Med Monthly May 2013

Med Monthly MAY 2013

the

Your Practice S taff

WHO IS THE MOST IMPORTANT PERSON IN A PRACTICE?

issue

pg. 40

PA/NP Workforce– Will the Market Supply Meet Your Practice Demand? pg. 46

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Medical Practice Staffing Advice pg. 20

Key Components to Growing Your Practice From Within

THE POWER OF INTERNAL MARKETING pg. 42

contents

48

‘Art By Nurses’

features

40 WHO IS THE MOST IMPORTANT PERSON IN A PRACTICE? 42 THE POWER OF INTERNAL MARKETING: 3 Key Components to Growing Your Practice From Within 46 PA/NP WORKFORCE – Will The Market Supply Meet Your Practice Demand?

insight 10 NIH-SUPPORTED STUDY FINDS U.S. DEMENTIA CARE COSTS AS HIGH AS $215 BILLION IN 2010 12 PRIVATE AND PUBLIC SECTOR COLLABORATION IS CRITICAL FOR WOMEN’S HEALTH MARKET TO TRULY FLOURISH 14 THE TOP FIVE THINGS YOU NEED TO KNOW ABOUT THE AFFORDABLE CARE ACT

practice tips 16 DESIRED QUALITIES WHEN STAFFING POSITIONS AT YOUR PRACTICE 18 ONE-THIRD OF DOCTORS MISS ELECTRONIC TEST RESULTS 20 MEDICAL PRACTICE STAFFING ADVICE

international 24 INCREASING OBESITY LEVELS AND HIGH GENETIC VULNERABILITY DRIVING THE PREVALENCE OF DIABETES IN INDIA

research and technology 26 NEW GENETIC LINK FOUND BETWEEN NORMAL FETAL GROWTH AND CANCER 28 EHR TECHNOLOGY – No Surprises With Release of the Proposed Rule For Stage 2 Meaningful Use 30 SMART MOBILE TECHNOLOGY FOR YOUR PRACTICE AND YOUR PATIENTS

legal 34 AFFORDABLE CARE ACT EXTENDED FREE PREVENTIVE CARE TO 71 MILLION AMERICANS WITH PRIVATE HEALTH INSURANCE 36 WILL FEDERAL PROTECTION FOR ELECTRONIC HEALTH RECORDS (EHR) DONATIONS BE EXTENDED BEYOND DECEMBER 31, 2013?

38 SOUTH CAROLINA SELECTS IBM SMARTER CITIES SOLUTION TO HELP MODERNIZE DELIVERY OF VITAL SOCIAL PROGRAMS

the arts 48 ‘ART BY NURSES’ The Power of Internal Marketing

42

healthy living 50 BLACK BEAN QUESADILLAS

in every issue 4 editor’s letter 8 news briefs

56 resource guide 72 top 9 list

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editor’s letter “Your Practice’s Staff ” is the theme for Med Monthly’s May issue. Staff retention for medical offices and other businesses is beneficial for many reasons: better productivity, cost effectiveness and higher morale. We explore the importance of each staff member’s role, the importance of physician assistants and nurse practitioners, and how your support team can help with your practice’s internal marketing.

While it may seem obvious that the doctors are the most vital staff members of a practice, Philip Driver, in his article “Who is the most Important Person in a Practice” offers a different perspective. With many years experience owning practices and staffing others, he argues that the most critical person in the office may be the last one to come to mind: the person behind the front desk. They are the first and last staff member a patient sees, and a significant part of their job is relationship building and client retention.

As far as direct patient care goes, a physician assistant or nurse practitioner may be the doctor’s most significant resource. Lisa Shock’s feature, “PA/NP Workforce – Will the Market Supply Meet Your Practice Demands?” highlights the vital role that PAs and NPs play in a health care setting. This is especially true because the supply of primary care physicians has not keep up with demand in the past several decades. An extender contributes to the basic care of a patient so that doctors can focus on the more complicated cases, or shorten the time that the physician needs to spend with a patient.

What about the rest of your staff? How can you use your employees most efficiently to grow your business? It is easiest to build your practice though marketing your current client base. In “The Power of Internal Marketing: 3 Key Components to Growing Your Practice from Within” by Amanda Kanaan, we learn that consistent contact with your patients keeps your business in the forefront of their patients’ mind when making their next doctor appointment increasing the likelihood of a referral.

A practice’s staff has the ability to increase your client base. If you make a concerted effort to hire conscientious and friendly people, your patients will return time and time again. Keep your eyes open for our June issue where Med Monthly will be taking on dermatology.

