The Practice Primer

Probably the first decision to make when searching for a new position is the type of practice you want to join. Here's our one-stop handbook to guide you through the styles of practice and help you make the best choice.

By Julie Sturgeon | Feature Articles | Spring 2010


Whic Practice Type is for You?

Which Practice Type is for You?

THE WORLD IS YOUR OYSTER. WHEN YOU COME TO A ROADBLOCK, TAKE A DETOUR. Believe you can have it, believe you deserve it, and believe it’s possible for you. Don’t worry, be happy. Yes, job searching is full of inspirational pats on the back and locker room speeches.

Unfortunately, for many physicians, that’s the sum of the advice they seek out during their job hunt, says Gregory Buford, MD, a board-certified plastic surgeon in the Denver area. “A lot of physicians get caught up in their own arena and get walled off. They expect they know something about everything and they need to put the ego down and ask colleagues what they like, what they don’t like, and find out what practice model fits them,” he says. “In reality, in medicine we’re running a business.” more »



Rural Medicine — Worth a Second Look

Small-town physicians urge other doctors to ignore the myths of rural practice and join the relationship-based practices they love while reform initiatives aim to increase access to care for rural residents.

By Teresa Odle | Feature Articles | Spring 2010


Could a rural practice be right for you?

Could a rural practice be right for you?

Ralph Riley, MD, Bought his practice in Saluda, South Carolina, after a 15-minute phone conversation and a handshake. “Nothing was ever signed; I bought the entire building and practice,” he says. While lawyers and practice management advisors would frown on such loose business practices, it fit Riley’s unique situation. He was coming home to his rural roots.

Riley was from Saluda, a town of about 3,000 people in central South Carolina. In the nearly 25 years since the handshake, Riley Family Practice Associates has grown with the addition of two full-time and two part-time nurse practitioners. A few years ago, he hired an additional physician. He knows that one of the challenges of rural practice is keeping the workload at a manageable level, but he wouldn’t trade it. “It was always my dream to go into family medicine and come back to Saluda,” Riley says. more »



Should You Opt Out of Medicare?

Ever-shrinking reimbursements, paperwork hassles and an uncertain future with healthcare reform are leading more physicians to abandon the nation's medical safety net for older Americans. Is it worth the financial risk and is it an ethical move?

By Vicki Gerson | Feature Articles | Spring 2010


Daniel Cosgrove, MD, an internal medicine physician, has been in private practice for 12 years and opted out of Medicare 10 years ago. The decision has allowed him to build a “personal health portfolio” for each of his patients. Cosgrove isn’t concerned about the national healthcare picture; he’s concerned about each patient he sees.

Daniel Cosgrove, MD, an internal medicine physician, has been in private practice for 12 years and opted out of Medicare 10 years ago. The decision has allowed him to build a “personal health portfolio” for each of his patients. Cosgrove isn’t concerned about the national healthcare picture; he’s concerned about each patient he sees.

IN 1945, PRESIDENT HARRY TRUMAN SENT A MESSAGE to Congress asking for legislation establishing a national health insurance plan, which created uproar. At the end of Truman’s administration, he’d backed off the idea for universal coverage. Two decades of debate ensued because opponents, like the American Medical Association, warned of the dangers of “socialized medicine.” Yet, administrators in the Social Security system and other leaders remained focused on the idea that such a program would benefit older Americans.

On July 30, 1965, President Lyndon Baines Johnson signed the Medicare and Medicaid programs into law in Independence, Missouri, at the Truman Library. For $3 per month, people 65 and older were told that they could sign up for Medicare Part B. The first to enroll? Former President Truman. So what has happened to a program that was supposed to provide senior citizens with excellent health care from our country’s physicians? more »



Consent to Settle: Who Decides?

The consent to settle provision of a professional liability insurance policy can affect more than just a suit's outcome.

By Bruce Armon and Jennifer L. Beidel | Legal Matters | Spring 2010


NEITHER A PHYSICIAN NOR ANY PROFESSIONAL likes to be accused of wrongdoing or sued for negligence. Litigation is time consuming and can be filled with anxiety regardless of whether the dispute ends in a verdict or settles during the litigation process.

