Med Monthly July 2015

Med Monthly July 2015

the

Your Practice Website issue

How to Structure Your Practice Website for Success pg. 32

Does My Medical Practice Need a Website? pg. 6

YOUR PRACTICE WEBSITE CAN MAKE OR BREAK YOU pg. 38

When Bad Websites Happen to Good Doctors: Do-It-Yourself Templates or Custom Design? pg. 36

Medical Practice Website Checklist pg. 20

contents features 32 HOW TO STRUCTURE YOUR PRACTICE WEBSITE FOR SUCCESS

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EAT THE PRODUCE OF THE SEASON

36 WHEN BAD WEBSITES HAPPEN TO GOOD DOCTORS: Do-It-Yourself Templates or Custom Design?

38 YOUR PRACTICE WEBSITE CAN MAKE OR BREAK YOU

insight 6

DOES MY MEDICAL PRACTICE NEED A WEBSITE?

10 EAT THE PRODUCE OF THE SEASON 12 HOW MUCH DOES SHORT-TERM HEALTH INSURANCE COST?

practice tips 16 MEDICAL PRACTICE WEBSITE INFOGRAPHICS 18 THREE TIPS TO GET MORE TIME 20 MEDICAL PRACTICE WEBSITE CHECKLIST

HOW TO STRUCTURE YOUR PRACTICE WEBSITE FOR SUCCESS

research and technology 22 NIH RESEARCHERS PILOT PREDICTIVE MEDICINE BY STUDYING HEALTHY PEOPLE’S DNA 24 ICD-10 PCS: We Don’t Know What We Don’t Know 26 STRONG MARKET FOR DIGITAL HEALTH SOLUTIONS AIMED AT CLOSING INFORMATION GAPS IN PATIENT CARE

legal 28 “IMPLAUSIBLE” THAT SCHEME TO INDUCE REFERRALS WOULD LEAVE PHYSICIAN IGNORANT OF ITS TRUE PURPOSE 30 SEVERAL STATES ENACT TELEHEALTH PARITY LAWS IN 2015

healthy living

32

42 GRILLED VEGETABLE QUESADILLA WITH GOAT CHEESE AND PESTO

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.

Call us today at 919-833-3836 x141

Providing Jobs, Services, Vendors, and CME www.ncmedsoc.org

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Med Monthly July 2015 Publisher Creative Director Contributors

Philip Driver Thomas Hibbard Ashley Acornley, MS, RD, LDN. Naren Arulrajah Lauren D’Agostino Dr. Jonathan Elion, MD, FACC Starla Fitch, M.D. Barbara Hales, M.D. Vishal Gandhi, BSEE, MBA Amanda Kanaan Marie Klee Tony Maida Audrey McLaughlin, RN Philip Peisch Vikas Vij

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 Dr. Jonathan Elion, MD, FACC is the founder and president of ChartWise Medical Systems, the industry leader in Computer-Assisted Clinical Documentation Improvement (CACDI) software. Dr. Elion is a practicing board-certified cardiologist in Providence, RI and an Associate Professor of Medicine at Brown University.

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

Amanda Kanaan is the owner/founder of WhiteCoat Designs – an online marketing agency committed to growing doctors’ practices through costeffective and powerful online marketing solutions. Amanda regularly speaks at medical association meetings and conventions and is a published expert in the field of medical marketing. To learn more or for a free website evaluation, contact her at Amanda@whitecoat-designs. com or http://www.whitecoat-designs.com.

Marie Klee is a Danish freelance nutritionist.

She writes articles about health, nutrition and wellness and also works as a corporate health strategist.

She is chief editor on the Danish health website Carrotstick.dk. Carrotstick is a blog-like health forum that has a scientific approach to health, and commits to delivering high quality articles about food, nutrition and general health. Connect with Marie on LinkedIn.

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.

WWW.MEDMONTHLY.COM |5

insight

M

edical practices, in general, are small businesses, and small businesses advertise to grow their enterprises.

Therefore, having a website is an important component to any successful advertising campaign.

Websites are “the new storefronts” and medical practices should not be missing out on this valuable opportunity.

Acknowledging the fact that doctors are either some of the first or some of the last to adopt new forms of media and marketing to maximize their practice, the world is constantly evolving and patient behaviors are changing.

Patients are spending more time online, searching the Internet for answers to their medical questions.

Many surfers, between 50 and 90 million, are researching healthrelated questions. They get their answers from a variety of online

By Thomas Hibbard resources, and eventually some will Creative Director, Med Monthly seek to establish a patient-physician relationship for specific medical advice and treatment. This is your practice website are: mission, location, and medical core audience. Traditional means • Use a good color scheme to services to new patients of finding a physician are still enhance readability • Improved patient services with used (i.e. word-of-mouth, yellow • Leave white space for the eyes downloadable patient forms, pages), but it is becoming more to rest - a crowded page is more and easy directions to the common for patients to choose difficult to read practice or evaluate their physicians from • Speed is essential. Pages should • Enhanced professional their selection of choices on the load within 8-15 seconds. Don’t image among colleagues, Internet. This is especially true for “bloat” pages with too much an important referral base. prospective patients who have just text or graphics. If copy runs Additionally, adding the web recently relocated to a new area. too long, make another page address to marketing material, Having a medical practice • Use a consistent navigation so business cards, and other website that is attractive, concise, the user can easily traverse the office letterhead can increase well organized, and easy to site awareness navigate, can reap many benefits for • Limit use of multimedia, a practice, including: Website Design Tips animation, and Flash to • Increased marketability to appropriate areas. These can Some basic tips to keep in mind prospective patients, including slow down a site and frustrate information about the practice’s when designing any medical

6 | JULY 2015

Does My Medical Practice Need a Website?

the viewer • Use clear, sharp photos of the office, patients, and medical staff • KIS (Keep It Simple) - Starting and ending a medical web site project can be challenging.

Therefore, it’s recommended that practices start with a finite scope, then add to the web site after a few months of service. In the world of web, often less is more

6 “Musts” for a Medical Practice Website 1. Bio Page. The most online traffic will be to your bio page

of physicians and staff. Make sure all information is current and complete, including any new specialties, certifications and medical associations to keep patients informed.

2. Patient registration and forms. Ensure patients can make appointments, register and access important forms no matter where they are. Putting the registration form under “new patient” or “welcome” on one’s site will allow patients to find it easily. A registration form is okay to have on your website, but avoid posting any forms about patient’s personal

medical information because they would not be secure and could be a HIPAA violation.

3. Accessible contact information. Display contact information clearly on every page. Make sure it shows up on local search results, and include the address on the footer of each page.

4. Services and insurance. List all services and insurance companies your practice accepts. Practices should keep this open-ended, so that if the patient’s insurer is not listed, he or she can call for options. continued on page 8 WWW.MEDMONTHLY.COM | 7

continued from page 7

5. Timely news and updates.

Make sure to display recent blogs, news and other alerts or updates to make sure the website looks fresh and timely. This helps patients feel comfortable that their doctor is engaged with the community and current issues. It also makes the practice look fresher, bigger and more sophisticated.

Practices will also be rewarded

by Google if they show they are constantly updating the site and will rank higher than other practices.

6. Patient education resources.

Patients are relying more and more on the Internet for medical information and news, which can often lead to confusion and inaccurate diagnoses. With so many people looking for health information online, it is critical your healthcare practice website include easy to understand educational content and that you direct patients to the information after a diagnosis is made. It also plays an important role in your online marketing efforts. If you provide patient education on your website and a patient is searching for a particular set of symptoms or conditions, they are much more likely to find you if your content is relevant to their search.

And what better way to find a qualified provider than through the educational content on your website.

Once You Have a Website If your medical practice has a 8 | JULY 2015

website, it may have been a while since you last updated it, or perhaps you’re not using it to its fullest potential. One option is to include frequently asked questions (FAQs) online. You can also use your website to offer online scheduling for things such as flu-shot clinics, or to offer downloadable electronic forms. And don’t forget about promotion. If you have a flatscreen TV set in your waiting room, you should have information playing about your website.

Attract With a Low-Risk Offer Another option to attract viewers is to have an irresistible low-risk offer on the practice homepage for a prospective patient enticing them to want to take the next step and learn more about your practice, services and staff. A lowrisk or irresistible offer is usually something free for the prospective patient or reader of your website. It can be a coupon, a free pamphlet, a checklist, or a free DVD that engages and entices the reader to want to know more about who you are and what you offer. Just about everyone will give you their email address to get something free. If you make it easy to get ‘something of value’ for free, people inevitably will take you up on the offer. You then have a lead and can start accumulating a clearer message to those now showing interest in your practice.

Increase Your SEO High traffic is important but all your efforts will be for nothing if your visitors can’t find you when using important keywords and

phrases. Realize they’re not going to Google Search the name of your practice. They’ll most likely search your name, city and services offered.

Get Rid of FLASH You have between 3 and 5 seconds for your web site homepage to load. Visitors judge the value of your practice and business in a matter of seconds. Bear in mind, the more you add to your site, the longer it takes to load. The amount of visibility you’re losing with a Flash movie on your homepage makes it more likely the viewers will leave your website rather than fight with the hassles of adding a Java download to speed up their viewing. And iPhones and iPads do not support Flash, so you’ll lose some of your potential viewers.