Ashley Austin Managing Editor

4 | MAY 2013

Med Monthly May 2013

Publisher Philip Driver Managing Editor Ashley Austin Creative Director Thomas Hibbard Contributors Ashley Acornley, MS, RD, LDN Philip Driver Kelly Fitzgerald Thomas Hibbard Amanda Kanaan Karen S. Lovitch Denise Price Thomas Frank J. Rosello Lisa Shock

contributors Ashley Acornley, RD, LDN holds a BS in Nutritional Sciences with a minor in Kinesiology from Penn State University. She completed her Dietetic Internship at Meredith College and recently completed her Master’s Degree in Nutrition. She is also an AFAA certified personal trainer. Her blog can be found at: ashleyfreshfromthefarm.wordpress.com

Amanda Kanaan is the Founder and President of WhiteCoat Designs – a medical marketing agency providing doctors with online marketing services as medical website design, search engine optimization (SEO), social media management, e-newsletters, blog writing, graphic design, referring physician outreach and more. To contact Amanda or to learn more about WhiteCoat Designs, visit www.whitecoat-designs.com.

Denise Price Thomas

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

retired in 2009 as a surgical practice administrator where she was employed for 32 years. She is certified in healthcare management through Pfeiffer College. Speaking invitations have taken her from NC to SC, Georgia, Florida, Chicago, Alaska and more. Website: www. denisepricethomas.com

Frank J. Rosello Environmental Intelligence, LLC, is a complete, full-service healthcare IT solution provider. With a team having more than 10 years of proven clinical expertise in delivering end-to-end health IT solutions, Environmental Intelligence provides medical practices and facilities onsite expert IT consulting, installation, and implementation that is focused on physicians, their patients, and the quality of their care.

Lisa P. Shock, MHS, PA-C is a PA who has practiced in primary care and geriatrics. She enjoys part-time clinical practice and is the President and CEO of Utilization Solutions in Healthcare – a specialty consultant company for physician practices and hospitals, offering services to help implement and improve the utilization of PAs and NPs in the health care system. Contact her with questions at lisa@pushpa.biz MEDMONTHLY.COM |5

designer's thoughts

From the Drawing Board Medical technologies and research are intended to improve the quality of health care delivered through earlier diagnosis, less invasive treatment options, reductions in hospital stays, rehabilitation times and cost reductions. This includes the pharmaceuticals, devices, procedures and organizational systems used in health care today.

This month, in the “Research and Technology” section of this month’s magazine, researchers at the National Institute of Health have discovered a new genetic link between the rapid growth of healthy fetuses and the uncontrolled cell division in cancer. Dr. Baron of the NICHD states “We’ve long known that some of the genes that promote rapid growth in prenatal and early postnatal life become reactivated in cancer cells.

Now we’ve identified a molecular switch that appears to turn on some of these genes, taking us a step forward in understanding normal body growth and the abnormal growth in some types of cancer.”

Frank J. Rosello’s “EHR Technology – No Surprises with Release of the Proposed Rule for Stage 2 Meaningful Use” explains the next level, after Stage 1, of motivating providers to utilize their record sharing capability to actually exchange information in a variety of transactions driving incremental quality and care improvement.

“Smart Mobile Technology for Your Practice and Your Patients” describes new mobile apps and websites to assist both doctors and patients before and during office visits. Physicians have apps like Microdex for the iPad that provide critical drug information at their fingertips, including vital dosage information, generic alternatives and adverse effect warnings. Patients can keep track of all medical information for themselves and their families using the My Medical app with the information kept securely on their mobile devices and not on a remote server.

If there are topics or insights on advances in medical technology you would like to share with us for future issues, please contact us at medmedia9@gmail.com.

Thomas Hibbard Creative Director

6 | MAY 2013

news briefs

Biotech Growth to Slow Down in the U.S in the Coming Years

Ansell Launches First of its Kind Medical Glove to Protect Against Infection

A new report from IMARC Group expects the biopharmaceutical market in the US to grow at a CAGR of around 5% during 2012-2017. This is significantly lower than the average 8-9% growth rate observed in this market in the last five years.

According to an analyst at IMARC Group,“the rise of biosimilars in the US is expected to have a major impact on market growth. Recombinant proteins, which currently account for around 60% of the total US biopharmaceutical sales, are expected to be the worst hit during the forecast period. During 2012-2017, we expect nine biological brands in this segment to face biosimilar competition.

Recombinant proteins are expected to witness a CAGR growth of less than 3% during this period. The growth of monoclonal antibodies, on the other hand, is expected to be significantly faster than recombinant proteins during the forecast period. The key factors driving the monoclonal antibodies will be a rich pipeline and approval of additional indications for currently marketed drugs. Although some monoclonal antibodies such as Rituxan and Humira may face biosimilar competition, we expect significantly lower biosimilar threat for monoclonal antibodies during the forecast period compared to recombinant proteins.

IMARC’s new report “Global Biopharmaceutical Market Report & Forecast (2012-2017)” gives a deep insight into the global biopharmaceutical market.

