state of medical care in rural areas, highlighting models used in Port Augusta, Mount Gambier, and Port Lincoln. It concludes that these models are successful and should be further developed. PMID: 19944815 [PubMed - in process] (Source: The Surgical Clinics of North America)

HITECH Imposes New EHR Security Measures: Federal penalties for breaches of personal health information are significant and will be enforced.

Rheumatology News — Tue, 01 Dec 2009 00:00:00 +0100

DENVER — If federal stimulus money to the tune of $44,000 per physician has warmed more solo and small group practices to the idea of adopting electronic health record systems, the new Health Information Technology for Economic and Clinical Health Act could cool their enthusiasm. (Source: Rheumatology News)

New Security Regs Could Short Circuit EHRs: Potential for violation of the HITECH law could be exacerbated by information technology.

Caring for the Ages — Tue, 01 Dec 2009 00:00:00 +0100

Erik L. Goldman is a freelance writer in New York. DENVER — If federal stimulus money to the tune of $44,000 per physician has warmed more solo and small group practices to the idea of adopting electronic health record systems, the new Health Information Technology for Economic and Clinical Health Act could throw a wet blanket on their enthusiasm. (Source: Caring for the Ages)

HITECH Will Tighten Data Security Rules in 2010

Internal Medicine News — Tue, 01 Dec 2009 00:00:00 +0100

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The Psychiatric Medical Record, HIPAA, and the Use of Electronic Medical Records

Child and Adolescent Psychiatric Clinics of North America — Mon, 30 Nov 2009 16:55:54 +0100

This article addresses the practical and legal issues related to the psychiatric medical record, with an emphasis on the issues related to confidentiality. Implications of HIPAA (Health Insurance Portability and Accountability Act) legislation for the practice of child and adolescent psychiatry are addressed. The advantages and disadvantages of electronic medical records are reviewed, with guidelines for selecting software for solo and group practices. (Source: Child and Adolescent Psychiatric Clinics of North America)

Preface

Child and Adolescent Psychiatric Clinics of North America — Mon, 30 Nov 2009 16:55:53 +0100

Management is doing things right; leadership is doing the right things.—Peter F. Drucker Much of the medical literature in child and adolescent psychiatry is correctly focused on the nature of the illnesses that afflict our patients and the technical aspects of their treatment. Yet, in the real world within which we all work and practice following residency, our patients rely on well-functioning systems for the delivery of our services. These systems do not run themselves, and for optimal functioning, require the involvement of child and adolescent psychiatrists with substantial leadership and management skills, as well as a thorough understanding of the business and management of health care services. Indeed, it is often these areas that produce the greatest anxiety for not only the ne...

Design of an Equine Ambulatory Practice

Veterinary Clinics of North America: Equine Practice — Mon, 30 Nov 2009 16:41:11 +0100

In this article, the author discusses the design of an equine ambulatory practice. He suggests a more systematic approach to the design of an ambulatory practice that should answer the needs of group and solo practices. Today's practitioners must actively manage their practices so that their resources can be leveraged in such a fashion that a return can be realized on their capital investment and the hours spent in practice. (Source: Veterinary Clinics of North America: Equine Practice)

Rural Surgery: The Australian Experience

Surgical Clinics of North America — Mon, 30 Nov 2009 15:49:15 +0100

The ACR Practice Leaders Meeting

Journal of the American College of Radiology : JACR — Mon, 30 Nov 2009 15:33:08 +0100

Group practices are the most common form of organizational structure for radiology in the United Sates. Apart from a shrinking number of radiologists in solo practice, the vast majority of US radiologists belong to some form of defined radiology group, whether in independent practice, academic practice, or part of another structure such as a multispecialty group or government entity. (Source: Journal of the American College of Radiology : JACR)

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House Approves Legislation to Help Small Practices Purchase Health IT Systems

AAFP Government and Medicine — Wed, 25 Nov 2009 20:35:00 +0100

Congress has moved a step closer to approving a bill that would give small and solo physician practices the ability to obtain low-cost loans for the purchase of health information technology, or health IT, systems. (Source: AAFP Government and Medicine)

Marginal adaptation of an etch-and-rinse adhesive with a new type of solvent in class II cavities after artificial aging

Clinical Oral Investigations — Tue, 24 Nov 2009 07:10:15 +0100

Abstract This in vitro study evaluated the marginal adaptation of etch-and-rinse adhesives. Standardized class II cavities were cut in 40 human molars with one proximal box limited within enamel and one proximal box extending into dentin. Teeth were assigned randomly to five groups (n = 8) and restored with incrementally placed composite restorations. Five combinations were tested: G1, XP Bond + Ceram-X Mono; G2, P&B NT + Ceram-X Mono; G3, Optibond Solo Plus + Ceram-X Mono; R1, Syntac Classic + Tetric EvoCeram; R2, Scotchbond 1 XT + Z250. After finishing and polishing, teeth were stored for 48 h in water at 37°C before subjected to artificial aging by thermal stress (5/55°C; ×2,000; 30 s) and mechanical loading (50 N; ×50,000)...

Surgeons, Medical Errors, and Burnout

About.com Health Careers — Tue, 24 Nov 2009 00:00:00 +0100

Is burnout affecting your practice? A recent survey of thousands of members of the American College of Surgeons, published by the Annals of Surgery, found that roughly 9% of surgeons fear they have committed a serious medical error in the past three months of their career. According to The Wall Street Journal Health Blog, those surgeons who have committed recent medical errors are more likely to suffer from burnout and depression, the survey found. However, it has not been determined if the errors caused the depression, or if the depression led to the medical errors. Of the nearly 8,000 surgeons who responded to the survey, about 40% described themselves as "burned out", and 30% have suffered from depression, according to The Wall Street Journal. If you're feeling intense stress in your...

$10B loan program targeted at small medical groups

Healthcare IT News — Fri, 20 Nov 2009 14:47:27 +0100

A bill that provides loans of up to $350,000 for physicians and $2 million for medical groups to buy electronic health record systems or other healthcare information technology is likely to benefit solo and small group practices the most, according to investment bank Piper Jaffrey. (Source: Healthcare IT News)

Hypocrisy, Why We Are Sometimes Guilty Of This

Psychology Today Parenting Center — Mon, 09 Nov 2009 17:20:54 +0100

Recently Carrie Prejean, the former Miss California beauty queen was found to have contradicted her Christian values, after pageant officials discovered a solo sex tape, starring her. But this isn't the first time a well known public figure outspoken in support of righteous values has being found to have contradicted his or her moral high ground. As a matter of fact this is so rampant, that it is not a matter of how often the media can find a public figure engaging in hypocrisy, but how well known the culprit is.In all fairness, at some point in time, everyone has engaged in hypocrisy and sadly there are multiple offenders. So why do we do it? After all, most people can agree that "do as I say, not as I do" is an inefficient way to teach youth. Sure, they will listen to you, but compliance...

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Introverts: Stretch and Get Ahead

Psychology Today Work Center — Tue, 03 Nov 2009 11:51:37 +0100

New York was crawling with Madonnas and Madoffs, Blagos and Jackos, and no shortage of Sarah Palins this past weekend. Would you benefit from taking an occasional holiday from your workaday persona? Who were you for Halloween? And who are you on the other 364 days of the year? If you’re an introvert, you probably avoid drawing attention to yourself (although an occasional mask and a costume can be a clever workaround if you enjoy taking on a different persona!).In the context of work, you probably spend more time immersing yourself in the tasks at hand than creating buzz about what you've accomplished. Sound familiar? However, if you'd like to advance in your career, chances are you'll need to get some recognition for your good work. Consider the following activities to help you build s...

Solo doctors and ethical isolation

Journal of Medical Ethics — Fri, 30 Oct 2009 17:01:41 +0100

This paper uses the case of solo doctors to explore whether working in relative isolation from one’s peers may be detrimental to ethical decision-making. Drawing upon the relevance of communication and interaction for ethical decision-making in the ethical theories of Habermas, Mead and Gadamer, it is argued that doctors benefit from ethical discussion with their peers and that solo practice may make this more difficult. The paper identifies a paucity of empirical research related to solo practice and ethics but draws upon more general medical ethics research and a study that identified ethical isolation among community pharmacists to support the theoretical claims made. The paper concludes by using the literary analogy of Soderberg’s Doctor Glas to illustrate the issues raised...