Google doesn’t read Flash script either, so it won’t help you climb up the SEO ranks either.

Final Thoughts These tips are only some of the actions you can take to design an attractive, inviting website and to increase the effectiveness of your web presence. A combination of professional web design and regularly updated, relevant content (i.e. stories, articles, blog posts, etc.) are able to make your website more interesting and cause your visitors will stay longer and interact with you more. Google also gives websites that keep current information recognition with higher rankings in their results pages. As long as your site is dynamic and informative, your patients will keep visiting and you’ve increased the growth potential of your medical practice. 

WWW.MEDMONTHLY.COM | 9

insight

Eat the Produce of the Season – For a Healthier You and a Healthier Planet

By Marie Klee Chief Editor Carrotstick.dk

‘‘

The fruit you get in the winter time is usually a long time under way from its’ origin, and the transportation time and circumstances will lower the nutritional value.

10 | JULY 2015

Benefits of the seasonal produce When you eat the fruit and veggies that are in season there are many benefits you may not be aware of. In this article you will get the information about why and what, and a list over which types of fruit and vegetables you should be tossing in your shopping cart the next few months and how to use them. Oh, and then you get recipe of a delicious summer salad, where watermelon is the main ingredient!

The first benefit of eating ”by the season” is that the food is usually cheaper. The availability lowers the price, compared to when the food is out of season.

Think of the price you sometimes have to pay for produce like artichokes, asparagus and berries.

The second benefit is that the food in season is healthier. Generally it has a better nutritional value, because the time for the growing is perfect. You simply can’t get perfect strawberries all year round.

The fruit you get in the winter time is usually a long time under way from its’ origin, and the transportation time and circumstances will lower the nutritional value.

The food in season should be considered as the food in season in your specific geographic location.

The closer to your location the food is grown, the better. Locally grown produce has a shorter way ”from soil to spoon” and therefore it is fresher and healthier.

And it leaves a lower CO2 food print. Good for you and the coming generations.

Fruits and greens of the summer season Depending on where you are in the world, this list will differ a bit. But generally these foods are in season June, July and August.

Fruit The most common fruits of the summer are: almost all kinds of berries and melons, plums, grapes, peaches, limes, lychee, figs and some varieties of apples.

Using fruit in your salads, desserts and main courses can create a nice contrast and brings out the flavours of the rest of the meal. Try adding peaches to your salad with some roasted nuts, or try adding grapes or figs when you oven roast your meat. It is all about experimenting - maybe you’ll find your new go-to recipe!

Vegetables The summer is all about the vegetables with a large amout of water – cucumber, tomatoes, a variety of lettuce. Then you also have zucchini, eggplant, radishes, corn, bell peppers and beans.

Vegetables are mostly used in salads, but try grilling it on the BBQ and add some olive oil and a pinch of salt! It brings out the flavours and sweetness. You can also mix grilled veggies with some fresh lettuce and dry roasted nuts or some cheese. Only your imagination sets the limits. 

Try a Watermelon Salad!

Ingredients:

(you choose how much you want of each ingredient, but the main ingredient should be the watermelon)

Watermelon – not too ripe Tomatoes and/or cucumber Roasted pumpkin seeds A salad friendly cheese like feta or goat cheese A large handful of parsley Olive oil A pinch of salt, if you desire

Preparation:

Start out with roasting the pumpkin seeds on a medium heat frying pan. Stir regularly. When some of the pumpkin seeds are starting to get golden, you place them on a large dish to cool off. Chop the watermelon into bite size friendly cubes. Chop the tomatoes and/or cucumber in smaller pieces. Chop the parsley coarsely and add a teaspoon of olive oil and maybe a pinch of salt. Mix the salad gently and place in a decorative platter. Sprinkle the cheese on by hand, breaking it apart into small pieces. Finish off by sprinkling the pumpkin seeds.

WWW.MEDMONTHLY.COM | 11

insight

How Much Does Short-Term Health Insurance Cost?

eHealth Reports that Applications for Short-Term Coverage Surged Over 130% in 2014, Prices Rose Slightly Today eHealth, Inc. (NASDAQ: EHTH), which operates eHealth.com, the nation’s first and largest private online health insurance exchange, published a report describing the increased popularity of shortterm health insurance plans in 2014, the year when major provisions of the Affordable Care Act (ACA) first came into effect. The company also published average premiums and deductibles for short-term health 12

| JULY 2015

insurance plans selected by eHealth customers on a national and state-by-state basis.

Short-term health insurance plans do not meet the coverage requirements of the ACA and may leave consumers open to penalties on their federal taxes. However, short-term health insurance plans are available outside the ACA’s nationwide open enrollment period and do not require consumers to experience a qualify-

ing life event before they can enroll.

“We’ve seen a significant shift in the marketplace as consumers turn to affordable short-term coverage as an alternative to ACA-compliant health plans, even though these do not provide the same benefits and protections as major medical plans,” said eHealth CEO and Chairman Gary Lauer. “We believe that interest in short-term coverage may increase dramatically if the Supreme Court rules for the plaintiff in the case of King vs. Burwell and the ruling results in the loss of health insurance subsidies for millions of Americans.

“The Department of Health and Human Services has said that it does not have a ‘Plan B’ if the Supreme Court rules for King,” Lauer continued, “but consumers are likely to create their own Plan B if they can no longer afford their major medical coverage. For many, that may be short-term health insurance coverage.”

Interest in short-term health insurance plans increased dramatically at eHealth in 2014 • Applications for short-term health insurance at eHealth increased over 130% between 2013 and 2014 • More than 60,000 consumers applied for shortterm health insurance at eHealth in 2013 • More than 140,000 consumers applied for shortterm health insurance at eHealth in 2014 • In 2013, 9% of all short-term applications at eHealth were declined, primarily for medical reasons; in 2014, that figure increased to 12% • In 2014, 61% of the applications for short-term coverage at eHealth occurred outside of the open enrollment period • Individuals between the ages of 18 and 34 made up over half (55%) of all short-term insurance applicants at eHealth in 2014 Short-term plans are typically less expensive than traditional major medical plans • The average monthly premium for individual short-term plans purchased through eHealth in 2014 was $110 • The average monthly premium for family shortterm plans purchased through eHealth in 2014 was $262 • By comparison, average premiums for individual major medical plans selected by unsubsidized eHealth shoppers during the 2015 open enrollment period were $286 per month for individuals

and $727 per month for families • Between 2013 and 2014, average monthly premiums for short-term plans purchased through eHealth increased 7% (from $103 to $110) for individuals and 17% (from $224 to $262) for families Average deductibles are lower for individuals on short-term plans vs. major medical plans • The average annual deductible for individual short-term plans selected by eHealth shoppers in 2014 was $3,589; the average annual deductible for families was $8,566 • By comparison, average annual deductibles for major medical plans selected by unsubsidized eHealth shoppers during the 2015 open enrollment period were $4,120 for individuals and $7,760 for families • Between 2013 and 2014, average monthly annual deductibles for short-term plans purchased through eHealth increased 18% (from $3,047 to $3,589) for individuals and 26% (from $6,816 to $8,566) for families Most affordable and least affordable states for short-term health insurance1 • California was the most expensive state for shortterm health insurance at eHealth, with premiums averaging $161 per month for individuals and $419 per month for families • Utah was the least expensive state for individuals at eHealth, with premiums averaging $76 per month; Maine was the least expensive state for families at eHealth, with premiums averaging $171 per month • California had the highest deductible for individual short-term plans available through eHealth, at $4,459 on average; North Carolina had the highest deductible for family short-term plans available through eHealth, at $11,549 on average • Minnesota had the lowest deductible for individual short-term plans available through eHealth at $1,946 on average; Washington had the lowest deductible for family short-term plans available through eHealth, at $3,490 on average continued on page 14 WWW.MEDMONTHLY.COM | 13

continued from page 13

Most short-term enrollees first considered major medical plans • A survey of eHealth customers who purchased short-term plans showed that nearly two-thirds (63%) had considered purchasing a major medical health insurance plan before purchasing shortterm health insurance2 What should consumers know about the limits of short-term coverage?

• While some coverage may be better than no coverage, short-term plans do not meet the coverage requirements of the Affordable Care Act, potentially leaving you open to a penalty on your federal taxes • Short-term plans typically do not cover things like preventive care, pre-existing conditions or maternity care, and may not cover prescription drugs • Short-term plans typically last no longer than six months, after which you may have to re-apply for coverage again, and re-application limits may apply • It is possible to be declined for short-term health

insurance coverage based on your personal medical history and pre-existing medical conditions For more information, read eHealth’s full report or visit the eHealth Media Center.  Notes 1. Based on analysis of short-term health insurance plans for sale through eHealth on eHealth.com. Not all short-term health insurance plans in a particular state are available for sale through eHealth. As such, statistics derived from plans on eHealth.com may not be representative of the entire short-term health insurance market within a state or other geographical area. A plan available in a state may not be available throughout the entire state, so state-wide statistics may not be representative of the plans available in any particular geographical area within a state.