The research study serves as an analytical as well as a statistical tool to understand the strengths, weaknesses, opportunities, threats, market trends, geographical structure, therapeutic structure, competitive structure and the outlook of the global biopharmaceutical market till 2017. This report will serve as an excellent guide for investors, researchers, consultants, marketing strategists, and all those who are planning to foray into the global biopharmaceutical market in any form. 

It is the only glove approved with demonstrated effective kill rates up to 99.999% against eight common gram-negative and gram-positive bacterial species, including drug resistant strains, as rapidly as one minute after exposure.

Transmission of pathogens to patients occurs most frequently from contaminated hands or gloves of healthcare workers.3 The GAMMEX® Nitrile Antibacterial exterior glove coating reduces the risk of cross-contamination between surfaces and patients, breaking the chain of transmission from the environment to the patient through the hands of the healthcare worker, further reducing the potential of HealthcareAssociated Infection (HAI) and related costs.

According to the World Health Organization, of every 100 hospitalized patients worldwide, seven in developed countries and ten in developing countries will acquire at least one HAI. These infections can lead to significant mortality and financial losses for health systems.

“Ansell is dedicated to providing innovative and clinically relevant solutions to help reduce infections and the associated costs,” said Anthony B. Lopez, President and General Manager, Ansell Medical Solutions. “We are proud to introduce another first into the healthcare environment that will help protect patients and healthcare workers globally.”

Made of 100% nitrile material, GAMMEX® Nitrile Antibacterial medical gloves are not manufactured with natural rubber latex, therefore protecting patients and healthcare workers against Type I (latex) allergies. Additionally, the gloves are packaged in an innovative new vacuum-packed pouch to ensure a cleaner glove than cardboard dispensers. The GAMMEX® Nitrile Antibacterial will first launch in Canada, with global roll-out to follow. 

Source: http://www.newswiretoday.com/ news/126226/

http://www.newswiretoday.com/news/126759/

8 | MAY 2013

AETNA FOUNDATION AWARDS $75,000 GRANT TO FOODCORPS Funding supports nutrition program for American Indian children in Arizona Continuing its efforts to promote health and wellness, the Aetna Foundation has awarded a $75,000 grant to FoodCorps. The funding aims to help transform eating habits of children from low-income communities by promoting nutrition, teaching gardening and expanding healthful school food choices.

To pursue its work, FoodCorps recruits emerging leaders for a year of full-time public service dedicated to improving child health in limited-resource communities.

Working with partner organizations in K-12 public schools, these AmeriCorps service members use a three-ingredient recipe for healthy kids: teaching children what healthy food is and where it comes from, helping them grow fresh food in school gardens, and working with farmers, chefs and others to transform school meals.

The Aetna Foundation grant will support team members leading FoodCorps’ activities in Arizona among children in the Navajo, White Mountain Apache, and Tohono O’odham reservation communities. Here, childhood overweight and obesity rates approach 50%, and children as young as six have been diagnosed with Type II diabetes.

“We are pleased to support FoodCorps, and applaud their inspiring and productive approach to improving nutrition and reducing diet-related health problems in Arizona’s American Indian communities,” said Gillian Barclay, vice president of the Aetna Foundation and director of national grant making. “By combining nutrition education with hands-on activities, FoodCorps is giving children

the knowledge and tools to acquire or grow healthful foods and to effectively incorporate these foods into their diets at home and at school.”

Beyond the quantitative measures of FoodCorps’ impact, the organization’s Arizona team reports children running to snatch up veggie snacks after they have spent a lesson learning how vegetables are grown. Service members also cite the success of Family Feast nights and community workshops.

At these events, parents talk about the quality of school food and ways to increase their communities’ access to fresh fruits and vegetables.

“America’s obesity problem does not affect all parts of our country equally. In addition to geographic, demographic and environmental factors, ethnicity also plays a major role, such as in Arizona, where American Indian children suffer obesity at three times the rate of non-Hispanic Whites,” said Curt Ellis, executive director of FoodCorps. “We are grateful for the Aetna Foundation’s support in advancing better nutrition among children in American Indian communities in Arizona, and for its genuine interest in our organization and its mission.”

FoodCorps currently operates in 61 sites across 12 states.

Last year, its service members worked with more than 50,000 young people to improve their access to healthy food and increase their understanding of a healthy diet.  Source: hhttp://www.pressreleasepoint.com/aetna-foundation-awards-75000-grant-foodcorps

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insight

NIH-supported Study Finds U.S. Dementia Care Costs As High as $215 Billion in 2010 Formal and Unpaid Dementia Care Costs Are Tallied

T

he costs of caring for people with dementia in the United States in 2010 were between $159 billion to $215 billion, and those costs could rise dramatically with the increase in the numbers of older people in coming decades, according to estimates by researchers at RAND Corp. and the University of Michigan, Ann Arbor. The researchers found these costs of care comparable to, if not greater than, those for heart disease and cancer.