Use of Interpreters by Physicians Treating Limited English Proficient Women with Breast Cancer: Results from the Provider Survey of the Los Angeles Women's Health Study

Health Services Research — Thu, 29 Oct 2009 00:00:00 +0100

Little is known about how cancer physicians communicate with limited English proficient (LEP) patients. We studied physician-reported use and availability of interpreters. A 2004 survey was fielded among physicians identified by a population-based sample of breast cancer patients. Three hundred and forty-eight physicians completed mailed surveys (response rate: 77 percent) regarding the structure and organization of care. We used logistic regression to analyze use and availability of interpreters. Most physicians reported treating LEP patients. Among physicians using interpreters within the last 12 months, 42 percent reported using trained medical interpreters, 21 percent telephone interpreter services, and 75 percent reported using untrained interpreters to communicate with LEP patients. ...

Ownership loses its luster: Physicians less likely to go solo

American Medical News - BUSINESS — Mon, 19 Oct 2009 12:00:00 +0100

Higher costs for practice start-ups, lower reimbursement rates and a desire for more work-life balance have driven the trend. (Source: American Medical News - BUSINESS)

Call-Sharing for Small-Group Docs

Physicians Practice — Thu, 17 Sep 2009 18:14:12 +0100

Dealing with constant call is the bane of many small physician groups. But with the right planning, even solo physicians can share call just like their big-practice peers. Here’s how. (Source: Physicians Practice)

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The Moral According to Smartmarriages: “Incredible, Painful Loneliness”

Psychology Today Relationships Center — Thu, 17 Sep 2009 07:46:44 +0100

So I guess I'm not the only one who read that New York Times story about the single-again 50-something year-old woman and had a very different reaction than the moderator of another listserv. (You can read the original Times story here if you haven't already. Then read the very thoughtful set of comments to my original post about it.)As I mentioned in my last post, I read an account of the story before I read the story itself. The description was in an email posted to the Smartmarriages listserv. Here's some of what the moderator of that listserv said about the story: "We [she means the Smartmarriages group members] don't need to preach, we can just hand this article to our ‘is this all there is?' gals." The moderator then thanks the reporter for "letting it rip - letting this divorcee's...

Management decisions in nontraumatic complaints of arm, neck, and shoulder in general practice.

Annals of Family Medicine — Mon, 31 Aug 2009 23:00:00 +0100

CONCLUSIONS: Diagnostic category, long duration of complaints, and high functional limitations were key variables in management decisions with these complaints. In addition, several physician characteristics played a role as well. PMID: 19752473 [PubMed - in process] (Source: Annals of Family Medicine)

How to avoid malpractice liability in cross-coverage arrangements

Modern Medicine Medical Economics — Thu, 20 Aug 2009 11:24:29 +0100

For a solo practitioner or a small group practice, cross-coverage arrangements are like oxygen: Without them, there is no life—that is, no weekends, no evenings, no vacations, and no holidays. (Source: Modern Medicine Medical Economics)

How to avoid malpractice liability in cross-coverage arrangements

Modern Medicine — Thu, 20 Aug 2009 10:34:37 +0100

CMS touts success of three hospital projects, issues nearly $50M in incentives

Cardiovascular Business News — Wed, 19 Aug 2009 14:25:41 +0100

The Centers for Medicare & Medicaid Services (CMS) has announced the results from three value-based purchasing demonstrations, one for large physician practices, one for small and solo physician practices and one for hospitals. They agency simultaneously commissioned the launch of three additional value-based purchasing demonstrations. (Source: Cardiovascular Business News)

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CMS touts success of three hospital projects, issues nearly $50M in incentives

CMIO.net: The News Weekly for Health IT Executives — Wed, 19 Aug 2009 14:25:41 +0100

CMS touts success of three hospital projects, issues nearly $50M in incentives

Health Imaging News — Wed, 19 Aug 2009 14:25:41 +0100

CMS touts success of three hospital projects, issues nearly $50M in incentives

Health Imaging News — Wed, 19 Aug 2009 14:25:41 +0100

Association between satisfaction and stress with aspects of job and practice management among primary care physicians.

Quality in Primary Care — Fri, 24 Jul 2009 06:48:02 +0100

CONCLUSION: Reform strategies aimed at improving the quality of care among PCPs needs to take into account the contextual determinants of physician satisfaction and stress, and should highlight programmes that might be pursued to improve the integration of PCPs within the Italian National Health System. PMID: 19622272 [PubMed - in process] (Source: Quality in Primary Care)

Solo GPs face more hearings

BBC News | Health | UK Edition — Wed, 22 Jul 2009 16:02:13 +0100

GPs working alone are six times more likely to face a disciplinary hearing than those in group practices. (Source: BBC News | Health | UK Edition)

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A hybrid technique: video-assisted thoracoscopic surgery (VATS) pulmonary resections for community-based surgeons

Surgical Endoscopy — Thu, 09 Jul 2009 12:46:12 +0100

Conclusions This series shows that our hybrid VATS approach to pulmonary resection is safe and feasible at community hospital-based practices. Content Type Journal ArticleCategory TechniqueDOI 10.1007/s00464-009-0615-zAuthors Roger H. Kim, Virginia Commonwealth University School of Medicine and Massey Cancer Center Division of Surgical Oncology, Department of Surgery P.O. Box 980011 West Hospital, Room 7-402, 1200 East Broad Street Richmond VA 23298-0011 USAKazuaki Takabe, Virginia Commonwealth University School of Medicine and Massey Cancer Center Division of Surgical Oncology, Department of Surgery P.O. Box 980011 West Hospital, Room 7-402, 1200 East Broad Street Richmond VA 23298-0011 USACharles G. Lockhart, Bon Secours Health System Thoracic Surgery Institute Richmo...

An Audit of Health Products Advertised for Sale on Chiropractic Web Sites in Canada and Consideration of These Practices in the Context of Canadian Chiropractic Codes of Ethics and Conduct

Journal of Manipulative and Physiological Therapeutics — Tue, 30 Jun 2009 23:00:00 +0100

Conclusions: Variations in codes of ethics and in the proportions of practitioners advertising health products for sales across the country suggest that opinions may be divided on the acceptability of health product sales. Such practices raise questions and considerations for the chiropractic profession. (Source: Journal of Manipulative and Physiological Therapeutics)

Diversity in Entertainment - Why it Matters

Psychology Today Parenting Center — Tue, 30 Jun 2009 04:35:53 +0100

"Nothing is ever so wrong in this world that a sensible woman can't set it right in the course of an afternoon." -Jean Giraudoux, The Madwoman of Chaillot Recently, I wrote about an NPR.org posting by Linda Holmes on her blog, Monkey See. Her post, entitled "Dear Pixar, From All The Girls With Band-Aids On Their Knees" is an open letter to Pixar in praise of their films, but also identifying the lack of a single female lead character in any of their ten (plus two more in the works) films. This would seem to be a significant phenomenon given that females comprise about one half of the world's population. Imagine flipping a coin twelve times and have heads come up each time. Better yet, imagine the sheer impossibility of the American League team winning Major League Baseball's All-Star game ...

Labor of Love: A Midwife's Memoir

Journal of midwifery & women's health — Thu, 25 Jun 2009 08:59:22 +0100

Cara Muhlhahn has been operating a solo home birth midwifery practice in New York City for 12 years. She's a globe-trotting, jazz-singing, salsa-dancing single mom, so it comes as a surprise when reading this very modern memoir to find oneself thinking often of Martha Ballard, the 17th-century rural Maine midwife whose diaries were so lovingly explored by Laurel Thatcher Ulrich in her Pulitzer Prize–winning A Midwife's Tale. (Source: Journal of midwifery & women's health)

Who's The Crazy One???

