AdvisorsMD Releases White Paper – 4 Reasons Why Specialty Physicians are Feeling the Squeeze with Patient Referrals

Daphne, AL (PRWEB) February 13, 2013

AdvisorsMD CEO Bricken McKenzie explains the new obstacles that specialized physicians face when it comes to networking with reference suppliers.

Throughout the landscape of health care, competition for patient referrals is becoming more intense. Specialists who once found inappropriate to promote to their physician colleagues are now discovering it is necessary to stay afloat. Here are four reasons why the specialty practices are struggling to connect with their physician colleagues to receive these valuable references for patients:

# 1 – Hospital systems are on a buying spree private practice.

With health reform looming, hospital administrators expect to see a record number of new patients as more people get health insurance and seek primary care. With many US regions that already suffer from a primary care physician shortage, these doctors are becoming a rare commodity in the health care sector. In 2010, for the first time, the number of new physicians have joined practices belonging to the hospital exceeded the number of first-year practitioner who became employed by medical groups belonging to doctors. The buying frenzy was so fierce that some hospital administrators believe that if they do not buy physician practices in their community, the medical center in the street will. According to a Medical Group Management Association (MGMA) National Survey: in 2002, about 20 percent of physician practices surveyed were owned hospital; in 2008, more than 50 percent of the practices of physicians surveyed owned hospital; and 2012, the number of respondents belonging to hospitals has increased to over 69 percent.

volume of patients is one of the key factors for the sustainability of long-term hospital. The directors believe that they have more influence on doctors employed doctors in private practice. Ultimately, the hospital that sees the highest number of insured patients in the most efficient manner, wins. In the most competitive markets, seven of the 10 patients admitted to a hospital used to come from within the network of the hospital doctors; the other three percent are from admissions and emergency room admits a projection of private practices.

Not only do health systems and hospitals buy more medical practices – and lead their doctors employed to keep all of their patient referrals in-house – they are also increasingly closing the admitting doctor released from hospital altogether and using their own on-site to oversee hospital inpatients. These factors make it difficult for specialists to keep the lines of communication open with primary care physicians.

# 2 – The treatment options are expanding at an exponential rate.

The number of specialists (and sub-specialists) categories has almost doubled over the past 15 years, more referrals diluted patient. According to the American Board of Medical Specialists, one pediatrician can receive certification in up to 20 different subspecialties. These specialized certifications may seem attractive to a health care provider, but sub-specialists have the additional burden to convince doctors that their new treatment option is superior to an existing protocol. When primary care physicians are overwhelmed with patient care, the time they have to learn new subspecialties is extremely limited.

# 3 – Doctors are not networked by traditional means. Historically, references have been treated by a more direct professional network. Specialists would meet internists and family physicians as they have been rounded in hospitals, attend conferences, and sometimes social events. It was a way to keep organic suppliers in the know about the latest treatments, procedures and diagnostic tools available to patients.

Today, many of these channels have disappeared. Conferences and events where medical doctors met once moved online. Doctors struggling with declining reimbursements and rising costs do not have time for bonding recreation. Health care consumers have a world of options when it comes to primary health care. They may appear in a facility for emergency care in the street, get vaccinated against the flu at the grocery store, or have a ear infection diagnosed and treated at the local pharmacy; others are self-diagnosing online and bypassing primary care altogether. The image of the patriarchal family doctor omniscient took the edge.

# 4 – Specialty doctors practices are in a dilemma as to whether they were to sell their practices or to remain independent.

private practices are facing cuts in reimbursements, increasing the number of uninsured patients, and uncertainty on the reform of health care. With increasing government audits and the impending charge of information systems, many private physicians yield to offers of economic certainty and reduction of hours that the hospital staff. As doctors employed, they are promised a better life, more resources, and the ability to devote more time to patient care.

In addition to the financial security and a better quality of life, access to specialized gains for treating physicians already affiliated with the hospital network. These hospital networks are constantly trying to avoid removal “leakage.” Smart Health Systems will do all they can to ensure that the references of patients stay within their network. Specialists who do not work under a large umbrella network will continue to see challenges in communication with primary care physicians. In both cases, these organizations need help getting their message.

Links doctors Solution-

bonds of highly qualified doctors give positive results the organizations they represent. Consumers of health care want to believe that primary care physicians refer them to a specialist, as they have first hand knowledge of this specialist skills. Unfortunately, the charges mentioned earlier, make that almost impossible. Specialists will not receive references if providers do not know about them. Those wishing to stay afloat should establish a comprehensive plan referral generation and empowerment of the individual within their practice to implement this plan.

Enter the liaison physician. Large health care networks have used for years and links independent specialized practices see the value of a seller engaged. There are a growing number of links independent doctors who provide contractual services to regional hospitals, ancillary providers and private clinics in a certain market sector.

