Hands down, COVID-19 will change medical practice

Coronavirus disease 2019 (COVID-19) has challenged us to incorporate technology into engaging, interacting with, and caring for patients, using televisits and video conferencing in ways that have previously been resisted or derided.

Nurturing the Virtues: Upholding Professionalism in the Midst of Busy Medical Practice

Tom L. Beauchamp and James F. Childress' (B&C) book Principles of Biomedical Ethics is well known for its four-principle approach to biomedical ethics. However, the authors also emphasize the importance of the virtues of health care personnel. After a short overview of virtue ethics, the five "focal virtues" described by B&C are discussed and applied to a chronic pain example. The question of how virtues are learned in the health care setting is addressed, and it is argued that virtues such as the ones defended by B&C are acquired when health care personnel are socialized in an environment dedicated to the continuous upholding of practices that aim at the telos of medicine. Viewed from this perspective, professional isolation can be considered to be dangerous; the upholding of medical professionalism throughout a whole career largely presupposing the existence of a community where virtues relevant to the practice of medicine are embodied and kept alive. The concept of professional socialization is important in that respect. Finally, some potential general implications of this view for continuing professional development are proposed.

Five Trends in Healthcare that Will Change the Way Managers Manage

The pace of change in the field of medical practice management is unprecedented. Five major trends are affecting the business of healthcare: quality as a criterion for reimbursement; regulatory controls on fees and services; consumer influence on healthcare payments; full disclosure of claims data (i.e., transpar- ency); and increases in active patient load per physician. Successful practice administrators must remain well-informed about these trends in order to guide their practices toward modifications that will allow them to continue to flourish. The changes have been driven by economics, government regulations, and shifts in the country's population. In particular, the aging of the baby boomer generation has opened the eyes of the nation to the potential for costs of healthcare that are unsupportable within the current system: Independent physician practices can still be financially viable if the leadership team becomes nimble in adopting necessary operational changes that support opportunities for revenue optimization.

A NEW ECOLOGY IN HEALTH CARE

Providers and practices need to start making changes now to prepare for a new way of doing business and caring for patients; and physician leaders need to lead the charge.

Medicine and management in European hospitals: a comparative overview

BACKGROUND

Since the early 1980s all European countries have given priority to reforming the management of health services. A distinctive feature of these reforms has also been the drive to co-opt professionals themselves into the management of services, taking on full time or part time (hybrid) management or leadership roles. However, although these trends are well documented in the literature, our understanding of the nature and impact of reforms and how they are re-shaping the relationship between medicine and management remains limited. Most studies have tended to be nationally specific, located within a single discipline and focused primarily on describing new management practices. This article serves as an Introduction to a special issue of BMC Health Services Research which seeks to address these concerns. It builds on the work of a European Union funded COST Action (ISO903) which ran between 2009 and 2013, focusing specifically on the changing relationship between medicine and management in a European context.

MAIN TEXT

Prior to describing the contributions to the special issue, this Introduction sets the scene by exploring four main questions which have characterised much of the recent literature on medicine and management. First is the question of what we understand by the changing relationship between medicine and management and in particular which this means for the emergence of so called 'hybrid' clinical leader roles? A second question concerns the forces that have driven change, in particular those relating to the wider project of management reforms. Third, we raise questions of how medical professionals have responded to these changes and what factors have shaped their responses. Lastly we consider what some of the outcomes of greater medical involvement in management and leadership might be, both in terms of intended and unintended outcomes.

CONCLUSIONS

The paper concludes by summarising the contributions to the special issue and highlighting the need to extend research in this area by focusing more on comparative dimensions of change. It is argued that future research would also benefit theoretically by drawing together insights from health policy and management literatures.

Opening the Door to Patient Retention: A Look at New Technology Trends

What is the number one factor that shapes a patient's overall opinion of his or her medical practitioner and fosters the loyalty we all seek? The answer might surprise you, and you may find that you have been using your resources ineffectively. This article uncovers the latest technology trends for retaining and reactivating your patients, an approach that is much more cost effective than constantly bringing in new patients as others go out the back door. We also look at a couple of recent studies that blow the lid off traditional thinking with regard to patient communication and practice loyalty. The result will be an increased recognition of what drives and motivates patients. Find out how your practice can use the newest technology to streamline and simplify a number of important, but ordinary, communication processes to help keep patients engaged. Effective, ongoing, and timely communication not only enhances the patient experience, it also increases staff efficiency and helps your office run more smoothly.