Psychology Today Depression Center — Fri, 19 Jun 2009 12:07:49 +0100

There was an episode of Larry David's Curb Your Enthusiasm in which Larry felt it necessary to discontinue therapy as a result of running into his therapist on the beach and seeing him wearing a thong bikini. Not quite as dramatic, last weekend my wife and I pulled into the parking lot at our local pool; Shari went in ahead of me and unwittingly set up our spot right next to the new psychiatrist I had just started seeing, primarily for a meds consult.In our first session, however, when I mentioned that I was also seeking a psychotherapist, he declared himself a "One-Stop Shop," and told me that he'd been trained as an old-fashioned, lie-on-the-couch, Freudian psychoanalyst. Since psychoanalysis normally requires three to five sessions a week, I knew it would be way beyond...

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Practicing Excellence: A new beginning for laid-off docs

Modern Medicine — Thu, 18 Jun 2009 23:00:00 +0100

For the first time in his 12-year hospital career, Kevin Deighton, MD, had a choice to make: In six months, he could either go solo, find another employer, or unite with other physicians to launch their own practice. (Source: Modern Medicine)

Practicing Excellence: A new beginning for laid-off docs

Modern Medicine Medical Economics — Thu, 18 Jun 2009 23:00:00 +0100

Why turmeric could be the spice of life

Guardian Unlimited Science — Wed, 20 May 2009 23:01:00 +0100

Eating high-fat curries may not be as bad for us as we thought - at least, not if we lace them with turmeric. Scientists at Boston's Tufts University found that mice fed a high-fat diet that contained curcumin, a component of turmeric, put on less weight. This puts the spice in that magic group of foods with health-giving properties - along with garlic, ginger and fish oils.Like ginger, turmeric is a rhizome, a horizontal stem of a plant that grows underground. Generally speaking, it is prized more for its colour than its flavour: turmeric is the oldest natural food dye in the world, and is now seen in ingredients lists as E100. In my opinion, however, this downgrading from flavour to colour is largely due to the spice we get in Britain being old and dull by the time it reaches us. In Zanz...

Health facilities at the district level in Indonesia

Australia and New Zealand Health Policy - Latest articles — Mon, 18 May 2009 04:00:00 +0100

Conclusions: The relatively good distribution of health facilities in Indonesia was achieved through establishing public health centers at the sub-district level and staffing them through a system of compulsory service for doctors, nurses and midwives. Subsequently, these public sector staff also established solo-provider facilities for their own private practice; these solo-provider facilities, of which those for nurses are almost half, comprise the largest category of outpatient care facilities, most are not included in official statistics. Now that Indonesia no longer has mandatory service for newly graduated doctors, nurses and midwives it will have difficulty maintaining the distribution of facilities and providers established through the 1980s. The current challenge is to envision a ...

Dental Providers' Attitudes Regarding the Application of Fluoride Varnish by Pediatric Health Care Providers

Journal of Public Health Dentistry — Wed, 13 May 2009 04:00:00 +0100

Conclusions: Half of dental professionals felt that it was appropriate for medical providers to apply fluoride varnish; pediatric dental professionals were less supportive. A few dental practice characteristics were associated with acceptance of the use of fluoride varnish by medical care providers: targeting messages to dental hygienists and those with practices in mixed rural-urban areas may be a useful approach to garner greater support for this medical/dental partnership. (Source: Journal of Public Health Dentistry)

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Allscripts, Cardinal Health announce partnership to sell EHRs to physicians

Healthcare IT News — Thu, 07 May 2009 13:19:09 +0100

One of the nation’s largest electronic health record vendors is teaming up with a major healthcare distributor in an effort to convince solo and small-practice physicians to adopt healthcare IT. Thursday’s deal between Allscripts-Misys Healthcare Solutions and Cardinal Health is the latest and largest forged by Chicago-based Allscripts to create a distribution network for its MyWay EHR. The partnership allows Cardinal Health, based in Dublin, Ohio, to add Allscripts MyWay to its portfolio of products and services. (Source: Healthcare IT News)

Letters

Family Practice News — Fri, 01 May 2009 04:00:00 +0100

I am a solo pediatric practitioner in Canton, Mich., taking the plunge after many years in hospital practice. About the numerous articles discussing universal immunization: None of us in the trenches needs any convincing about the advisability of immunizing children completely. What we do need help with is being reimbursed for it. (Source: Family Practice News)

The Emotional Ups and Downs of Solo Practice

Medscape Allergy Headlines — Mon, 27 Apr 2009 16:00:00 +0100

There are times when the emotional aspects of practicing medicine crop up suddenly and without warning. (Source: Medscape Allergy Headlines)

Riding Raw: Interview with Raw Vegan Endurance Cyclist Harley Johnstone

NaturalNews.com — Mon, 20 Apr 2009 07:00:00 +0100

(NaturalNews) Harley Johnstone has been an endurance cyclist for ten years, and he has been eating a 100% vegan diet for 7 years and a 100% raw vegan diet for over 3 years. He promotes a raw vegan diet as the ultimate in healthy eating, sustainable farming, and blissful living with a passion to realize Mother Earth as an abundant fruit-bearing paradise.David: What are some of your accomplishments as an athlete?Harley: I am the 2008 South Australian 24-hour solo Cross Country Champion. Rode Paris - Brest - Paris in 51:30 (unsupported), ran many marathons, and still compete at national level on the bike. I raced full time in Belgium. Raw vegan diet turned me from chronic fatigue couch potato to world class ultra endurance athlete, and drug free.David: Were you always an athlete?Harley: No, a...

The EDUCATE Study: A Continuing Education Exemplar for Clinical Practice Guideline Implementation.

Clinical Journal of Oncology Nursing — Wed, 01 Apr 2009 04:00:00 +0100

Authors: Friedman L, Engelking C, Wickham R, Harvey C, Read M, Whitlock KB Cancer care is evolving from a solo practitioner care delivery system based on tradition and anecdotal experience to a multidisciplinary, collaborative, science-driven paradigm. Evidence-based practice facilitates optimal care quality for patients with cancer and is effected for medical and nursing practitioners through clinical practice guideline implementation. Clinician education based on principles of adult learning is one method of implementing clinical practice guidelines in clinical practice. However, research demonstrates that conventional static methods of education do little to change behavior; instead, effective education incorporates interactive formats, provides feedback, and includes reminder and r...

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New resource for the exploration of western classical music heritage - 1000 historic recordings

MEDEV News — Wed, 18 Mar 2009 04:00:00 +0100

The British Librarys Archival Sound Recordings project, supported by JISC, today launches a vital new resource for the exploration of western classical music heritage. Bringing together nearly 1000 historic recordings, this freely available online collection allows researchers to easily compare various interpretations of great composers, tracing the impact of globalisation on performance style and its evolution throughout the early 20th Century. Available works include:  Bach Brandenburg concertos, orchestral suites and solo concertos  Haydn Symphonies  Mozart Symphonies and concertos  Beethoven String quartets, symphonies and concertos  Brahms Symphonies, overtures and concertos Celebrating the success of p...

Does the culture of a medical practice affect the clinical management of diabetes by primary care providers?

Journal of Health Services Research and Policy — Wed, 18 Mar 2009 04:00:00 +0100

Conclusions Attention is beginning to focus on physician behavior in the context of different organizational environments. This study provides additional support for the suggestion that organization-level interventions (especially focused on practice culture) may offer an opportunity to reduce health care disparities and improve the quality of care. (Source: Journal of Health Services Research and Policy)

What do general practitioners do differently when consulting with a medical student?

Medical Education — Sun, 01 Mar 2009 05:00:00 +0100

Conclusions This organising of clinical activities in order to meet the needs of both patient and student is likely to require different processing skills to solo consulting. PMID: 19250354 [PubMed - in process] (Source: Medical Education)

Physician organization agreements: reining in physician contractual autonomy--why you should do it now.

