Med Monthly April 2014

Med Monthly APRIL 2014

the

Your S taging or f Practice Success

How to Build a Website That Will Propel Your Medical Practice to Success

issue

pg. 44

STAGING YOUR PRACTICE FOR SUCCESS pg. 38

ATTRACTING IDEAL NEW PATIENTS TO YOUR PRACTICE pg. 42

It’s Time to Get Social:

Promoting the Right Image For Your Practice pg. 40

contents

features

38 STAGING YOUR PRACTICE FOR SUCCESS 40 IT’S TIME TO GET SOCIAL: Promoting the Right Image for Your Practice 42 ATTRACTING IDEAL NEW PATIENTS TO YOUR PRACTICE 44 HOW TO BUILD A WEBSITE THAT WILL PROPEL YOUR MEDICAL PRACTICE TO SUCCESS

insight 10 ALZHEIMER’S DEATH TOLL LARGER THAN REPORTED, STUDY SAYS 12 CDC REPORTS FLU HIT YOUNGER PEOPLE PARTICULARLY HARD THIS SEASON

Cover Photo Courtesy of:

Diversified Design Technologies

Design Project for Attleboro Falls Family Dentistry In collaboration with RMD Interiors

14 PRACTICE HABITS THAT EQUATE SUCCESS

research and technology

practice tips

28 NIH ADDS SUBSTANTIAL SET OF GENETIC, HEALTH INFORMATION TO ONLINE DATABASE

16 3 WAYS THE RIGHT PAYMENT PROCESSING TECHNOLOGY CAN INCREASE PHYSICIAN PROFITABILITY 18 ESTABLISHING AND MAINTAINING POSITIVE SOCIAL MEDIA PRESENCE 20

MAKE YOUR CLEARINGHOUSE DO THE WORK FOR YOU

international 22 NURSE STAFFING AND EDUCATION LINKED TO REDUCED PATIENT MORTALITY

research and technology 24 ZOLL IMPLEMENTS HL7 FOR DATA EXCHANGE BETWEEN HEALTHCARE PROVIDERS 26 NEW RESEARCH POINTS TO TALKINGTHERAPY TREATMENTS TO MANAGE OSTEOARTHRITIS PAIN

legal 30 UNPRECEDENTED HIPAA FINE MAY MEAN INCREASED SCRUTINY AND PENALTIES 32 FINAL AFFORDABLE CARE ACT (ACA) SHARED RESPONSIBILITY REGULATIONS RELEASED 36 2014 WORK PLAN HIGHLIGHTS FOR PHYSICIANS

the arts 48 CHIP THOMAS, A DOCTOR AND ARTIST IN NAVAJO NATION

healthy living 50 BARBEQUE CHICKEN CHOP SALAD

in every issue 4 editor’s letter 8 news briefs

58 resource guide 78 top 9 list

January 1, 2014 begins the attestation period for Stage 2 Meaningful Use. If you are a member of the North Carolina Medical Society, you have access to the resources provided for our members to help your practice achieve Meaningful Use in 2014.

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editor’s letter

In order for your medical practice to thrive it needs brand recognition. Med Monthly’s April issue focuses on how to “stage a practice for success.” It is important to consider what message you want your practice to convey. Make sure you make a personal, professional and team commitment to develop your reputation. The creditability and brand awareness of your practice can be strengthened through your website, networking and social media.

In “Staging Your Practice for Success” Rhonda Granja has several suggestions. Her initial piece of advice is to stay current on industry changes. A good example of why this is intelligent is to be able to answer questions about changing amount of billing when patients call. Rhonda further recommends building a strong network with colleagues. Also, practices should take care to keep their staff happy and ask patients frequently about the care they’ve received.

Nisha Salin focuses on one thing to build brand awareness: an excellent website. Nisha’s feature “How to Build a Website that Will Propel Your Medical Practice to Success” gives tips on how to create a website that will attract patients. These include making it as appealing visually as possible by using a professional, updating its information frequently and including a blog.

In her article “Attracting Ideal New Patients to Your Practice” Audrey McLaughlin, RN, takes this a step further. She suggests characterizing a preferred patient and catering to their needs.

She was able to create a profile for herself and make marketing efforts to attract likeminded patients. One of the doctors Audrey discusses realized she liked working best with busy professionals who travel frequently. She added wireless internet in her waiting room, offered telemedical care, and had early and late appointments for their convenience.

Please stay tuned for our May issue when our focus will be on “Physician Salaries and Careers.”

Ashley Austin Managing Editor

4 | APRIL 2014

Med Monthly April 2014 Publisher Philip Driver Managing Editor Ashley Austin Creative Director Thomas Hibbard Contributors Ashley Acornley, MS, RD, LDN Andy R. Anderson Tricia Maddrey Baker Lisa H. Barton Michelle Durner, CHBME Marie Ellis Saghi “Sage” Fattahian Kimberly Gold Rhonda Granja, B.S., CMC, CMOM, CMA, CPC Barbara Hales, M.D. Emily M. Hord Audrey McLaughlin, RN Nisha Salim Brent Warrington

Med Monthly is a national monthly magazine committed to providing insights about the health care profession, current events, what’s working and what’s not in the health care industry, as well as practical advice for physicians and practices.

We are currently accepting articles to be considered for publication. For more information on writing for Med Monthly, check out our writer’s guidelines at medmonthly.com/writers-guidelines P.O. Box 99488 Raleigh, NC 27624 medmedia9@gmail.com Online 24/7 at medmonthly.com

contributors Tricia Maddrey Baker became Executive Director, for Pitt County Medical Society in 2012. She is a Tar Heel “born and bred,” but has moved with her family both far north and south of her current address in NC. You can find her on social media, and find the Society on LinkedIn Groups, Facebook, and Google+.

Rhonda Granja, B.S., CMC, CMOM, CMA, CPC is a certified professional coder and certified medical assistant.

Rhonda has been in the medical office profession since 1990 and is currently working as an independent medical consultant. She is an active member of the American Academy of Professional Coders; Medical Group Manager’s Association, and the Consumer Family Advisory Committee and is an advocate for the non-profit organization, Autism Speaks....

Barbara Hales, M.D. is a skilled expert in promoting your health services. As seen on NBC, CBS,ABC and FOX network affiliates as well as Newsweek, Dr. Hales writes all the content you need to promote your medical services. Her latest book is on the best seller list and she can do the same for you. Check out her site at www.TheWriteTreatment.com

Audrey McLaughlin, RN is a physicians practice expert, medical practice business strategist & marketing specialist. She uses her more than 12 years of diverse medical industry experience to help physicians, practice owners and managers to breathe new life into their practices.

Brent Warrington is CEO of SecureNet Payment Systems, an Austin-based firm that has been streamlining the way businesses accept payments since 1997. Brent has more than two decades of experience in the payments industry.

WWW.MEDMONTHLY.COM |5

designer's thoughts From the Drawing Board In the April Med Monthly’s “Research and Technology” section we report on the implementation of an exchange of clinical and administrative data between pre-hospital emergency medical services (EMS) and hospital electronic medical record systems.

Also covered is an article suggesting of the need for new therapies to target brain mechanisms to enable the brain to cope more effectively with chronic pain, including mindfulnessbased talking therapies. The final article announces the availability to access new genetic data linked to medical information on a diverse group of more than 78,000 people, enabling investigations into many diseases and conditions.

“ZOLL Implements HL7 for Data Exchange Between Healthcare Providers”, covers Poudre Valley Hospital EMS in Fort Collins, Colorado, becoming the first service to facilitate an automated data exchange transmitting patient health record data from Poudre Valley’s ZOLL ePCR to a University of Colorado Health’s electronic medical records system (EPIC). Prior to implementing ZOLL’s HL7 for EMS, Poudre Valley Hospital EMS printed, manually scanned and uploaded every patient care report, taking up to five minutes per report.

The findings by Arthritis Research UK-funded researchers at the University of Manchester are reported in the article “New Research Points to Talking-Therapy Treatments to Manage Osteoarthritis Pain”. They share their research of looking at the overlaps in how pain is processed in the brain, between osteoarthritis and fibromyalgia to help understand why some sufferers of arthritis can experience much worse pain than others.

The article “NIH Adds Substantial Set of Genetic, Health Information to Online Database” shares about the addition of information to the database of Genotypes and Phenotypes (dbGaP), made possible with $24.9 million in support from the National Institute of Health (NIH). NIH Director Francis S. Collins, M.D., Ph.D. states, “Data from this immense and ethnically diverse population will be a tremendous resource for science.

It offers the opportunity to identify potential genetic risks and influences on a broad range of health conditions, particularly those related to aging.”

MedMonthly will continue to report on the latest medical research and technology. If there are topics or insights on advances in medical technology you would like to share with us for future issues, please contact us at medmedia9@gmail.com.

Thomas Hibbard Creative Director

6 | APRIL 2014

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news briefs

GE Healthcare Launches New Perioperative Analytics Suite GE Healthcare, a leading provider of healthcare information technology, today announced the release of a new product Centricity* Perioperative 8.0 with High Acuity Analytics - which may help perioperative managers measure and improve key metrics like on-time starts, patient throughput and reduced supply costs.

Centricity Perioperative 8.0 was designed in collaboration with Directors of Surgery and OR Managers and brings key operational data together in an easy-to-read dashboard. This gives them and their perioperative staff a better picture of the day, arming them with predictive insights and information to help optimize patient satisfaction, productivity and costs.

“Centricity Perioperative 8.0 with High Acuity Analytics will help hospital administrators to enhance profitability by monitoring surgery department metrics such as start times,”1 says Mike Jackman, Vice President Specialty Solutions for GE Healthcare IT. “The actionable and predictive insights are reinforced by visual design standards, making it easy for department managers to use.”

Some existing Centricity Perioperative users are leveraging its current capabilities to make significant improvements to their perioperative environment, helping to increase first-case on-time start rate from 75% to over 90%2, reduce OR turnaround time from 45 minutes to 30 minutes3 and create a fast-track system which, for one customer, resulted in around 50% of patients being able to by-pass the PACU (Post Anesthesia Care Unit).4 Jackman explains: “We see some of our customers making tangible improvements to their productivity and patient satisfaction by using the data from our existing software. With Centricity Perioperative 8.0 with High Acuity Analytics, managers and executives will have an easy-to-use dashboard with key metrics and business intelligence at their fingertips making it simpler for more customers to drive these kinds of improvements.”

To ensure a world class level of visual design standard, Centricity Perioperative 8.0 with High Acuity Analytics was designed using Predix™, GE’s software platform which harnesses the power of the Industrial Internet to help industrial organizations achieve peak productivity. *Centricity is a registered trademark of General Electric Company.  Source: http://www.newswiretoday.com/news/139800/ 8 | APRIL 2014

RESEARCH IN THE NEWS: COMBINATION THERAPIES COMBAT HIV AT CELL JUNCTIONS, YALE RESEARCHERS FIND

A new Yale University study indicates that cell-tocell transmission of HIV particles contributes to the development of full-blown AIDS and helps predict which anti-retroviral therapies will be most effective at keeping the disease at bay.

The new research reinforces recent findings that a heavy concentration of the virus at the point of contact between cells is crucial to the development of AIDS. The study also suggests that earlier findings that antiretroviral therapy fails to suppress HIV at cell junctions might be premature. In their new exhaustive analysis of 16 anti-retroviral drugs researchers showed that 13 are effective. Three drugs were effective chiefly reducing viral levels of free-floating HIV, but they fail to suppress HIV spread from cell to cell. However, researchers found that if two of the three that fail are combined they also suppress the spread of HIV, explaining why existing combination anti-viral therapies are effective.

Senior author Walther Mothes, associate professor of microbial pathogenesis, said the effectiveness against highly concentrated HIV should be tested by companies developing more powerful therapies to combat AIDS. The full study may be read in PLOS Pathogens.  Source: http://www.pressreleasepoint.com/researchnews-combination-therapies-combat-hiv-cell-junctionsyale-researchers-find

SOON COMING NTHLY O IN MED M

coming In the up d issue, Me May 2014 be l il theme w Monthly’s Salaries Physician & Careers

Agfa HealthCare and Dell Team Up to ‘Image-Enable’ the EHR Collaboration advances the “Evolution of Visual Healthcare” by uniting Dell’s Unified Clinical Archive (UCA) solution with Agfa HealthCare’s ICIS platform to create a comprehensive image-enabled EHR - Fully integrated “document + image” EHR increases operational efficiencies, as well as clinical workflows, across the entire enterprise - Provides customers with a proven, validated reference architecture to capture, store, access and exchange all images generated by a health system Agfa HealthCare announced today that it has teamed with Dell to integrate Agfa HealthCare’s ICIS platform with Dell DRIVE Plus to offer medical image management within an Epic or other electronic health record (EHR).

Highlighted in conjunction with the HIMSS14 Annual Conference & Exhibition, the collaboration is part of Agfa HealthCare’s and Dell’s focus to streamline customer workflows by providing easily integrated enhancements for the EHR, including seamless access to medical images within a patient’s electronic health record.

Dell DRIVE Plus integrates the leading healthcare IT technologies and optimizes the solutions on Dell opensource platforms to make deploying and optimizing the EHR easier and more cost effective. In doing so, the platform helps customers expand their digital healthcare infrastructure to include a larger ecosystem of applications while eliminating the challenges of selecting, negotiating, integrating and deploying these solutions together.

“Dell’s reliable infrastructure and secure cloud technology and long-standing positive relationship with Agfa HealthCare made the company an ideal cloud provider to demonstrate the value of ICIS solutions and advance the ‘visual healthcare evolution, ’ ” commented Lenny J. Reznik, Director, Enterprise Imaging and Information Solutions, Agfa HealthCare North America. “With this collaboration, hospitals and health systems can achieve significant clinical workflow and patient care benefits, as well as operational and cost efficiencies, because all patient documents and images are now integrated and accessible from a single, cloud-based EHR system.”

Agfa HealthCare’s ICIS solution is a proven, comprehensive approach to enterprise imaging management that delivers a workflow-centric platform to make multispecialty image data readily available to physicians across the continuum of care. This model supports the potential clinical and resource benefits of images that are provided by the patient-centric presentation of an EHR. “Agfa HealthCare’s robust ICIS platform empowers Dell DRIVE Plus with the highly important element of medical image management,” said August Calhoun, Ph.D., vice president/general manager of Dell Healthcare and Life Sciences. “This not only helps to reduce costs, but also enhances patient care by improving clinician accessibility to the full scope of patient information. ICIS allows for images and data from multiple medical imaging applications as well as non-medical imaging applications to be consolidated into one single view, heightening the value of the EHR.” Showcasing the value of a fully integrated,“document + image” EHR, Agfa HealthCare (agfahealthcare.com) will be sponsoring the “HIMSS Enterprise Imaging Educational Breakfast” on February 25, 2014 from 7:00 8:30 am. Cheryl Petersilge, MD, Medical Director, MyPractice Imaging Solutions, Cleveland Clinic, and Louis M. Lannum, Director of Enterprise Imaging, MyPractice Imaging Solutions, Cleveland Clinic, will be the featured speakers in a thought leadership program focused on the importance of patientcentric medical imaging and document accessibility in an enterprise-wide EHR. HIMSS attendees who are hospital CIOs, CMIOs, vice presidents, directors of clinical applications, and other healthcare provider executives or healthcare editors are invited to register at HIMSS.org/imaging14.  Source: http://www.newswiretoday.com/news/139937/ WWW.MEDMONTHLY.COM |9

insight

Alzheimer’s Death Toll Larger Than Reported, Study Says

By Marie Ellis Medical News Today

10 | APRIL 2014

According to the Centers for Disease Control and Prevention, Alzheimer’s disease is the sixth leading cause of death in the US, trailing the top two killers, heart disease and cancer. But a new study suggests Alzheimer’s actually contributes to nearly as many deaths as the top two, pointing to incorrect identification of the disease as the real reason for death.

The researchers, led by Bryan D. James of Rush University Medical Center in Chicago, published the results of their study in Neurology, the journal of the American Academy of Neurology.

To conduct their study, they followed 2,566 people over the age of 65 who received annual testing for dementia.

After an average of 8 years, 1,090 of the participants died.

Of the participants who did not have dementia at the start of the study, a total of 559 developed the neurological condition, and the average time from diagnosis to when they died was about 4 years.

After the participants died, an autopsy was performed, and it confirmed Alzheimer’s disease for about 90% of the patients who were clinically diagnosed, the researchers say.

James explains that Alzheimer’s and other dementias are commonly under-reported. “Death certificates often list the immediate cause of death, such as pneumonia, rather than listing dementia as an underlying cause,” he says.

The authors note that the rankings from the Centers for Disease Control and Prevention (CDC) for causes of death are based on what is reported on death certificates.

Deaths from Alzheimer’s ‘six times higher than reported’ After analyzing their data, the team found that the death rate was over four times higher for participants between the ages of 75 and 84 after an Alzheimer’s diagnosis, and it was nearly three times higher for people over the age of 85.

The researchers note that more than one third of deaths

in those age groups were due to Alzheimer’s disease.

James says this means an estimated 503,400 deaths were attributable to Alzheimer’s in the US population over the age of 75 in 2010. However, the number reported by the CDC is 83,494, which means the study’s estimate is nearly six times higher.

He notes that attempts to pinpoint a single cause of death is not always accurate for most elderly people, since multiple health issues can be responsible. James adds: “The estimates generated by our analysis suggest that deaths from Alzheimer’s disease far exceed the numbers reported by the CDC and those listed on death certificates.”

Quite a bit of research has recently gone into identifying key causes of dementia. Medical News Today recently reported on a study that suggested eating grilled meat increases risk of Alzheimer’s.

Another study recently suggested infections impair the brain’s ability to make memories, while another claimed a byproduct of dichlorodiphenyltrichloroethane (DDT) in the blood is linked to increased risk of Alzheimer’s.

Given that Alzheimer’s affects so many people in the US, the researchers say understanding the disease is vital.

“Determining the true effects of dementia in this country is important for raising public awareness and identifying research priorities regarding this epidemic,” James says.  Read the original article at MNT Article courtesy of Medical News Today

Subscribe to receive Med Monthly e-news Click here to join our e-news subscribers and get current medical news as it happens Visit us online anytime at medmonthly.com WWW.MEDMONTHLY.COM | 11

insight

CDC Reports Flu Hit Younger People Particularly Hard This Season

Vaccination lowered risk of having to go to the doctor by about 60 percent for people of all ages This influenza season was particularly hard on youngerand middle-age adults, the Centers for Disease Control and Prevention reported in today’s Morbidity and Mortality 12 | APRIL 2014

Weekly Report. People age 18-64 represented 61 percent of all hospitalizations from influenza—up from the previous three seasons when this age group represented only about

35 percent of all such hospitalizations. Influenza deaths followed the same pattern; more deaths than usual occurred in this younger age group.

A second report in this week’s MMWR showed that influenza vaccination offered substantial protection against the flu this season, reducing a vaccinated person’s risk of having to go to the doctor for flu illness by about 60 percent across all ages.

“Flu hospitalizations and deaths in people younger- and middle-aged adults is a sad and difficult reminder that flu can be serious for anyone, not just the very young and old; and that everyone should be vaccinated,” said CDC Director Tom Frieden, M.D., M.P.H. “The good news is that this season’s vaccine is doing its job, protecting people across all age groups.”

U.S. flu surveillance data suggests that flu activity is likely to continue for a number of weeks, especially in places where activity started later in the season. Some states that saw earlier increases in flu activity are now seeing decreases.

Other states are still seeing high levels of flu activity or continued increases in activity.

While flu is responsible for serious illness and death every season, the people who are most affected can vary by season and by the predominant influenza virus. The currently circulating H1N1 virus emerged in 2009 to trigger a pandemic, which was notable for high rates of hospitalization and death in younger- and middle-aged people. While H1N1 viruses have continued to circulate since the pandemic, this is the first season since the pandemic they have been predominant in the U.S. Once again, the virus is causing severe illness in younger- and middle-aged people.