2. Based on a voluntary survey of eHealth customers who purchased short-term health insurance plans through eHealth.com. The survey was conducted between April 6 – April 18, 2015 and a total of 585 responses were collected.

Source: http://www.pressreleasepoint.com/how-muchdoes-short-term-health-insurance-cost-ehealth-reportsapplications-short-term-coverage-surg

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practice tips

Medical Practice Website Infographics Contributed by Vishal Gandhi, BSEE, MBA – Founder and CEO of Clinicspectrum

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practice tips

THREE TIPS TO GET MORE TIME

By Starla Fitch, M.D.

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A

re you thinking you don’t have time to update your website?

If you have enough time, then feel free to skip this article.

That’s what I thought.

The doctors I coach have one common complaint: they are time crunched. As a full-time physician, I totally understand.

Here’s what works for me and my clients:

Make a list of everything you do in a week.

Yes, that will take some time. But until you see where all your “time leaks” are in your system, you don’t know how to plug them up.

Write down everything. Laundry, carpool, office, operating room, grocery shopping. Don’t forget to include sleeping, eating, the essentials!

This will be worth it. Trust me.

Look at how you can better, bag or barter things on your list.

The fantastic Martha Beck (Oprah’s favorite life coach) taught me the “better, bag or barter” technique.

Do you have to walk the dog? Make it better by asking your good friend down the street to join you, so you can have some social interaction at the same time. Or listen to a book or good tunes as you’re walking Fido.

Are there chores on your list (dusting, sweeping, filing) that always make the list and never get done? Maybe it’s time to bag them and either let that stuff go (swept floors are so overrated!) or look for some help from an outside source.

Hint: You may find some kids around your house during summer break that could be good sweepers!

Do you hate doing the dishes but love cooking? Now is the time to set up your barter system. Sit down with your spouse, partner or children and work out a plan so you can do more of the things you love and less of the things you don’t.

It’s important to know that this system can work around the office, too.

Batch it!

Group things together: errand running; catching up on dictation; calling back patients.

Studies show we’re more efficient when we group similar things together and just knock them out.

What next?

I’d love for you to join our fast-growing international community at LoveMedicineAgain.com and get weekly stress-busting tips and a free ebook on how to reduce stress now at www.lovemedicineagain.com.

And if you want to work with me on some real one-on-one strategies, email me at info@lovemedicineagain.com to see about available coaching spots. I just have two openings left in my three month private coaching program, where we look at lots of answers to the hard questions.  Starla Fitch, MD, author of the #1 Amazon international best-seller Remedy for Burnout, is the creator of the hugely popular international online community lovemedicineagain.com for doctors, nurses, other healthcare providers, and patients who want to restore humanity to health care. Dr. Fitch speaks to audiences around the world on The 4 Steps from Burnout to Balance.

She is an oculoplastic surgeon and senior partner in practice in Atlanta. To follow Dr. Fitch and get free weekly stress-busting tips and inspiration, sign up for updates here. You can also connect with her on Facebook, Twitter, and LinkedIn. WWW.MEDMONTHLY.COM | 19

practice tips

Medical Practice Website Checklist

By Audrey Christie McLaughlin, RN It is uncommon to find a physician practice that is really maximizing the impact they could be having with their website and online presence. My team and I are frequently giving out information and checklists to clients so that they can get out of their heads and into their websites.

To start, if your practice doesn’t have a website, then your first step is to get a site — TODAY. But, by in large, the bigger challenge is what to do with your website once you have one.

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Here are a few basics: 1. Look into a user friendly website platform.

WordPress, for example, offers is one of the best platforms for your website. With a little shopping around you can get a custom, professional WordPress site designed for about $2500-$3500 (that should include logo design, and branding for your social media platforms to match). Generally hosting costs, domain purchase and registration will cost about $70 to $100 per year.

It is advisable to use a hosted WordPress site and NOT one originating from wordpress.com or .org.

Using a platform like Wordpress allows you or your staff to easily make simple changes, and to easily publish your blog if you desire.

2. Check for easy loading.

Your site should take less four seconds to load across major browsers. Avoid dense, heavy graphics, animations, auto-started videos or music, and pop-up ads that monopolize the entire screen until you close out or click thru the ad. (Pop-ups that float can be useful for mailing lists if you test them in your market and determine if they are right for you.) Be sure and leave plenty of white space.

3. Optimize your website for most browsers and mobile devices.

Patients/customers/clients come from all browsers; the top three continue to be Internet Explorer, Firefox, and Chrome users that come to your site. Make sure that your content is viewed easily on at least the top three browsers. More than 80% of people will be using their smartphones and tablets to find you online, so make sure your site is optimized for mobile. This is so important that Google actually checks this for search engine ranking.

tion from another trusted source. Sprinkle in a few posts about events or a particular upcoming holiday and you are running a well-maintained blog.

7. Stay-in-touch.

If you aren’t utilizing your website to stay-in-touch with your patients and prospective patients, you are missing the proverbial marketing boat! Weekly is best, but even a monthly newsletter is better than nothing.

This helps you stay in the forefront of your patients mind and ensure you are their go to resource.

Here is the most important tip for your website: 8. Throw away the digital brochure.

Gone are the days where your website works as a digital brochure listing all the great accolades of your staff and providers. Now your website should be a resource for patients and prospective patients that not only provides an insight into you and your practice but also informs them of other patients you have helped like them and how you can help them.

Your web presence is too important to leave to chance. Take action today and download our checklist. 

4. Connect to social media.

Use your web site to drive patients/clients/customers to your clinic’s Facebook fan page, Twitter account, LinkedIn company profile, and even YouTube channel and visa versa.

5. Check to see how recently your site has been updated.

Your website should be updated at a minimum of once per month., it keeps the Google Gods happy and means you stay relevant. Update your copyright dates too. And double check your pictures, make sure that your professional photo is up to date (no fresh-out-ofmed-school glamour shots, unless you are really fresh out of medical school).

6. Get blogging.

Statistically somewhere between 60-80 percent (depending on the source) of Internet users look up medical information online; if you have a blog with small posts about the aspects or ailments you are most passionate about, your site will become a living resource. Aim for one to two posts per month: At least one should be original information, the other could link to and discuss an interesting article or informaWWW.MEDMONTHLY.COM | 21

research & technology

NIH Researchers Pilot Predictive Medicine

by Studying Healthy People’s DNA

A new study by National Institutes of Health researchers has turned traditional genomics research on its head. Instead of trying to find a mutation in the genomic sequence of a person with a genetic disease, they sequenced the genomes of healthy participants, then analyzed the data to find “putative,” or presumed, mutations that would almost certainly lead to a genetic condition.

Out of almost 1,000 volunteers whose genomes were examined, about 100 had genomic variants predicting that they would have a rare disease. Almost half of them indeed had the disease when researchers went back and carefully evaluated them, said Leslie G. Biesecker, M.D., chief of the Medical Genomics and Metabolic Genetics Branch (MGMGB) at the National Human Genome Research Institute (NHGRI) and corresponding author of the study published June 4, 2015, in the American Journal of Human Genetics.

“We were surprised that this many individuals had positive findings in a group of individuals that is basically healthy,” said Jennifer Johnston, Ph.D., lead author and staff scientist with the Clinical Genetics Sec22 | JULY 2015

tion of the MGMGB. The research is part of ClinSeq, a large-scale, NIH research study that explores the fundamental medical, molecular and bioinformatic challenges facing individualized genome sequencing in a clinical research setting.

Once they identified participants with genomic mutations, researchers called them back to the clinic to give them a customized work-up. They called this method of looking at the person after looking at the genomic data “iterative phenotyping.” Researchers sifted through more than 100,000 variants per participant – nearly all harmless – and studied only potentially harmful mutations that were found in about 100 of the 951 participants. Of those hundred or so patients, 79 were followed up, and they confirmed that 34 had the specific condition linked to their genetic mutation.

These findings indicate that 3 percent or more of the U.S. population may have a genetic condition compared to previous estimates of less than 0.02 percent.

“We achieved about a 50 percent accuracy of predicting disease in people not knowing anything about their health status beforehand,” Dr. Biesecker said. In

‘‘

“These results show that you can dramatically improve your predictions based on genome sequence information.”

Dr. Biesecker Chief, Medical Genomics and Metabolic Genetics Branch (MGMGB) at NHGRI

other words, the researchers changed the odds of these patients having one of these diseases from something like 1 in 50,000 to 1 in 2.

Given this accuracy, Dr. Biesecker is upbeat about the future of genomic medicine. “These results show that you can dramatically improve your predictions based on genome sequence information.”

NHGRI Director Eric Green, M.D., Ph.D, agreed, adding: “Today, we tend to deliver medical care based on the expected response of the average patient, and yet we know that this is far from perfect. Eventually, we want to deliver medical care based on individual genomic differences that enable more precise ways to prevent and treat disease. These findings move us closer to that reality.”