The Journal of Medical Practice Management : MPM — Sun, 01 Mar 2009 00:00:00 +0100

This article addresses the rarely discussed cause and consequence of physician contractual autonomy and tactics...to rein it in. PMID: 19455863 [PubMed - in process] (Source: The Journal of Medical Practice Management : MPM)

NEJM Perspectives Examine Physicians' Shift to Larger-Group Practices, Medicare Physician Payment System

kaisernetwork.org: Health Policy Daily Report — Thu, 12 Feb 2009 05:00:00 +0100

"The Independent Physician -- Going, Going ...," New England Journal of Medicine: In the perspective, Stephen Isaacs and Paul Jellinek, partners in Isaacs/Jellinek, a firm that advises health foundations; and Walker Ray, vice president of the Physicians' Foundation, discuss the lack of information about physicians' "ongoing migration from independent solo or small-group practices to larger-group practices where they are often employees." According to the authors, "This trend and its consequences for the care of patients and the practice of medicine have scarcely been explored." They conclude that the "gaps in our understanding are troubling because many of the forces that have been driving the decline of independent practice are likely to persist, and perhaps even intensify, in the coming ...

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Big Brother Health Care Provisions Slipped Into Economic Stimulus Bill

NaturalNews.com — Tue, 10 Feb 2009 07:00:00 +0100

(NaturalNews) The new $800 billion economic stimulus bill contains some striking new "Big Brother" health care language that should give pause to all freedom-loving Americans. For starters, the bill requires the electronic tracking of the medical records of all Americans. All your private medical data will be stored in a government database, including your history of disease, pharmaceutical treatments, surgeries and even emergency room visits.How would you like the government knowing all the details about your drug rehab? Or alcoholism treatments? Abortion? Sexually-transmitted disease diagnosis? Pregnancy status? Blood test results?But it gets even more interesting than that: Under the new provisions found in the bill, all U.S. doctors will now be stripped of autonomy and forced to follow...

Physician's production of primary care in Ontario, Canada

Health Economics — Thu, 05 Feb 2009 05:00:00 +0100

This paper examines the factors affecting the number of patient visits per week reported by family physicians in Ontario. The way that a physician is paid is potentially endogenous to the number of patients seen per week, thus an instrumental variable method of estimation is employed to account for the endogeneity bias. Once account is taken of the endogeneity of remuneration as well as relevant physician and practice characteristics, the estimated elasticity of output with respect to hours worked is 0.74; 0.68 in group practices and 0.82 in solo practices. Physicians paid on a non-fee-for-service (NFFS) conduct 15-31% fewer patient visits per week in comparison to those paid under an FFS scheme. Certain patient populations in practices affect patient visits in important ways, as do a numb...

ORIGINAL ARTICLE: Racial Differences in Visit Duration of Outpatient Psychiatric Visits

Archives of General Psychiatry — Mon, 02 Feb 2009 05:00:00 +0100

Conclusions In recent years, progress has been made in closing a racial gap in the length of psychiatric office-based outpatient visits by African American vs white patients. Against a backdrop of persisting racial disparities in other areas of mental health care, ongoing attention to reducing disparities will be necessary to sustain and extend these gains. (Source: Archives of General Psychiatry)

Physicians Practice Pearls: Give a Little, Get a Lot

Physicians Practice — Fri, 30 Jan 2009 18:27:25 +0100

Rob Lamberts, MD, on the benefits of partnership over working solo. (Source: Physicians Practice)

Changing Careers: Is It Different for Singles?

Psychology Today Work Center — Wed, 28 Jan 2009 03:25:52 +0100

Recently, I received a book in the mail with a request that I review it for this blog. Hallie Crawford's Flying Solo: Career Transition Tips for Singles may be of interest to some singles for what it offers at face value. I'll describe that in Section I of this post. What I find even more intriguing, though, is the worldview that is conveyed between the lines. Crawford is an author who wants to send a positive message to singles. She is not a deliberate practitioner of singlism. So I read the book closely to see what assumptions about single and married life were woven throughout her text. That's in Section II. As always, my hope is that from my analysis, you can get more than just a sense of the implicit messages in this particular book. I hope you can also hone your skills at recognizing...

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Solo Practice -- My Waiting Room

Medscape FamilyMedicine Headlines — Mon, 12 Jan 2009 17:09:23 +0100

Popular physician blogger, #1 Dinosaur, considers waiting room decor. Medscape Business of Medicine (Source: Medscape FamilyMedicine Headlines)

Long-Term Impact of a Robot Assisted Laparoscopic Prostatectomy Mini Fellowship Training Program on Postgraduate Urological Practice Patterns

The Journal of Urology — Sat, 10 Jan 2009 10:00:46 +0100

Conclusions: An intensive, dedicated 5-day educational course focused on learning robot assisted laparoscopic prostatectomy enabled most participants to successfully incorporate and maintain this procedure in clinical practice in the short term and long term. (Source: The Journal of Urology)

San Francisco chiropractor sues patient over negative online comments

Medical Economics - Technology — Fri, 12 Dec 2008 05:00:00 +0100

A billing dispute between a chiropractor and his patient escalated into a lawsuit early this year with the chiropractor accusing the patient of defamation for comments posted about the solo practitioner on an online ratings site. (Source: Medical Economics - Technology)

San Francisco chiropractor sues patient over negative online comments

Modern Medicine Medical Economics — Fri, 12 Dec 2008 05:00:00 +0100

San Francisco chiropractor sues patient over negative online comments

Medical Economics - Technology — Fri, 12 Dec 2008 00:00:00 +0100

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Setting Up a Solo Practice? Don't Go It Alone

Blogged_Arteries — Mon, 03 Nov 2008 00:00:00 +0100

Are you thinking of opening a solo practice, but don't know where to begin? From securing a loan to hiring staff to choosing software and equipment, a myriad of tasks and important decisions awaits you. (Source: Blogged_Arteries)

Letters

Pediatric News — Sat, 01 Nov 2008 04:00:00 +0100

The Bigger Picture: Death of Solo Practice — A Myth

Physicians Practice — Sat, 01 Nov 2008 04:00:00 +0100

It’s true that more physicians are choosing group practices, but reports of the death of the solo practice have been greatly exaggerated. (Source: Physicians Practice)

Factors influencing the adoption of an innovation: An examination of the uptake of the Canadian Heart Health Kit (HHK)

BioMed Central — Thu, 02 Oct 2008 04:00:00 +0100

Conclusions: The results of this study suggest that future information innovations must demonstrate an advantage over current resources and the research evidence supporting the innovation must be clearly visible. Findings also suggest that the innovation adoption process has a social element, and collegial interactions and discussions may facilitate that process. These results could be valuable for knowledge translation researchers and health promotion developers in future innovation adoption planning. (Source: BioMed Central)

The Business Coach: My "New & Improved" Blog

Psychology Today Personality Center — Tue, 23 Sep 2008 00:22:46 +0100

Welcome to my “New & Improved” blog, The Business Coach: Everything You Ever Wanted to Know About What Coaches Do, and Cannot Do For You, but Didn’t Know You Could Ask. To answer the obvious question, “Why switch from ‘Success Without Distress’ to this subject?” it’ easy: I think this will be of greater interest to Psychology Today’s readers.As Hara Marano, Editor-at-Large at PT (and my official great friend & godmother) remarked regarding my request to switch foci; “You’ll address some of the issues you planned to raise in your old blog anyway, won’t you?” Of course, I said. I have studied success, successful people, and self-sabotaging successes for (I hate to admit it) over 30 years. With that degree of immersion in a subject it’s hard not to discuss ...

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A survey of the primary care management of osteoarthritis in Malaysia: a view from a rheumatologist's perspective

APLAR Journal of Rheumatology — Sat, 20 Sep 2008 04:00:00 +0100

Conclusion: The data suggest that in the primary care setting, the majority of GPs over-investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesics and NSAIDs. The use of physiotheraphy and non-drug approaches were significantly under-utilized. There is a need to further educate GPs in the management of OA. (Source: APLAR Journal of Rheumatology)

Letters

Pediatric News — Mon, 01 Sep 2008 04:00:00 +0100

I fully agree with Dr. Andrew D. Racine regarding his vaccine cost analysis (“Plethora of Shots Burdens Providers,” June 2008, p. 1). I am in solo practice and find that vaccine administration and tracking consume a substantial amount of nursing time—or my time if my nurse is on vacation or ill. Probably the greatest burden on my practice is the great cost of purchasing and storing the vaccines. This cost coupled with the absurdly low reimbursement rates by the insurance companies makes running a pediatric practice very challenging. (Source: Pediatric News)

Campaign '08: New Jersey Physician Delegate Drawn to Obama's Vision

MedPage Today Public Health — Fri, 29 Aug 2008 23:23:27 +0100

DENVER (MedPage Today) -- Margaret Hurley, D.O., a solo family practitioner in rural Woodstown, N.J., was a delegate to the Democratic National Convention who came to cheer long and hard for Barack Obama. (Source: MedPage Today Public Health)

Chiropractors in Finland - a demographic survey

Chiropractic & Osteopathy — Wed, 27 Aug 2008 04:00:00 +0100

Conclusions: The Finnish chiropractic profession is relatively young. Consequently, many of the practitioners have a university-degree, which reflects recent developments in undergraduate chiropractic education. Their practice profile and the manner in which they practice appear to be fairly traditional. (Source: Chiropractic & Osteopathy)

Which physicians have access to electronic prescribing and which ones end up using it?