Approximately 61 percent of flu hospitalizations so far this season have occurred among persons aged 18-64 years. Last season, when influenza A (H3N2) viruses were the predominant circulating viruses, people 18 to 64 years accounted for only 35 percent of hospitalizations. During the pandemic season of 2009-2010, people 18 to 64 years old accounted for about 56 percent of hospitalizations.

Hospitalization rates have also been affected. While rates are still highest among people 65 and older (50.9 per 100,000), people 50 to 64 years now have the secondhighest hospitalization rate (38.7 per 100,000), followed by children 0-4 years old (35.9 per 100,000). During the pandemic, people 50 to 64 years also had the second-highest hospitalization rate. Note that hospitalization rates are cumulative and thus will continue to increase this season.

Influenza deaths this season are following a pattern a similar to the pandemic. People 25 years to 64 years of age have accounted for about 60 percent of flu deaths this season compared with 18 percent, 30 percent, and 47 percent for the three previous seasons, respectively. During 2009-2010, people 25 years to 64 years accounted for an estimated 63 percent of deaths.

“Younger people may feel that influenza is not a threat to them, but this season underscores that flu can be a serious disease for anyone,” said Dr. Frieden. “It’s important that everyone get vaccinated. It’s also important to remember that some people who get vaccinated may still get sick, and we need to use our second line of defense against flu: antiviral drugs to treat flu illness. People at high risk of complications should seek treatment if they get a flu-like illness. Their doctors may prescribe antiviral drugs if it looks like they have influenza.”

People at high risk for flu complications include pregnant women, people with asthma, diabetes or heart disease, people who are morbidly obese and people older than 65 or children younger than 5 years, but especially those younger than 2 years. A full list of high risk factors and antiviral treatment guidance is available on the CDC website. More information about flu vaccine and how well it works also is available.

Flu Vaccine Best Tool Available In the flu vaccine effectiveness (VE) study, CDC looked at data from 2,319 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness (Flu VE) Network from December 2, 2013 to January 23, 2014. They found that flu vaccine reduced the risk of having to go to the doctor for flu illness by an estimated 61 percent across all ages.

The study also looked at VE by age group and found that the vaccine provided similar levels of protection against influenza infection across all ages. VE point estimates against influenza A and B viruses by age group ranged from 52 percent for people 65 and older to 67 percent for children 6 months to 17 years. Protection against the predominant H1N1 virus was even slightly better for older people; VE against H1N1 was estimated to be 56 percent in people 65 and older and 62 percent in people 50 to 64 years of age. All findings were statistically significant.

The interim VE estimates this season are comparable to results from studies during other seasons when the viruses in the vaccine have been well-matched with circulating influenza viruses and are similar to interim estimates from Canada for 2013-14 published recently.

While flu vaccine can vary in how well it works, vaccination offers the best protection currently available against influenza infection. CDC recommends that everyone 6 months and older get an annual flu vaccine.

“We are committed to the development of better flu vaccines, but existing flu vaccines are the best preventive tool available now. This season vaccinated people were substantially better off than people who did not get vaccinated. The season is still ongoing. If you haven’t yet, you should still get vaccinated,” said Dr. Frieden.  Source: http://www.cdc.gov/media/releases/2014/p0220-flureport.html WWW.MEDMONTHLY.COM |13

insight

Practice Habits That Equate Success

After you have read some of the very informative feature articles in the April edition of Med Monthly, you should have your practice looking like success. Not only is your facility looking its best, your staff is dripping with knowledge, personality and compassion for your patients and you are more determined than ever to break out of average and be exceptional.

These are the MUST DO steps you need to take to assure you will not only succeed, but your practice will prosper.

 Provide your patients with a unique experience

when they visit your practice. Strive to have the most attractive staff, the best looking lobby, the most efficient office, and ease of check-in and check-out.

Be polite to every patient and inform them you are expanding and would appreciate their referral.

 Contract with a experienced and reputable Billing

Company. The small to medium practice can no longer afford the salary and unpredictability of a single biller employee in the practice. Physicians should have

14

| APRIL 2014

the greatest self-interest in optimizing coding practices and they must recognize that they are ultimately responsible for any coding inadequacies. Research and outsource your billing and stop putting this off. Also make sure your office manager and assistant manager talk with your billing company on regular basis. Your billing can be outsourced to a local or regional billing company for 3 to 5 percent of the collectables. We suggest you stay with a billing company within your own country. This may save you time and money.

 Get a practice website, NOW.

If your website is tired, upgrade your image and if you don’t have a practice website, you probably will struggle to be even average.

Your website is the most powerful tool to quickly and consistently present your image and will earn you money in a very short time. A professional website will attract new patients, keep your current patients informed and make it easier for your colleagues to refer patients to you.

 Measure yourself to know how you’re doing

clinically, financially, and in delivering service. Track indicators of operational efficiency such as deliveries, diagnostic tests, surgeries by type, outpatient visits, etc. Also track relative value units and revenue per doctor. The practice should take great care with how this information is presented and discussed within the group in order to avoid conflict between physicians or damage existing working relationships. Look at budgeted versus actual expenses and evaluate your service mix each month. Develop appropriate patient accounting indicators such as accounts receivable; 30-, 60-, and 90-day outstanding invoices; cash trend reports; and denial tracking. The resulting reports will show what your practice is doing and where improvement is needed. These need to be examined each month.

 Make Med Monthly part of your reading habit.

The writers of Med Monthly are experts in their field and have worked with dozens if not hundreds of practices like yours and have developed successful outcomes.

If you are one of our followers, we would like to hear from you. What type themes or articles would you like to read in Med Monthly? Your feedback if very important to us. Send us your recommendation today and thank you for reading Med Monthly. 

The Write Treatment

Ezines and NewslettersCost Effective Powerful Tools • Drive traffic to your business website • Build relationships between yourself and patients • Get new patients • Announce a new service or product • Give great impact Have you got a newsletter yet or want to spread a message?

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Barbara@TheWriteTreatment.com 516-647-3002

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practice tips

3 WAYS

THE RIGHT PAYMENT PROCESSING TECHNOLOGY CAN INCREASE PHYSICIAN PROFITABILITY

By Brent Warrington CEO, SecureNet

T

he rollout of the Affordable Care Act raises several legitimate concerns among physicians about maintaining a profitable practice. Insurance companies are under intense pressure to cut costs while growing revenues. This could result in lower payments to doctors for patient visits and services performed, making it difficult for doctors to cover even basic operating expenses.

At the same time, President Obama’s new healthcare law is expected to cut annual reimbursement rates for physicians by more than 20 percent. The effects on physician profitability are very real.

Medicare and Medicaid reimbursement rates have long been lower than reimbursement rates for patients with private insurance. In order to cover an additional 32 million Americans, the Affordable Care Act will increase Medicaid participation to include approximately 16 million additional individuals. An uptick in Medicare and Medicaid enrollment translates into a reduction in reimbursements for many doctors who accept these patients.

With the enactment of the Affordable Care Act, the federal government lowered medical reimbursement rates from health insurance companies, and private insurance

16 | APRIL 2014

companies are expected to follow suit. While there are still uncertainties around the implications and regulations of the law, a significant reduction in reimbursements will have a negative impact on bottom line of physician offices.

There is also a shift happening toward a flat reimbursement rate model driven by the Centers for Medicare and Medicaid Services (CMS) after it announced that its five different billing code levels for outpatient visits would be consolidated into one flat rate. This means that a physician’s facility will be reimbursed a flat rate regardless of the type and level of care provided.

In addition, current ICD-9 codes for medical diagnosis will replaced by IDC-10 codes on October 1, 2014. The updates to the codes will have the biggest impact on insurance reimbursement timelines, which will take anywhere from two to three months or longer to process, meaning cash flow for physician offices could be severely restricted.

The sum total of these factors paints a troubling picture for medical offices. But cost savings can be found hiding in plain sight – for example, office managers should take a serious look at their payment processing technology to look for opportunities to create efficiency and keep more money from each transaction.

Payment Technologies Improve Physician Profitability In today’s complex healthcare environment, streamlined billing and collection management powered by progressive payment technology can dramatically improve profitability and shield medical practices from future changes in federal regulations.

Physicians and medical office managers must take advantage of cutting-edge payment technologies to increase automation, streamline workflow and speed payments receipt. The right payment technology also offers value-add business benefits, including access to actionable insights and analytics that can further improve financial performance and payment collections.

With credit and debit cards as the preferred payment form of patients, physicians can make several simple changes in the way they process credit and debit cards to improve cash flow and profitability. When you decide it’s time to reevaluate your payment processor, take a close look at these capabilities: 1. Secure vault & recurring billing. The ideal payment processing technology stores credit card information for recurring payments such as a patient’s balance-due after insurance settlements.

Instead of billing the patient and waiting for reimbursements, the right platform allows you to charge the credit card at amounts up to a predetermined limit as soon as the insurance settlement is received. Stop waiting weeks or months for the payment to be submitted.

Look for a payment processor with a credit card “vault” and recurring billing features that make automatic payments possible. In situations where a patient cannot cover the entire medical bill in one payment, recurring billing allows for installment plans to be set up. This can improve cash flow while reducing back-office paperwork and billing bottlenecks, improving efficiency and productivity in any medical office, while providing patients will a plan that best works for them.

2. Multiple payment options. A strong payment processing solution will allow physicians to accept payments through multiple channels, depending on what is most convenient for the patient.

This includes hosting payment pages on the practice’s website, allowing patients to make secure medical payments online with their credit or debit cards, as well as point-of-service (POS) payments after an office visit.

The ideal payment processor accepts multiple payment types under one account and reports payments on one statement.

The payment processor should also be responsible for meeting Payment Card Industry (PCI) security standards and compliance requirements for the protection of patient data.

3. Lower credit card processing fees. When selecting a payment processing solution, practice managers should carefully compare the fees, typically structured as a small percentage of each card transaction. Because this money comes directly off the top of the revenue of each transaction, it’s in the offices best interest to seek the lowest fee possible.

It may seem trivial at first, but this small percentage can add up quickly. I’ve seen a single medical office save $10,000 per year at a two-physician practice by opting for a lower fee option.

Given that the total size of the healthcare payments market is $442 billion annually, even a small percentage savings in credit card processing fees could add up to billions in savings per year.

While cash flow and profitability pressures will continue to mount in the medical industry, simple changes in payment processing can help physicians and other healthcare practitioners lower costs and increase revenues.

And the best part – once these changes are made, you can get back to what matters: patient care. 

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practice tips

Establishing and Maintaining Positive Social Media Presence

By Tricia Maddrey Baker Executive Director Pitt County Medical Society

So you have worked behind the scenes for months, preparing to open your practice. You may even have a book of patients you are bringing with you, but you know the limited list won’t last forever.

18 | APRIL 2014

How can you develop a growing patient base of qualified patients?

Your online presence is your reputation in the 21st century.

Although past generations developed reputations through word-of-mouth, current patients rely on online information for their referrals.

Your online presence also is your voice among patients. Although you will receive referrals from peers, patients now examine Facebook pages and Websites in order to determine the quality of care, communication effectiveness, and even value among practitioners.

How can you stand out among the competition whose websites are also beautifully created and fully functional?

The answer is social media. These platforms can help you maintain an appealing presence, driving business to your website and to your door, and keeping your practice engaged with patients. You will be the expert in your field through your social media postings. More importantly, your thorough social media presence will move your ranking higher on the search engines.

The example I have is our little county’s Medical Society. Shortly after the revised website was launched, Hits per Month tallied only about 300. Once the social media platforms had been in use for five months, that number was up to 1800 HPM, and three months after that, reached a high of 2700 HPM. Why was this significant? Our Society’s website hosts an online referral page, so visits to that site translate directly into income for the Members.

There are two goals for your social media strategy: to maintain a great reputation while building a patient base, and to drive traffic to the practice website. When there is an intentional, scheduled effort, designed with these

two goals in mind, you will succeed in developing your book of patients.

For help developing your social media strategy, there are a number of businesses that can do that for you. If you are willing to put in a little time, you can achieve the social media presence that you want by following these steps.

1. Gather your ideas. You want to present information that is useful to patients that might use your practice. For example, a neurologist might want to choose symptoms of head injury or accident injury, detailing warning signs. Here are some suggestions to rotate: a. Profile of provider/team member b. Statistic about specialty c. Link to specialty article online (written for non-physicians) d. Exercise routine to suggest e. Diet routine to suggest f.

Anecdote g. Something silly or funny (joke or cartoon) h. Date to remember (even Daylight Savings time) i.

Coupon j. Short video k. “Tips” for a great visit with the practitioner l. Announce new service or new web page 2. Set a schedule. Decide on the days and times of updates. For example, Mondays and Thursdays are our Society’s posting days, plus more as qualified news breaks.

3. Assign each category of item an upload date. By planning months in advance, you decrease time spent on social media.

4. If preferred, choose a scheduling App to automatically distribute the item across media platforms.

One of these is Hoot Suite, but there are several available for free or low cost. This technique insures content distribution on schedule, preferably at 8:00am, the busiest time for social media.

Of course, all this work is for naught if you do not monitor your own online presence. The easiest way to do this is to create Google Alerts for • Your own name, • Your practice name, • Your team members’ names, • Your affiliated locations names (hospital, surgical center, satellite offices).

Please be sure to do these searches as you create them to discover your current online reputation. If you have recent negative comments, try to handle them before your new practice opens.

Please note: when a negative review occurs, please follow these steps to rebuild your online presence. 1) Reach out to the reviewer to try to resolve the issue; 2) Post how you resolved the issue; and 3) Ask contented patients to write their own positive reviews for you. Prospective patients who are searching for care will weigh the number of positive VS negative, and be able to evaluate the numbers.

Even if you choose to wait to begin your online presence, be sure to create the search for your name. There is a review of you already, on one of the health-focused review sites or elsewhere, and you need to know now what is being said about you and your work. Healthgrades and WebMD do not need your permission to receive reviews on you, so please take 30 minutes to investigate your name online.

Finally, don’t forget to use multiple platforms for your social media presence. At a minimum, use Google+ and Facebook, and add Twitter also if you can. Nor should you forget to put social media “buttons” on your website, so that your current patients can say that they “like” you!

Best of luck as you stage your practice for success!  For media-specific statistics visit: http://www.searchenginejournal. com/growth-social-media-2-0infographic/77055/ WWW.MEDMONTHLY.COM | 19

practice tips

Make Your Clearinghouse Do the Work for You

By Michelle Durner, CHBME Applied Medical Systems, Inc. Managing your revenue plays an important role in your profitability. Accurate documentation, coding, and timely claim filing are the main drivers in the financial health of a practice. A lot of times, getting paid quickly is about using the right tool for the right job. In terms of documentation the tool is likely the EHR you have chosen or, if you have not implemented an EHR, how you handle your documentation on paper. For coding, the choices are between provider coding, EHR assisted coding, utilizing a professional coder, or some combination of all three.

Likewise, when it comes to managing your revenue cycle, there is more than one way to skin a cat. The way that you 20 | APRIL 2014

choose, whether it be to submit your claims directly to the individual insurance carriers, or through a clearinghouse, is up to you. Regardless of your choice, it is important that the decision you make is an informed one.

Clearinghouses help manage the claims revenue cycle.

They allow practices to transmit electronic claims to many different insurance carriers while offering a single portal for managing all of the electronic transactions. They are quick, accurate, and all claim information is stored in one location. The downside is they usually cost money. It is up to you to decide if the money they save you is more than the money they cost.

In addition to claim submission, many clearinghouses offer other services to assist in the revenue cycle. Bear in mind that not all clearinghouses offer the same services.

Your options will range from the bare minimum (claim filing) to more options than you will likely ever need.

Clearinghouses offer many different services outside of just “claims submission”. The numbers in parenthesis below represent the ANSI standardized electronic format for each file type. It can be confusing, but they are worth paying attention to because they have become a common part of the revenue cycle vernacular. l l l l l l l l l l l l l

Claim Submission (837) Eligibility Verification (270/271) ERA - Electronic Remittance Advice (835) Real Time Edits based on LCD’s Rules Based Edits Claim Status Reports (276) Rejection Analysis Data Analytics Online Access Printed Paper Claims Patient Statement Services Patient Portals for Payments Tools to submit records with the claim

The most common transactions outside of claims (837) are ERAs (835) which allows for importing of Explanation of Benefits (EOB) from carriers.

Carriers are now mandated to allow electronic Eligibility Inquiries (270/271). The 270 transaction set is used to transmit Health Care Eligibility Benefit Inquiries from health care providers, clearinghouses and other health care adjudication processors. The 270 Transaction Set can be used to make an inquiry about the type of insurance plan, type of service performed, where the service is performed, where the inquiry is initiated and where the inquiry is sent. The 271 Transaction Set is the appropriate response mechanism for Health Care Eligibility Benefit Inquiries.

Imagine the time savings of checking patient eligibility with the click of a button vs. sitting on hold for 30 minutes.

Other significant transactions, the Health Care Claim Status Inquiry (276) is used to inquire about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically. And the Health Care Claim Status Response (277) is used to respond to a request inquiry about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically.

Among other things, Clearinghouses allow billing staff to check patient eligibility, view the status of claims, denial reasons, days in accounts receivable as well as allow immediate resubmission of corrected claims.

With some of the larger Practice Management Systems, there might already be integration with one or more clearinghouses. This allows you to work the edits inside of

your Practice Management system versus having to log into the clearinghouse directly. One word of caution, if your Practice Management System has an exclusive arrangement with just one clearinghouse, you might pay more than average rates for the various services offered.

Claims are cleaner because of the interface that is in place between the Practice Management System and the Clearinghouse. The interface reduces human error that can occur in the data entry process. Coding and payer edits allow for detection and correction prior to being submitted to insurance carriers. Clearinghouses also have the ability to allow practices to create their own custom edits.

Reports can be generated that show comprehensive analytics regarding denial trends, financial data and the overall operational status. Payment posting is much more expedient and accurate because EOB’s can be imported vs manually posted by hand. Secondary and Tertiary claims are easy to file without the expense of printing to paper.

Filing directly through insurance carrier websites can significantly slow down the payment process. Practices must submit claims individually at the expense of a person hand keying all claim information. Insurance website submission doesn’t always allow practices to see where claims are in the billing process nor do they necessarily provide edits, reports or immediate resubmission of a corrected claim. There is no way to compare data or define benchmarks of the overall practice when filing claims direct to individual carriers. Additionally, there can be confusion around having multiple sign ons, lack of tools for claim management and little to no support. The ONLY benefit to direct filing is that it is less expensive or sometimes free (with the exception of the person being paid to hand key the claim data).

It’s smart to utilize all electronic methods available in the management of the revenue cycle. If done properly, it should decrease your labor cost, speed up cash flow and increase collections. 

Michelle L. Durner, CHBME is the President of Applied Medical Systems, Inc. – a Durham, NC-based company which provides medical billing, coding, practice management, and consulting services to start-up practices, hospitals, private practices, and emergency physician groups across the nation. To contact Michelle or to learn more about Applied Medical Systems, please visit www.appliedmedicalsystems.com WWW.MEDMONTHLY.COM | 21

international

Nurse Staffing and Education Linked to Reduced Patient Mortality NIH-EU supported study demonstrates critical role of nurses in improving patient outcomes

22 | APRIL 2014

H

ospitals in Europe where nursing staff care for fewer patients and have a higher proportion of bachelor’s degree-trained nurses had significantly fewer surgical patients die while hospitalized according to a new study. These findings underscore the potential risks to patients when nurse staffing is cut and suggest an increased emphasis on bachelor’s education for nurses could reduce hospital deaths.

The study, supported by the European Union’s Seventh Framework Programme and the National Institute of Nursing Research (NINR), part of the National Institutes of Health, is the largest and most detailed analysis to date of patient outcomes associated with nurse staffing and education in Europe.