The team also found that having a mutation did not always lead to a condition that looked like a textbook case. Indeed, 20 of 79 of the participants with harmful mutations and an associated physical change didn’t know they might have a genetic condition. Sometimes these physical changes were so mild that the participant had neither sought a diagnosis nor reported them to the research team during enrollment in the study. While it may seem unnecessary to find these mild cases, one key aspect of genomics is that the same mutation can affect family members with different levels of severity.

“A couple of the participants with LDLR (low density lipoprotein receptor) mutations thought they just had garden variety high cholesterol, when in fact they had familial hypercholesterolemia,” said Dr. Biesecker.

This led to more aggressive cholesterol screening in other family members, including children as young as eight, because early treatment can delay heart attacks and prolong life.

Researchers found other evidence that genetic conditions are underestimated. That is because, until now, knowledge about genetic conditions has mostly been based on family health history or ill people who walk

into a clinic. This has led researchers to study only those who are more severely affected and not those who are mildly affected or not affected at all, which eventually leads to an overestimation of the condition’s severity and an underestimation of its prevalence. The problem (ascertainment bias) has long been known and acknowledged by genetics researchers. They have only recently been able to address it as DNA sequencing costs have plummeted.

At this rate, just above 9 million people, about the population of New Jersey, may be living with some sort of genetic condition. The authors caution that not all healthy people need to have their genomes sequenced, emphasizing that this is a proof-of-concept study that may lead to a better understanding of how these mutations affect health. “We want to add DNA sequencing to the physician’s toolbox,” Dr. Biesecker said. “It is fine to take care of patients once they are sick and that’s appropriate, but wouldn’t it be better to find some patients before they are sick and take care of them?”  Source: http://www.nih.gov/news/health/jun2015/nhgri-04.htm

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research & technology

ICD-10 PCS -

We Don’t Know What We Don’t Know

By Dr. Jon Elion Founder and CEO of ChartWise Medical Systems After decades of experience with ICD-9, we have learned and come to grips with its quirks. We do not yet have that comfort level with ICD-10 -- after all, it’s still pretty new to most of us in the U.S. I’m not really concerned about the 24

| JULY 2015

diagnosis side of ICD-10 and its Clinical Modification, ICD-10CM. But what does concern me is ICD-10 PCS. So far, we don’t have a good idea of how this is going to impact reimbursement, and what documentation requirements are

really going to be needed. We really don’t know what we don’t know.

ICD-10-PCS coding demands a new level of documentation and coding specificity. There are few procedure codes in ICD-10 that will allow nonspecific or “not otherwise

specified” codes, as are allowed in ICD-9. In the ICD-9 coding environment, it is still possible to generate a code and get reimbursed even with minimal specificity. But under ICD-10, if specificity is lacking, there may not be a procedure code that can be used, and the reimbursement will therefore suffer.

Let’s look at “lysis of adhesions” to see how this applies. If a surgeon performs a laparoscopic procedure to free up something in the abdomen that’s trapped in scar tissue and the operative note concludes that the physician performed a “laparoscopic lysis of adhesions in the peritoneum,” that would be enough information to use ICD-9 code 54.51. But there is no direct equivalent for this in ICD-10, no code that is as vague as the one in ICD-9. Instead, the surgeon needs to describe exactly what organ or organs were “released” or freed up during the procedure. If it was a loop of small bowel caught up in adhesions, then the appropriate ICD-10 code would 0DN84ZZ (release small intestine, percutaneous endoscopic approach). It would require specific mention of the small bowel in order to be coded.

So where does the problem or uncertainty come into play with this? Well, let’s suppose (as is likely to happen) that the surgeon writes his or her usual comprehensive operative note that describes the procedure that includes a description of the dissection that was done around the small intestine. But the note itself simply states in the closing summary that the operation was a “laparoscopic lysis of adhesions in the peritoneum.” Can the coder use the description of the dissection around the small bowl to go ahead and code 0DN84ZZ? This

seems to still be open to interpretation, and the last thing coding managers want as we prepare to enter the ICD-10 era is uncertainty.

As I have traveled around the country speaking with various professional groups including national and local AHIMA chapters, ACDIS chapters and coding societies, the opinions on this subject vary. Many boldly state that they would be comfortable coding from this scenario, while others want the physician to be responsible for stating the details explicitly.

Where does this leave the Clinical Documentation Specialist? Will they be left with the responsibility for creating and managing the thousands and thousands of queries that are going to be needed to get the necessary clarification from the surgeons?

We don’t yet know.  Dr. Jonathan Elion, MD, FACC, is a practicing board-certified cardiologist in Providence, RI and an Associate Professor of Medicine at Brown University. With over 40 years of experience in computing and more than 25 years of experience in medical computing and information standards, Dr. Elion has committed his career to innovations in high value services and healthcare delivery to maximize efficiency and cost effectiveness. Jon is the founder of ChartWise Medical Systems, Inc., a Rhode Island based company that recently introduced ChartWise 2.0.

It is the first-to-market interactive software system designed to improve precision in quality clinical documentation and to support revenue assurance through its web-based, comprehensive built-in expertise, electronic queries and robust ondemand reporting.

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research & technology

Strong Market for Digital Health Solutions Aimed at Closing Information Gaps in Patient Care

26 | JULY 2015

An important driver of the rapid adoption of new digital health solutions by payers and providers is the need to better track and manage patients across acute, ambulatory and home care settings. While the use of electronic health records (EHRs) are critical to improving data capture, EHRs are often siloed data sources that lack the interoperability and functionality needed for full coordination and communication among dispersed patient care teams. Care Coordination Software refers to IT applications that are specifically designed to enable team-based patient care, particularly for at-risk patients with chronic conditions and for patients transitioning between care settings (e.g., hospital to home).

New analysis from Frost & Sullivan, Care Coordination Software: Overview and Outlook, 2014-2020, finds that IT solutions that enable various functions related to proactive patient care management are expected to grow significantly over the next six years.

“Care coordination is an expansion of the traditional care management function assumed mostly by payers,” said Frost & Sullivan Principal Connected Health Analyst Nancy Fabozzi. “Hospitals and physicians will increasingly look to deploy new IT to manage this function as they take on more risk, but key purchasing decisions for care coordination are likely to remain entrenched in the enterprise (e.g., health plans, IDNs, ACOs).

Care coordination software’s end-use applications span a wide range of health IT solutions, from rudimentary to robust. To enable team-based care and ensure smooth care transitions and efficient use of healthcare resources, care coordination software should

‘‘

“In the next six years, the digital health market is likely to experience a continuous flurry of new products and services specifically designed to help smooth the pain points associated with transitioning from fee-for-service.”

be flexible and extensible, with corresponding accountability, transparency of information, and ability to provide analysis and reporting among key stakeholders.

The winners in this market will provide solutions with unified, secure and workflow-enabled platforms that can quickly identify and manage at-risk patients. Additionally, the solutions will enable care teams to implement and track care plans, engage patients in self-management, as well as provide closedloop, 24/7 communication among all stakeholders, including patients and their families.

Frost & Sullivan forecasts the total market to grow at a compound annual growth rate (CAGR) of 26.1 percent between 2015 and 2020.

Among the three key market segments addressed in the study, care coordination software deployed by physicians in ambulatory practice is expected to be the fastest growing, at a CAGR of 43.2 percent. It is followed by the hospital market segment at a CAGR of 33.2 percent.

Although the largest revenue for 2014 belonged to the healthcare payers segment, this segment is expected to grow more slowly than the other segments with a CAGR of 21.5% over for the forecast period.

“In the next six years, the digital health market is likely to experience a continuous flurry of new products and services specifically designed to help smooth the pain points associated with transitioning from fee-for-service,” according to Fabozzi. “The move to value-based reimbursement is already a key driver for health IT, and efforts toward developing solutions for care coordination and population health management will accelerate significantly.”

Care Coordination Software: Overview and Outlook, 2014-2020 is part of the Connected Health Growth Partnership Service program, which also includes research in the following markets: health information exchange, health data analytics, telehealth, emerging wireless technologies, acute care information systems, enterprise clinical information systems and billing and revenue cycle management systems. All research services included in subscriptions provide detailed market opportunities and industry trends evaluated following extensive interviews with market participants.  About Frost & Sullivan Frost & Sullivan (frost.com), the Growth Partnership Company, works in collaboration with clients to leverage visionary innovation that addresses the global challenges and related growth opportunities that will make or break today’s market participants.

Source: http://www.newswiretoday. com/news/152696/ WWW.MEDMONTHLY.COM | 27

legal

“Implausible” That Scheme to Induce Referrals Would Leave Physician Ignorant of Its True Purpose

By Tony Maida and Lauren D’Agostino McDermott Will & Emery In a rare motion to dismiss ruling, a Pennsylvania federal judge rejected as “implausible” a theory that a hospital entered into on-call contracts with a physician with an illicit intent that was so covert that even the physician himself did not understand that the contracts were designed to induce him to refer Medicare patients in violation of the Anti-Kickback Statute (AKS). Although the relator in Cooper v. Pottstown Hospital Co., LLC, No. 13-01137, 2015 WL 1137664 (E.D. Penn. Mar. 12, 2015) alleged that the on-call contracts were improper inducements based upon the 28 | JULY 2015

later efforts of the hospital to pressure the physician to end his financial relationship with a competitor, the court found that the relator failed to plead enough facts to show that the hospital entered into the contracts with the intent to induce referrals. This case is unusual because most AKS cases that turn on issues of the defendant’s intent involve factual disputes that survive motions practice and are slated for resolution at trial.