According to Americans for Insurance Reform, a national coalition of public interest organizations that supports insurance industry reforms, approximately 85,000 medical malpractice lawsuits are
filed annually. A physician who is sued and has professional liability insurance — most states require a physician to have this coverage—will generally have counsel appointed by his insurance carrier. A 2007 report published by the U.S. Department of Justice’s Bureau of Justice Statistics says that between the years of 2000 and 2004—the most recent period for which information is publicly available—approximately 95 percent of all medical malpractice claims settled prior to trial. more »



Improve Your Revenue Cycle

Increase profits by managing the billing and revenue cycle of your practice.

By Deborah Walker Keegan, PHD and Elizabeth W. Woodcock, MBA, CPA | Financial Fitness | Spring 2010


THE CLINICAL PRACTICE AND BUSINESS OF MEDICINE intersect in the revenue cycle of a medical practice. In the revenue cycle, the patient’s diagnosis and the services you provide to the patient are translated into codes that permit you to be paid. It is this payment that allows your medical practice to keep its doors open to treat patients today, tomorrow, and in the future.

Changes occurring in today’s healthcare environment present a challenge to optimal revenue performance. With the increasing prevalence of high deductible health plans, patients are more financially responsible for their health care. In turn, this means that a greater portion of a medical practice’s revenue is derived from its patients. The change in financial responsibility— from the insurance company to the patient—means that your medical practice will have to adjust its revenue cycle to capture patient payments earlier in the billing process.

If you are seeking a new practice opportunity, ask questions regarding the practice’s revenue cycle and its financial health. If you are continuing in your current position, routinely evaluate the performance of your practice’s revenue cycle. In any situation, it is important to determine if the revenue cycle is functioning at its optimal level. Throughout this article, we’ll describe actions to help you take your revenue cycle to the next level of performance. more »



Surgeons Reign Supreme

With little variation among regions, surgical subspecialists earn the most among all physicians.

By UO Staff | Spring 2010 | Vital Stats


Physician compensation is an important factor that affects the decision to enter into the medical profession, choice of medical specialty, practice location, and it can drive productivity. The American Medical Group Association’s 2009 (AMGA), compensation survey (based on 2008 data) compares physician compensation by geographic region.

As expected, specialists earn more than physicians in family medicine, internal medicine, and pediatrics. Orthopedic surgery, radiation therapy, and obstetrics and gynecology rate among the highest-paid specialties. Physicians practicing family medicine earn an average annual compensation of $197,655, while neurological surgeons are on top, earning an average of $548,186 annually. Earnings can vary according to number of years in practice, the number of hours worked, and professional reputation. Survey data shows that earnings can also vary regionally from a low of $480,676 in the East to a high of $570,076 in the West in a specialty such as cardiac and thoracic surgery. more »



No Excuses: Making Time to Make Changes

A medical mission trip provides a wealth of rewards for one plastic surgeon and the dozens of children she helped heal.

By Angeline Lim, MD | Remarks | Spring 2010


Angeline Lim, MD

Angeline Lim, MD

I AM OFTEN ASKED HOW I FOUND TIME TO ATTEND A recent mission trip in China to repair cleft lips and palates. I have to explain that some of my favorite moments in plastic surgery have been on these missions. There is already such breadth and depth to plastic surgery, but these trips have added sparkle to those dimensions.

I was asked to be a part of this trip to Changde, China by, and having had such incredible cleft surgery experiences in Guatemala and Mexico, I jumped at the opportunity. We’d be spending two weeks at a hospital in Hunan province with a team of almost 40 American medical providers and about 20 local Chinese staff.

Spearheaded by the generous folks at the Chinese Agape Foundation, the focus of this medical mission trip to Changde was purely cleft lips and palates. Additional support came from the Jackson Family Foundation, the CARIS Foundation, and SmileTrain. more »



Variety – The Spice of Life

By Mollie Vento Hudson | Editor's Note | Spring 2010


Mollie Vento Hudson, Editor

Mollie Vento Hudson, Editor

On a recent trip to Chicago, my husband and I made the rounds of our favorite haunts. Being from a town of about 50,000, we enjoy the wealth of choices the Windy City offers. We made our usual trek to Old Town to the salt water aquarium store to gaze at the tropical fish, wandered up the street to treat ourselves to the best caramel apples we’ve ever tasted, and then entered one of my favorite places: The Spice House. The aroma envelops you the minute you open the door—sweet Chinese cinnamon and Mexican, Moroccan saffron (the world’s most expensive spice), the more subtle smells of Spanish basil and Greek oregano. It’s like traveling around the world. If you love to cook, the plethora of choice is awe-inspiring and a bit overwhelming. more »