Known as Registered Nurses Forecasting (RN4CAST), the study estimated that an increase in hospital nurses’ workloads by one patient increases the likelihood of in hospital death by 7 percent. Also, a better educated nurse workforce was associated with fewer deaths. For every 10 percent increase in nurses with bachelor’s degrees, there was an associated drop in the likelihood of death by 7 percent. The results of the study are published in the Feb. 25 issue of The Lancet.

“Building the scientific foundation for clinical practice has long been a crucial goal of nursing research and the work supported by NINR,” said NINR Director Dr. Patricia A. Grady. “This study emphasizes the role that nurses play in ensuring successful patient outcomes and underscores the need for a well-educated nursing workforce.”

For the RN4CAST study, a consortium of scientists led by Dr. Linda Aiken of the University of Pennsylvania School of Nursing, Philadelphia, and Dr. Walter Sermeus of the Catholic University of Leuven in Belgium, reviewed hospital discharge data of nearly 500,000 patients from nine European countries who underwent common surgeries. They also surveyed over 26,500 nurses practicing in study hospitals to measure nurse staffing and education levels. The team analyzed the data and surveys to assess the effects of nursing factors on the likelihood of patients dying within 30 days of hospital admission.

Based on their analysis, the researchers estimated that patients in hospitals where 60 percent of nurses had bachelor’s degrees and cared for an average of six patients had a nearly one-third lower risk of dying in the hospital after surgery than patients in hospitals where only one-third of nurses had bachelor’s level education and cared for an average of eight patients each.

“Our study is the first to examine nursing workforce data across multiple European nations and analyze them in relation to objective clinical outcomes, rather than patient or nurse reports,” said Dr. Aiken. “Our findings complement studies in the U.S. linking improved hospital nurse staffing and higher education levels with decreased mortality.”

In the U.S., analysis of patient outcomes associated with nurse staffing practices has informed proposed or actual legislation in nearly 25 states. These types of analyses also informed the recommendation of the Institute of Medicine that 80 percent of nurses in the U.S. have a bachelor’s degree by 2020. Hospitals have responded to this recommendation with preferential hiring of bachelor’s degree-trained nurses.

The RN4CAST study was designed to provide scientific evidence for decision makers in Europe to guide planning for the nurse workforce for the future. The study’s findings provide evidence to guide important decisions about improving hospital care in the context of scarce resources and health care reforms.

“This study is another example of how nursing science can help inform policies that promote positive patient outcomes not only in the U.S., but around the world,” added Dr. Grady.  About the National Institute of Nursing Research (NINR): NINR supports basic and clinical research that develops the knowledge to build the scientific foundation for clinical practice, prevent disease and disability, manage and eliminate symptoms caused by illness, and enhance end-of-life and palliative care. For more information about NINR, visit the website at http://www.ninr.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services.

NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Source: http://www.nih.gov/news/health/feb2014/ninr-26.htm WWW.MEDMONTHLY.COM | 23

research research & & technology technology

ZOLL Implements HL7 for Data Exchange Between Healthcare Providers

ZOLL Medical Corporation, a manufacturer of medical devices and related software solutions, today announced it has successfully implemented an exchange of clinical and administrative data between pre-hospital emergency medical services (EMS) and hospital electronic medical record systems using the Health Level Seven® (HL7®) International Standard.

ZOLL’s new HL7 for EMS solution operates as a component of RescueNet® ePCR. Poudre Valley Hospital EMS, Fort Collins, Colorado, became the first service to facilitate an automated data exchange when it transmitted patient health record data from Poudre Valley’s ZOLL ePCR to a University of Colorado Health’s electronic medical records system (EPIC).

24 | APRIL 2014

“ZOLL’s HL7 for EMS solution has radically improved our process at Poudre Valley Hospital EMS. It saves us time and provides improved integration of data with the EMS and hospital reports,” said Wyandt Holmes, Paramedic, FPC, Media Liaison of Poudre Valley Hospital EMS. He further explained that prior to implementing ZOLL’s HL7 for EMS, Poudre Valley Hospital EMS printed and manually scanned every patient care report. Subsequently, each scanned report was uploaded to the hospital’s medical records system. It took approximately five minutes per report. Handling 20,000 reports per year created a substantial burden for the organization. With ZOLL’s HL7 for EMS system, they expect to save close to 2,000 labor hours, a full-time equivalent, every year.

“Effective healthcare systems require a tight integration between EMS and hospital care. The use of the standardsbased HL7 CDA® for EMS lets ZOLL ePCR users easily exchange EMS patient records with hospitals and other health information systems. This timely flow of information is essential to assure each patient has the opportunity for the best possible outcome,” said Greg Mears, MD, Medical Director for ZOLL Data Management Products.

HL7 creates standards that allow health care information interoperability. HL7 provides a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery, and evaluation of health services.  About Health Level Seven International (HL7): Founded in 1987, Health Level Seven International (HL7) is a nonprofit ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7’s 2,300+ members include approximately 500 corporate members who represent more than 90% of the information systems vendors serving healthcare.

About ZOLL Medical Corporation: ZOLL Medical Corporation (zoll.com), an Asahi Kasei Group company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, fluid resuscitation, and therapeutic temperature management, ZOLL provides a comprehensive set of technologies that help clinicians, EMS and fire professionals, and lay rescuers treat victims needing resuscitation and acute critical care.

Source: http://www.newswiretoday.com/ news/140464/

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research & technology

New Research Points to Talking-Therapy Treatments to Manage Osteoarthritis Pain Scientists have shown for the first time that the abnormalities in the way the brain experiences pain may be to blame for the chronic pain suffered by osteoarthritis patients.

The findings by Arthritis Research UK-funded researchers at The University of Manchester suggest the need for new therapies to target brain mechanisms to enable the brain to cope more effectively with chronic pain, including mindfulness-based talking therapies.

Chronic pain can affect up to 30% of the population at any one time – with 26 | APRIL 2014

most complaints relating to arthritis.

Patients can become more disabled as their pain spreads to other areas and find it difficult to cope as it interrupts sleep and other normal daily routines.

Professor Anthony Jones, from The University of Manchester’s Human Pain Group based at Salford Royal NHS Foundation Trust, said: “The extent of pain experienced by sufferers

of arthritis has always been thought to result from the direct consequences of joint destruction. However the extent of pain is often poorly related to the amount of damage and can spread to nearby regions of the body where there is no evidence of arthritic disease.

We wanted to look at what might be causing this.”

“Currently it is not understood

why patients with arthritis have such variability in how much pain they experience but, in spite of this, we continue to spend large sums of money using potentially damaging antiinflammatory drugs.”

Researchers thought that the spreading and intensification of pain in arthritis may be similar to that experienced by sufferers of fibromyalgia, a widespread chronic pain condition associated with psychological distress and sleep disturbance – where there is currently no consensus about the cause of the pain. Earlier research had suggested that patients with fibromyalgia have abnormalities in the way in which the brain deals with pain so the Manchester team looked at the overlaps in how pain is processed in the brain, between osteoarthritis and fibromyalgia to help them understand why some sufferers of arthritis can experience much worse pain than others.

The study, published in the European Journal of Neuroscience recently , measured brain waves in response to short painful laser pulses to the skin in patients with osteoarthritic or fibromyalgic pain and those with no pain. They found that while anticipating the painful pulse a brain area called the insula cortex increased its activity and this predicted the extent and intensity of the patients’ own chronic pain.

Dr Christopher Brown, Honorary Research Associate, Human Pain Research Group, The University of Manchester, said: “Increased activity in this brain area has been linked to a number of phenomena, including body perception and emotional processing, which might explain the greater pain perception in some patients.

“Interestingly, responses during pain anticipation were reduced in an area at the front of the brain called the dorsolateral prefrontal cortex. These reduced responses corresponded to less ability to develop positive ways of coping with the pain in both groups of

patients.

“We think that boosting activity either directly or indirectly in this area of the brain is likely to result in better coping and better control of pain responses in other areas of the brain.”

The study suggests there are common abnormalities in the way the brain expects pain in fibromyalgia and osteoarthritis - which can be considered potential common brain mechanisms for these conditions.

Professor Wael El-Deredy, from The University of Manchester, added: “More research is needed but this suggests we should be putting more resources into a common approach to developing new therapies that target these potential brain mechanisms.

“Our previous work has shown that brain responses to pain expectation can be altered by relatively short and inexpensive mindfulness-based talking therapies in patients with different types of chronic pain. Our current findings therefore provide both a new target for development of new therapies and some optimism for simple interventions to improve the brain’s control of chronic suffering endured by many patients with chronic pain conditions.”

Professor Alan Silman, medical director of Arthritis Research UK, which funded the research, said: “This research provides a fascinating insight into the way the brain processes the pain of osteoarthritis, and goes some way to explaining why so many people with osteoarthritis with similar levels of joint damage experience such varying degrees of pain.

“Focussing research on targeting abnormal brain mechanisms rather than more conventional approaches looking at joint damage could be a major step forward, that could reduce people’s dependency on antiinflammatories and painkillers.”  Source: http://www.pressreleasepoint. com/new-research-points-talkingtherapy-treatments-manageosteoarthritis-pain

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research & technology

NIH Ad sta d n t i of G al S s ene et tic, Info H eal On r m line atio th n to Dat aba se Sub

Information on older adults is largest ever resource for researchers 28 | APRIL 2014

R

esearchers will now have access to genetic data linked to medical information on a diverse group of more than 78,000 people, enabling investigations into many diseases and conditions.

The data, from one of the nation’s largest and most diverse genomics projects — Genetic Epidemiology Research on Aging (GERA) — have just been made available to qualified researchers through the database of Genotypes and Phenotypes (dbGaP), an online genetics database of the National Institutes of Health.

The GERA cohort — average age 63 — was developed collaboratively by Kaiser Permanente and the University of California, San Francisco (UCSF). The addition of the data to dbGaP was made possible with $24.9 million in support from the National Institute on Aging (NIA) and the National Institute of Mental Health, and the Office of the Director, all at NIH. Catherine Schaefer, Ph.D., of Kaiser Permanente Northern California and Neil Risch, Ph.D., of UCSF are co-principal investigators for GERA. “Data from this immense and ethnically diverse population will be a tremendous resource for science,” said NIH Director Francis S. Collins, M.D., Ph.D. “It offers the opportunity to identify potential genetic risks and influences on a broad range of health conditions, particularly those related to aging.”

The GERA cohort is part of the Research Program on Genes, Environment, and Health (RPGEH), which includes more than 430,000 adult members of the Kaiser Permanente Northern California system.

Data from this larger cohort include electronic medical records, behavioral and demographic information from surveys, and saliva samples from 200,000 participants obtained with informed consent for genomic and other analyses. The RPGEH database was made possible largely through early support from the Robert Wood Johnson Foundation to accelerate such health research.

“The GERA cohort has the largest number of people — of any age — with data in dbGaP,” said NIA Director Richard J. Hodes, M.D. “Federal funds were used to develop new approaches to genomics for this project and I’m pleased that the data are now ready in dbGaP for researchers’ use. I look forward to new insights that such a unique resource might offer for better health with age.”

The genetic information in the GERA cohort translates into more than 55 billion bits of genetic data.

Using newly developed techniques, the researchers conducted genome-wide scans to rapidly identify single nucleotide polymorphisms (SNPs) in the genomes of the people in the GERA cohort. These data will form the basis of genome-wide association studies (GWAS) that can look at hundreds of thousands to millions of SNPs at the same time. The RPGEH then combined the genetic data with information derived from Kaiser Permanente’s comprehensive longitudinal electronic medical records, as well as extensive survey data on participants’ health habits and backgrounds, providing researchers with an unparalleled research resource.

In addition to diseases and conditions traditionally associated with aging, such as cardiovascular disease, cancer and osteoarthritis, researchers can explore the potential genetic underpinnings of a variety of diseases that affect people in adulthood, including depression, insomnia, diabetes, certain eye diseases and many others representing a variety of disease domains. Researchers will also be able to use the database to confirm or disprove other studies that use data from relatively small numbers of people, as well as to increase the size and power of their samples by adding participants from GERA to metaanalyses. The large cohort will also serve as a reference source of controls that researchers can compare to individuals with different conditions that they have studied.

“An exciting aspect of this dataset is that it will be updated and refreshed,” noted Winifred Rossi, deputy director of NIA’s Division of Geriatrics and Clinical Gerontology and program officer for the project. “As information is added to the Kaiser-UCSF database, the dbGaP database will also be updated.” dbGaP was developed and is managed by the National Center for Biotechnology Information, a division of the National Library of Medicine at NIH. Investigators who are interested in applying for access to this database should follow the procedures on the dbGaP website. Specific information on the data can be found at http://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs000674. v1.p1.  About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Source: http://www.nih.gov/news/health/feb2014/nia-26.htm WWW.MEDMONTHLY.COM | 29

legal

Unprecedented HIPAA Fine May Mean Increased Scrutiny and Penalties

By Kimberly Gold Associate, Mintz Levin Triple-S Management Corp. (“Triple-S”), a Puerto Ricobased health insurer, has been fined $6.8 million by the Puerto Rico Health Insurance Administration (“PRHIA”) following a Health Insurance Portability and Accountability Act (“HIPAA”) breach by its subsidiary, Triple-S Salud Inc. (“TSS”), involving more than 13,000 beneficiaries.

The breach occurred last September, when TSS accidentally mailed to approximately 70,000 Medicare Advantage beneficiaries a pamphlet that inadvertently displayed Medicare Health Insurance Claim Numbers (“HICNs”), which are considered protected health information under HIPAA. In a Securities and Exchange Commission filing, Triple-S disclosed that in addition to the fine, PRHIA imposed administrative sanctions, including the suspension of all new enrollments of clients enrolled in both Medicare and Medicaid (“Dual Eligibles”) and the obligation to notify affected individuals of their right to disenroll.

Triple-S stated that TSS conducted an investigation and reported the incident to the appropriate Puerto Rico and federal government agencies, responding to requests for information about Dual Eligibles. Triple-S added that TSS took additional steps to remedy the breach, including issuing a breach notification through the local media and notifying all affected beneficiaries by mail.

The amount of the penalty imposed by the Puerto Rican government is unprecedented, higher than any 30 | APRIL 2014

HIPAA fine ever issued by the Department of Health and Human Services’ Office for Civil Rights (“OCR”) and far exceeding the maximum federal fine per incident of $1.5M established by the HIPAA Omnibus Rule. While OCR has entered into many settlement agreements with financial penalties, it has imposed a civil monetary penalty for a HIPAA violation only one time, when it issued a $4.3 million fine against Cignet Health in 2011.

The amount of the TSS fine is also significant considering that there have been much bigger breaches affecting larger numbers of individuals, and the information that was released – HICNs – is not the type of sensitive information that typically leads to more aggressive enforcement.

What does this mean for HIPAA covered entities and business associates? The staggering fine may embolden federal regulators or state Attorneys General to take a more aggressive position and impose more civil monetary penalties for HIPAA breaches, even breaches previously considered less serious. Organizations should take extra precautions to prevent and remedy breaches, including complying with all federal and state breach notification requirements. Please see our previous post for additional tips that may be used to avoid data breaches that may lead to large penalties.  Source: http://www.healthlawpolicymatters. com/2014/02/26/unprecedented-hipaa-fine-may-meanincreased-scrutiny-and-fines/

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legal

Final Affordable Care Act (ACA) Shared Responsibility Regulations Released

Plan sponsors now have the final piece of the puzzle needed to finalize their 2015 pay-or-play strategies.

By Andy R. Anderson Lisa H. Barton Saghi “Sage� Fattahian Morgan, Lewis & Bockius LLP

T

he Internal Revenue Service (IRS) and the U.S. Department of the Treasury recently issued the highly anticipated final shared responsibility regulations under the Affordable Care Act (ACA). These regulations provide transition rules for certain employers as well as much-needed clarity for many aspects of the shared responsibility requirements. The final regulations took effect on February 12, 2014 and apply for periods beginning after December 31, 2014. However, employers are permitted to rely on the final regulations earlier than December 31.

This guidance contains important information that will allow employers to finalize their pay-or-play strategy for 2015 and beyond.

32 | APRIL 2014

Background

Effective in 2015, large employers with 100 or more full-time or full-time-equivalent employees are required to offer affordable health coverage to full-time employees and their dependents. If the coverage does not satisfy minimum value and affordability requirements, the employer will be assessed a penalty if any of its full-time employees purchase insurance from a public health exchange and receives a premium tax credit or cost-sharing reduction. Specifically, if an employer fails to offer health coverage to the required number of full-time employees (generally 95%) and one of its full-time employees goes to a public health exchange and receives a premium tax credit or cost-sharing reduction, the employer will be subject to a nondeductible

penalty equal to $2,000 (indexed for inflation) multiplied by each full-time employee employed by the employer (the No Coverage Penalty). Also, if the health coverage that is offered does not meet minimum value and affordability requirements and a full-time employee goes to the public health exchange and receives a premium tax credit or cost-sharing reduction, the employer will be subject to a nondeductible penalty equal to $3,000 (indexed for inflation) multiplied by each full-time employee who goes to a public exchange and receives a tax subsidy (the Inadequate Coverage Penalty).

On January 2, 2013, the IRS released proposed regulations outlining the shared responsibility requirements.1 On July 2, 2013, the IRS announced a one-year delay for implementation.2 Final regulations were released on February 10, 2014. Additionally, the IRS has also released a shared responsibility Fact Sheet3 and Questions/Answers.4

Determining Employers Subject to Shared Responsibility Requirements

The ACA requires that large employers—employers employing at least 50 full-time employees or fulltime-employee equivalents—comply with the shared responsibility requirements or face possibly paying the No Coverage Penalty or the Inadequate Coverage Penalty. For 2015 only, the 50-employee threshold has been increased to 100 employees. Thus, employers that employ at least 50, but fewer than 100, full-time or full-time equivalent employees will be exempt from the No Coverage Penalty and the Inadequate Coverage Penalty until January 1, 2016, so long as certain requirements are met. Specifically, in order to take advantage of the delayed effective date, such employers must certify that (i) between February 9 and December 31, 2014, the employer did not reduce the size of its workforce and overall hours of service of its employees (other than for a valid business reason); and (ii) from February 9, 2014 through December 31, 2015, the employer did not materially eliminate or materially reduce the health coverage offered, if any, as compared to the coverage offered on February 9, 2014.

Controlled-Group Aggregation. The final regulations maintain that controlled-group members must be aggregated for purposes of determining whether an employer is a large employer. Additionally, the final regulations, consistent with the proposed regulations, also provide that any shared responsibility penalty will be assessed on an employer-by-employer basis and not on a controlled-group basis.

New Large Employers. The final regulations provide that an employer that is close to 50 full-time employees or full-time-equivalent employees will have a transition period before being required to offer ACA-compliant health coverage to full-time employees. Specifically, with

respect to employees who were not offered coverage at any point in the prior calendar year, if the employer offers health coverage that provides minimum value by April 1 of the first year during which the employer has 50 or more full-time employees, the employer will not be subject to an assessable payment for January through March of the first year the employer is an applicable large employer.

Foreign Employees. For purposes of determining whether an employer is a large employer under the ACA, the regulations clarify that an employer generally must only take into account employees who performed work in the United States. Thus, if a foreign employer has fewer than 50 full-time employees in the United States, but has more than 50 full-time employees internationally, the foreign employer generally would not be subject to the ACA shared responsibility requirements.

Determining Large Employers for 2015. For 2015. employers may use a six-month period in 2014 to determine whether they cross the 50 or 100 full-time/ full-time-equivalent employee threshold. Going forward, large-employer status is determined based on the average number of full-time/full-time-equivalent employees in the prior calendar year (with a special transition rule for 2016 if an employer was under 100 for 2014).