This case highlights how allegations of AKS violations can intermingle with the “economic credential-

ing” policies of hospitals who have a legitimate interest in preserving their ability to choose who to contract with and under what restrictions. One takeaway from this case is the importance of hospitals having clear policies concerning competitive restrictions in its physician contracts and medical privileges. Misunderstandings on this issue can result in unnecessary litigation. While clear policies may decrease some misunderstandings, non-competes and other economic credentialing practices carry inherent risk under various laws, including the AKS. The relator, an orthopedic surgeon, was employed

by Pottstown Medical Specialists, Inc. (PMSI) and had privileges at Pottstown Memorial Medical Center (Pottstown) since 1999. In 2005, Community Health Systems, Inc. acquired Pottstown and purchased a minority interest in PMSI. In February 2010, the relator entered into an on-call contract with Pottstown compensating him a fixed fee for any day he provided oncall coverage for the ER. The on-call contract allowed either party to terminate without cause by providing 60 days’ written notice. The relator alleged that in October 2010, Pottstown’s management learned that he had a financial interest in a new hospital opening a few miles away and pressured him to divest his interest in this new competitor and refer his patients to Pottstown. After the relator refused, Pottstown exercised its right to terminate his on-call contract without cause.

The following year, the parties entered into a new on-call contract, which allowed the relator to continue his affiliation with the competitor, but added a restrictive covenant preventing the relator from entering into any agreement to provide services to any other facility within 30 miles without Pottstown’s prior written consent. The relator alleged that while his second on-call agreement was in effect, his employment contract with PMSI was not renewed because of his financial interest in the competitor. The relator then entered into employment with another hospital and, as a result of that new employment agreement, Pottstown invoked the restrictive covenant to terminate his second oncall contract. The relator brought aqui tam complaint alleging that Pottstown’s on-call contracts, and the payments made under them, violated the AKS because Pottstown’s intended purpose behind the on-call contracts was to induce him to refer patients (particularly his Medicare patients) to Pottstown. The United States declined to intervene.

The key weakness in this complaint was the ab-

sence of any classic hallmark of illegal intent by the hospital during the negotiation of the on-call contracts; instead the relator relied solely on the hospital’s behavior after the agreements were in place for several months. Most significantly to the court, the relator failed to plead facts showing that (a) the on-call contract negotiations were not at arms-length, (b) the hospital lacked a business need for on-call coverage by orthopedic surgeons and (c) his compensation exceeded fair market value. Combined with other more plausible explanations for the hospital’s behavior and the relator’s proclaimed ignorance of the hospital’s alleged illicit intent to induce referrals until after his employment and on-call contracts ended, the court concluded that the relator had not alleged sufficient facts showing that the on-call contracts were meant to induce referrals, reasoning that “[a]ny practicable scheme to induce referrals would not have left him [Relator] ignorant of its true purpose.”

Notwithstanding this decision, providers should proceed cautiously and seek legal advice related to arrangements with physicians based upon economic credentialing. Courts, and regulatory agencies, may interpret tying certain contracts for physician services to economic criteria as giving a physician an opportunity to earn money, which may constitute an improper inducement if the requisite intent exists. For instance in United States ex rel. Fry v. Health Alliance of Greater Cincinnati, No. 1:03-CV-00167 (S.D. Ohio Dec. 10, 2008), a federal trial judge denied a motion to dismiss a complaint alleging that defendants engaged in a “pay to play” scheme by assigning time to cardiologists in their hospital’s heart station in proportion to the volume of referrals of cardiac procedures made by the cardiologists to the hospital. Ultimately, those defendants paid $108 million to the government in an FCA settlement. And, while initially rejecting a Corporate Integrity Agreement as part of the resolution, the hospital entered into one after receiving a rare notice proposing exclusion of the hospital from the Office of Inspector (OIG) General following the settlement.

The significant payment and the very rare action by OIG to begin potential exclusion proceedings against a large hospital show the gravity of the possible risks of getting on the wrong side of the government on these thorny issues.  Source: http://www.fcaupdate.com/2015/03/implausible-that-scheme-to-induce-referrals-would-leave-physician-ignorant-of-its-true-purpose/ WWW.MEDMONTHLY.COM | 29

legal

Several States Enact Telehealth Parity Laws in 2015

By Philip Peisch Covington & Burling LLP

States are continuing to debate the role telehealth services should play in the health care system. Thus far in 2015, several States have enacted parity laws requiring that certain telehealth services be reimbursed to the same extent as in-person services. While on the whole more states are moving toward parity and encouraging or requiring reimbursement for telemedicine, that trend is not universal, and many of the States with parity laws 30 | JULY 2015

only extend parity to telehealth services that meet certain conditions.

In 2015, a handful of states have enacted important telehealth legislation: • Last month Washington enacted an wide-ranging telehealth parity law requiring health plans to cover services delivered through “telemedicine” or “store and forward technology,” if: the plan covers the service when delivered in person; the

service is medically necessary; and the service is “recognized as an essential health benefit” under the Affordable Care Act. The breadth of the law is impressive: it covers PPOs, HMOs, Medicaid MCOs, and entities that offer either disability insurance or health plans to state employees. On the other hand, the law does include several restrictions on telehealth reimbursement. It has a narrow definition

of telemedicine that excludes telephone, facsimile, email, text or other telehealth methods that do not include a video component, which is a common statutory restriction found in other parity laws. It also only allows hospitals with patients receiving telemedicine services to rely on a distant site’s privileging decision only if the physician is licensed by the State of Washington. Finally, the law is silent on whether telemedicine payment rates must be identical to rates for the same services provided in-person (in fact, an earlier version of the law that would have expressly required parity in rates was not adopted).

• In March, Arkansas enacted a much more limited telehealth parity law. Arkansas’ law covers physician services only and requires patients to establish a face-to-face relationship with the physician before telehealth services are eligible for reimbursement.

• In January, New York amended its preexisting parity law to broaden coverage for telehealth specialty care services. Most notably, it expanded the list of telehealth care providers that must be reimbursed at the same rate as in-person providers to include psychologists, social workers, speech language pathologists and midwives, among others. The law also clarifies that services that use of audio-only telephones, facsimile or email are still covered by the parity law so long as they are used in conjunction with telemedicine, remote patient monitoring, or store and forward technology.

• Colorado amended its tele-

health parity law to require health plans to provide parity in coverage for urban residents by removing a restriction that had limited application of the State’s parity requirements to coverage provided to individuals residing in counties with 150,000 residents or fewer.

• Texas is the only State thus far this year to impose additional limits on telemedicine. In April, the Texas Medical Board sharply curtailed the use of telemedicine by voting to prohibit doctors from treating patients through e-mail, text, or telephonic communication, unless another medical professional is physically present to examine the patient. This severely limits the effect of the state’s existing parity law, which was enacted in 1997, and highlights how the existence of a parity law may not necessarily mean access to telehealth services. However, a suit has been filed to overturn the board’s decision.

So what can providers, insureres, technology developers, and other interested parties take away from all of these developments in 2015?

First, states are increasingly encouraging or requiring health plans to reimburse for telehealth services to ensure access to health care, including by enacting or broadening the applicability of telehealth parity laws.

Notwithstanding these developments, the expansion of telehealth coverage in 2015 can also be described as two steps forward and one step back, as States are adopting both parity laws and restrictions to constrain reimbursement.

For example, while Arkansas made progress by enacting a parity law, it also codified restrictions that

will severely limit coverage. The Washington law, although not nearly as restrictive as its Arkansas counterpart, also limits the types of telehealth services for which health plans must provide parity. And the Texas Medical Board’s decision is a major setback for parity advocates.

In addition, the jury is still out as to whether States will require telemedicine to reach urban populations. For example, Arizona, Oklahoma, and Utah all still require private insurers to provide coverage only when the originating site is located in a rural region.

Finally, at least one area of coverage has been curtailed by several states: the use of telemedicine to prescribe “abortion-inducing drugs” was banned in Arkansas and Idaho in 2015, bringing the total number of states that have done so to 16. A similar restriction recently passed the Montana legislature, but it was vetoed by the governor.

A case challenging the Iowa Board of Medicine’s actions to the same effect is currently being litigated before the Iowa Supreme Court.

On the whole, the expansion of telehealth services through parity laws has gained traction in 2015, but wide-scale adoption has been met with resistance in some states.

Moving forward, special attention should be paid to the Minnesota, Pennsylvania, and Delaware legislatures, among others, where proposed parity legislation may be acted on in 2015.  Gabriel Kohan, co-author of this article, is a summer associate and student at Harvard Law School.