Direct Pay/Concierge/Blended Care: Where Is the Sweet Spot? Part I: Practice and Physician Considerations

Physicians are actively considering the direct pay and concierge models as a plausible option in providing more patient-oriented care. What are the major considerations and how do we attain accurate data that may help in sophisticated decision-making? Part I of this article provides an introduction of the models, typical patient contract configurations, and physician/provider and commercial payer considerations. Part II will discuss the access, cost, and value from a patient's point of view; patient loyalty and self-care; approaches for inviting patients and other providers; and community relations.

How I changed my practice in the last five years and what is likely to change in the next five years

The fast development of our field in the last decades has had significant impact on the way we practice our profession. This year my editorials will focus on the impact of these developments on my own daily practice.

Trends in nephrology practice

The analysis of this benchmarking data tells us several things. Nephrology practices are more complex. Physicians are generating more RVUs for less money and a greater percentage of income is coming from things other than direct patient care. Practices have responded partly by becoming larger and looking for revenue stream diversification. The ability to predict the financial future from the historical data is problematic. We know from the most recent survey that a significant number of nephrology practices are already participating in accountable care organizations, shared savings programs, and even risk sharing contracts. We know that the incentive for participation in government quality reporting programs and meaningful use is transitioning from the carrot to the stick and that reductions in reimbursement will be applied to those who are unsuccessful. In order to take on the challenges and complexity that the future holds, successful nephrology practices will likely be larger, more sophisticated and tightly aligned with all stakeholders in the pursuit to provide high quality, low cost care to patients with kidney disease.

[Electronically or face to face - quicker and more facile services for the client]

While many services have moved or are moving to the Net, the standard of activity of the healthcare still continues to be based on booking an appointment and face-to-face consultation. Electronic services may solve the availability problem in basic healthcare. The client and the producer of a health service can meet electronically both synchronically at the same time and non-synchronically, i.e. through communicating at a time that is best suited for each. The asymmetry of information changes when the patient and the professional have access to the same information. The expansion of virtual services presents a challenge to our training, which is based on a chain advancing from anamnesis to status, investigations and treatment plan.

[The basis of modern technologies in management of health care system]

For the development of national heaIth care it is required to implement modern and effective methods and forms of governance. It is necessary to clearly identify transition to process management followed by an introduction of quality management care. It is necessary to create a complete version of the three-level health care system based on the integration into the system "Clinic - Hospital - Rehabilitation", which will ensure resource conservation in general throughout the industry. The most important task is purposeful comprehensive management training for health care--statesmen who have the potential ability to manage. The leader must possess all forms of management and apply them on a scientific basis. Standards and other tools of health management should constantly improve. Standards should be a teaching tool and help to improve the quality and effectiveness of treatment processes, the transition to the single-channel financing--the most advanced form of payment for the medical assistance. This type of financing requires managers to new management approaches, knowledge of business economics. One of the breakthrough objectives is the creation of a new type of health care organizations, which as lead locomotives for a rest.

Physicians beware: revisiting the physician practice acquisition frenzy

This commentary compares the current physician practice acquisition frenzy to that of the mid-1990s and reflects on lessons learned. The bottom line: Physicians must understand that there were no "white knights" in the 1990s, and there really aren't any today. This article delineates five main factors that both physicians and hospital executives should thoroughly explore and agree on before an alignment or acquisition. Agreement on these issues is the glue that holds the deal together after the merger. These factors eliminate both buyer and seller remorse and delve into the true cultural alignment that must take place as the healthcare industry addresses the challenges of the future.

The state of medical practice

The fifth-annual State of Medical Practice issue highlights what healthcare industry changes MGMA members will face in 2014, from assuming risk for patients populations to big data and much more. Our subject-matter experts provide high-level perspectives to help inform your strategic plans.

How physicians can survive the "perfect storm" developing in healthcare today--and thrive

The healthcare environment post-Affordable Care Act is changing the way that physicians practice and the way that they are compensated for patient care services. With the change from fee-based to value-based reimbursement comes significant stress related to needed change in processes and procedures, as well as the potential for a reemergence of some "traditional risk" categories. Physicians need to be vigilant and refocus efforts in some of these traditional risk areas. There is also a role for innovative health insurers and medical professional liability insurers in supporting physicians during this time of change. Best clinical practices and the patient experience are two key strategies that can also help physicians today.

Lean health care

Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery.

Strategic planning: how medical practices can succeed in a post-healthcare-reform world

This article addresses the recent trend of physicians being pressured to sell to hospitals in order to stay in practice. The author utilizes his experience in the healthcare industry to identify causes of this trend and ways in which physician groups can avoid finding themselves in these situations. The author uses real data from an existing medical practice to support his ideas and demonstrate how implementing change now will be beneficial for the success of this medical practice in the future. Objective practice evaluation and the execution of an efficient strategic plan are cited as the most important factors contributing to the financial solvency of medical practices in the current and future healthcare environment.