Health Policy — Mon, 18 Aug 2008 04:00:00 +0100

CONCLUSIONS: Insights from segmentation analyses could be used to identify adoption barriers and to develop targeted interventions to accelerate the implementation of e-prescription systems in physician practices. PMID: 18715669 [PubMed - as supplied by publisher] (Source: Health Policy)

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Solo Practice -- Making It on Your Own

Medscape FamilyMedicine Headlines — Tue, 05 Aug 2008 19:05:13 +0100

A popular physician blogger writes about the pitfalls and unexpected pleasures of solo practice. Medscape Business of Medicine (Source: Medscape FamilyMedicine Headlines)

Lawmakers, Witnesses at House Hearing Cite High Costs, Patient Privacy as Concerns Regarding Health IT Adoption

kaisernetwork.org: Health Policy Daily Report — Mon, 04 Aug 2008 05:00:00 +0100

Lawmakers and witnesses at a House Committee on Small Business hearing on Thursday discussed various barriers, such as high costs and privacy concerns, to adopting health information technology services for small and private health care practitioners, CQ HealthBeat reports. Legislation (HR 6357) aimed at spurring the adoption of health IT, such as a nationwide electronic health records system to raise the quality of health care and reduce medical costs, currently is under review in the House.Committee Chair Nydia Velazquez (D-N.Y.) said that implementing an EHR system could cost a physician more than $44,000, with additional costs to maintain the systems. Velazquez said, "For small health care providers with limited resources, these upfront costs are enough to break the bank." She said tha...

[Articles] Use of Buprenorphine for Addiction Treatment: Perspectives of Addiction Specialists and General Psychiatrists

Psychiatr Serv — Mon, 04 Aug 2008 04:00:00 +0100

CONCLUSIONS: Office-based pharmacotherapy offers a promising path to improved access to addictions treatment, but prescribing has expanded little beyond the addiction specialist community. (Source: Psychiatr Serv)

Office-Based Management of Opioid Dependence with Buprenorphine: Clinical Practices and Barriers

Journal of General Internal Medicine — Tue, 01 Jul 2008 06:01:43 +0100

Conclusions Capacity for increased buprenorphine prescribing exists among physicians who have already obtained a waiver to prescribe. Increased efforts to link waivered physicians with opioid-dependent patients and initiatives to improve institutional support may mitigate barriers to buprenorphine treatment. Several guideline-driven practices have been widely adopted, such as adjunctive counseling and monitoring patients with drug screening. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11606-008-0686-xAuthors Alexander Y. Walley, Boston Medical Center and Boston University School of Medicine Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine Boston MA USAJulie K. Alperen, Harvard School of Public Health De...

Price fixing in general practice.

Australian Family Physician — Tue, 01 Jul 2008 04:00:00 +0100

Authors: Brushin B, Watts I Dr Bev Young has just finished packing up her office. This is her last day in her Preston practice of 19 years. Bev enjoys the autonomy of being a solo general practitioner, but lately she finds managing the practice increasingly stressful. Teaming up with a fellow GP seemed a good alternative. PMID: 18592077 [PubMed - in process] (Source: Australian Family Physician)

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Delayed Ejaculation

Psychology Today Sex Center — Sun, 22 Jun 2008 02:28:59 +0100

Delayed ejaculation is when a guy can usually get a rock hard erection and have intercourse for a really long time, but can't ejaculate. What's particularly fascinating is that the majority of men with this problem are able to ejaculate just fine when they masturbate. It's when you put a flesh-and-blood partner between the guy's hand and his penis that he comes slower than a slug on sandpaper.Delayed ejaculation used to be known as retarded ejaculation, until we decided that calling a man a "retarded ejaculator" was a bit harsh. It's also referred to as inhibited ejaculation. Even though somewhere between 2% to 6% of men have the problem, very little research has been done on it and very little credible information is available for consumers.Of course, if you're a man who comes f...

Personality, gender and medico-legal matters in medical practice.

Australasian Psychiatry — Thu, 12 Jun 2008 04:00:00 +0100

Conclusions: The known demographic and practice factors that differ for doctors having a medico-legal matter are replicated here - being male, a proceduralist and working longer hours. There is not a consistent pattern regarding personality traits and medico-legal matters. PMID: 18608158 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)

Delivery models of rural surgical services in British Columbia (1996-2005): are general practitioner-surgeons still part of the picture?

Canadian Journal of Surgery — Sun, 01 Jun 2008 04:00:00 +0100

CONCLUSION: GP-surgeons still play an integral role in the provision of emergency and elective surgical services in rural communities without the population base to sustain resident specialist surgeons. As GP-surgeons retire and surgical programs close, there is no accredited training program to replace them. More outcome comparisons between procedures performed by GP-surgeons and general surgeons are needed, as is the creation of a nationally accredited training program to replace these practitioners as they retire. PMID: 18682795 [PubMed - in process] (Source: Canadian Journal of Surgery)

[The Practice of Radiology] Prevalence of Productivity-Enhancing Technologies in Radiology

American Journal of Roentgenology — Tue, 20 May 2008 04:00:00 +0100

CONCLUSION. Most operational technologies are fairly widely diffused, but a surprising number of radiologists work without some basic supports. (Source: American Journal of Roentgenology)

Introduction: Divorce for Grownups

Psychology Today Relationships Center — Tue, 13 May 2008 14:20:54 +0100

As this post is the first of many to this blog some statement of purpose seems in order. My posts to this blog are intended to educate as many people as I can about the American way of divorce. It is not my purpose to analyze why people get divorced although some of that discussion will inevitably occur. Nor is my purpose to reduce the incidence of divorce. I am not about saving marriages in this blog. Rather, I seek, in my mediation practice, in the books and articles I have written and in this blog to critique the way people get divorced using conventional divorce lawyers and heavy reliance on the courts. It has long been my mission to convince people that the way most people get divorced is unnecessarily painful, hurtful and emotionally and financially wasteful. Further, though it suppo...

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Small practice evolution: New models go mainstream

Medical Economics - Practice Management — Fri, 02 May 2008 04:00:00 +0100

A growing number of doctors are dedicated to keeping the small practice model alive. In using innovative strategies to keep solo or small group practices successful, they're stubbornly bucking a trend that's become familiar in recent years. (Source: Medical Economics - Practice Management)

Small practice evolution: New models go mainstream

Medical Economics - Medical Economics magazine — Fri, 02 May 2008 04:00:00 +0100

Small practice evolution: New models go mainstream

Medical Economics - Medical Economics magazine — Thu, 01 May 2008 23:00:00 +0100

Small practice evolution: New models go mainstream

Medical Economics - Practice Management — Thu, 01 May 2008 23:00:00 +0100

A Dialogue-Building Pilot Intervention Involving Traditional and Biomedical Health Providers Focusing on STIs and HIV/AIDS Care in Zambia

Complementary Health Practice Review — Tue, 29 Apr 2008 04:00:00 +0100

Collaboration between traditional and biomedically trained health workers is regarded as key in HIV/AIDS control. However, few studies have focused on exploring ways of enhancing this collaboration. Using a pre- and postintervention questionnaire, the authors assessed changes in attitudes to and practices of collaboration among 19 biomedical and 28 traditional health care providers following a 12-month dialogue-building intervention in Ndola, Zambia. The intervention consisted of peer group discussions, interactive group discussions, training sessions, and peer-influenced networking. The results show that although both groups of providers had fairly positive attitudes toward each other before the intervention, further improvements in attitudes were observed after the intervention. Referral...