Source: http://www.covingtonehealth.com/2015/06/several-statesenact-telehealth-parity-lawsin-2015/ WWW.MEDMONTHLY.COM | 31

features

How to Structure Your Practice Website for Success

By Naren Arulrajah with Vikas Vij Ekwa Marketing

A

well-designed healthcare practice website can prove to be one of the most effective ways of introducing a practice brand to potential patients. Patients today are extremely selective about their choices and will look at a variety of aspects of a brand before deciding whether or not it addresses their needs effectively. However, regard-

32

| JULY 2015

less of how extensive the digital presence of a brand is, one of the first places that prospects visit is the brand website.

This is one of the reasons why it is important to structure your practice website in a way that both appeals to your target base and builds credibility. Not only does this help in making it easier for potential patients to decide which

practice brand is in sync with their needs and expectations but it also effectively improves the website’s search engine rankings. The more relevant your practice website is to user queries, the better your rankings in search engine results page (SERP).

User-friendly Website Design A user-friendly website can go a long way in delivering improved

user experience (UX). Everything from how easy it is to navigate your practice website, to accessing your content, and to the availability of contact information are important aspects of a user-friendly website.

Here are a few more things to keep in mind.

Simple and Intuitive Navigation Site navigation is crucial to delivering high quality UX. Ensure that every element of your practice website is easy to access. Simplify your resources menu so visitors find it easy to access and navigate the other pages of your practice website.

Include a Search Bar A search bar can help your site visitors quickly access information that is specific to their needs.

Ideally, the search bar should be located near the upper right side of the website page.

Update your Content on a Regular Basis Regular content updates not only help in keeping search engine bots happy and busy on your site, but they also keep you fresh in the minds of your target audience. In addition to updating your site with useful articles, maintain a blog and address niche-focused topics that help you build a reputation as a though leader. In addition to these, make sure to include visual elements such as videos, podcasts, Slideshare, webinars, and infographics to deliver information.

ternal links or external links, make sure they are appropriate and that they work.

Easy Access to Contact Information Clearly feature all contact information on your practice website as well as directions or maps to your offline practice location. Your email address and phone number should be featured on the top right or in the footer of your web pages. Make sure to provide a contact form so potential patients can easily leave a name and return email address.

Sophistication without Complications Website designs today include a lot of design trimmings that definitely make for pretty viewing.

However, loud colors, auto-playing tracks in the background and flashing adverts don’t appeal to today’s audiences. This is why it is best to adopt design elements that add a level of sophistication while also giving your practice website a professional appeal. Try not to include too many elements on your web pages. Keep in mind that each page has a specific purpose. Remove unnecessary page elements as they only serve to distract the visitor.

The Right Domain Name One of the most important and critical aspects of a well-structured website pertains to the domain name. In addition to ensuring that your website domain name is appropriate to the services your practice provides, it needs to be easy enough for potential patients Feature Links that are Highly to remember. When planning your Relevant and Useful The use of links can help improve practice website domain name, spend a little time thinking of your overall content structure as words that best describe your praclong as they are highly relevant tice. A unique name that is not too to the topic and are of use to the reader. Whether you include incontinued on page 34 WWW.MEDMONTHLY.COM | 33

continued from page 33

long and is reflective of your practice brand is always a good choice.

Search Engine Optimized Website Search engine optimization or SEO can help boost your practice website in search engine rankings.

Search engines prioritize websites based on the quality and relevance of their content in context to search queries. This means the best way to optimize your site for search engines is by providing highly relevant, useful and quality-based content. Make sure you update your content on a regular basis and use local optimization techniques to attract users searching for a doctor or medical professional nearby. Also ensure that you have a local landing page for your practice location(s) including an embedded Google Map in addition to featuring all

16

| JULY 2015

other important contact information. Claim your Google+ page; build a robust social presence in addition to building a presence on leading review sites.

Responsive Website Design is no Longer Optional In addition to easy navigation, websites need to be completely responsive if they want to appeal to the growing number of mobile device users. Mobile is getting bigger and each day the number of potential patients who use their mobile devices to access your practice website is also increasing. Furthermore, Google has now made it official – the search engine giant is prioritizing rankings for mobile-friendly websites.

The basic premise of a responsive site is simple – make it easy for people to access a website without having to zoom and scroll horizon-

tally and vertically to see the entire page and regardless of the device type in use. If your practice website can be easily accessed and is readable on mobile and tablet devices, potential patients will find it easier to learn about your practice and to contact you.  About the Author: Naren Arulrajah is President and CEO of Ekwa Marketing, a complete Internet marketing company which focuses on SEO, social media, marketing education and the online reputations of Dentists and Physicians.

With a team of 130+ full time marketers, www.ekwa.com helps doctors who know where they want to go, get there by dominating their market and growing their business significantly year after year. If you have questions about marketing your practice online, call Naren direct at 877-249-9666.

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features

When Bad Websites Happen to Good Doctors: Do-It-Yourself Templates or Custom Design?

By Amanda Kanaan WhiteCoat Designs

Various surveys have confirmed that a large number of patients search online for healthcare information these days (roughly 75% of American adults – about half of which are seeking treatment). With that many patients online, it’s undeniable that having a website is important. However, how important is it that your website be well-designed and highly ranked in Google? The answer to that may determine whether a do-it-yourself template or a custom design is your best option.

Some doctors may think that all they really need is an online brochure essentially (a site with the practice phone number, address, a list of services and a few pretty pictures). So they use a do-it-yourself web template thinking they’ll get the site up quick, and for very little cost. Pursuing a do-it-yourself website builder is similar to how your patients attempt to diagnose themselves through medical websites like WebMD – it’s possible, but it just can’t take the place of a trained professional.

Your website may be patients’ first and last impression of your practice. And it’s not just about the way your website looks; a bad website can also negatively affect your patients’ experience and also inhibit you from ranking well in the search engines (Google).

Here are three reasons why you might want to consider hiring a professional web design agency to create your website.

36 | JULY 2015

1. Branding

Your website has less than 7 seconds to make an impression on a patient or it’s on to the next.

Just as taking a one-size-fits-all approach to your patient care would have negative effects on outcomes, a do-it-yourself website design can have a negative impact on your branding.

Customization options with do-it-yourself templates are limited and therefore your site may end up looking very generic. For patients who are searching online and comparing you to your competition (who may have put much more thought and effort into their online presence), you just made the decision very easy for that patient.

To many patients, an outdated website implies outdated care. If you want to accurately “tell your story” online, you need a website that truly represents who you are as a practice. A surgical practice may offer state-of-the-art robotic surgery, but if their website looks like it hasn’t been touched since 2001 then they are sending a mixed message.

Think about it – would you trust Amazon.com if its design quality was comparable to the local hair salon down the street?

2. Search Engine Rankings

One thing all these do-it-yourself website builders don’t advertise is the fact that they are not

favorable for Search Engine Optimization purposes (your rankings in Google and other search engines).

The way your site is programmed and optimized to be crawled by the search engines is important; it’s the difference between Google having to take the “stairs” versus the “elevator” to crawl your site – i.e. it’s much more difficult to rank your site when the coding doesn’t support such.

3. Patient Experience

By not investing in a customizable website, you may also negatively impact the patient experience. A well-thoughtout custom medical site allows for such patient-friendly features as HIPAA compliant online registration forms, special tools like a pediatric dosage calculator, and a layout that improves the ease of navigation.

The mobile experience can also suffer since self-built sites that are data and graphics heavy are slow-loading and turn off mobile users by using up their limited data plans faster.

Patients are searching online more than ever and it doesn’t matter if your patient population is young or old (the 55+ age group is the fastest growing on Facebook according to a report from iStrategyLabs). Therefore, a well-designed, highly functional and well-ranked website is one of your most important, if not THE most important marketing investment you’ll make in your practice.

With that said, just because you decide to go the custom route does not mean you are guaranteed a great website.

Everyone, including the neighbor’s teenage son, advertises custom website design these days, so be sure to do your homework and ask for past examples and references. It also helps to work with an agency who is experienced in medical web design specifically.

While a do-it-yourself template is more of a time commitment and a professional web design is more of a financial commitment, when choosing between the two keep in mind the factors explained above. While you may save money on the front-end with a website builder, it can definitely cost you more in the long-term. Professional web design is an art that requires a true process; a series of questions need to be answered to establish goals and ensure the site is intuitive, is a strong marketing tool and improves the patient experience.  Amanda Kanaan is the President and Founder of WhiteCoat Designs – a medical marketing agency whose mission is to help physicians stand out in today’s competitive healthcare market.

Services include medical website design, internet marketing, social media, branding and physician liaison programs (increase referrals). Learn more at www.whitecoat-designs.com.

features

Your Practice Website Can Make or Break You (Do you have the 12 crucial key elements?)

By Barbara Hales, M.D. www.thewritetreatment.com

38 | JULY 2015

Visualize the experience that viewers have when visiting your website.

Designing a website is one that is planned in an optimal manner with precise sequencing. While every site needs fresh content, throwing it all up on the screen, hoping that some resonates, will only serve to create needless clutter and anxiety.

Ideally, your site includes the 3 I’s: • Inviting • Informative • Interactive When a viewer lands on your site, it should be clear as to: 1. How to contact the practice Telephone number, fax number, email addresses and location are crucial bits of information. Providing a Contact Us page gathers all this data in one place.