2015 Shared Responsibility Penalty Transition Relief

The proposed regulations indicated that an employer would be treated as offering health coverage to substantially all full-time employees and their dependents if the employer offered health coverage to at least 95% of its full-time employees and their dependents. While the final regulations retain the 95% threshold, for 2015 only, employers will not be subject to the No Coverage Penalty if health coverage is offered to at least 70% of full-time employees and their dependents.

For purposes of calculating any No Coverage Penalty, employers that do not meet the 95% threshold are permitted to disregard the first 30 full-time employees before assessing the penalty. However, for 2015 only, the final regulations indicate that, for purposes of calculating the No Coverage Penalty, employers are permitted to disregard the first 80 full-time employees. This means that, in 2015, the monthly No Coverage Penalty would be 1/12 of $2,000 multiplied by the employer’s total number of fulltime employees, minus the first 80 full-time employees.

NOTE: While the final regulations provide a transition period for the No Coverage Penalty, employers may still be subject to the Inadequate Coverage Penalty for failure to offer health coverage that meets minimum value and affordability requirements for each employee who receives a premium tax credit. continued on page 34 WWW.MEDMONTHLY.COM |33

continued from page 33

Determining Full-Time Employees

The final regulations outline the following two approaches for determining full-time employees: • Look-Back Measurement Method. Under this method, which closely models the proposed regulations, an employer is permitted to determine the status of an employee during a future “stability period” based upon an employee’s hours of service in a prior “measurement period.” The measurement period must generally be at least three months, but not more than 12 months, in length. The stability period, however, must be at least six months long, but not shorter than the measurement period.

NOTE: In determining full-time employees for 2015, subject to certain requirements, employers are permitted to use a six-month measurement period, even with a 12-month stability period, on a one-time basis.

• Monthly Measurement Method. The final regulations clarify the use of a monthly measurement method whereby employees will be identified as full-time employees using hours of service during each calendar month. The final regulations contain specific requirements regarding how this method may be used.

Using Different Measurement Periods for Different Groups. The final regulations provide that, although employers must generally use the same measurement method for all employees, they are permitted to use either the look-back or monthly measurement method for certain categories of employees. The final regulations limit an employer’s ability to use different measurement periods for different groups other than those listed below. An employer is not permitted, for example, to use the look-back measurement method for variable-hour employees and the monthly measurement period for employees with more predictable hours. Employers may use either the look-back or monthly measurement methods for the following types of employees: • Salaried and hourly employees • Employees whose primary places of business are in different states • Union and nonunion employees • Collectively bargained employees covered by different collective bargaining agreements The final regulations also clarify that different employers in a controlled group may use different measurement periods for the same categories of employees.

Factors Used for Determining Whether a New Hire Is a Full-Time or Variable-Hour Employee. The final regulations outline the criteria to be used when 34 | APRIL 2014

determining whether a new employee is full time or variable hour when using the look-back measurement method. Factors to consider include, but are not limited to, whether the employee is replacing an employee who was not a full-time employee, the extent to which employees in the same or comparable positions are or are not fulltime employees, and whether the job was advertised, or otherwise communicated to the new hire or otherwise documented, as requiring hours of service that would average 30 or more per week.

Rehire Rules Following Breaks in Service. The final regulations shorten the period of time that an employee may be treated as a new hire following a break in service.

Under the proposed regulations, an employee could be treated as a new hire if the employee did not have an hour of service with the employer for a period of at least 26 consecutive weeks before the rehire date. The final regulations shorten this time period to 13 weeks for employers other than educational organizations.

Employees Who Change Categories of Employment.

The final regulations contain specific requirements for employees who change categories of employment, which will cause them to move between measurement methods.

For example, if an employee goes from hourly status (with a look-back measurement period) to full-time status (with a monthly measurement period), there are specific and detailed requirements that must be followed.

Seasonal Employees. Under both the proposed and final regulations, the look-back measurement method may be applied to seasonal employees in the same way that it is applied to variable-hour employees. However, the final regulations clarify the definition of “seasonal employee” and indicate that seasonal employees are those for whom customary annual employment is six months or less. The reference to “customary” means that, by the nature of the position, the employee hired in such a position will typically work six months or less and the period of time will begin at approximately the same time during each calendar year.

Change to Definition of “Dependent”

In order to avoid a No Coverage Penalty and the Inadequate Coverage Penalty, employers are required to offer health coverage to the dependents of eligible full-time employees. The final regulations provide that dependents include biological children and adopted children (including those placed for adoption) until they attain age 26. The definition of “dependent” does not include an employee’s spouse, and, unlike the proposed regulations, the final regulations do not require coverage of stepchildren or foster children.

Employers will not generally be subject to a shared responsibility penalty in 2015 if they fail to offer dependent coverage until 2016. However, this transition rule is only

available if an employer did not previously offer dependent coverage during 2013 or 2014.

coverage is affordable if it does not exceed 9.5% of the wages paid to the employee by the employer, as reported in Box 1 of IRS Form W-2, for the calendar year.

• Rate of Pay Safe Harbor. Under this method, coverage is affordable if it does not exceed 9.5% of an amount equal to 130 hours times an hourly employee’s rate of pay during the beginning of the coverage period (or 9.5% of a salaried employee’s monthly salary). While the proposed regulations did not permit employers to use this safe harbor method if an employer reduced an hourly employee’s rate of pay during the year, the final regulations permit employers to use this safe harbor in such a situation, so long as the premium does not exceed 9.5% of the reduced amount. This safe harbor cannot be used if monthly salary is reduced, even if the reduction is a result of reduced work hours.

• Federal Poverty Line Safe Harbor. Under this safe harbor, an offer of coverage is affordable if the employee’s required contribution for the calendar month for the lowest self-only coverage does not exceed 9.5% of a monthly amount determined as the federal poverty line for a single individual for the applicable calendar year, divided by 12.

Transition Relief for Non-Calendar-Year Plans The final regulations permit employers that sponsor non-calendar-year plans to delay required implementation of the shared responsibility requirements until the first day of the 2015 plan year if certain requirements are satisfied.

Specifically, the plans must have been in existence on December 27, 2012, and the employer cannot have made a change to the plan year of the plan on or after that date.

Below is a description of the transition relief.

• Existing Employees with Coverage. For employees eligible to participate in a health plan as of February 9, 2014 (even if such employees did not elect coverage), employers are not required to offer compliant coverage until the first day of the plan year starting in 2015.

• Coverage for All Employees. If an employer offered a health plan to at least 1/3 of all employees during the most recent open enrollment period ending on or before February 9, 2014 or covered at least 1/4 of all employees on any day during the 12-month period ending on February 9, 2014, the employer is not required to offer coverage until the first day of the plan year starting in 2015.

• Coverage for Full-Time Employees. If an employer offered heath coverage to at least 1/2 of ACA full-time employees during the most recent open enrollment period ending on or before February 9, 2014 or at least 1/3 of all ACA full-time employees on any day during the 12-month period ending on February 9, 2014, the employer is not required to offer coverage until the first day of the plan year starting in 2015.

Determining If Coverage Meets Affordability Requirements

As described above, an employer could be subject to an Inadequate Coverage Penalty if the healthcare options offered to employees are not “affordable” and if at least one employee enrolls in coverage on an exchange. In general, coverage is considered affordable if the employee contribution for the lowest-cost single coverage does not exceed 9.5% of the employee’s household income. However, because most employers will not know the household income of their employees, the final regulations maintain safe harbors for purposes of determining affordability.

The three safe harbors are the (i) IRS Form W-2 wages safe harbor, (ii) the rate of pay safe harbor, and (iii) the federal poverty line safe harbor. If the employer satisfies the requirements for one of the safe harbors, the offer of coverage will be considered to be “affordable.” Each safe harbor method is discussed briefly below.

• IRS Form W-2 Wages Safe Harbor. Under this method,

Next Steps

Now that the final regulations have been issued, employers have the information needed to implement their ACA strategy. Many employers were waiting on the final regulations to make sure their compliance strategies were consistent with the regulations. Employers should now move quickly to make plans for 2015 compliance or determine that they can postpone compliance until 2016.  ___________ For more information on the proposed regulations, see our February 28, 2013 presentation, “The Road to 2014: ACA Considerations for Employers,” available here.

2 For more information on the on the one-year delay, see our July 3, 2013 LawFlash, “Affordable Care Act Shared Responsibility Penalty Delayed Until 2015,” available here.

3 View the Fact Sheet here.

4 View the Questions/Answers here.

1

Source: http://www.natlawreview.com/article/finalaffordable-care-act-aca-shared-responsibility-regulationsreleased Copyright 2014. Morgan, Lewis & Bockius LLP. All Rights Reserved.

This article is provided as a general informational service and it should not be construed as imparting legal advice on any specific matter.

WWW.MEDMONTHLY.COM | 35

legal

2014 Work Plan Highlights For Physicians

By Emily M. Hord McBrayer, McGinnis, Leslie and Kirkland, PLLC

On January 31, 2014, the Office of Inspector General (“OIG”) finally released its Work Plan for fiscal year 2014. The Work Plan is a dense summary of the OIG’s various enforcement priorities for the year. This overview is specifically for physicians, hospitals, and other health care providers. Some of this year’s plan’s significant focus areas are discussed below.

Place-of-service coding errors

Federal reimbursement regulations, including Medicare regulations, provide different levels of payment depending on the setting of the performed services. Non-facility or physician clinic payments are higher than many hospital-based payments. Specifically, OIG will be looking at the services provided in ambulatory surgical centers and hospital outpatient departments to see whether miscoding with respect to the site of services is a source of Medicare overpayment and as such can be recovered from providers.

Inappropriate E&M payments The OIG will be analyzing whether 36 | APRIL 2014

payments for physician’s evaluation and management services are correct.

Because electronic medical records present the opportunity to “cut and paste,” OIG will be specifically examining whether electronic records have diminished the accuracy and, in some cases, the appropriateness of billing for E&M services.

Utilization of laboratory tests, diagnostic radiology, and sleep disorder clinics According to OIG, there has been a high utilization rate of lab tests, diagnostic testing, and independent diagnostic facilities for sleep-testing procedures. The OIG plans to review the appropriateness of test ordering, billing, and payment practices.

Chiropractic services

Prior audits and research conducted by the OIG revealed payments for chiropractic services that were medically unnecessary or improperly documented. One of OIG’s new initiatives is to determine the extent of such questionable billing for chiropractic services, including identifying chiropractic maintenance therapy billing, which Medicare does

not reimburse. In addition, the OIG will be examining Medicare Part B payments to verify that the claims were billed properly in accordance with Medicare rules.

Ophthalmological services

The 2012 Medicare claims data will be reviewed with respect to ophthalmological services (and their geographic location) in order to identify questionable billing practices and/or inappropriate payments.

Assignment rules

Physicians participating in Medicare receive payment on “assignment” for all services provided to Medicare beneficiaries. The OIG plans to examine physicians’ non-compliance with assignment rules and excessive billing of beneficiaries.

Physician Compare website The Physician Compare website, which helps Medicare beneficiaries choose a health care provider, will be examined for informational accuracy. 

Source: http://www.natlawreview.com/ article/2014-work-plan-highlightsphysicians

features

Staging Your Practice For Success

By Rhonda Granja, BS, CMA, CMC, CMOM, CPC 38 | APRIL 2014

As a Consultant, I am often asked “How can my practice be successful”? With hospitals acquiring physician groups and costs of overhead expenditures continuing to rise, it can be difficult to be profitable and thriving in the healthcare industry.

I have some suggestions and with my background of teaching coding, billing and compliance, I feel like the exposure that I have has given me some insight to share this with others when asked.

1.) The first recommendation is to stay on top of changes that occur in the industry. For example, CPT and HCPCS codes change and evolve every year. It is vital to order your resource material early in the year so that our billing staff and coders can have the latest and greatest information. According to the OIG (Office of Inspector General); we must provide accurate coding and billing. It can be very discouraging for a patient to be asked why they are expected to pay for services and the person that we task to collect this money has no clue as to what and why we are billing them. I firmly believe that knowledge is power and therefore training and continuing education is priceless. The industry changes all of the time and we have to sharpen our skills on a continuum basis. ICD-10 is right around the corner and bringing even more changes and a new language as to how we communicate diagnosis codes. It is a very exciting time to be in healthcare. Be sure to follow the letter of the law as state regulations and federal guidelines are in place for many reasons.

Compliance cannot be emphasized enough.

2.) The second item is to maintain good working relationships with your peers and other consultants as well as your patients. With health care reform upon us, quality care is what we all should strive for.

It is imperative to have a good networking system to ensure that the patients are receiving the best of care and can ensure our practice growth in the community.

Word of mouth is still the best marketing tool available.

3.) Take care of your employees. These folks are the heartbeat of your practice. Happy employees tend to be on time for work, compassionate in their work and thus reduce costs and turnover within a practice. If your staff feel that they are not equipped to handle job functions and do not feel appreciated in what they do, they may seek employment elsewhere. Show respect and acknowledge how vital our team members are. Employees need to feel like we care about them.

Offering appraisals and encouragement are just simple things that can be put into play. Motivation techniques are invaluable. Patients can feel tension if the staff are not treated well.

4.) Keep the lines of communication open with everyone. I like to poll patients periodically and just

ask them to write down three things that they like about my practice. It is a simple yet effective tool for finding out things that need my attention. Not only will they list three things that they like about the office, but they also point out things that they don’t like or something that could use some improvement. It is important to respect others viewpoints and concerns.

Constructive criticism offers us a chance to look at what others are seeing and we can learn from one another.

5.) Offer payment options to patients and colleagues.

Patients want to know that you care about their physical, mental, emotional health more than you do your profit margin. There could be missed opportunity in possibly adding a practice benefit to an employee.

Employees refer patients and if they express how caring and concerning the practice is about them as a staff member, it may send the message to the patient that the practice cares about their personal needs as well.

Look at your payment options, payment plans and what your outstanding A/R is. Asking for payment is not an easy task for everyone and therefore it is vital to have the best and qualified staff member in that role.

6.) Keep medical and administrative costs to a minimum without sacrificing care. Have staff be accountable for ordering only what they need and eliminate waste. I have consulted a practice before where all the staff have left for the day but yet had left radios playing, computers on, space heaters left running, and lights burning all over the building. Be conservative and let staff know that waste cannot be tolerated. Little dollars can turn into big dollars. We should all do our part to conserve.

7.) Display honesty and integrity. This is common sense.

I once sat in for an administrator and watched a staff member take toilet paper out of the office and load in her car as she left for the day. Had she asked for a roll of toilet tissue, I would have certainly given it to her, but she took it without asking and therefore was stealing from the practice. How was I to know that she was stealing other items as well?

8.) Make it known that above all else, patients are our number one priority. Taking care of them to the best of our ability should be our main focus. Do not sacrifice things when it comes to patient care. Never neglect your patient. The golden rule still stands “treat others as you want to be treated”.

Patients are consumers and medicine is more competitive than ever before. You want your practice to be the best within your area and a place where patients know that they can get the best care at the best price. Simply stated, be the best that you can be. 

WWW.MEDMONTHLY.COM | 39

features

It’s Time to Get Social: Promoting the Right Image For Your Practice

By Barbara Hales, M.D. www.thewritetreatment.com “Staging your practice,” means paying extra attention to perceptions - that which is created by you with your staff and those that are shared by the public of you. Each is important and will be discussed specifically.

40 | APRIL 2014

Create a persona of the “caring and engaging physician”

A great way to promote a positive image or persona is with social media.

After all, “sharing is caring”. Engage patients with instructional videos and new information about healthcare.

Social media is a chance to let clients and patients know about medical breaking-news, interesting articles and the results of new studies in your niche, along with maintaining a useful dialogue. Adding fresh and useful content on a regular basis makes your viewers want to return to your site again and again. It also establishes you as an authority in your field, puts you ahead of your competition and spreads the word about you in the community.

Encourage your patients to learn from your social media sites for information and general questions but let them know that if there were specific questions pertaining to them, an appointment to the office would be prudent.

Take a look at the HIPAA regulations in the state you dwell in for any restrictions, so that posts that you make are in compliance. Check out: http://www.hipaasurvivalguide. com/hipaa-regulations/hipaaregulations.php. Note that according to the Department of Health and Human Services’ Office of Civil Rights, “a covered entity (which applies to healthcare providers) is not responsible for the actions by a patient’s friends or family.”

Social Media Plan

Decide which site is the one you want to dominate. You will want to set up a profile for both your practice and yourself on Facebook, Twitter, YouTube and Pinterest since your patients are on them.

Don’t forget Google+

This year promises to be an active one for this site as it has been slowly refining the services it offers. As we

transition into Web3.0, Google+ links people with providers of the services they are searching for and helps to establish business relationships, strengthen branding and increase your visibility.

Content shared on Google+ creates discussion groups, forums and communities, furthering your exposure online and improving online ranking. People within Google communities share experiences and help others, which is perfectly aligned with healthcare.

Resources for Valuable tips in Google+ Here are some communities where you can get valuable tips and solutions to actively market within Google+: 1. http://plus.google.communities/ 111485579524064707357 (for small business marketing) 2. http://plus.google.communities/ 116964887426108499397 (Plus your business) “A community and agency to help you get the most out of using Google+ for business.”

3. https://plus.google.com/ communities/ 100733314294792518208 (Google Plus for Small Business) “helping businesses use Google Plus”

Public Perception of You and Your Practice

Even if you don’t personally have a website for yourself or your practice (which is shortsighted these days), you are still on the web. Your patients rate you on various sites: • Vitals.com • Healthgrades.com • RateMDs.com • Yelp Though most patients still see new physicians by personal referrals of friends and family, people do go onto online sites to check on providers before making appointments. Once, people checked mainly to see whether a doctor accepted the insurance they

participated in, or hospital affiliations.

Now, people are also searching for: • Length of time doctors have been in practice • Education and training • Certifications and licenses • And most importantly patient satisfaction

Patient Satisfaction

Information here provides: • Wait time to see the doctor • Whether the doctor is attentive • Pleasantness and efficiency of office staff Patients can use a star rating (with 5 stars being the best) as well as a review where the patient may state how the decision about the doctor was made or what occurred during the patientdoctor transaction that one was pleased with (or irritated by)

Damage Control

It is important to go in periodically and check these sites out for comments that were made about you. If they are negative, you can add comments of your own (or flood the site with patients that are enamored of you).

Register your name with Google Alert. This is a free service that Google provides. When your name comes up in conversation online or appears on any pages of the web, you will then be notified. This enables you to read comments about yourself so that you can take action.

Ignoring the situation is very naïve at best. Damage control is a crucial aspect to “staging your practice”, ensuring that your brand is positive and not marred in any way.

Kudos to You

Many of you are already engaging your patients with social media and making a presence in your community.

Good for you!

For those that would like to be proactive but can’t seem to find the time to do so, it needn’t be a problem.

Simply outsource it!  WWW.MEDMONTHLY.COM | 41

features

Attracting Ideal New Patients to Your Practice

by Audrey McLaughlin, RN

www.physicianspracticeexpert.com

T

here are many ways to “stage a practice for success”. Some are practical, some are legally required, and some are just plain smart business.

From the smart business angle, one of the key factors to focus on is attracting new ideal patients.

What is an ideal patient?

Have you interpreted your professional obligation as an obligation to market to, see, and treat virtually anyone who can use their telephone and present their body in your office?

I would like you to consider that this type of thinking leads to requiring escalating numbers of patients in order to grow your practice, which no doubt leaves you overworked and stressed.

I am not suggesting that if you have the capacity to serve those seeking care, you deny them access based on a social standard or profile because that would be wrong and unethical.

What I want you to do is to simply identify characteristics of those patients you especially enjoy serving and make a specific effort to attract and retain those patients. Again, this does NOT mean to turn away patients that are not your “ideal patients.”

What types of patients and clients do you enjoy serving?

What are their common denominators? Health attitudes?

