PharmFree medical schools

How does your medical school’s conflict-of-interest policies rank?

Web Exclusive


Do gifts from pharmaceutical companies, including meals, influence physicians’ decisions about what medications to prescribe? What about an expenses-paid trip to a conference or unregulated drug samples?
The American Medical Student Association website notes that, “Medical personnel consistently underestimate the extent to which they personally are influenced.”

So starting in 2007, AMSA decided to rank medical schools’ policies on managing conflicts of interest, the “PharmFree Scorecard.”

The report identifies how institutions regulate behaviors such as accepting gifts, pharmaceutical samples and compensation for off-site conferences.

Schools that received “A’s” include:
•    University of South Dakota Sanford School of Medicine
•    Mount Sinai School of Medicine
•    Mayo Medical School—College of Medicine
•    University of Iowa Health Care
•    University of Pittsburgh Medical Center
•    Emory University School of Medicine
•    Miller School of Medicine
•    University of Pennsylvania School of Medicine
•    University of Texas Medical Branch at Galveston
•    Des Moines University College of Osteopathic Medicine
•    University of California Davis School of Medicine
•    University of California San Francisco School of Medicine
•    University of California Los Angeles—David Geffen School of Medicine
•    Tufts University School of Medicine
•    Stanford University School of Medicine
•    Keck School of Medicine of the University of Southern California
•    Johns Hopkins School of Medicine
•    Georgetown University School of Medicine
•    University of Maryland School of Medicine

How does your med school stack up? See the full list here:



Medical liability rates stay mostly stable for now

Annual rate survey shows mostly unchanged premiums

Web Exclusive


The rates for physicians’ 2010-2011 liability insurance premiums remained largely unchanged for the majority of doctors, according to Medical Liability Monitor’s nationwide Annual Rate Survey.

At first glance, this year’s Rate Survey depicts another year of flat premiums—with 67 percent of rates holding stable between 2009 and 2010. But a closer look at the responses to the Rate Survey suggests there may be tougher times ahead for the medical professional liability insurance (MPLI) industry before things begin to get better.

“Despite declining—or stagnant—premium rates since 2006, unusually strong underwriting results in recent years have had a very strong, positive effect on the MPLI industry’s balance sheet,” said Michael Matray, Medical Liability Monitor editor. “As Chad Karls—the actuarial/author behind the Executive Summary in this year’s Rate Survey—points out, the precipitous decline in claims frequency that began between 2002 and 2004, which has largely continued through the present, has been at the root of the industry’s currently strong financials. That seems to now be changing with certain data sets showing an upward trend in claims frequency. If claims frequency does spike, and rates remain flat, it could spell a period of difficulty for the industry.”

In this year’s Rate Survey, Medical Liability Monitor asked participating companies for their take on the potential implications of the Patient Protection & Affordability Act healthcare reforms for the MPLI industry. Surprisingly, respondents exhibited little concern.

“Only 31 percent of respondents believe this year’s healthcare reforms will increase claims frequency or severity,” Matray said. “Sixty percent believe it will either have no effect or they simply don’t know how it will affect the industry.”

A new concern reported in the responses to this year’s Rate Survey Questionnaire was the increased use of self-insurance and/or captives as an alternative to the traditional MPLI market. Also, there appears to be concern over the related trend of hospitals purchasing practices and rolling the physician’s exposure into their self-insured programs.

For details on the survey, visit



Demand for shrinks grows

Aging psychiatrists and challenging economic times means psychiatry is one specialty that’s in high demand.

By The PracticeLink Magazine staff | Web Exclusive


The recession has caused portfolios and bank accounts to shrink, and the demand for shrinks to…grow?

The recession has slowed the pace of recruiting for those in other medical specialties, but it has significantly increased the demand for psychiatrists, now the fastest-growing specialty need. That’s according to the 2010 Review of Physician Recruiting Incentives, a report by Merritt Hawkins ( that analyzed 2,813 physician and advance allied professional assignments. During a one-year period ending in March, Merritt Hawkins reports that recruiting requests for psychiatrists increased 47 percent from one year ago—and is up 121 percent from three years ago.

Why the increased demand?

Perhaps to help people address all of the issues that come with challenging economic times—like those shrinking portfolios and bank accounts. Another piece of the puzzle is an aging population of doctors, as more than half of all psychiatrists are age 55 or older. Pair those reasons with less med school interest in psychiatry, and you’ve got a recipe for a growing need.