The most effective routes to stick to a comprehensive business development plan for the previous reporting database, payer mix, and market share. Often doctors connections can make an educated guess when it comes to developing an appropriate awareness strategy. Using MDreferralPRO Web application, the connections can create predictive analytics-based marketing plans that are exclusive to the organizations they represent. MDreferralPRO allows connections geographically target areas and identify untapped sources of reference by name, specialty and location. They can identify suppliers should be a top priority, and where they should focus their efforts to generate more revenue. The program also identifies the external service providers have targeted patients, and whether or not these reference models are increasing or decreasing.

A good doctor bond is one that is sure of himself and has a wide knowledge of practitioners / organizations it represents. The best connections can get in front of all the people who influence a referral, whether planners, nurses, nurse practitioners or MD. They need to have a clear communication strategy and a defined list of people they want to achieve before you start. Hospitals and specialty practices that invest in bonds doctors will see a marked increase in their patient referrals if these connections are given the right tools to do their job. Links physicians who are armed with MDreferralPRO continue to keep their busy doctors see new patients. Health organizations that believe references come to them without any business development effort may be looking at an empty waiting room.

About AdvisorsMD – AdvisorsMD health council was created to meet the needs of hospitals and specialist physicians’ offices throughout the country. As we have seen doctors inundated with increasing responsibilities for compliance, electronic health records and insurance reimbursements, we have seen that these health care providers were pulled out of their true vocation, which was give patients the highest quality care.

About the author – Richardson “Bricken” McKenzie, IV, MBA is the founder and CEO of the consulting firm of AdvisorsMD health. He is a member of the Medical Group Management Association (MGMA), Fellow of the American College of Medical Practice Executives (FACMPE) and Fellow of the American College of Healthcare Executives (FACHE).

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Timely Referrals to Pain Management Specialists Could Reduce Unnecessary Back Fusion Surgeries Says Pain Management Specialist Reza Ghorbani, MD, ABIPP, FIPP

Washington, D.C. (PRWEB) December 27, 2013

While new federal data questions increases in costly back fusion surgery, early referrals to board certified pain management specialists could eliminate many operations saving trauma and money.

A Washington Post investigation found some experts fear “as many as half “ the procedures weren’t justified.

“Generally surgeons aren’t pain management specialists and as a result may recommend operations that aren’t necessary. Since we take a multidisciplinary approach, we can often find a solution that doesn’t require an operation,” says Reza Ghorbani, MD, ABIPP, FIPP, Ghorbani, MD, ABIPP,FIPP.

Dr. Ghorbani is president and medical director of the Advanced Pain Medicine Institute of Greater Washington, DC. He is also the author of the new book, “Secrets to a Pain Free Life” which stresses the importance of mainstream medical treatments combined with natural, alternative remedies shown to be safe and effective over time.

In his pain management practice, Dr. Ghorbani sees many failed back fusion patients who wind up in even worse pain.    

“I wish they’d come to me first, but often a primary care physician will refer his patient directly to a surgeon without giving a pain management specialist a chance to make a difference. That’s an aspect of medical culture that needs to change,” says Ghorbani.

When physical therapy or drugs don’t work, doctors can fuse two or more bones in the spine to prevent painful movement. However, the procedure may ultimately weaken the area around the injury leading to further complications.

This problem even has a name, “Failed Back Surgery Syndrome.” However, it can be treated with an implantable device called a spinal cord stimulator—similar to a cardiac pacemaker. It sends an electronic message to the brain through the spine that eases pain.

“Many of my patients are asking for this device as a result of other treatment failures,” says Ghorbani.

An aging population of Baby Boomers hoping to stay active and better surgical techniques may be trends underlying the bone fusion boom, but skeptics say the real rationale is compensation, not compassion. In the current “fee-for-service” environment, the more procedures a doctor does, the more he gets paid.

From 1993 to 2011 the number of US spine fusion procedures increased from 60,973 to 465,070 and the commensurate cost ballooned from $ 24,045 to $ 100,785, according to an analysis from the Agency for Healthcare Research and Quality.

Appropriate or not, these operations have proven increasingly lucrative for doctors with financial interests in companies that sell plates, screws and rods–devices that can add up to $ 11,000 or more per procedure.

However, Dr. Ghorbani says the fix isn’t just on the doctor’s side. As more patients gain coverage under the Affordable Care Act, they will need to be more proactive about their own health so the system won’t be overburdened.

“We can’t be all things to all people, particularly with younger patients coming into the system and older patients needing more care. If people would just follow common sense lifestyle guidelines, it’s possible to keep pain in check. That’s one of the secrets to a pain free life,” says Dr. Ghorbani.