The telephone number of the practice is so important that not only should it be very visible, it should also appear prominently on every page of the site. When prospective patients want to make an appointment, don’t make them hunt or frustrate them into remembering where the only number appears.

2. Who you are Prospective patients are researching online all about physicians within a practice nowadays before an appointment is even made.

Include a bio page that names each physician along with medical school diplomas, and hospital trainings. Be sure to include fellowships and additional certifications.

Most importantly, if you are certified in a specific area of medicine, this should be prominently displayed.

3. Services you provide List the procedures that you provide with descriptions that are understandable to patients including specification as to which ones are performed in the office, and which ones are done in the hospital or surgicenter. Links to videos showing techniques in depth are quite helpful.

4. Insurance plans and Billing List which insurance plans that your office accepts along with how payment is received including which credit cards you take, checks, PayPal or any payment plans.

Invite prospective patients to call about any coverage they have that is not listed.

5. Hospital Affiliations List all hospital affiliations that your practice works with along with location information and any links to them.

6. Coverage Inform viewers whether your practice is covered by associated physicians or strictly with doctors within the practice. Inform them what they should do after office hours or in an emergency.

7. Office and Staff Prominently display office hours and days of the week that the practice sees patients (including any special call hours if there is such a policy).

Include photos of nurses, nurse practitioners, medical assistants and other office staff along with a description of their function and their bios. This way, new patients continued on page 40 WWW.MEDMONTHLY.COM | 39

continued from page 39

are already familiar with the flow of the office even before the first visit which decreases stress and tension.

8. Website Navigation Include a tab bar with titles and links to various pages so that viewers can transition between pages they are seeking with only one or two clicks.

9. Instructional Forms Include links to various instructional forms written in PDF format. These would include: • Preoperative and Postoperative instructions • How to prepare for an examination or procedure • What to bring to the hospital or office • What to expect prior to a procedure • What recovery periods look like including duration • Most popular F and Q sheets Having these sheets available make patients more informed and more comfortable while cutting down on frantic calls to the office.

10. Online Services More and more patients are tech savvy and want an instant connection to your practice so that they can connect on their own time. Delineate what you offer such as: • Online appointment requests • Patient personal history • Prescription refills • Questions • Lab results • Connection with their smart devices • Telemedicine/ e-visits 11. Web Portal Services To meet the criteria of meaningful use, a minimum of 5% of your patients must be interactive with your practice through a patient portal although it is a good idea that all your patients have access to one.

Provide a link on the home page to the web portal and have a portal area, complete with log in and password for security. When patients make entries, responses should be forthcoming.

12. Blogs and Social Media Interactions Having a link to your blog posts enables you to let your viewers know about the latest medical break40 | JUNE 2015

throughs, latest medical trends, and any ongoing information that you would like to let your patients know about.

You can add entertaining stories and case studies related to your practice. Let your personality shine through so patients feel that they know you. This is a place where fresh content can be constantly added which helps patients, keeps viewers returning to your site and increases your ranking on various search engines like Google.

YouTube is a great place to showcase medical and surgical procedures (taking care not to disclose a specific patient in any way).

Instagram, which is growing in popularity, allows you to add photos of equipment and various techniques.

Your website will determine how successful your practice is at attracting prospective patients and converting them from mere lookers into active, engaged and happy patients.  Contact me for a free consultation at Support@CompleteContentPackage.com. I would be happy to discuss your needs and how to successfully get you there.

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?

Contact Barbara Hales, M.D. for a free consultation.

Barbara@TheWriteTreatment.com 516-647-3002

WWW.MEDMONTHLY.COM | 35

healthy living

Grilled Vegetable Quesadilla with Goat Cheese and Pesto

(Adapted from: http://www.domesticate-me.com/grilled-vegetable-quesadilla/)

By Ashley Acornley, MS, RD, LDN June starts the beginning of summer and nothing says summer like grilling outside on a beautiful day. Packed with flavor and color, this quesadilla is satisfying and delicious while giving you healthy vegetables, calcium and whole grains. With the yellow squash and zucchini being fresh and in season right now, there is no better time to whip up a quick and easy, nutrient rich quesadilla that is suitable for any day of the week.

Ingredients: 1 small zucchini, diagonally sliced into ¼ inch pieces 1 small summer squash, diagonally sliced into ¼ inch pieces 1 red bell pepper, stem and seeds removed 1 small red onion, sliced into ¼ inch rounds 1 large Portobello mushroom, cleaned & sliced into ½ inch pieces 1 tablespoon extra virgin olive oil 1 pinch of salt 1 pinch of pepper 4 whole grain tortillas (can use corn tortillas if desired) 4 tablespoons pesto, divided 3/4 cup part-skim mozzarella cheese, divided 4 oz. goat cheese, divided

Preparation: Nutrition Facts Per Serving Calories: 550 Fat: 32g Saturated Fat: 13g Sodium: 640mg Carbs: 13g Fiber: 6g Protein: 24g Potassium: 420mg

42

| JULY 2015

1. Preparing the vegetables: drizzle the sliced vegetables with 2 tbsp. olive oil and season with salt and pepper.

2. Place vegetables on the grill and cook for approximately 3 minutes on each side (until tender) 3. Remove vegetables from grill and let cool for 5 min. Cut vegetables into 1 inch pieces and set aside.

4. Assembling Quesadilla: spread tortilla with 1 tablespoon of pesto.

Sprinkle ¼ cup of mozzarella cheese on ½ of the tortilla, Add ¼ of the grilled vegetables and crumbled 1oz of goat cheese over them.

Sprinkle another ¼ cup mozzarella on top and fold the tortilla over to close.

5. Place the quesadilla on a lightly oiled grill and cook for 3 minutes on each side until cheese is melted. Slice and Serve.

U.S. OPTICAL BOARDS Alaska P.O. Box 110806 Juneau, AK 99811 (907)465-5470 http://www.commerce.state.ak.us/dnn/ cbpl/ProfessionalLicensing/DispensingOpticians.aspx Arizona 1400 W. Washington, Rm. 230 Phoenix, AZ 85007 (602)542-3095 http://www.do.az.gov Arkansas P.O. Box 627 Helena, AR 72342 (870)572-2847 California 2005 Evergreen St., Ste. 1200 Sacramento, CA 95815 (916)263-2382 http://www.optometry.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.ct.gov/dph/cwp/view. asp?a=3121&q=427586 Florida 4052 Bald Cypress Way, Bin C08 Tallahassee, FL 32399 (850)245-4474 http://www.pof.org/opticianry-board/ Georgia 237 Coliseum Dr. Macon, GA 31217 (478)207-1671 http://sos.ga.gov/index.php/licensing/ plb/20 Hawaii P.O. Box 3469 Honolulu, HI 96801 (808)586-2704 http://hawaii.gov/dcca/pvl/programs/ dispensingoptician/

Idaho 450 W. State St., 10th Floor Boise , ID 83720 (208)334-5500 http://www.ironforidaho.net/

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

Kentucky P.O. Box 1360 Frankfurt, KY 40602 (502)564-3296 http://www.opticiantraining.org/optician-training-kentucky/

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

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

South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4665 www.llr.state.sc.us

Nevada P.O. Box 70503 Reno, NV 89570 (775)853-1421 http://nvbdo.state.nv.us/

Tennessee Heritage Place Metro Center 227 French Landing, Ste. 300 Nashville, TN 37243 (615)253-6061 http://health.state.tn.us/boards/do/

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/

Texas P.O. Box 149347 Austin, TX 78714 (512)834-6661 http://www.tob.state.tx.us/ 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 http://www.dpor.virginia.gov/Boards/ HAS-Opticians/ 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 | 43

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://commerce.alaska.gov/dnn/cbpl/ ProfessionalLicensing/BoardofDentalExaminers.aspx Arizona 4205 N. 7th Ave. Suite 300 Phoenix, AZ 85103 (602)242-1492 http://azdentalboard.us/

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/

Arkansas 101 E. Capitol Ave., Suite 111 Little Rock, AR 72201 (501)682-2085 http://www.asbde.org/

Illinois 320 W. Washington St. Springfield, IL 62786 (217)785-0820 http://bit.ly/svi6Od

California 2005 Evergreen Street, Suite 1550Â Sacramento, CA 95815 877-729-7789 http://www.dbc.ca.gov/

Indiana 402 W. Washington St., Room W072 Indianapolis, IN 46204 (317)232-2980 http://www.in.gov/pla/dental.htm

Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7800 http://www.dora.state.co.us/dental/

Iowa 400 SW 8th St. Suite D Des Moines, IA 50309 (515)281-5157 http://www.state.ia.us/dentalboard/

Connecticut 410 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/cwp/view. asp?a=3143&q=388884

Kansas 900 SW Jackson Room 564-S Topeka, KS 66612 (785)296-6400 http://www.dental.ks.gov/

Delaware Cannon Building, Suite 203 861 Solver Lake Blvd.