Income? Occupation? Hobbies? Lifestyle? Personal habits?

Age? Cash? Insurance? Condition?

42 | APRIL 2014

Every practice and practitioner will have a different set of qualifiers that creates their ideal patient. There are a few qualities that universally go on all ideal patient profiles. All ideal patients are patients: • You enjoy working with • That need your help • Who will happily pay what you are worth (privately, via insurance, or a combination) • That will get great results from the services you can/do offer Now taking a look at just that short list of criteria, can you imagine what it would be like to have a practice full of these types of patients?

How do you discover your ideal patient?

You start with categorizing your current patients so you can see what your ideal patients have in common, then creating your ideal patient client profile, identifying who they are, what their issues tend to be, and how to identify their biggest problems. Then, you look at obstacles and challenges that you have the solutions for (or can create solutions for) and where to find them.

Again, knowing your ideal patient is so important; it is the foundation of creating a successful (and personally fulfilling) practice. Without knowing this you won’t have a clear picture on the best way to talk to your ideal patients,

so that they listen and be engaged. You won’t know what to do for them, you won’t know what products and services to create for them and you won’t know where to reach them.

Step 1: Categorizing Your Current Patients The best place to begin to find your ideal patient is to start with what you have. You may have hundreds or even thousands of patients that have been through your doors over the years. Pick a random day’s patients load, maybe two days: one you remember as a great day and one you remember as a so-so or bad day.

Categorize your patients into categories ranging from best patients to worst patients and include a category for so-so patients.

Once you have everyone sorted out, gather your good patients and search for common threads. Why did they come to you? Are they all professionals? Blue-collar?

Single? Young? Old? Married? Moms? Do they all have a particular health concern? What is their insurance? What are their health attitudes?

There are no specific rules here, and after analyzing these patients you may discover that the unique factors in your ideal patient transcend age, sex, income, occupation, and other qualifiers: Your ideal patient maybe an attitudinal description.

One of my clients is a young family practice physician, and she enjoys working with young executives who are busy, on a tight schedule, and travel frequently. She caters to these executives locally and provides telemedical care for established patients while they are traveling. She has identified her ideal patient as an age range, income level, and lifestyle and is now catering to them.

Once you have all of the common threads sorted out, begin to create your ideal patient profile based on these traits. This profile will serve as a guide for you to speak to and find your ideal patients in your marketing efforts. Then begin to transform your practice physically in your office amenities and offer established and new services to meet the needs of your ideal patient.

In my previous example, my client who serves busy executives made sure her waiting room had free wireless Internet. She also offers these executives “walk-in” hours that our slightly earlier and slightly later than typical office hours. Her practice has coffee, tea, and bottled water available. She offers established patients telemedicine appointments when they are traveling.

moms, perhaps it is at schools or gyms with childcare? For business professionals, perhaps it is at Starbucks, chamber meetings or at large cubicle-filled corporations? If you are targeting seniors, maybe it is the local health fair?

One of my clients, a dermatologist, performed simple skin cancer screenings in a “feet on the ground” type of marketing plan for a large executive sales firm. She performed one afternoon of 31 exams and yielded 25 new ideal patients for her practice.

In addition to “feet on the ground” type initiatives or getting out in your community, you also want to look at online to determine where these patients are hanging out digitally. Since it simply isn’t possible to go through all of the places your ideal patient is collecting in droves in your community, closely examine a few places that you will need to be present online. This includes social media, websites, blogging, and stay-in-touch marketing vehicles.

Going back to my family practice client that works with executives, she used her stay in touch tactic to let her established patients know that she would be able to see them for telemedicine visits as they traveled. The work she did, literally staged her practice for success.

To sum it up, discovering and marketing your ideal patient is key to staging your practice for success by growing a successful and personally fulfilling practice. 

Step 2: Find where your ideal patients hang out, and be present there.

Start by taking a look at the common threads you found in your favorite patients to get ideas on where in your community you can begin to build a presence. For WWW.MEDMONTHLY.COM | 43

features

How to Build a Website That Will Propel Your Medical Practice to

Success

By Nisha Salim Freelance Writer NishaSalim.com 44 | APRIL 2014

Whether you have a small medical practice or a big multispecialty hospital, a website can be your central digital channel for marketing and reputation building.

Out of 85% of all adults who use the Internet in the United States, 72% look online for health information.

This presents a unique opportunity for medical practices to be visible and provide helpful information to potential customers.

Why does your practice need a website?

Out of the millions of users who search online for health-related information, a significant number is likely seeking to establish a medical relationship for specific advice and ongoing treatment. If the patient has been receiving helpful information from your website, it is only natural that they favor you to approach for treatment.

Traditional methods of finding a physician, such as word of mouth and insurance directories, are still quite popular, but it is becoming increasingly common for patients to choose physicians based on whom they find online.

With almost 3 billion Internet users all over the world, it would be foolish for any organization to opt out of an online presence. More than that, building a website that is professional, informative, friendly, and easy to navigate can bring you several other benefits such as the following: • Easy way of attracting new customers to your medical practice.

• Build a reputation by projecting through the website the attributes that you want your practice to be known for.

• Effectively communicate the mission, services available, location information, and directions to find the practice.

• Create an information resource to provide accurate medical information for existing and new patients.

• Improve productivity and reduce telephone time of staff by having a webpage for frequently asked questions.

• Create an enhanced professional image among other medical practices and physicians, and also attract the best talent to work for you.

• Provide an online reference point in written communication, online and off-line advertisements, business cards, and other marketing material.

How to build a medical practice website that will stand out

Your website must look as inviting and trustworthy as your physical practice does. Here are a few tips to help medical practices create and maintain websites that will stand out from the rest.

First impression is the best impression

Houses with the best curb appeal are the ones that attract the best price in the real estate market. How a practice or its website looks can play a vital role in creating the best first impression in the mind of a potential customer. The website must be appealing, easy to navigate, and reflect the values that you’re trying to communicate. Get the help of a professional website designer rather than attempting to do it on your own.

Make sure that you have the latest information on your website

It goes without saying that your website must have complete and accurate information about the location of the practice, and the services on offer. Display your contact information, including your address, clearly on every page. This will ensure that your website will appear on local search results.

Include a blog in your website

Search engines prioritize continually updated websites in their organic search results. One of the best ways to continually refresh information on your website is to blog frequently. Blogging is not just important in terms of catching the attention of search engines, but it is also an important tool to communicate with your existing and potential patients. Dr. Andrew Weil’s daily health tips blog is an excellent example of how blogging can be used to connect with and build trust with new and existing customers.

Patient education resources

As patients are relying more and more on the Internet for health information, it is only prudent to provide continued on page 46 WWW.MEDMONTHLY.COM | 45

features Optimize for search engines

continued from page 43

Search engine optimization is important to ensure that your website appears among the top search results for Google and other search engines. Once you have a website up and running, you may also want to register it with online hospital directories which list medical practices by location and specialty.

them with content that are relevant and aligned to the treatment plans that you offer. Build a resource on your website which is comprehensive enough so that your patient will not have to look elsewhere for anything that they want to find. By keeping them on your website, you are retaining them as well.

Patient registration and forms

Make it easy for the patients to consult with you by providing a facility to make appointments online. Let them also access important documents and forms from your website, no matter where they are. Registration forms for new visitors are especially helpful because they can fill it in at home before they actually come in for a consultation.

Upload a PDF version of your registration form on your website and put it under the new patient section to allow people to find it easily.

Ensure easy accessibility via other devices

Remember that websites are being accessed not only via computers, but also through mobile devices as well. Make sure that you are website is easily accessible through any device.

You don’t just build a website and then forget about it.

Review and update the information frequently. And always think about how you can use the website to connect with the most important person – your patient. 

Nisha Salim is a freelance writer who specializes in writing factually accurate, research-backed healthcare articles.

General science, education, social media and content marketing are her other areas of interest. Take a look at her website, NishaSalim.com, to learn more about her.

Eastern North Carolina Family Practice Available Well-appointed Eastern North Carolina Family Practice established in 2000 is for sale in Williamston, NC. This organized practice boasts a wide array of diagnostic equipment including a GE DEXA scanner with a new tube, GE case 8000 stress testing treadmill and controller and back up treadmill, Autoclave and full set of operating equipment, EKG-Ez EKG and much more.

The average number of patients seen daily is between 12 to 22.

The building is owned by MD and can be purchased or leased.

The owning physician is retiring and will assist as needed during the transition period. The gross receipts for the past three years are $650,000 and the list price was just reduced to $240,000.

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medlisting@gmail.com medicalpracticelistings.com 46 | APRIL 2014

the arts

Chip Thomas, a Doctor and Artist in Navajo Nation Physician Chip Thomas treats Navajo Nation citizens by day – and creates large-scale portraits of them by night.

By Stephanie Pearson

For the past 26 years, physician Chip Thomas has treated patients at a low-cost clinic on the Navajo Nation – but his greatest contribution may be his artwork. Scattered across the U.S.’s largest Native American–governed territory – the 27,400-square-mile Nation encompasses sections of Arizona, Utah, and New Mexico – Thomas’ building-size black-and-white portraits of Navajo people adorn water tanks, abandoned barns, and any other surface he can find.

Disintegrating in the desert’s triple-degree heat, the images reflect a community struggling to survive on one of the country’s most violent reservations (last year, the Nation’s police received four unrelated homicide calls in a single day). While Thomas, 56, has gained worldwide recognition for his images, he forgoes a full-time art career for the one he has – treating Navajo patients. “Both are attempting to restore balance and create beauty,” he says of his medical practice and artwork. “One just happens to be more fun.”

Thomas’ path from physician to artist has been a wandering one. Born in Raleigh, North Carolina, as the lone son of an African-American doctor, he eventually attended Nashville’s Meharry Medical College and then spent his residency summers leading first-aid teams to Liberia. “When my plane touched down in Africa in 1985, I knelt on the ground and kissed it,” Thomas says. “Being there was part of a political awakening for me.” After 48 | APRIL 2014

medical school, Thomas decided to pursue universal health care in the U.S. and soon realized he had three job options: at a veteran’s hospital, a prison, or an Indian reservation. In 1987, he signed a four-year contract to work on the Navajo Nation. “I saw myself returning to a developing country,” Thomas says, “but started to appreciate the parallels between here and Africa.”

Almost three decades later, Thomas is still on the reservation and has a 16-year-old half-Navajo son. Most

the reservation. “It was an interesting predicament not to be the most outstanding element on the landscape – I can’t compete with Monument Valley,” Gaia, a Smithsonian National Portrait Gallery artist, says. “What Chip does is very courageous. It speaks to the community and is simultaneously provocative.”

Despite the acclaim, Thomas downplays his own achievements, preferring to let the work speak for itself. “I’m just a wannabe hipster in a way isolated spot,” he says. 

everyone knows Thomas by name – he’s either delivered their babies or photographed their cousins. Often wearing salmon-colored pants and flying-saucer socks, he lives in a government-issued house stocked with a drum set, an Eames molded-plywood chair, and floor-to-ceiling art. In 1992, a photo of Thomas (in dreadlocks) treating an elderly Navajo woman ran in the Patagonia catalog. The widely seen image led to an invitation to join AfricaTrek, a 12,107mile cycling trip the length of the continent, which earned Thomas and his team a Guinness world record. “I like to call it cosmic affirmative action,” he says of his eclectic résumé.

To avoid burnout, in 2009 Thomas took a vacation in Brazil and came across the work of a French artist who pastes giant photographs of Rio de Janeiro citizens on favela shacks. Thomas was inspired to create his own version on the reservation. “My work as a physician brings me happiness,” he says, “but at times it depresses me. My objective with my art is to restore and reflect back the beauty I’ve witnessed.”

While the Navajo have long been averse to photographs – the tribe believes the images will steal their souls – Thomas asks his subjects for permission before shooting them, blowing up their images on bond paper and pasting them onto buildings. Amid the austere landscape, the outsize artwork has a gravity unattainable in any gallery. The images change daily with the elements, deteriorating from exact replicas to impressionistic mirages until disappearing completely. Thomas’ work has begun attracting attention beyond the reservation – street artists worldwide know him by his tag name, Jetsonorama; he was recently invited to collaborate with local Navajo as part of a nationwide Honor the Treaties project; and other artists have traveled to collaborate with him on

Source: http://www.mensjournal.com/magazine/chipthomas-a-doctor-and-artist-in-navajo-nation-20131029 View more of Dr. Chip Thomas’ artwork at his website: www.speakingloudandsayingnothing.blogspot.com

WWW.MEDMONTHLY.COM | 49

healthy living

Barbecue Chicken Chop

Salad

Ingredients: Salad:

44 ounces boneless chicken-breast halves, visible fat 1 teaspoon olive oil Salt and pepper to taste 4 tablespoons barbecue sauce 10 cups finely shredded romaine lettuce 2 cups seeded, diced, chopped tomatoes 1 ½ cups seeded, diced cucumber 2 cups diced zucchini 2 ounces light cheddar cheese, finely shredded ½ cup chopped red onion

Vinaigrette:

¼ cup balsamic vinegar 2 tablespoons Dijon mustard 1 tablespoon honey 2 tablespoons extra virgin olive oil 2 tablespoons finely chopped fresh basil leaves pinch salt Black pepper to taste Recipe from Fitness Magazine Makes 4 servings

50 | APRIL 2014

By Ashley Acornley, MS, RD, LDN

Preparation: 1. Preheat the grill to high heat. Place the chicken between two sheets of plastic wrap or waxed paper on a cutting board. Using the flat head of a meat mallet (or a rolling pin), pound the chicken until it is 1/2 inch thick.

Rub each breast with the olive oil, salt and pepper. Grill 3 to 5 minutes per side, or until cooked through. Let chicken cool.

2. Whisk together the vinegar, mustard and honey. Slowly whisk in the oil. Stir in the basil and season with salt and pepper. Chop the chicken and transfer it to a medium bowl. Mix in the barbecue sauce and stir to coat. In a large serving bowl, toss the lettuce, tomatoes, cucumber, zucchini, cheddar, red onions, and dressing. Top with the chicken and serve.

Providing customized, simple

NUTRITION SOLUTIONS to

ENHANCE HEALTH and

OPTIMIZE SPORTS PERFORMANCE Tracy Owens, MPH, RD, CSSD, LDN Ashley Acornley, MS, RD, LDN 4030 Wake Forest Road, Suite 300 Raleigh, NC 27609 919-876-9779

Blue Cross Blue Shield of North Carolina and Cigna insurance provider.

WWW.MEDMONTHLY.COM | 51

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U.S. OPTICAL BOARDS Alaska P.O. Box 110806 Juneau, AK 99811 (907)465-5470 http://www.dced.state.ak.us/occ/pdop.htm

Idaho 450 W. State St., 10th Floor Boise , ID 83720 (208)334-5500 www2.state.id.us/dhw

Oregon 3218 Pringle Rd. SE Ste. 270 Salem, OR 97302 (503)373-7721 www.obo.state.or.us

Arizona 1400 W. Washington, Rm. 230 Phoenix, AZ 85007 (602)542-3095 http://www.do.az.gov

Kentucky P.O. Box 1360 Frankfurt, KY 40602 (502)564-3296 http://bod.ky.gov

Arkansas P.O. Box 627 Helena, AR 72342 (870)572-2847

Massachusetts 239 Causeway St. Boston, MA 02114 (617)727-5339 http://1.usa.gov/zbJVt7

Rhode Island 3 Capitol Hill, Rm 104 Providence, RI 02908 (401)222-7883 http://sos.ri.gov/govdirectory/index.php? page=DetailDeptAgency&eid=260

California 2005 Evergreen St., Ste. 1200 Sacramento, CA 95815 (916)263-2382 www.medbd.ca.gov Colorado 1560 Broadway St. #1310 Denver, CO 80202 (303)894-7750 http://www.dora.state.co.us/optometry/ Connecticut 410 Capitol Ave., MS #12APP P.O. Box 340308 Hartford, CT 06134 (860)509-7603 ext. 4 http://www.dph.state.ct.us/ Florida 4052 Bald Cypress Way, Bin C08 Tallahassee, FL 32399 (850)245-4474 doh.state.fl.us Georgia 237 Coliseum Dr. Macon, GA 31217 (478)207-1671 www.sos.state.ga.us Hawaii P.O. Box 3469 Honolulu, HI 96801 (808)586-2704 optician@dcca.hawaii.gov

Nevada P.O. Box 70503 Reno, NV 89570 (775)853-1421 http://nvbdo.state.nv.us/ New Hampshire 129 Pleasant St. Concord, NH 03301 (603)271-5590 www.state.nh.us New Jersey P.O. Box 45011 Newark, NJ 07101 (973)504-6435 http://www.njconsumeraffairs.gov/ ophth/ New York 89 Washington Ave., 2nd Floor W. Albany, NY 12234 (518)402-5944 http://www.op.nysed.gov/prof/od/ North Carolina P.O. Box 25336 Raleigh, NC 27611 (919)733-9321 http://www.ncoptometry.org/ Ohio 77 S. High St. Columbus, OH 43266 (614)466-9707 http://optical.ohio.gov/

South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4665 www.llr.state.sc.us Tennessee Heritage Place Metro Center 227 French Landing, Ste. 300 Nashville, TN 37243 (615)253-6061 http://health.state.tn.us/boards/do/ Texas P.O. Box 149347 Austin, TX 78714 (512)834-6661 www.roatx.org Vermont National Life Bldg N FL. 2 Montpelier, VT 05620 (802)828-2191 http://vtprofessionals.org/opr1/ opticians/ Virginia 3600 W. Broad St. Richmond, VA 23230 (804)367-8500 www.state.va.us/licenses Washington 300 SE Quince P.O. Box 47870 Olympia, WA 98504 (360)236-4947 http://www.doh.wa.gov/LicensesPermitsandCertificates/MedicalCommission. aspx

WWW.MEDMONTHLY.COM | 53

U.S. DENTAL BOARDS Alabama Alabama Board of Dental Examiners 5346 Stadium Trace Pkwy., Ste. 112 Hoover, AL 35244 (205) 985-7267 http://www.dentalboard.org/ Alaska P.O. Box 110806 Juneau, AK 99811-0806 (907)465-2542 http://bit.ly/uaqEO8 Arizona 4205 N. 7th Ave. Suite 300 Phoenix, AZ 85103 (602)242-1492 http://azdentalboard.us/ Arkansas 101 E. Capitol Ave., Suite 111 Little Rock, AR 72201 (501)682-2085 http://www.asbde.org/ California 2005 Evergreen Street, Suite 1550Â Sacramento, CA 95815 877-729-7789 http://www.dbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7800 http://www.dora.state.co.us/dental/ Connecticut 410 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/site/default.asp Delaware Cannon Building, Suite 203 861 Solver Lake Blvd.