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Solo Practitioner

bizjournals.com Health Care:Hospitals headlines — Mon, 28 Apr 2008 04:00:00 +0100

Christ Hospital CEO Susan Croushore knew immediately what the hospital's leaving the Health Alliance meant for her: She would have to stand against her employer, and specifically the man who hired her, Health Alliance CEO Ken Hanover. (Source: bizjournals.com Health Care:Hospitals headlines)

A continuing medical education approach to improve sexual boundaries of physicians

Bulletin of the Menninger Clinic — Thu, 17 Apr 2008 04:00:00 +0100

Conclusion: A CME course offers a model for future training experiences for faculty, residents, medical students and community physicians to teach skills that may help prevent and remediate professional boundary crossings. (Source: Bulletin of the Menninger Clinic)

The perceived obstacles in performing patch test to detect allergic contact dermatitis: a comparison between community allergists and directors of allergy training programs.

Annals of Allergy, Asthma and Immunology — Tue, 01 Apr 2008 04:00:00 +0100

CONCLUSIONS: Previous training in PT among PDs and community allergists was associated with a higher likelihood of performing PT. We recommend that training in the application and interpretation of PT for diagnosis of allergic contact dermatitis should be an integral part of the curriculum of allergy fellowship training programs and should also be incorporated into the continuing medical education program of practicing allergists. Furthermore, although allergists may continue to rely on dermatologists for more comprehensive PT, use of the thin-layer rapid use epicutaneous test is a simple screening tool that should be available to all allergy practices. PMID: 18450116 [PubMed - indexed for MEDLINE] (Source: Annals of Allergy, Asthma and Immunology)

Using computer based templates for chronic disease management.

Australian Family Physician — Tue, 01 Apr 2008 04:00:00 +0100

This study suggests that templates assist GPs in claiming for GPMP and TCA Medicare Benefits Schedule item numbers but do not in themselves facilitate care coordination. To improve care coordination between general practice and other agencies, communication regarding TCAs must be improved. PMID: 18398531 [PubMed - indexed for MEDLINE] (Source: Australian Family Physician)

Going solo: Young doctor pursues dream of neighborhood practice

bizjournals.com Health Care:Industry Regulation headlines — Mon, 31 Mar 2008 04:00:00 +0100

To her patients, walking into Dr. Laure DeMattia's medical office at 5500 W. Vliet St., Milwaukee, may feel like walking into a spa. The office is filled with natural light, cozy furniture and exposed brick as part of DeMattia's goal to create the "idealized micro practice" -- a family practice to serve patients in the tradition of a neighborhood doctor. (Source: bizjournals.com Health Care:Industry Regulation headlines)

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Going solo: Economics aside, a few doctors prefer to practice on their own

bizjournals.com Health Care:Physician Practices headlines — Mon, 31 Mar 2008 04:00:00 +0100

Contracts with insurance companies, changing insurance plans and the costs of running a business are all challenges to the independent physician. But one physician who has long been solo said the autonomy one has is worth the challenge of the business side of running a practice. (Source: bizjournals.com Health Care:Physician Practices headlines)

Going solo: Young doctor pursues dream of neighborhood practice

bizjournals.com Health Care:Physician Practices headlines — Mon, 31 Mar 2008 04:00:00 +0100

How Strategies for Managing Patient Visit Time Affect Physician Job Satisfaction: A Qualitative Analysis

Journal of General Internal Medicine — Wed, 26 Mar 2008 15:02:53 +0100

CONCLUSION For the study physicians, disregarding time limits on patient visits is an adaptive short-term strategy that enhances satisfaction with direct patient care. It is unlikely that such a strategy alone will help physicians cope with their broader—and growing—dissatisfaction with the profession. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11606-008-0596-yAuthors Jeffrey Solomon, Edith Nourse Rogers Memorial Veterans Hospital Center for Health Quality, Outcomes and Economic Research Bedford MA USA Journal Journal of General Internal MedicineOnline ISSN 1525-1497Print ISSN 0884-8734 (Source: Journal of General Internal Medicine)

Living Single: It Is How We Spend the Better Part of Our Adult Lives

Psychology Today Relationships Center — Fri, 21 Mar 2008 08:26:21 +0100

Welcome to the Living Single blog! This is my first post, so let me tell you a bit about myself and what you can expect to find in this space.I'm 54-years old and I've been living single my entire life. So I have quite a lot of experience in the practice of singlehood. Over the past decade or so, I've also become a scholar of the single life.I started taking mental notes on what it means to be single long before I decided to approach the topic scientifically. Probably my most jarring life transition was going from graduate school, where just about all of my friends were single, to my first job as an Assistant Professor, in 1979, in a psychology department in which just about all of my colleagues were institutionalized (i.e., married) or acting as if they were. Now, nearly three decades lat...

Performance measurement in the small office practice: challenges and potential solutions.

Annals of Internal Medicine — Tue, 04 Mar 2008 05:00:00 +0100

This article reviews the practice landscape in the United States; describes performance measurement challenges in small practice settings, including financial and staffing implications; discusses statistical issues that affect assessment of practice quality; and describes potential solutions to the issues raised. Challenges of performance measurement in small practice settings include lack of infrastructure and health information technology, lack of support staff, and increased burden. These issues are compounded by the difficulty of assessing a smaller number of patients spread over multiple payers. To overcome some of these challenges, design and measure selection recommendations for the performance assessment system are presented and practice-level and health plan-level interventions ar...

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Improve your sex life

NHS Direct News and health alerts — Wed, 06 Feb 2008 13:28:43 +0100

-Fancy finding out how to fine-tune your orgasm ability? Want to boost your bedroom antics with some new toys? Need some advice on condoms and contraception?Well, don't sweat it - we've got loads of top tips on having a healthy happy sex life. So read on to whip your sexual self into shape and increase your pleasure.OrgasmsOrgasms are different for everyone. Some describe a tingle where other, luckier people feel explosions. Remember - only barrier methods of contraception like the male condom can protect you from STIsFor some of us, orgasms are pretty rare - you might find it difficult to reach orgasm through intercourse alone, or never experience it. Don't let your sex life be an anti-climax. Follow these simple sensation tips and you might just get there...First, spend some time on your...

Assessing Disparities in Adult Vaccination Using Multimodal Approaches in Primary Care Offices: Methodology

Journal of Urban Health — Wed, 30 Jan 2008 16:28:33 +0100

Abstract Racial disparities in invasive pneumococcal disease and pneumococcal polysaccharide vaccination (PPV) persist despite significant progress. One reason may be that minority patients receive primary care at practices with fewer resources, less efficient office systems, and different priorities. The purposes of this paper are: (1) to describe the recruitment of a diverse array of primary care practices in Pittsburgh, Pennsylvania serving white and minority patient populations, and the multimodal data collection process that included surveys of key office personnel, observations of practice operations and medical record reviews for determining PPV vaccination rates; and (2) to report the results of the sampling strategy. During 2005, 18 practices participated in the s...

Doctors have no cure for lack of good office space

bizjournals.com Health Care:Physician Practices headlines — Mon, 14 Jan 2008 05:00:00 +0100

When cardiologist Sonny Wong wanted to branch out and open his own solo practice after more than 20 years in medicine, it took him about six months to find the right space. (Source: bizjournals.com Health Care:Physician Practices headlines)

Bigger practice, better quality? Practice size not the complete answer

American Medical News - PROFESSION — Mon, 19 Nov 2007 13:12:56 +0100

New research suggests that larger physician groups deliver better care, but some doctors say there are ways solo practices can compete on quality benchmarks. (Source: American Medical News - PROFESSION)

Get what you want in 2008: five steps to success.