Dover, DE 19904 (302)744-4500 http://1.usa.gov/t0mbWZ

Kentucky 312 Whittington Parkway, Suite 101 Louisville, KY 40222 (502)429-7280 http://dentistry.ky.gov/

Florida 4052 Bald Cypress Way Bin C-08 Tallahassee, FL 32399 (850)245-4474 http://floridasdentistry.gov/ 44

Georgia 237 Coliseum Drive Macon, GA 31217 (478)207-2440 https://gbd.georgia.gov/

| JULY 2015

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.ok.gov/dentistry/

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://governor.vermont.gov/boards_ and_commissions/dental_examiners 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 | 45

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://commerce.alaska.gov/dnn/cbpl/ ProfessionalLicensing/StateMedicalBoard.aspx 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/cwp/view. asp?a=3143&q=388902 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://doh.dc.gov/bomed 46 | JULY 2015

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/Pages/default.aspx

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://www.tmb.state.tx.us/

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/licensing/physician_surgeon.html

Oklahoma P.O. Box 18256 Oklahoma City, OK 73154 (405)962-1400 http://www.okmedicalboard.org/ Oregon 1500 SW 1st Ave., Suite 620 Portland, OR 97201 (971)673-2700 http://www.oregon.gov/OMB/ 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/

Vermont P.O. Box 70 Burlington, VT 05402 (802)657-4220 http://1.usa.gov/wMdnxh Virginia Virginia Dept. of Health Professions Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4400 http://1.usa.gov/xjfJXK 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://dsps.wi.gov/Boards-Councils/ Board-Pages/Medical-Examining-BoardMain-Page/ Wyoming 320 W. 25th St., Suite 200 Cheyenne, WY 82002 (307)778-7053 http://wyomedboard.state.wy.us/

WWW.MEDMONTHLY.COM | 47

medical resource guide ACCOUNTING

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

www.pushpa.biz

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

BILLING & COLLECTION

DENTAL 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

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

48 | JULY 2015

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

The Dental Box Company, Inc.

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

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 www.AccountingProfessionalsAgency.com

FINANCIAL CONSULTANTS 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

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

LOCUM TENENS Physician Solutions

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

MEDICAL ARCHITECTS MMA Medical Architects

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

medical resource guide WhiteCoat Designs

MEDICAL ART Deborah Brenner

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

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

MEDICAL PRACTICE SALES

PROFESSIONAL SPEAKER Capri Health

Angela Savitri, OTR/L, RYT, IHC, RCST速 919-673-2813 angela@caprihealth.com www.freedomfromchronicstress.com

MedImagery

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

Medical Practice Listings

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

MEDICAL EQUIPMENT MEDICAL PRACTICE VALUATIONS

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

BizScore

www.assurepharma.com

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

www.thetps.com

MEDICAL RESEARCH

Bank of America

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

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

STAFFING COMPANIES

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

MEDICAL EQUIPMENT FINANCING

REAL ESTATE

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

SUPPLIES, GENERAL

Scynexis, Inc.

3501 C Tricenter Blvd.

Durham, NC 27713 (919) 933-4990

CNF Medical www.scynexis.com

PRACTICE FINANCING

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

www.bankofamerica.com/practicesolutions

Bank of America

MEDICAL MARKETING Ekwa Marketing

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

303, Pinetree Way Mississauga Ontario L5G 2R4, Canada (855) 345-0593 www.ekwa.com

WWW.MEDMONTHLY.COM | 49

Practices for Sale Medical Practices Primary Care specializing in Women’s Practice Location: Morehead City, N.C. List Price: Just reduced to $20,000 or Best Offer Gross Yearly Income: $540,000 average for past 3 years Year Established: 2005 Average Patients per Day: 12 to 22 Building Owned/Leased: MD owned and can be leased or purchased Contact: Cara or Philip at 919-848-4202

Family Primary Care Practice

Location: Minutes East of Raleigh, North Carolina List Price: $15,000 or Best Offer Gross Yearly Income: $235,000 Average Patients per Day: 8 to 12 Total Exam Rooms: 6 Physician retiring, Beautiful practice Building Owned/Leased: Owned (For Sale or Lease) Contact: Cara or Philip 919-848-4202

Family Practice/Primary Care

Location: Hickory, North Carolina List Price: $425,000 Gross Yearly Income: $1,5000,000 Year Established: 2007 Average Patients Per Day: 24-35 Total Exam Rooms: 5 Building Owned/Leased: Lease or Purchase Contact: Cara or Philip at 919-848-4202

Med Spa

Location: Coastal North Carolina List Price: $550,000 Gross Yearly Income: $1,600,000.00 Year Established: 2005 Average Patients Per Day: 25 to 30 Total Exam Rooms: 4 Building Owned/Leased: Leased Contact: Cara or Philip at 919-848-4202

Practice Type: Mental Health, Neuropsychological and Psychological Location: Wilmington, NC List Price: $110,000 Gross Yearly Income: $144,000 Year Established: 2000 Average Patients Per Day: 8 Building Owned/Leased/Price: Owned Contact: Cara or Philip at 919-848-4202

Practice Type: Internal Medicine

Location: Wilmington, NC List Price: $85,000 Gross Yearly Income: $469,000 Year Established: 2000 Average Patients per Day: 25 Building Owned/Leased: Owned Contact: Cara or Philip at 919-848-4202

Dental Practices Place Your Ad Here

Optical Practices Place Your Ad Here

Special Listings Offer We are offering our “For Sale By Owner” package at a special rate. With a 6 month agreement, you receive 3 months free.

Considering your practice options? Call us today.

50 | JULY 2015

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

PRIMARY CARE PRACTICE - Hickory, North Carolina This is an outstanding opportunity to acquire one of the most organized and profitable primary care practices in the area. Grossing a million and a half yearly, the principal physician enjoys ordinary practice income of over $300,000 annually.

Hickory is located in the foot-hills of North Carolina and is surrounded by picturesque mountains, lakes, upscale shopping malls and the school systems are excellent. If you are looking for an established practice that runs like a well oiled machine, request more information.

The free standing building that houses this practice is available to purchase or rent with an option. There are 4 exam rooms with a well appointed procedure room. The owning physician works 4 to 5 days per week and there is a full time physician assistant staffed as well.

For the well qualified purchasing physician, the owner may consider some owner-financing. Call us today.

List price: $425,000 | Year Established: 2007 | Gross Yearly Income: $1,500,000

Medical Practice Listings Selling and buying made easy

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

Wanted: Urgent Care Practice

PEDIATRICIAN

or family medicine doctor needed in

FAYETTEVILLE, NC

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.

Comfortable seeing children. Needed immediately.

Medical Practice Listings Buying and selling made easy

Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com 52 | JULY 2015

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

Women’s Health Practice in Morehead City, NC

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

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

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

Buying and selling made easy

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

Please direct all correspondence to driverphilip@gmail.com.

Only serious, qualified inquirers.

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 WWW.MEDMONTHLY.COM | 53

NC Opportunities DENTISTS AND HYGIENISTS

Practice for Sale in Raleigh, 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

Physician Solutions has immediate opportunities for dentists and hygienists 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

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

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.

If you are looking to purchase a well equipped primary care practice, please contact us today.

Contact: Cara or Philip at 919-848-4202

medlisting@gmail.com medicalpracticelistings.com 54 | JULY 2015

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 $50,000 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

NC MedSpa For Sale MedSpa Located in North Carolina

Pediatrics Practice Wanted

We have recently listed a MedSpa in NC

Pediatrics practice wanted in 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.

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 Medical Practice Listings today to discuss the practice details.

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

www.medicalpracticelistings.com

Contact us today to discuss your options confidentially.

Medical Practice Listings Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com WWW.MEDMONTHLY.COM | 55

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

Primary Care Practice For Sale

Med Spa in the Raleigh-Durham, NC Area

Wilmington, NC 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 for more information.

Medical Practice Listings 919.848.4202 | medlistings@gmail.com www.medicalpracticelistings.com 56 | JULY 2015

Beautiful Med Spa located in the Raleigh-Durham is among our newest listings.

This very upscale facility is established and boosts consistent gross revenues of a million plus. Some of the procedures performed are: Botox, Dermal Fillers, Minimal light based treatments, laser hair removal, cool sculpting (external cooling treatment that freezes the hair and the body metabolizes the fat). This practice is ideal for the Plastic Surgeon or Dermatologist.

Established: 2010 l Annual Revenue: $1,000,000 Average Patients per Day: 15 to 25

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

Adult & pediAtric integrAtive medicine prActice for sAle 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

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

Gross Yearly Income: $335,000+ | List Price: $125,000

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

Primary Care Specializing in Women’s Health

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

Located on NC’s Beautiful Coast, Morehead City

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 $20,000.

919.848.4202 medlisting@gmail.com medicalpracticelistings.com WWW.MEDMONTHLY.COM | 57

is now hiring primary care MD’s and PA’s, DDS’s, dental hygienists, and registered dental assistants in North Carolina, Virginia and South Carolina

Ongoing and intermittent shifts are available for physicians, mid-levels, DDS, dental hygienists, and registered dental assistants as well as permanent placement. Find out why providers choose Physician Solutions.

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