Dover, DE 19904 (302)744-4500 http://1.usa.gov/t0mbWZ Florida 4052 Bald Cypress Way Bin C-08 Tallahassee, FL 32399 (850)245-4474 http://bit.ly/w1m4MI 54

| APRIL 2014

Georgia 237 Coliseum Drive Macon, GA 31217 (478)207-2440 http://sos.georgia.gov/plb/dentistry/ Hawaii DCCA-PVL Att: Dental P.O. Box 3469 Honolulu, HI 96801 (808)586-3000 http://1.usa.gov/s5Ry9i Idaho P.O. Box 83720 Boise, ID 83720 (208)334-2369 http://isbd.idaho.gov/ Illinois 320 W. Washington St. Springfield, IL 62786 (217)785-0820 http://bit.ly/svi6Od Indiana 402 W. Washington St., Room W072 Indianapolis, IN 46204 (317)232-2980 http://www.in.gov/pla/dental.htm Iowa 400 SW 8th St. Suite D Des Moines, IA 50309 (515)281-5157 http://www.state.ia.us/dentalboard/ Kansas 900 SW Jackson Room 564-S Topeka, KS 66612 (785)296-6400 http://www.accesskansas.org/kdb/ Kentucky 312 Whittington Parkway, Suite 101 Louisville, KY 40222 (502)429-7280 http://dentistry.ky.gov/ Louisiana 365 Canal St., Suite 2680 New Orleans, LA 70130 (504)568-8574 http://www.lsbd.org/

Maine 143 State House Station 161 Capitol St. Augusta, ME 04333 (207)287-3333 http://www.mainedental.org/ Maryland 55 Wade Ave. Catonsville, Maryland 21228 (410)402-8500 http://dhmh.state.md.us/dental/ Massachusetts 1000 Washington St., Suite 710 Boston, MA 02118 (617)727-1944 http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/ dentist/ Michigan P.O. Box 30664 Lansing, MI 48909 (517)241-2650 http://www.michigan.gov/lara/0,4601,7154-35299_28150_27529_27533---,00. html Minnesota 2829 University Ave., SE. Suite 450 Minneapolis, MN 55414 (612)617-2250 http://www.dentalboard.state.mn.us/ Mississippi 600 E. Amite St., Suite 100 Jackson, MS 39201 (601)944-9622 http://bit.ly/uuXKxl Missouri 3605 Missouri Blvd.

P.O. Box 1367 Jefferson City, MO 65102 (573)751-0040 http://pr.mo.gov/dental.asp Montana P.O. Box 200113 Helena, MT 59620 (406)444-2511 http://bsd.dli.mt.gov/license/bsd_ boards/den_board/board_page.asp

Nebraska 301 Centennial Mall South Lincoln, NE 68509 (402)471-3121 http://dhhs.ne.gov/publichealth/Pages/ crl_medical_dent_hygiene_board.aspx

Ohio Riffe Center 77 S. High St.,17th Floor Columbus, OH 43215 (614)466-2580 http://www.dental.ohio.gov/

Nevada 6010 S. Rainbow Blvd. Suite A-1 Las Vegas, NV 89118 (702)486-7044 http://www.nvdentalboard.nv.gov/

Oklahoma 201 N.E. 38th Terr., #2 Oklahoma City, OK 73105 (405)524-9037 http://www.dentist.state.ok.us/

New Hampshire 2 Industrial Park Dr. Concord, NH 03301 (603)271-4561 http://www.nh.gov/dental/

Oregon 1600 SW 4th Ave. Suite 770 Portland, OR 97201 (971)673-3200 http://www.oregon.gov/Dentistry/

New Jersey P.O Box 45005 Newark, NJ 07101 (973)504-6405 http://bit.ly/uO2tLg

Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)783-7162 http://bit.ly/s5oYiS

New Mexico Toney Anaya Building 2550 Cerrillos Rd. Santa Fe, NM 87505 (505)476-4680 http://www.rld.state.nm.us/boards/Dental_Health_Care.aspx

Rhode Island Dept. of Health Three Capitol Hill, Room 104 Providence, RI 02908 (401)222-2828 http://1.usa.gov/u66MaB

New York 89 Washington Ave. Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/prof/dent/

South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4599 http://www.llr.state.sc.us/POL/Dentistry/

North Carolina 507 Airport Blvd., Suite 105 Morrisville, NC 27560 (919)678-8223 http://www.ncdentalboard.org/

South Dakota P.O. Box 1079 105. S. Euclid Ave. Suite C Pierre, SC 57501 (605)224-1282 https://www.sdboardofdentistry.com/

North Dakota P.O. Box 7246 Bismark, ND 58507 (701)258-8600 http://www.nddentalboard.org/

Tennessee 227 French Landing, Suite 300 Nashville, TN 37243 (615)532-3202 http://health.state.tn.us/boards/dentistry/

Texas 333 Guadeloupe St. Suite 3-800 Austin, TX 78701 (512)463-6400 http://www.tsbde.state.tx.us/ Utah 160 E. 300 South Salt Lake City, UT 84111 (801)530-6628 http://1.usa.gov/xMVXWm Vermont National Life Building North FL2 Montpelier, VT 05620 (802)828-1505 http://bit.ly/zSHgpa Virginia Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4538 http://www.dhp.virginia.gov/dentistry Washington 310 Israel Rd. SE P.O. Box 47865 Olympia, WA 98504 (360)236-4700 http://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/Dentist.aspx West Virginia 1319 Robert C. Byrd Dr. P.O. Box 1447 Crab Orchard, WV 25827 1-877-914-8266 http://www.wvdentalboard.org/ Wisconsin P.O. Box 8935 Madison, WI 53708 1(877)617-1565 http://dsps.wi.gov/Default. aspx?Page=90c5523f-bab0-4a45-ab943d9f699d4eb5 Wyoming 1800 Carey Ave., 4th Floor Cheyenne, WY 82002 (307)777-6529 http://plboards.state.wy.us/dental/index.asp WWW.MEDMONTHLY.COM | 55

U.S. MEDICAL BOARDS Alabama P.O. Box 946 Montgomery, AL 36101 (334)242-4116 http://www.albme.org/ Alaska 550 West 7th Ave., Suite 1500 Anchorage, AK 99501 (907)269-8163 http://bit.ly/zZ455T Arizona 9545 E. Doubletree Ranch Rd. Scottsdale, AZ 85258 (480)551-2700 http://www.azmd.gov Arkansas 1401 West Capitol Ave., Suite 340 Little Rock, AR 72201 (501)296-1802 http://www.armedicalboard.org/ California 2005 Evergreen St., Suite 1200 Sacramento, CA 95815 (916)263-2382 http://www.mbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7690 http://www.dora.state.co.us/medical/ Connecticut 401 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/site/default.asp Delaware Division of Professional Regulation Cannon Building 861 Silver Lake Blvd., Suite 203 Dover, DE 19904 (302)744-4500 http://dpr.delaware.gov/ District of Columbia 899 North Capitol St., NE Washington, DC 20002 (202)442-5955 http://www.dchealth.dc.gov/doh 56 | APRIL 2014

Florida 2585 Merchants Row Blvd.

Tallahassee, FL 32399 (850)245-4444 http://www.stateofflorida.com/Portal/ DesktopDefault.aspx?tabid=115

Louisiana LSBME P.O. Box 30250 New Orleans, LA 70190 (504)568-6820 http://www.lsbme.la.gov/

Georgia 2 Peachtree Street NW, 36th Floor Atlanta, GA 30303 (404)656-3913 http://bit.ly/vPJQyG

Maine 161 Capitol Street 137 State House Station Augusta, ME 04333 (207)287-3601 http://bit.ly/hnrzp

Hawaii DCCA-PVL P.O. Box 3469 Honolulu, HI 96801 (808)587-3295 http://hawaii.gov/dcca/pvl/boards/medical/

Maryland 4201 Patterson Ave. Baltimore, MD 21215 (410)764-4777 http://www.mbp.state.md.us/

Idaho Idaho Board of Medicine P.O. Box 83720 Boise, Idaho 83720 (208)327-7000 http://bit.ly/orPmFU

Massachusetts 200 Harvard Mill Sq., Suite 330 Wakefield, MA 01880 (781)876-8200 http://www.mass.gov/eohhs/gov/departments/borim/

Illinois 320 West Washington St. Springfield, IL 62786 (217)785 -0820 http://www.idfpr.com/profs/info/Physicians.asp

Michigan Bureau of Health Professions P.O. Box 30670 Lansing, MI 48909 (517)335-0918 http://www.michigan.gov/lara/0,4601,7154-35299_28150_27529_27541-58914-,00.html

Indiana 402 W. Washington St. #W072 Indianapolis, IN 46204 (317)233-0800 http://www.in.gov/pla/ Iowa 400 SW 8th St., Suite C Des Moines, IA 50309 (515)281-6641 http://medicalboard.iowa.gov/ Kansas 800 SW Jackson, Lower Level, Suite A Topeka, KS 66612 (785)296-7413 http://www.ksbha.org/ Kentucky 310 Whittington Pkwy., Suite 1B Louisville, KY 40222 (502)429-7150 http://kbml.ky.gov/default.htm

Minnesota University Park Plaza 2829 University Ave. SE, Suite 500 Minneapolis, MN 55414 (612)617-2130 http://bit.ly/pAFXGq Mississippi 1867 Crane Ridge Drive, Suite 200-B Jackson, MS 39216 (601)987-3079 http://www.msbml.state.ms.us/ Missouri Missouri Division of Professional Registration 3605 Missouri Blvd.

P.O. Box 1335 Jefferson City, MO 65102 (573)751-0293 http://pr.mo.gov/healingarts.asp

Montana 301 S. Park Ave. #430 Helena, MT 59601 (406)841-2300 http://bsd.dli.mt.gov/license/bsd_ boards/med_board/board_page.asp Nebraska Nebraska Department of Health and Human Services P.O. Box 95026 Lincoln, NE 68509 (402)471-3121 http://www.mdpreferredservices.com/ state-licensing-boards/nebraska-boardof-medicine-and-surgery Nevada Board of Medical Examiners P.O. Box 7238 Reno, NV 89510 (775)688-2559 http://www.medboard.nv.gov/ New Hampshire New Hampshire State Board of Medicine 2 Industrial Park Dr. #8 Concord, NH 03301 (603)271-1203 http://www.nh.gov/medicine/ New Jersey P. O. Box 360 Trenton, NJ 08625 (609)292-7837 http://bit.ly/w5rc8J New Mexico 2055 S. Pacheco St. Building 400 Santa Fe, NM 87505 (505)476-7220 http://www.nmmb.state.nm.us/ New York Office of the Professions State Education Building, 2nd Floor Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/ North Carolina P.O. Box 20007 Raleigh, NC 27619 (919)326-1100 http://www.ncmedboard.org/

North Dakota 418 E. Broadway Ave., Suite 12 Bismarck, ND 58501 (701)328-6500 http://www.ndbomex.com/

Texas P.O. Box 2018 Austin, TX 78768 (512)305-7010 http://bit.ly/rFyCEW

Ohio 30 E. Broad St., 3rd Floor Columbus, OH 43215 (614)466-3934 http://med.ohio.gov/

Utah P.O. Box 146741 Salt Lake City, UT 84114 (801)530-6628 http://www.dopl.utah.gov/

Oklahoma P.O. Box 18256 Oklahoma City, OK 73154 (405)962-1400 http://www.okmedicalboard.org/

Vermont P.O. Box 70 Burlington, VT 05402 (802)657-4220 http://1.usa.gov/wMdnxh

Oregon 1500 SW 1st Ave., Suite 620 Portland, OR 97201 (971)673-2700 http://www.oregon.gov/OMB/

Virginia Virginia Dept. of Health Professions Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4400 http://1.usa.gov/xjfJXK

Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)787-8503 http://www.dos.state.pa.us/portal/server. pt/community/state_board_of_medicine/12512 Rhode Island 3 Capitol Hill Providence, RI 02908 (401)222-5960 http://1.usa.gov/xgocXV South Carolina P.O. Box 11289 Columbia, SC 29211 (803)896-4500 http://www.llr.state.sc.us/pol/medical/ South Dakota 101 N. Main Ave. Suite 301 Sioux Falls, SD 57104 (605)367-7781 http://www.sdbmoe.gov/ Tennessee 425 5th Ave. North Cordell Hull Bldg. 3rd Floor Nashville, TN 37243 (615)741-3111 http://health.state.tn.us/boards/me/

Washington Public Health Systems Development Washington State Department of Health 101 Israel Rd. SE, MS 47890 Tumwater, WA 98501 (360)236-4085 http://www.medlicense.com/washingtonmedicallicense.html West Virginia 101 Dee Dr., Suite 103 Charleston, WV 25311 (304)558-2921 http://www.wvbom.wv.gov/ Wisconsin P.O. Box 8935 Madison, WI 53708 (877)617-1565 http://drl.wi.gov/board_detail. asp?boardid=35&locid=0 Wyoming 320 W. 25th St., Suite 200 Cheyenne, WY 82002 (307)778-7053 http://wyomedboard.state.wy.us/

WWW.MEDMONTHLY.COM | 57

medical resource guide Urgent Care & Occupational Medicine Consultant

ACCOUNTING Boyle CPA, PLLC 3716 National Drive, Suite 206 Raleigh, NC 27612 (919) 720-4970 www.boyle-cpa.com

Lawrence Earl, MD COO/CMO ASAP Urgentcare Medical Director, NADME.org 908-635-4775 (m) 866-405-4770 (f ) http://www.asap-urgentcare.com/ UrgentCareMentor.com

EQUIPMENT APPRAISER Brumbaugh Appraisals 8601 Six Forks Road, Suite 400, Raleigh, NC 27615 (919) 870-8258 www.brumbaughappraisals.com

Utilization Solutions service@pushpa.biz (919) 289-9126

ADVERTISING

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MedMedia9

PO Box 98313 Raleigh, NC 27624 (919)747-9031

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BILLING & COLLECTION

Biomet 3i

4555 Riverside Dr. Palm Beach Gardens, FL 33410 (800)342-5454 www.biomet3i.com

Dental Management Club Applied Medical Systems, Inc. Billing - Coding - Practice Solutions 4220 NC Hwy 55, Suite 130B Durham, NC 27713 (800) 334-6606 www.ams-nc.com

CODING SPECIALISTS Place Your Ad Here

CONSULTING SERVICES, PRACTICE MANAGEMENT Physician Wellness Services 5000 West 36th Street, Suite 240 Minneapolis, MN 55416 888.892.3861 www.physicianwellnessservices.com

Urgent Care America

17595 S. Tamiami Trail Fort Meyers, FL 33908 (239)415-3222 www.urgentcareamerica.net

58 | APRIL 2014

EXECUTIVE ACCOUNTING & FINANCE RECRUITER Accounting Professionals Agency, LLC Adrienne Aldridge, CPA, CGMA, FLMI President 1204 Benoit Place Apex, NC 27502 (919) 924-4476 aaldridge@AccountingProfessioinals Agency.com

4924 Balboa Blvd #460 Encino, CA 91316 www.dentalmanagementclub.com

www.AccountingProfessionalsAgency.com

The Dental Box Company, Inc.

FINANCIAL CONSULTANTS

PO Box 101430 Pittsburgh, PA 15237 (412)364-8712 www.thedentalbox.com

DIETICIAN Triangle Nutrition Therapy 4030 Wake Forest Road, Suite 300 Raleigh, NC 27609 (919)876-9779 http://trianglediet.com/

ELECTRONIC MED. RECORDS

Sigmon Daknis Wealth Management 701 Town Center Dr. , Ste. #104 Newport News, VA 23606 (757)223-5902 www.sigmondaknis.com

INSURANCE, MED. LIABILITY Jones Insurance 820 Benson Rd. Garner, North Carolina 27529 (919) 772-0233 www.Jones-insurance.com

AdvancedMD 10011 S. Centennial Pkwy Sandy, UT 84070 (800) 825-0224 www.advancedmd.com

CollaborateMD 201 E. Pine St. #1310 Orlando, FL 32801 (888)348-8457 www.collaboratemd.com

LOCUM TENENS Physician Solutions

PO Box 98313 Raleigh, NC 27624 (919)845-0054 www.physiciansolutions.com

medical resource guide MEDICAL ARCHITECTS MMA Medical Architects

520 Sutter Street San Francisco, CA 94115 (415) 346-9990 http://www.mmamedarc.com

MEDICAL MARKETING

Bank of America

MedMedia9

PO Box 98313 Raleigh, NC 27624 (919)747-9031 www.medmedia9.com

WhiteCoat Designs

Web, Print & Marketing Solutions for Doctors (919)714-9885 www.whitecoat-designs.com

MEDICAL ART

PRACTICE FINANCING

Mark MacKinnon, Regional Sales Manager 3801 Columbine Circle Charlotte, NC 28211 (704)995-9193 mark.mackinnon@bankofamerica.com www.bankofamerica.com/practicesolutions

REAL ESTATE

Deborah Brenner

877 Island Ave #315 San Diego, CA 92101 (619)818-4714 www.deborahbrenner.com

MedImagery

Laura Maaske 262-308-1300 Laura@medimagery.com http://www.medimagery.com

MEDICAL EQUIPMENT Assured Pharmaceuticals Matthew Hall (704)419-3005 mhall@assuredpharma.com

MEDICAL PRACTICE SALES Medical Practice Listings

8317 Six Forks Rd. Ste #205 Raleigh, NC 27624 (919)848-4202 www.medicalpracticelistings.com

MEDICAL PRACTICE VALUATIONS

PO Box 99488 Raleigh, NC 27624 (919)846-4747 www.bizscorevaluation.com

Tarheel Physicians Supply 1934 Colwell Ave. Wilmington, NC 28403 (800)672-0441

MEDICAL PUBLISHING www.thetps.com

MEDICAL EQUIPMENT FINANCING Bank of America

Mark MacKinnon, Regional Sales Manager 3801 Columbine Circle Charlotte, NC 28211 (704)995-9193 mark.mackinnon@bankofamerica.com www.bankofamerica.com/practicesolutions

Headquarters & Property Management 1900 Cameron Street Raleigh, NC 27605 (919) 821-1350 Commercial Sales & Leasing (919) 821-7177 www.yorkproperties.com

STAFFING COMPANIES Additional Staffing Group, Inc. 8319 Six Forks Rd, Suite 103 Raleigh, NC 27615 (919) 844-6601 Astaffinggroup.com

BizScore

www.assurepharma.com

York Properties, Inc.

MedMedia9

PO Box 98313 Raleigh, NC 27624 (919)747-9031 www.medmedia9.com

MEDICAL RESEARCH

SUPPLIES, GENERAL CNF Medical 1100 Patterson Avenue Winston Salem, NC 27101 (877)631-3077 www.cnfmedical.com

Gebauer Company

4444 East 153rd St. Cleveland, OH 44128-2955 (216)581-3030 www.gebauerspainease.com

WEBSITE DESIGN

Scynexis, Inc.

3501 C Tricenter Blvd.

Durham, NC 27713 (919) 933-4990

MedMedia9 www.scynexis.com

PO Box 98313 Raleigh, NC 27624 (919)747-9031 www.medmedia9.com WWW.MEDMONTHLY.COM | 59

classified listings

Classified To place a classified ad, call 919.747.9031

Physicians needed North Carolina GP Needed Immediately On-Going 3 Days Per Week at Occupational Clinic . General Practictioner needed on-going 3 days per week at occupational clinic in Greensboro, NC. Numerous available shifts for October.

Averages 25 patients per day with no call and shift hours from 8:30 am to 5:30 pm. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com 3-5 days per week in Durham, NC . Geriatric physician needed immediately 3-5 days per week, on-going at nursing home in Durham. Nursing home focuses on therapy and nursing after patients are released from the hospital. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com GP Needed Immediately On-Going 1-3 Days Per Week at Addictive Disease Clinics located in Charlotte, Hickory, Concord & Marion North Carolina. General Practitioner with a knowledge or interest in addictive disease. Needed in October on-going 1-3 times per week. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Primary Care Physician in Northwest NC (multiple locations). Primary care physician needed immediately for ongoing coverage at one of the largest substance abuse treatment facilities in NC. Doctor will be responsible for new patient evaluations and supportive aftercare. Counseling and therapy are combined with physician’s medical assessment and care for the treatment of adults, adolescents and families. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Pediatrician or Family Medicine Doctor in Fayetteville Comfortable with seeing children. Need is immediate - Full time ongoing for maternity leave. 8 am - 5 pm.

Outpatient only. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

60 | APRIL 2014

Immediate need for full time GP/FP for urgent cares in eastern NC. Urgent care centers from Raleigh to the eastern coast of NC seek immediate primary care physician. Full time opportunity with possibility for permanent placement. Physician Solutions, PH: (919) 845-0054, email: physiciansolutions@gmail.com General Practitioner Needed in Greensboro. Occupational health care clinic seeks general practitioner for disability physicals ongoing 1-3 days a week. Adults only. 8 am-5 pm. No call required. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Pediatrician or Family Physician Needed Immediately at clinic in Roanoke Rapids, NC. Pediatric clinic in Roanoke Rapids, NC seeks Peds physician or FP comfortable with children for 2-3 months/on-going/full-time.