Starting a Career in Hospital Medicine

What you need to know about training for a career as a hospitalist

By Tim Lary | Web Exclusive


Are you thinking of joining hospital medicine—the fastest growing medical specialty medicine today?

According to the 2010 State of Hospital Medicine Report Based on 2009 Data from the Society of Hospital Medicine (SHM) and the Medical Group Management Association (MGMA), the nationwide average for all cash compensation (not including benefits) was $215,000.

Most physicians entering the hospitalist profession today are M.D.s or D.O.s with training in internal medicine. Others come from pediatrics, family medicine or an internal medicine subspecialty, such as infectious disease or pulmonology.

Physicians may choose to become certified in hospital medicine by the American Board of Hospital Medicine (ABHM), part of the American Board of Physician Specialties, or by the American Board of Internal Medicine (ABIM), which provides internists practicing in hospital settings the opportunity to maintain Internal Medicine Certification with a Focused Practice in Hospital Medicine.
Hospitalists are more than doctors without offices
The successful hospitalist understands the importance of aligning their clinical objectives for his or her patients with the organizational objectives of the hospital, must understand “systems thinking,” and needs to recognize the multiple systems of healthcare delivery in a hospital and how they relate to one another in the context of patient care.

To be successful practitioners, new hospitalists not only need to be up to date on clinical matters, but also must understand the business and administrative dimensions of the hospitalist specialty such as billing and coding, medical record documentation and risk management. Moreover, the nature of hospital medicine places a premium on interpersonal skills such as communication, conflict resolution and leadership.

Training. As part of the “onboarding” process with their new practice group and their facility, new hires should undergo a formalized orientation program that might include a variety of training vehicles such as self-study online tutorials, case studies, videos and presentations. A wide range of topics customized for hospitalists are available on topics such as best practices, managing referral relationships, and patient satisfaction. CME credits are often available for much of this training.

Mentoring. New hires typically participate in a mentoring program in which they are partnered with one or more experienced hospitalists in their practice group. Seasoned hospitalists mentor new hospitalists on a range of clinical and practical topics, such as optimizing patient care, working with interdisciplinary teams and the use of hospitalist-specific clinical communications technology. Mentors are also especially useful in helping the new hospitalist build relationships with hospital administration and the other members of the medical staff.

Performance monitoring. More and more hospitals are measuring hospitalists’ performance against a variety of internal and external benchmarks. The new hospitalist should familiarize himself with these measures early on so that expectations are clearly understood and mutually agreed to be acceptable.

Helping a new hospitalist learn and understand performance expectations is a responsibility of the entire practice group. Additionally, many groups have developed their own internally generated reporting capabilities that allow physicians to compare their performance on a number of important metrics. This information helps give positive feedback to hospitalists while identifying specific areas for improvement.

Questions you should ask about training programs
When looking at hospitalist job opportunities, here are some major questions to ask about training:

  • What type of formal and informal training programs are in place at my new practice?
  • Is there a true commitment to physician-hospital alignment at my new practice?
  • Will my new practice partners help train me in a culture of teamwork, mentoring and commitment to quality?
  • Will I receive training to help make me the very best hospitalist I can be?

To embrace your full potential as a hospitalist and prepare yourself for future leadership positions, it’s critical to augment your clinical skills with new expertise in promoting improved delivery of inpatient care, to the benefit of your patients, your facility, your practice and yourself.

Tim Lary is vice president of Physician Staffing for IPC The Hospitalist Company, Inc., a national physician group practice based in North Hollywood, Calif. Contact him at (800) 680-2492 or



The National Health Service Corps

You can earn scholarships and loan repayment through National Health Service Corps commitment. Is it for you?

Web Exclusive


The National Health Service Corps (NHSC) isn’t an employer of physicians, but through scholarships and loan repayment programs, it helps physicians pay for medical school in exchange for commitments to work for a contracted amount of time in Health Professional Shortage Areas (HPSA) throughout the country.

What often surprises people about the program is that many physicians are not assigned to rural areas but to urban ones.

Lawrence Reynolds, M.D., the president and CEO of Mott Children’s Health Center in Flint, Mich., performed his service obligation in Detroit at a city health department pediatric clinic.