The Journal of Medical Practice Management : MPM — Thu, 01 Nov 2007 04:00:00 +0100

Authors: Lipton-Dibner W Whether you are a large, multi-practitioner operation, or a small, solo practice, the question is the same: What can you do now that will ensure greater success for you in 2008? There is so much to look at when strategizing for the future, that it's easy to overlook key areas that might need attention. Even the most organized, well-staffed practices often miss crucial areas where a small intervention would yield a significant increase in their success. In this article, you'll discover the five critical steps to take to move your medical practice from where you are to where you want to be. PMID: 18225820 [PubMed - indexed for MEDLINE] (Source: The Journal of Medical Practice Management : MPM)

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Misys launches new EMR package

AuntMinnie.com Headlines — Thu, 25 Oct 2007 17:23:07 +0100

Misys Healthcare Systems of Raleigh, NC, has introduced an electronic medical record (EMR) package for small medical practices and solo practitioners, the company said. (Source: AuntMinnie.com Headlines)

Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial

Implementation Science — Mon, 24 Sep 2007 04:00:00 +0100

Conclusions: Educational outreach was accepted by general practitioners and was effective. It could be applied to other health care quality problems in this setting. (Source: Implementation Science)

Physicians Drawn to Mid-sized, Single-Specialty Practices

AAFP Professional Issues — Tue, 04 Sep 2007 20:35:00 +0100

A report released last month by the Center for Studying Health System Change, or HSC, says that fewer American physicians are working in solo and two-physician practices and that the number of physicians moving to mid-sized, single-specialty practices is increasing. (Source: AAFP Professional Issues)

Finances driving physicians out of solo practice

American Medical News - BUSINESS — Mon, 03 Sep 2007 12:00:15 +0100

The business of medicine has doctors moving into large groups or employed situations, studies find. (Source: American Medical News - BUSINESS)

Better off alone? Why physicians don't merge.

The Journal of Medical Practice Management : MPM — Sat, 01 Sep 2007 04:00:00 +0100

This article examines why, in spite of the challenges of being in solo and small group practices, many physicians still prefer the status quo and resist forming or joining larger groups. PMID: 17974081 [PubMed - indexed for MEDLINE] (Source: The Journal of Medical Practice Management : MPM)

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Predictors of self-reported discussion of cessation medications by physicians in New Jersey.

Addictive Behaviors — Fri, 24 Aug 2007 04:00:00 +0100

This study evaluates physician characteristics associated with higher rates of discussion of smoking cessation medications. 336 primary-care physicians in New Jersey completed a cross-sectional, self-administered, mail survey including physician demographics, practice type, previous training and confidence in treating tobacco dependence, awareness of guidelines, and perceived effectiveness of treatments. Two-thirds of respondents felt confident in using cessation medications despite only 24% having previous training and only 13% having read or implemented practice guidelines. After controlling for other variables, female physicians were more likely to discuss medications compared with males (adjusted odds ratio(AOR) 2.2; 95% confidence interval(CI) 1.0-4.6); physicians who were confident w...

Proportion Of Physicians In Solo/Two-Physician Practices Drops, USA

Health News from Medical News Today — Fri, 17 Aug 2007 10:00:00 +0100

The proportion of physicians in solo and two-physician practices decreased significantly from 40.7 percent in 1996-97 to 32.5 percent in 2004-05, according to a new national study released by the Center for Studying Health System Change (HSC). Changes in physician practice setting and organization have important implications for the practice of medicine and the care patients receive. [click link for full article] (Source: Health News from Medical News Today)

Report Shows Proportion of Solo-, Two-Physician Practices Declining

kaisernetwork.org: Health Policy Daily Report — Thu, 16 Aug 2007 05:00:00 +0100

"Physicians Moving to Mid-Sized, Single-Specialty Practices," Center for Studying Health System Change: The tracking report shows that the proportion of physicians in solo- and two-physician practices decreased from 40.7% in 1996-1997 to 32.5% in 2004-2005. The study examines how practice trends reflect changing incentives, how trends vary by specialty and policy implications as... (Source: kaisernetwork.org: Health Policy Daily Report)

Two Phone Calls and a Mountain.

Families, Systems, and Health — Tue, 19 Jun 2007 00:06:00 +0100

In this article, the author recalls various personal and professional experiences she has had during her career as a physician. She recounts her time in medical school, the establishment and closing of her solo practice, caring for her ill mother, the death of her nephew, a life-changing mountain climb, her work at an African clinic, and her decision to enter a new clinical field, focusing on special health care needs of the deaf and others who need health care through translation. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (Source: Families, Systems, and Health)

[Reviews and Overviews] Can Psychiatry Cross the Quality Chasm? Improving the Quality of Health Care For Mental and Substance Use Conditions

Am J Psychiatry — Wed, 02 May 2007 04:00:00 +0100

This article summarizes the Institute of Medicine’s analysis of these issues and recommendations for improving mental and substance use health care and discusses the implications for psychiatric practice and related advocacy efforts of psychiatrists, psychiatric organizations, and other leaders in mental and substance use health care. (Source: Am J Psychiatry)

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ORIGINAL INVESTIGATION: Physician Consideration of Patients' Out-of-Pocket Costs in Making Common Clinical Decisions

Archives of Internal Medicine — Mon, 09 Apr 2007 04:00:00 +0100

Conclusion Cost-sharing arrangements targeting patients are likely to have limited effects in safely reducing health care spending because physicians do not routinely consider patients' OP costs when making decisions regarding more expensive medical services. (Source: Archives of Internal Medicine)

Office-based medical practices: methods and estimates from the national ambulatory medical care survey.

Adv Data — Mon, 12 Mar 2007 04:00:00 +0100

Authors: Hing E, Burt CW OBJECTIVES: The report uses a multiplicity estimator from a sample of office-based physicians to estimate the number and characteristics of medical practices in the United States. Practice estimates are presented by characteristics of the practice (solo or group, single, or multi-specialty group, size of practice, ownership, location, number of managed care contracts, use of electronic medical records, and use of computerized physician order entry systems). METHODS: Data presented in this report were collected during physician induction interviews for the 2003-04 National Ambulatory Medical Care Survey (NAMCS). The NAMCS is a national probability sample survey of nonfederal physicians who see patients in an office setting in the United States. Radiologists, ane...

Find your tech tutor: What doctors need in a systems consultant

American Medical News - BUSINESS — Mon, 05 Mar 2007 15:00:00 +0100

Whether you're in solo practice or a large group, at some point you might need a consultant to help with information technology needs. Here is what a consultant will do, and what you should ask this person before signing a deal. (Source: American Medical News - BUSINESS)

The Solo Practitioner: Postcards From the Edge of Extinction

Medscape Med Students Headlines — Tue, 27 Feb 2007 17:00:00 +0100

A family physician writes about the frustrations and rewards of being a rare survivor of a dying species. Medscape Med Students (Source: Medscape Med Students Headlines)

Mentoring Success Story - Dream Practice (Pamela Wible MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Thu, 15 Feb 2007 07:00:00 +0100

A currently practicing solo FM physician describes how her happiness is influencing patients. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

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Diffusion of Surgical Techniques in Early Stage Breast Cancer: Variables Related to Adoption and Implementation of Sentinel Lymph Node Biopsy

Annals of Surgical Oncology — Wed, 07 Feb 2007 07:54:47 +0100

Conclusions??Surgical oncologists and university-based surgeons play key educational roles in disseminating new cancer treatments and therefore have a professional responsibility to educate other community physicians to increase the use of the most current, evidence-based practices. Content TypeJournal Article JournalAnnals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

Welcome to the Journal of Vision

Journal of Vision Articles — Mon, 05 Feb 2007 23:25:00 +0100

. We hope you will enjoy our inaugural issue. It is the product of efforts and ideas of many individuals, notable among them Denis Pelli, Rachel Necker, Bruce McClelland, Steven Shevell, Suzanne McKee, Joanne Angle, Cindy Fuss, David Beebe, the Journal of Vision Editorial Board, the ARVO Board of Trustees, the team at ScholarOne, and many others. It is also an evolving entity, and we hope you will let us know how it can be improved. When we envisioned this journal, our ambition was to create a vehicle that would serve, in a pure and optimal way, the publishing and reading needs of working vision scientists. Inherent in this dream was the notion of a digital, networked, or online journal. All of the content of the journal would be represented in digital form, and primary access to that c...