The chosen physician will need to be credentialed through the hospital, please email your CV, medical license and DEA so we can fill this position immediately. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Occupational Clinic in Greensboro, NC seeks FP/GP for On-Going Shifts. Locum tenens position (4-5 days a week) available for an occupational, urgent care and walk in clinic. The practice is located in Greensboro NC. Hours are 8 am-5 pm. Approximately 20 patients/ day. Excellent staff. Outpatient only. physiciansolutions@gmail.com Diabetic Clinic 1 hour from Charlotte seeks FP/GP/ IM for On-Going Shifts.Primary care physician needed immediately for outpatient diabetic clinic one hour outside Charlotte, NC On-going. Hours are 8 am -5 pm with no call. Approximately 15-20 patients a day. Call or email for more information. 919-845-0054 physiciansolutions@gmail.com Clinic between Fayetteville and Wilmington seeks FP/ GP/IM Mar 22 FT ongoing. A small hospital’s outpatient clinic located within an hour of both Fayetteville and Wilmington seeks PA to work FT ongoing beginning March 22. Shifts can be either 8 or 12 hours. No call. email: physiciansolutions@gmail.com

Classified To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Addictive Disease Clinic in Charlotte, NC and surrounding cities seeks GP/FP/IM for on-going shifts An addictive disease clinic with locations with locations in Charlotte, NC and surrounding cities seeks a GP with an interest in addictive medicine for on-going shifts. This clinic has 15-25 open shifts every month and we are looking to bring on a new doctor for consistent coverage. The average daily patient load is between 20 and 25 with shifts from 8 am - 5 pm and 6 am - 2 pm. If you are interested in this position please send us your CV and feel free to contact us via email or phone with questions or to learn about other positions.

Physician Solutions, PH: (919) 845-0054, email: physiciansolutions@gmail.com

FT/PT Mid-Level Provider needed for Wilmington practice immediately. Small internal medicine private practice 45 minutes outside Wilmington seeks mid-level provider starting immediately. FT/PT. M-F 8:00-5:00.

Possible permanent placement. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Asheboro Family Practice and Urgent Care seeks GP for intermittent coverage. Family Practice and Urgent Care seeks general practitioner for intermittent days from 8a-8p. Provider will see about 35 patients with no call. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Greensboro occupational health care clinic seeksgeneral practitioner for intermittent shifts. Primary care physicians needed for occupational medicine. Adults only. Hours are 8am-5pm. Large corporation, no call required. Please contact Physician Solutions at 919-8450054 or email: physiciansolutions@gmail.com.

Child Health Clinic in Statesville, NC seeks pediatrician or Family Physician comfortable with peds for on-going, full-time shifts. Physician will work M-F 8 am - 5 pm, ongoing. Qualified physician will know EMR or Allscripts software. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

IM/FP needed in Fayetteville clinic immediately. Fayetteville health department needs coverage March through June full or part time. Patients adult health and women’s health. Adults only. No call 8a-5p.

Please contact Physician Solutions at 919-845-0054 or email: physiciansolutions@gmail.com.

Peds Clinic near Raleigh seeks Mid-Level Provider for on-going coverage 4x/wk. Health Department pediatrics clinic 45 min from Raleigh needs coverage 4 days a week from January through June. Provider will see about 20 patients daily, hours are 8am-5pm with an hour for lunch. Please contact Physician Solutions at 919-8450054 or email: physiciansolutions@gmail.com.

Geriatric physician needed immediately 2 to 5 days per week, on-going eastern NC. Nursing homes in Durham, Fayetteville and Rocky Mount seek GP/IM/ FP with geriatric experience to work full or part time.

Nursing home focuses on therapy and nursing after patients are released from the hospital. 8a-5p, no call.

Please contact Physician Solutions at 919-845-0054 or email: physiciansolutions@gmail.com.

FT Mid-Level Provider needed for Wilmington practice immediately. Small private practice 45 minutes outside Wilmington seeks mid-level provider starting January.

M-F 8:00-5:00, PT or FT. This practice also is looking for a PA permanently in April. Accommodations, PLI, and mileage provided. Please contact Physician Solutions at 919-845-0054 or email: physiciansolutions@gmail.com.

Employee Health Clinic seeks Mid-Level Provider for FT on-going coverage near Charlotte. Practice 45 minutes from Charlotte seeks on-going coverage for employee health clinic beginning in March. Provider will see about 20-24 patients daily, hours are 8am-5pm with an hour for lunch. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Nursing home in Durham seeks PT/FT NP/PA for immediate ongoing scheduling. Durham nursing home seeks part time or full time mid-level for ongoing locums.

Must have geriatric experience. 8-5p. Other facilities in Fayetteville and Rocky Mount. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

continued on page 63 WWW.MEDMONTHLY.COM |61

Modern Med Spa Available

Located in beautiful coastal North Carolina Modern, well-appointed med spa is available in the eastern part of the state. This Spa specializes in BOTOX, facial therapy and treatments, laser hair removal, eye lash extensions and body waxing as well as a menu of anti-aging options. This impressive practice is perfect as-is and can accommodate additional services like; primary health or dermatology.

The Gross revenue is over $1,500.000 during 2012 with consistent high revenue numbers for the past several years. The average number of patients seen daily is between 26 and 32 with room for improvement. You will find this Med Spa to be in a highly visible location with upscale amenities. The building is leased and the lease can be assigned or restructured. Highly profitable and organized, this spa POISED FOR SUCCESS. 919.848.4202 medlisting@gmail.com medicalpracticelistings.com

classified listings

Classified

continued from page 61

To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Fayetteville occupational health care clinic seeks GP for May. Primary care physicians needed for occupational medicine. Adults only. 8-5p. Large corporation, no call required. Intermittent dates in the future and second office in Greensboro with ongoing scheduling.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Nursing home in Durham seeks PT/FT Geriatrics doctor for immediate ongoing scheduling. Durham nursing home seeks part time or full time MD for ongoing locums. Must have geriatric experience. 8-5p. Other facilities in Fayetteville and Rocky Mount. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Practice 1 h SE of Raleigh seeks coverage.

Goldsboro FP seeks MD for July 6-7 and intermittent shifts. 8-5p. Please contact Physician Solutions at 919845-0054 or email physiciansolutions@gmail.com.

Pediatric clinic near Greensboro needs 10 weeks of 3 day a week coverage beginning June 1. Burlington pediatric clinic seeks coverage June 1 3 days a week for 10 weeks. 8-5p. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Greenville Clinic seeks GP. GP/IM needed for intermittent shifts. Must have experience or be willing to do pain management and trigger point injections. 8-5p.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Raleigh practice seeks BC FP for permanent placement in new facility summer 2013. Board Certified Family Practitioner sought for FT permanent placement in new clinic in Raleigh to start summer of 2013.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Clinic between Fayetteville and Wilmington seeks FP/ GP/IM Mar 22 FT ongoing . A small hospital’s outpatient clinic located within an hour of both Fayetteville and Wilmington seeks PA to work FT ongoing beginning March 22. Shifts can be either 8 or 12 hours. No call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Western North Carolina Clinic needs continuing physician coverage. Clinic seeks coverage for their walk in clinic which sees all ages. Ongoing, 8am-5pm, no call.

35-40 patients a day. Well established clinic located in a beautiful area. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

IM/FP/Peds opportunity in Fayetteville clinic immediately. Fayetteville clinic needs immediate coverage for the following clinics: adult health, women’s health and STD. No call 8a-5p.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Pediatrician Needed MD June-Aug, Burlington NC 3x week for 10 wks starting June 1st, 8-5 Mon-Fri Burlington, NC: located 1 hour west of Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Pediatrician, IM & FP needed, Fayetteville NC Urgent Need for immediate MDs - Pediatrics, Family Practice or Internal Medicine - PT/FT, 8-5 Mon-Fri. Ongoing. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Locum & Permanent MD Needed , Kinston NC Urgent Need for immediate MD placement, 8-5 MonFri. Must be able to do family planning & light maternity, Kinston, NC: 1.5 hours outside Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

PT MD needed for Occupational practice, Greensboro NC. Urgent need for PT MD to do disability physicals 2-3 days weekly, 8-5, on-going scheduling.

Greensboro, NC. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Permanent PA or MD needed in Goldsboro, NC On-going permanent position Mon- Fri 8-5, Goldsboro, NC: 1 hour 10 minutes outside Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Practice MD needed 2-3x/week, Goldsboro intermittent dates, 8-5p,Goldsboro, NC 1h SE of Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

continued on page 64 WWW.MEDMONTHLY.COM | 63

classified listings

Classified

continued from page 63

To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

FULL TIME MD needed for Family Practice in Washington, N.C. Family Practitioner needed for FT MD June 15-Sept 1 on-going Mon- Fri 8-5, Washington, NC, 1 hour 45 minutes outside Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Geriatric Experienced Mid Level or MD, Durham NC Must have geriatric experience, PT/FT, Locations in Durham, Rocky Mount & Fayetteville, NC. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Practitioner opportunity available one hour east of Charlotte Monday through Friday. The hours will be 8:00am until 5:00pm either full time or part time.

You will be seeing 15-20 new patients a day. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Immediate opportunity for a Primary Care Physician at a large practice located one hour south of Raleigh. The hours are from 8:00am until 5:00pm You will be treating generally 20-25 patients per day. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family MD opportunity at an Urgent Care facility that sees all ages in the Jacksonville, NC area. This will be an ongoing schedule from 8:00am until 6:00pm 1-2 days a week, including weekend dates. You will treating generally 30-35 patients a day. There is potential for permanent placement. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Primary care physician opportunity for busy occupational medicine practices near Greensboro/Fayetteville, NC. There are two locations with positions available within 15 minutes of Greensboro and Fayettteville. Your schedule will be from 8:00am until 5:00 pm either full time or part time, no call necessary. Patient treatment will consist of adults only in both facilities. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Physician opportunity for a leading medical practice in the Raleigh area. Must be able to start immediately and be comfortable with seeing all ages.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

General Practitioner/ Internal Medicine/ Family Physician opportunity available at a large substance abuse treatment facilitiy in Western NC. Doctor will be responsible for new patient evaluations and supportive aftercare. Counseling and therapy are combined with physician’s medical assessment and care for the treatment of adults, adolescents and families. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com. continued on page 66

MD STAFFING AGENCY FOR SALE IN NORTH CAROLINA The perfect opportunity for anyone who wants to purchase an established business.

l One

of the oldest Locums companies l Large client list l Dozens of MDs under contract l Executive office setting l Modern computers and equipment l Revenue over a million per year l Retiring owner

Please direct all correspondence to driverphilip@gmail.com.

Only serious, qualified inquirers.

64 | APRIL 2014

NC OPPORTUNITIES

Woman’s Practice in Raleigh, North Carolina.

LOCUMS OR PERMANENT

Physician Solutions has immediate opportunities for psychiatrists throughout NC. Top wages, professional liability insurance and accommodations provided.

Call us today if you are available for a few days a month, on-going or for permanent placement.

Please contact Physican Solutions at 919-845-0054 or physiciansolutions@gmail.com For more information about Physician Solutions or to see all of our locums and permanent listings, please visit physiciansolutions.com

We have a established woman’s practice in the Raleigh North Carolina area that is available for purchase. Grossing a consistent $800,000.00 per year, the retained earnings are impressive to say the least. This is a two provider practice that see patients Monday through Friday from 8 till 6. This free standing practice is very visible and located in the heart of medical community. There are 7 well appointed exam rooms, recently upgraded computer (EMR), the carpet and paint have always been maintained. The all brick building can be leased or purchased.

Contact Cara or Philip for details regarding this very successful practice.

Medical Practice Listings; 919-848-4202

PHYSICIANS NEEDED: Mental health facility in Eastern North Carolina seeks: PA/FT ongoing, start immediately Physician Assistant needed to work with physicians to provide primary care for resident patients. FT ongoing 8a-5p. Limited inpatient call is required. The position is responsible for performing history and physicals of patients on admission, annual physicals, dictate discharge summaries, sick call on unit assigned, suture minor lacerations, prescribe medications and order lab work. Works 8 hour shifts Monday through Friday with some extended work on rotating basis required. It is a 24 hour in-patient facility that serves adolescent, adult and geriatric patients.

FT ongoing Medical Director, start immediately The Director of Medical Services is responsible for ensuring all patients receive quality medical care. The director supervises medical physicians and physician extenders. The Director of Medical Services also provides guidance to the following service areas: Dental Clinic, X-Ray Department, Laboratory Services, Infection Control, Speech/Language Services, Employee Health,

Pharmacy Department, Physical Therapy and Telemedicine. The Medical Director reports directly to the Clinical Director. The position will manage and participate in direct patient care as required; maintain and participate in an on-call schedule ensuring that a physician is always available to hospitalized patients; and maintain privileges of medical staff.

Permanent Psychiatrist needed FT, start immediately An accredited State Psychiatric Hospital serving the eastern region of North Carolina, is recruiting for permanent full-time Psychiatrist. The 24 hour in-patient facility serves adolescent, adult and geriatric patients. The psychiatrist will serve as a team leader for multi-disciplinary team to ensure quality patient care/treatment. Responsibilities include:

evaluation of patient on admission and development of a comprehensive treatment plan, serve on medical staff committees, complete court papers, documentation of patient progress in medical record, education of patients/families, provision of educational groups for patients.

Send copies of your CV, NC medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624 PH: (919) 845-0054 | email: physiciansolutions@gmail.com WWW.MEDMONTHLY.COM | 65

classified listings

Classified

continued from page 64

To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Primary Care Physician opportunity for a leading women’s practice in the Lenoir, NC area. Treating Physician must be comfortable with light OB and well women’s exams. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

General Practitioner/Internal Medicine Physician opportunity for intermittent shifts at a prominent practice in the Greenville, NC area. Treament schedule will be from 8:00am until 5:00pm. The practicing physician must have experience or be willing to perform pain management and trigger point injections. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Exceptional Family Physician opportunity at a practice in the Raleigh, NC area. Schedule will be ongoing Monday through Friday from 8:00am until 5:00pm. Must be comfortable with treating all ages. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Primary Care Physician - Washington area Seeking a physician for a general primary care practice.

Treatment will include seeing 3-4 pediatric and about 10 adult patients per day. The hours are 8:00- 5:00pm M-F. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Physician –Williamston area Immediate opportunity at a developing family practice in the Williamston area. You will be treating 8-16 patients per day from 8:00-5:00 pm. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

MD Suboxone Duties Suboxone is a prescription medicine used for the maintence treatment of oproid dependence. Duties include opioid dependence recovery, rehabilitation, substance abuse and general Internal medicine. We have 4 practices to support with 3 to 5 day coverage. This means you have choices in the city you wish to practice. Slow to moderate patient pace with an exceptional staff and facility. Please contact Physician Solutions at; (919) 8450054 or Email; physiciansolutions@gmail.com

Immediate Pediatrician opportunity at a small outpatient hospital. Located between Fayetteville and Wilmington, this facility requires someone for intermittent shifts. Please contact Physician Solutions at 919845-0054 or email physiciansolutions@gmail.com.

Family Practice located in Winston Salem has an opening for a Family Practice MD. The hours are from 8 till 6 Monday through Friday with NO call duties. You will average seeing a dozen patients per day with a small experienced staff. This position starts in March and will last through the summer of 2014. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com

Pediatrics Opportunity - Roanoke Rapids Area Northeastern North Carolina Pediatric Practice seeks on-going physician for full time coverage beginning mid-October through the end of the year. Practice sees about 16-25 patients a day, hours are 8:00-5:00 with negotiable call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Practice Opportunity, treating patients of all ages, looking for a FP or well informed Pediatric MD to work a full schedule Monday through Friday in Raleigh NC. This job is available immediately and is on-going contracted assignment. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@ gmail.com

Family Practitioner Opportunity - Greenville area Immediate opportunity for a family practitioner for a practice about 20 miles east of Greenville. The hours will be 8:00am until 5:00pm. Must see all ages. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Methadone Treatment facility in the Western part of North Carolina has an immediate opening for a dependable MD. This is a highly regulated facility and the nursing staff performs most of the routine duties. The physicians that currently work in this environment really enjoy the work environment. We are accepting applications for this position and we will consider 3 to 5 shifts per weekly. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com continued on page 69

66 | APRIL 2014

3 OCCUPATIONAL THERAPISTS POSITIONS IN JACKSONVILLE, NC These positions are 40 hour per week temp status to permanent positions with the following qualifications required: l Have graduated from an accredited Occupational Therapist program with a Masters Degree and 1 year experience or a Bachelors Degree with 3 years experience in Occupational Therapy. Program must be accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). l Possess and maintain a valid license or certificate to practice as an Occupational Therapist in any of the 50 states, District of Columbia, the Commonwealth of Puerto Rico, Guam or the US Virgin Islands. l Possess and Occupational Therapist Registered (OTR) certification by the National Board for Certification of Occupational Therapy (NBCOT). l Possess a minimum of one year experience as an Occupational Therapist, preferably working in the neurological based practice setting and with a familiarity of TBI specific patient care practice needs.

HOW TO APPLY: Send us your Resume/CV along with the following: available date to start, salary history, cover letter, eight hour shifts available per week. We will contact you by Email or phone to discuss our program. Make sure you provide your phone numbers and Email address.

Contact Ashley or Cara at: physiciansolutions@gmail.com or phone (919) 845-0054 for details

What’s your practice worth?

When most doctors are asked what their practice is worth, the answer is usually, “I don’t know.”

Doctors can tell you what their practices made or lost last year, but few actually know what it’s worth.

In today’s world, expenses are rising and profits are being squeezed. A BizScore Performance Review will provide details regarding liquidity, profits & profit margins, sales, borrowing and assets.

Our three signature sections include:  Performance review  Valuation  Projections

Scan this QR code with your smart phone to learn more.

919.846.4747 bizscorevaluation.com

classified listings

Classified

continued from page 66

To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Physician Assistant to work primary care settings in North Carolina. We have 5 or 6 primary care practices that are looking for permanent or locum to perm PA’s.

Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Fayetteville area practice on-going physician for full time coverage. Practice sees about 16-25 patients a day, hours are 8:00-5:00 with negotiable call. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Pediatrician needed for permanent placement at Fayetteville area practice. Board Certified or Board Eligible. Practice sees about 16-25 patients a day, hours are 8:00-5:00 with negotiable call. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Winston Salem clinic seeks PA for FT ongoing locums position immediately. Average daily patient load is 25.

Primary care services as well as some pain management. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Chiropractic Clinic seeks mid-level provider in Greenville, NC for Monday and Tuesdays shifts beginning in April. No call required, 8-5. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Cardiology practice has immediate opportunity for full time mid-level or physician in Fayetteville area to provide primary care assistance for the practice. The position has the potential for permanent placement. No call required, 8-5 M-F. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com North Charlotte area practice has immediate opportunity for mid-level provider. Position is 2-3 days per week (flexible) beginning in March 2014. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Clinic seeks PA immediately 3 days per week ongoing in Rocky Mount. Small clinic in Rocky Mount seeks 2-3 days coverage a week immediately. Few peds, 8-5pm M-F days flexible. Temp to perm. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com

Occupational Therapist (OT) - 3 positions available in Eastern, NC. We have opportunities for 3 on-going Occupational Therapists. These positions are 40 hour per week temp status to permanent positions. Contact Ashley or Cara at; physiciansolutions@gmail.com or PH: (919) 845-0054 for more details.

Immediate opportunity for a Family or Internal Medicine MD to practice 3 to 5 days per week in Charlotte.

Light patient volume along with top wage make this a very attractive position. If you have 3 to 5 hour shifts you can work from Monday through Friday, we would like to discuss this upscale practice opportunity.

Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com

Physicians needed South Carolina A family and urgent care in Little River, SC seeks an FP/EM physician for 1 to 2 days per week, on-going shifts. The practice is a one-physician facility and is looking for a physician to come in regularly. The practice is small and does not have a large patient load.

The qualified physician will have experience in Family or Emergency medicine. If you have any availability and a SC medical license contact us today and we will do our best to work around your schedule. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

Physicians needed Virginia Pediatric Locums Physician needed in Harrisonburg, Danville and Lynchburg, VA. These locum positions require 30 to 40 hours per week, on-going. If you are seeking a beautiful climate and flexibility with your schedule, please consider one of these opportunities. Send copies of your CV, VA. medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com continued on page 70 WWW.MEDMONTHLY.COM | 69

classified listings

Classified

continued from page 69

To place a classified ad, call 919.747.9031

Physicians needed

Medical Marketing & Sales needed

Virginia

North Carolina

Urgent Care opportunities throughout Virginia. We have contracts with numerous facilities and eight to 14-hour shifts are available. If you have experience treating patients from pediatrics to geriatrics, we welcome your inquires. Send copies of your CV, VA medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com

Accounts Manager; Physician Solutions has an immediate opportunity for a professional to work from our North Raleigh corporate offices. Duties include; calling on developed practice accounts while developing new accounts. Recruiting physicians and overseeing all marketing and sales duties. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com

Virginia practice outside of Washington DC seeks IM doctor FT/PT now – June 1. IM physician needed immediately FT/PT for Virginia clinic near Washington DC. 8-5p Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Nurse Practitioners needed North Carolina Permanent NP needed in Goldsboro, NC On-going permanent position Mon- Fri 8-5 Goldsboro, NC: 1hour 10 minutes outside Raleigh.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Charlotte Occupational clinic seeks NP in March for ongoing coverage. Nurse practitioner needed in employee health clinic for large corporation in Charlotte.

8a-5p ongoing full time or part time. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Permanent NP needed in Goldsboro, NC On-going permanent position Mon- Fri 8-5 Goldsboro, NC: 1hour 10 minutes outside Raleigh.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Charlotte Occupational clinic seeks NP in March for ongoing coverage. Nurse practitioner needed in employee health clinic for large corporation in Charlotte.

8a-5p ongoing full time or part time. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

70 | APRIL 2014

WebSite Development and Hosting Sales; MedMedia9 is accepting applications for Sales Associates in all parts of North Carolina. We are looking for Independent Medical Sales Reps that are looking for a really solid product that is needed by 6 out of 10 practices, cost effective and will enhance their practice income while attracting new patients. Easy sales delivery by a confident professional. Please send your resume and contact information to; medmedia9@gmail.com or go to www.medmedia9.com the About Us tab and view the Reseller Application. We pay exceptional commissions and offer the best back office support. We welcome the opportunity to discuss our program with you.

Practice wanted North Carolina Pediatric Practice Wanted in Raleigh, NC Medical Practice Listings has a qualified buyer for a pediatric practice in Raleigh, Cary or surrounding area. If you are retiring, relocating or considering your options as a pediatric practice owner, contact us and review your options. Medical Practice Listings is the leading seller of practices in the US. When you list with us, your practice receives exceptional national, regional and local exposure.

Contact us today at (919) 848-4202.

Classified To place a classified ad, call 919.747.9031

Practice for sale North Carolina Primary Care Practice Only Minutes East of Raleigh North Carolina. The retiring physician maintains a 5 day work week and has a solid base of patients that can easily be expanded. There are 6 fully equipped exam rooms, a large private doctor’s office, spacious business office, and patient friendly check in and out while the patient waiting room is generous overlooking manicured flowered grounds. This family practice is open Monday through Friday and treats 8 to a dozen patients per day. The Gross revenue is about $235,000 yearly. Contact Cara or Philip at 919 848 4202 or email: medlistings@gmail.com to receive details.

Family Practice located in Hickory, NC. Well-established and a solid 40 to 55 patients split between an MD and physician assistant. Experienced staff and outstanding medical equipment. Gross revenues average $1,500,000 with strong profits. Monthly practice rent is only $3,000 and the utilities are very reasonable. The practice with all equipment, charts and good will are priced at $625,000.

Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or email: medlistings@gmail.com Impressive Internal Medicine Practice in Durham, NC: The City of Medicine. Over 20 years serving the community, this practice is now listed for sale. There are four wellequipped exam rooms, new computer equipment and a solid patient following. The owner is retiring and willing to continue with the new owner for a few months to assist with a smooth transition. Contact Medical Practice Listings at (919) 848-4202 for more information. View additional listings at: www.medicalpracticelistings.com continued on page 72

PEDIATRICIAN

OR FAMILY MEDICINE DOCTOR NEEDED IN

ROANOKE RAPIDS, NC In mid December, a pediatrician or family medicine doctor comfortable with seeing children is needed full time in Roanoke Rapids (1 hour north of Raleigh, NC) until a permanent doctor can be found.

Credentialing at the hospital is necessary.

Call 919- 845-0054 or email: physiciansolutions@gmail.com www.physiciansolutions.com

Internal Medicine Practice for Sale Located in the heart of the medical community in Cary, North Carolina, this Internal Medicine practice is accepting most private and government insurance payments.

The average patients per day is 20-25+, and the gross yearly income is $555,000.

Listing Price: $430,000

Call 919-848-4202 or email medlistings@gmail.com www.medicalpracticelistings.com WWW.MEDMONTHLY.COM | 71

classified listings

Classified

continued from page 71

To place a classified ad, call 919.747.9031

Practice for sale

Practice for sale

North Carolina (cont.)

South Carolina

Primary Care Practice specializing in women’s care. The owning female physician is willing to continue with the practice for a reasonable time to assist with smooth ownership transfer. The patient load is 35 to 40 patients per day, however that could double with a second provider.

Exceptional cash flow and profitable practice that will surprise even the most optimistic practice seeker. This is a remarkable opportunity to purchase a well-established woman’s practice. Spacious practice with several wellappointed exam rooms throughout. New computers and medical management software add to this modern front desk environment. This practice is being offered for $435,000. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or send an email to medlistings@gmail.com

Lucrative ENT Practice with room for growth, located three miles from the beach. Physician’s assistant, audiologist, esthetician and well-trained staff. Electronic medical records, mirror imaging system, established patient and referral base, hearing aids and balance testing, esthetic services and Candela laser. All aspects of otolaryngology, busy skin cancer practice, established referral base for reconstructive eyelid surgery, Botox and facial fillers. All new surgical equipment, image-guidance sinus surgery, balloon sinuplasty, nerve monitor for ear/parotid/thyroid surgery. Room for establishing allergy, cosmetics, laryngology and trans-nasal esophagoscopy. All the organization is done; walk into a ready-made practice as your own boss and make the changes you want, when you want. Physician will to stay on for a smooth transition. Hospital support is also an option for up to a year. The listing price is $395,000 for the practice, charts, equipment and good will. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or email: medlistings@gmail.com

Internal Medicine Practice located just outside Fayetteville, NC is now being offered. The owning physician is retiring and is willing to continue working for the new owner for a month or two assisting with a smooth transaction. The practice treats patients four and a half days per week with no call or hospital rounds. The schedule accommodates 35 patients per day. You will be hard pressed to find a more beautiful practice that is modern, tastefully decorated and well appointed with vibrant art work. The practice, patient charts, equipment and good will is being offered for $415,000 while the free standing building is being offered for $635,000. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or email: medlistings@gmail.com Modern Vein Care Practice located in the mountains of NC. Booking seven to 10 procedures per day, you will find this impressive vein practice attractive in many ways.

Housed in the same practice building with an internal medicine, you will enjoy the referrals from this as well as other primary care and specialties in the community. We have this practice listed for $295,000 which includes charts, equipment and good will. Contact Medical Practice Listings at (919) 848-4202 for more information. View additional listings at www.medicalpracticelistings.com

72 | APRIL 2014

Practice for sale Washington Family Practice located in Bainbridge Island, WA has recently been listed. Solid patient following and cash flow makes this 17-year-old practice very attractive. Contact Medical Practice Listings for more details. email: medlistings@gmail.com or (919) 848-4202. 

PEDIATRICIAN

Practice for Sale in Raleigh, NC

or family medicine doctor needed in

FAYETTEVILLE, NC

Primary care practice specializing in women’s care Raleigh, North Carolina The owning physician is willing to continue with the practice for a reasonable time to assist with smooth ownership transfer. The patient load is 35 to 40 patients per day, however, that could double with a second provider. Exceptional cash flow and profit will surprise even the most optimistic practice seeker. This is a remarkable opportunity to purchase a well-established woman’s practice. Spacious practice with several well-appointed exam rooms and beautifully decorated throughout. New computers and medical management software add to this modern front desk environment.

List price: $435,000

Comfortable seeing children. Needed immediately.

Call Medical Practice Listings at (919) 848-4202 for details and to view our other listings visit www.medicalpracticelistings.com

Call 919- 845-0054 or email: physiciansolutions@gmail.com www.physiciansolutions.com

Unfortunately, its motor is inside playing video games.

Kids spend several hours a day playing video games and less than 15 minutes in P.E. Most can’t do two push-ups.

Many are obese, and nearly half exhibit risk factors of heart disease. The American Council on Exercise and major medical organizations consider this situation a national health risk. Continuing budget cutbacks have forced many schools to drop P.E.—in fact, 49 states no longer even require it daily.

You can help. Dust off that bike. Get out the skates.

Swim with your kids. Play catch. Show them exercise is fun and promotes a long, healthy life. And call ACE. Find out more on how you can get these young engines fired up. Then maybe the video games will get dusty.

A Public Service Message brought to you by the American Council on Exercise, a not-for-profit organization committed to the promotion of safe and effective exercise

American Council on Exercise

®

ACE Certified: The Mark of Quality Look for the ACE symbol of excellence in fitness training and education.

For more information, visit our website: www.ACEfitness.org

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A M E R I C A’ S A U T H O R I T Y O N F I T N E S S

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ADVERTISE YOUR PRACTICE BUILDING IN MED MONTHLY

Wanted: Urgent Care Practice Urgent care practice wanted in North Carolina.

Qualified physician is seeking to purchase an established urgent care within 100 miles of Raleigh, North Carolina.

If you are considering retiring, relocations or closing your practice for personal reasons, contact us for a confidential discussion regarding your urgent care. You will receive cash at closing and not be required to carry a note.

Medical Practice Listings Buying and selling made easy

Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

Primary Care Specializing in Women’s Health Practice established in 2005, averaging over $540,000 the past 3 years. Free standing practice building for sale or lease. This practice has 5 well equipped exam rooms and is offered for $38,000.

919.848.4202 medlisting@gmail.com medicalpracticelistings.com 74 | APRIL 2014

By placing a professional ad in Med Monthly, you're spending smart money and directing your marketing efforts toward qualified clients.

Contact one of our advertising agents and find out how inexpensive yet powerful your ad in Med Monthly can be.

medmonthly.com | 919.747.9031

Located on NC’s Beautiful Coast, Morehead City

Internal Medicine Practice Wilmington, North Carolina Newly listed Internal Medicine practice in the beautiful city of Wilmington, NC. With Gross revenues over $400,000, 18 to 22 patients per day, this practice is ready for the physician that enjoys beach life. The medical office is located in a brick wrapped condo and is highly visible. This well appointed practice has a solid patient base and is offered for $85,000.

Medical Practice Listings l 919-848-4202 l medlisting@gmail.com l medicalpracticelistings.com

NC MedSpa For Sale MedSpa Located in North Carolina

Primary Care Practice For Sale

We have recently listed a MedSpa in NC

Wilmington, NC

This established practice has staff MDs, PAs and nurses to assist patients. Some of the procedures performed include: Botox, Dysport, Restylane, Perian, Juvederm, Radiesse, IPL Photoreju Venation, fractional laser resurfacing as well as customized facials. There are too many procedures to mention in this very upscale practice. The qualified buyer will be impressed with the $900,000 gross revenue. This is a new listing, and we are in the valuation process.

Established primary care on the coast of North Carolina’s beautiful beaches.

Fully staffed with MD’s and PA’s to treat both appointment and walk-in patients.

Excellent exam room layout, equipment and visibility.

Contact Medical Practice Listings today to discuss the practice details.

Contact Medical Practice Listings for more information.

For more information call Medical Practice Listings at 919-848-4202 or e-mail medlistings@gmail.com

www.medicalpracticelistings.com

Medical Practice Listings 919.848.4202 | medlistings@gmail.com www.medicalpracticelistings.com

PRIMARY CARE PRACTICE East of Raleigh, North Carolina We are offering a well established primary care practice only minutes east of Raleigh North Carolina. The retiring physician maintains a 5 day work week and has a solid base of patients that can easily be expanded. There are 6 fully equipped exam rooms, a large private doctor’s office, spacious business office, and patient friendly check in and out while the patient waiting room is generous overlooking manicured flowered grounds. This family practice is open Monday through Friday and treats 8 to a dozen patients per day.

Currently operating on paper charts, there is no EMR in place. The Gross revenue is about $235,000 yearly.

We are offering this practice for $130,000 which includes all the medical equipment and furniture. The building is free standing and can be leased or purchased.

Contact Cara or Philip at 919-848-4202 to receive details and reasonable offers will be presented to the selling physician.

Medical Practice Listings Selling and buying made easy

MedicalPracticeListings.com | medlisting@gmail.com | 919-848-4202

Adult & pediAtric integrAtive medicine prActice for sAle

Women’s Health Practice in Morehead City, NC

This Adult and Pediatric Integrative Medicine practice, located in Cary, NC, incorporates the latest conventional and natural therapies for the treatment and prevention of health problems not requiring surgical intervention. It currently provides the following therapeutic modalities: • • • • •

Conventional Medicine Natural and Holistic Medicine Natural Hormone Replacement Therapy Functional Medicine Nutritional Therapy

• • • • • •

Mind-Body Medicine Detoxification Supplements Optimal Weigh Program Preventive Care Wellness Program Diagnostic Testing

There is a Compounding Pharmacy located in the same suites with a consulting pharmacist working with this Integrative practice. Average Patients per Day: 12-20 Gross Yearly Income: $335,000+ | List Price: $125,000

Newly listed Primary Care specializing in Women’s care located in the beautiful coastal city of Morehead City. This spacious practice has 5 exam rooms with one electronic tilting exam table and 4 other Ritter exam tables. Excellent visibility and parking make this an ideal location to market and expand. This practice is fully equipped and is ready for a new owner that is ready to hit the ground running. The owning MD is retiring and will be accommodating during the transition period. This medical building is owned and is offered for sale, lease or lease to own. The gross receipts for the past 3 years exceed $540,000 per year. If you are looking to purchase an excellent practice located in a picturesque setting, please contact us today.

Medical Practice Listings Buying and selling made easy

Call 919-848-4202 or email medlistings@gmail.com www.medicalpracticelistings.com

Call 919-848-4202 or email medlistings@gmail.com www.medicalpracticelistings.com

Pediatrics Practice Wanted Pediatrics practice wanted in NC Considering your options regarding your pediatric practice? We can help.

Medical Practice Listings has a well qualified buyer for a pediatric practice anywhere in central North Carolina.

Contact us today to discuss your options confidentially.

PRACTICE FOR SALE

OCCUPATIONAL HEALTH CARE PRACTICE FOR SALE Greensboro, North Carolina Well-established practice serving the Greensboro and High Point areas for over 15 years. Five exam rooms that are fully equipped, plus digital X-Ray. Extensive corporate accounts as well as walk-in traffic. Lab equipment includes CBC. The owning MD is retiring, creating an excellent opportunity for a MD to take over an existing patient base and treat 25 plus patients per day from day one. The practice space is 2,375 sq. feet. This is an exceptionally opportunity. Leased equipment includes: X-Ray $835 per month, copier $127 per month, and CBC $200 per month. Call Medical Practice Listings at (919) 848-4202 for more information.

Asking price: $385,000

Medical Practice Listings Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

To view more listings visit us online at medicalpracticelistings.com

FAMILY PRACTICE FOR SALE A beautiful practice located in Seattle, Washington This upscale primary care practice has a boutique look and feel while realizing consistent revenues and patient flow. You will be impressed with the well appointed layout, functionality as well as the organization of this true gem of a practice. Currently accepting over 20 insurance carriers including Aetna, Blue Cross and Blue Shield, Cigna, City of Seattle, Great West and United Healthcare. The astute physician considering this practice will be impressed with the comprehensive collection of computers, office furniture and medical equipment such as Welch Allyn Otoscope, Ritter Autoclave, Spirometer and Moore Medical Exam table.

Physician compensation is consistently in the $200,000 range with upside as you wish. Do not procrastinate; this practice will not be available for long.

List price: $255,000 | Year Established: 2007 | Gross Yearly Income: $380,000

Medical Practice Listings Selling and buying made easy

MedicalPracticeListings.com | medlisting@gmail.com | 919.848.4202

the top

Medical Tests Women Should Schedule for Better Health

1

MAMMOGRAM

2

Low-risk women ages 50 and older are supposed to get a mammogram every two years. If your breast cancer risk is elevated because of a personal or family history, yearly mammograms starting at age 40 (or younger) are still advised. Talk to your doctor during your annual physical about your cancer risks, and call your physician immediately if you have any breast problems.

PAP SMEAR

Starting at age 21, regardless of sexual history, women should have a Pap once every three years to look for signs of cervical cancer. As with mammograms, however, these guidelines apply only to women in good health who do not have an elevated risk for cancer. Talk with your doctor about a screening schedule that’s appropriate for you.

3

SKIN CHECK

4

Once a year (at one of your twiceannual cleanings) your dentist should perform a periodontal exam, probing the health of your gums and taking Xrays. Your dentist will check for gum inflammation, which can contribute to heart disease and diabetes.

5

| APRIL 2014

EYE EXAM

Women are more likely to experience eyesight problems because they have higher risks for dry-eye syndrome and auto¬immune diseases that affect eye health. If you wear glasses or contacts, visit your eye doctor for a vision screening every year; every other year if you don’t.

6

TSH SCREENING

Hypothyroidism is a deficiency of the thyroid gland that strikes about 10% of women and it’s symptoms include being cold, tired, achy, constipated, and gaining weight. It’s diagnosed with a thyroid stimulating hormone (TSH) blood test, given during your annual physical starting at age 50 (earlier if you experience symptoms).

Check yourself once a month for new or suspicious moles and get a total-body exam once a year from your doctor or a dermatologist. More than 1 million Americans will be diagnosed with skin cancer this year and it’s best to catch it early, when it’s highly curable.

78

PERIODONTAL EXAM

7

HEARING TEST

The standard for getting an audiogram, which checks your hearing at a variety of pitches and intensity levels, is once a year starting at age 50, when hearing typically begins to decline.

8

COLONOSCOPY

This test, during which a camera scans your colon for cancerous polyps while you’re sedated, is recommended for people 50 and older and should be repeated every 10 years (more often if polyps are found). Get a colonoscopy earlier if you have a family history of colon cancer, or if you have unexplained bleeding or other changes in bowel habits.

9

BLOOD TESTS

After a baseline screening for cholesterol levels in your 20s, get one at least every five years. From age 40 and up, get your cholesterol and blood sugar (to check for diabetes) tested every year because heart attack and diabetes risks rise with aging.

WWW.MEDMONTHLY.COM | 79

Physician Solutions is now hiring primary care MD’s and PA’s in North Carolina, Virginia and South Carolina

If you are a well informed physician or mid-level, we could use your services from 2 to 5 days per week. Find out why dozens of doctors choose Physician Solutions.

Short-term or long-term, Physician Solutions has you covered P.O. Box 98313, Raleigh, NC 27624 Scan this QR code with your smartphone to learn more.

phone: 919.845.0054 fax: 919.845.1947 e-mail: physiciansolutions@gmail.com www.physiciansolutions.com