Reynolds says, “The Corps is looking for someone who has a willingness to serve an underserved community, is part of an underrepresented population in the health professions, and who may have fewer resources to finance a medical education than the general population.”

According to Reynolds, choosing a service location is a roll of the dice but better odds than Las Vegas offers. “I’d guess you have a 75 percent chance of getting what you want,” though acceptance of the scholarship does limit practice choice and because the Corps wants primary care physicians.

Candidates must be admitted and registered in the appropriate school—in this case medical school (though nurse midwives, nurse practitioners, and physician assistants also participate)—to apply. The scholarships provide tuition, books and fees, plus a monthly stipend. Seek placement assignment early in the final year of residency. The NHSC does make retroactive payments.

Since 1972, more than 30,000 clinicians have served in the Corps, which requires a minimum two-year commitment for one to two years of loan support and then year for year up to four years. Actual dollars reimbursed aren’t an issue unless there is a default, at which time payback provisions kick in dollar for dollar plus interest in a limited term.

For information, visit the National Health Service Corps website:

—By Mark Terry



Running doctor completes 50 marathons in 50 states

“I take on marathons because they’re a mental and a physical challenge and sometimes an emotional challenge as well.” —Dr. Tom Hallee

By Paula Acker, | Web Exclusive


How does one run 14,000 miles? One hundred steps at a time.

This wonderfully simple prescription is Dr. Tom Hallee’s recipe for a successful running career. The 68-year-old psychiatrist has made running a lifetime passion.

Since his 40th birthday, he has logged 14,000 miles, but he ran many untracked miles before that.

When he was approaching age 60, when most people would think about slowing down, he decided to undertake an almost unimaginable feat, even for a much younger person—to run 50 marathons in 50 states—and do it by the time he turned 70.

“I decided when I found out about the 50-state marathon club, I said, ‘Hey, that would be a great way to stay motivated to continue running.’”

In May, after three attempts, he finally completed his goal by running the Rhode Island marathon in 6 hours 19 minutes. Since September 2001, when he set this challenge, Hallee has run 55 marathons.

“I take on marathons because they’re a mental and a physical challenge and sometimes an emotional challenge as well,” he explains. “Even though you have trained to go the distance, a lot of things intervene: sometimes the weather, sometimes my body, and it’s just a matter of keeping it all together for the six hours more or less—my usual finish.”

Keeping it together is the simple distillation of his running philosophy, which breaks down a seemingly gargantuan task into its basic component—putting one foot in front of the other.

“It’s just a matter of keep moving, keep moving, keep moving,” he says. “If you can walk, just keep walking. ’Cause every step you take, you’re one step closer to the finish. That’s a real motivator. The finish line doesn’t move, but I do.”

He reminds aspiring marathoners that finish times are relative because they are only competing against themselves. “Where you finish in the marathon is just a number. It doesn’t matter. People say, ‘Did you win the marathon.’ Well, finishing is winning,” he says emphatically.

Hallee has the perfect lifestyle for an itinerant runner. Since his official retirement in 1997, he has worked exclusively on a locum tenens basis. One of the early adopters of the locum tenens industry, Hallee has worked 29 assignments in 13 years.

“It’s worked out very well that I’ve been able to combine locums work with marathons,” Hallee says. In addition to a sympathetic locum tenens agency, he credits his wife for being his greatest supporter. A runner in her own right, Eileen Hallee had to give up marathons due to a knee injury. But now she is happy being Hallee’s “biggest help,” crisscrossing the country with him to support his pursuit of his marathon quest. She is his fitness partner at home, joining him for critical stretching, hikes and walks. She has become his roving aid station during marathons, supplying love, ice water, M&Ms, chips, Red Bull and whatever else to help him cover the next few miles until she finds him again during these long pursuits.

Does Hallee plan on resting on his laurels now that he has managed to accomplish what only 627 other people in the world have done?

Absolutely not. Since May, he’s gone foreign—completing the Edge to Edge Marathon in Ucluelet, British Columbia, in June and the Rio de Janeiro Marathon in July. On September 19, he will run the Danube River Marathon in Wachau, Austria and a week later the Berlin Marathon, which attracts 40,000 runners. In the spring, he will run the London and Paris marathons.

—By Paula Acker,




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