2006 Medical Weblog Awards: Meet the Winners!

Medgadget — Sat, 20 Jan 2007 05:00:00 +0100

The people and the judges have spoken! We are very proud to present to you this year's winners of the Medical Weblog Awards in seven categories. In its third year, Medical Weblog Awards are designed to highlight the diversity of the medical blogosphere, its newcomers, its rising stars, and its old time favorites. With so many blogs to choose from, these medical publications keep their readers with up to date latest in all fields of medicine, be it clinical specialties, technology, society's trends, or the latest ethical controversies. Without further delay, this year's winner of Best Medical Blog is... NHS Blog Doctor by Dr. John Crippen, a general practitioner from the UK. Described as an "extremely depressing" look at the state of the NHS, Dr. Crippen's blog also highlights the joys of b...

Improved injection safety after targeted interventions in the Syrian Arab Republic

Tropical Medicine and International Health — Mon, 15 Jan 2007 00:00:00 +0100

Conclusions The example of Syria shows that rapid improvement in injection safety is possible and that the necessary tools and methods to monitor and evaluate progress are at our disposal. Challenges remain in transferring this successful programme from the well-structured immunization programme to the more diverse curative health services. ObjectifsEvaluer la sûreté des injections en Syrie après une implémentation en mai 2002 d'un certain nombre de mesures visant à améliorer la sûreté des injections.Méthodes Deux surveillances représentatives ont été conduites à l'aide d'un outil standard d'évaluation. Une stratégie d'échantillonnage en grappe avec une probabilité proportionnée à la taille de la population a menéà l'inclusion de 80 services de santé dans 8 zones en 2...

Issue Brief Examines Trends In Physician Financial Incentives; Fact Sheets Discuss Long-Term Care Financing

Caregivers / Homecare News From Medical News Today — Tue, 09 Jan 2007 22:00:00 +0100

"Physician Financial Incentives: Use of Quality Incentives Inches up, but Productivity Still Dominates," Center for Studying Health System Change: The issue brief examines how productivity-based systems for providing physicians with financial incentives are still more commonly used than pay-for-performance programs, affecting about 70% of physicians in non-solo practices. [click link for full article] (Source: Caregivers / Homecare News From Medical News Today)

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[Health Tracking] Physician Practice Size And Variations In Treatments And Outcomes: Evidence From Medicare Patients With AMI

Health Affairs — Mon, 08 Jan 2007 07:00:00 +0100

We examined whether the practice size of attending physicians was related to within-hospital differences in care for Medicare patients with acute myocardial infarction (AMI). We found that patients treated by solo physicians were less likely to receive cardiac catheterization and angioplasty within a day of admission and more likely to die than other patients in the same hospital, even after a number of patient and physician characteristics were taken into account. These differences suggest that solo practitioners are less likely to follow guidelines calling for quick use of angioplasty. (Source: Health Affairs)

Correlates of electronic health record adoption in office practices: a statewide survey.

Journal of the American Medical Informatics Association — Mon, 01 Jan 2007 07:00:00 +0100

CONCLUSIONS: While almost half of physicians in Massachusetts are using an EHR, fewer than one in four practices in Massachusetts have adopted EHRs. Adoption rates are lower in smaller practices, those not affiliated with hospitals, and those that do not teach medical students or residents. Interventions to expand EHR use must address both financial and non-financial barriers, especially among smaller practices. PMID: 17068351 [PubMed - in process] (Source: Journal of the American Medical Informatics Association)

[Brief Reports] The Tipping Point From Private Practice to Publicly Funded Settings for Early- and Mid-Career Psychiatrists

Psychiatr Serv — Fri, 03 Nov 2006 07:00:00 +0100

CONCLUSIONS: The popular image of the psychiatrist sitting in a private office does not conform with current survey data, which show that psychiatric practice is increasingly taking place in publicly funded settings. Because it extends to mid-career psychiatrists, the shift from private office practice to publicly funded settings is not just a manifestation of early-career psychiatrists' earning a salary while building up their private practices but is a more enduring change in the landscape of psychiatric practice. The authors discuss the implications of these findings with regard to professional identity and training of psychiatrists. (Source: Psychiatr Serv)

Details emerge on new pay-for-performance test plan

American Medical News - GOVERNMENT — Mon, 30 Oct 2006 22:20:02 +0100

CMS hopes to recruit 800 solo or small- to medium-sized physician practices for the three-year Medicare pilot. (Source: American Medical News - GOVERNMENT)

Professional isolation and performance assessment in New Zealand

Journal of Continuing Education in the Health Professions — Tue, 26 Sep 2006 03:26:01 +0100

Discussion:The identification of physicians at risk for professional isolation may enable the prevention of poor performance. (Source: Journal of Continuing Education in the Health Professions)

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[Original articles] Overprescribing of lipid lowering agents

Quality and Safety in Health Care — Wed, 02 Aug 2006 06:00:00 +0100

Conclusions: Overprescribing of lipid lowering agents is commonplace and increased. At baseline and longitudinally, overprescribing was primarily associated with physician and practice characteristics and not with organisational factors. (Source: Quality and Safety in Health Care)

Use of a New Combined Vaccine in Pediatric Practices

PEDIATRICS — Tue, 01 Aug 2006 06:00:00 +0100

CONCLUSIONS. Although use of the vaccine results in fewer administration fees for most physicians, the magnitude of the change seemed not to be significant for the majority of respondents or was outweighed by other factors. It also is possible that larger practices or buying cooperatives were able to negotiate discounted rates for Pediarix relative to the constituent products. This may have been a strategy of manufacturers and/or distributors to provide incentive for practices to switch to the combination product. Of note was the appreciation of respondents for the preferences of patients for fewer vaccines and, to a lesser degree, for the decrease in office staff time required to provide vaccination with multiple antigens when using Pediarix. Also, the role of the availability of a given ...

Teamwork model allies doctors and nurses

bizjournals.com Health Care:Physician Practices headlines — Tue, 01 Aug 2006 04:54:01 +0100

Dr. Gail Morrison believes the days of doctors graduating from a medical school and "hanging up a shingle" as solo practitioners are history. (Source: bizjournals.com Health Care:Physician Practices headlines)

Pathology service and practice: Solo-practice pathologist in a community hospital in Japan: Personal experience and a proposal for cost- and time-effective practice

Pathology International — Wed, 12 Jul 2006 08:50:37 +0100

Pathology International Volume 56, Issue 8, Page 480-483, Aug 2006 (Source: Pathology International)

Solo practice lets physician treat all aspects of business

bizjournals.com Health Care:Physician Practices headlines — Mon, 03 Jul 2006 06:00:00 +0100

Dr. Peter Kambelos has to manage a staff, pay the mortgage and think about the cost of office supplies. (Source: bizjournals.com Health Care:Physician Practices headlines)

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Do group practices have lower caesarean rates than solo practice obstetric clinics? Evidence from Taiwan

Health Policy and Planning - current issue — Wed, 21 Jun 2006 06:00:00 +0100

Conclusions: Solo physicians are the most likely to provide caesarean delivery, and CS likelihood decreases with increasing number of physicians in the practice. Group practice support may reduce the CS likelihood, when it is not clinically indicated. Policy makers should consider initiatives to limit full service delivery privileges to group practice obstetric clinics, in order to reduce unnecessary CS. Solo practice clinics should, at best, be licensed as birthing centres, required to transfer patients needing CS to a larger facility. (Source: Health Policy and Planning - current issue)

Clinicians' Management of Children and Adolescents With Acute Pharyngitis

PEDIATRICS — Thu, 01 Jun 2006 06:00:00 +0100

CONCLUSIONS. here is much room for improvement in the management of acute pharyngitis in children and adolescents. Most physicians use appropriate management strategies; however, a substantial number uses inappropriate ones, particularly for children with likely viral pharyngitis. Efforts to help physicians improve practices will need to be multifaceted and should include health policy and educational approaches. (Source: PEDIATRICS)

Welcome to the Journal of Vision

Journal of Vision Articles — Tue, 23 May 2006 08:59:00 +0100

Developing a solo practice exit strategy.

Family Practice Management — Sun, 14 May 2006 06:00:00 +0100

Authors: Kalogredis VJ PMID: 16736905 [PubMed - in process] (Source: Family Practice Management)