The study, supported by the

10 | MAY 2013

National Institutes of Health and published April 4 in The New England Journal of Medicine, totaled direct medical expenditures and costs attributable to the vast network of informal, unpaid care that supports people with dementia. Depending on how informal care is calculated, national expenditures in 2010 for dementia among people aged 71 and older were found to be $159 billion to $215 billion. Dementia is a loss of brain function that affects memory, thinking, language, judgment, and

behavior; the most common form is Alzheimer’s.

The researchers first looked at care purchased in the health care market — formal costs for nursing homes, Medicare, and out-of-pocket expenses. The direct costs of dementia care purchased in the market were estimated to be $109 billion in 2010, exceeding direct health costs for heart disease ($102 billion) and cancer ($77 billion) that same year.

Adding informal, unpaid care to the equation as much as doubled

the estimated total national costs for dementia care. The study estimated full costs per case of dementia in 2010 at $41,000 to $56,000. The lower number accounts for foregone wages among caregivers, while the higher figure valued hours of informal care as the equivalent of formal paid care.

The range of national expenditures was tallied based on an estimated prevalence of dementia of 14.7 percent in the U.S. population older than 70.

The researchers also project skyrocketing costs as the baby boom grows older; the Bureau of the Census estimates that the population age 65 and older will double to about 72 million over the next 20 years. Rates of dementia increase with age, and unless new ways are found to treat and effectively prevent it, national health expenditures for dementia could come close to doubling by 2040, as the aging population increases and assuming the rate of dementia remains the same.

“These findings reveal that the enormous emotional and physical demands of caring for people with dementia are accompanied by the similarly imposing financial burdens of dementia care,” said Richard J. Hodes, M.D., director of the NIH’s National Institute on Aging (NIA), which funded the analysis. “The national costs further compel us to do all we can to find effective treatments for Alzheimer’s disease and related dementias as soon as possible.”

The complex analysis is one of the most comprehensive yet to determine health care costs for dementia. It is based on a nationally representative sample from the Health and Retirement Study (HRS), a survey of people 51 years and older that is funded by the NIA with contributions from the Social Security Administration. Interest in national health expenditures for Alzheimer’s disease and related dementias has intensified with the January 2011 signing of the National Alzheimer’s Project Act (NAPA),which calls

for stepped up efforts to find new treatments and to improve care and services. Under NAPA, the Administration is leading development and implementation of a National Plan to Address Alzheimer’s Disease, under which new research studies, the new web portal www.alzheimers.gov, and new clinical training initiatives have moved forward.

“We are just entering the second year of our national plan to fight Alzheimer’s disease,” said NIH Director Francis Collins, M.D. “It is a dedicated battle on many fronts, including capitalizing on research opportunities now before us. The new BRAIN initiative announced by the President just this week, for example, will use a new generation of tools to help us learn the secrets to many neurological disorders, including Alzheimer’s disease.”

Identifying costs of dementia has been challenging. People with Alzheimer’s and other dementias are typically older and often have multiple medical conditions, such as stroke and depression, diseases commonly co-occurring with dementia. It is also difficult to capture the national costs of family-provided or other informal care. To overcome such barriers, the researchers focused on dementia rates and costs among volunteers aged 71 and older participating in a sub-study of the HRS, the Aging, Demographics, and Memory Study (ADAMS). For this analysis: • Some 856 ADAMS volunteers received a three– to four-hour in-home clinical assessment for dementia. An expert panel reviewed the test results to determine who was demented, cognitively impaired but not demented, and normal.

• Researchers then used these data to determine the national prevalence rate, and previously collected cognitive and functional measures on 10,903 people in the full HRS sample of people older

than 70 to estimate dementia care costs based on the use and costs of health care services reported by this same group.

“Dementia costs currently rival those of cancer and heart disease.

But, within 30 years, dementia may be in a league of its own,” said Richard M. Suzman, Ph. D., director of NIA’s Division of Social and Behavioral Research. “Unless effective interventions are found to treat Alzheimer’s, formal long-term dementia care costs will escalate for the baby boom generation, as they have fewer children available to provide unpaid, informal care.”

The NIA leads the federal government effort in conducting and supporting research on aging and the health and well-being of older people. It provides information on age-related cognitive change and neurodegenerative disease specifically at its Alzheimer’s Disease Education and Referral (ADEAR) Center at http://www.nia.nih.gov/Alzheimers.

For expanded information on Alzheimer’s care and resources, please visit the federal government’s portal website http://www.Alzheimers.gov.

Information on health and on aging generally can be found at http://www. nia.nih.gov. To sign up for e-mail alerts about new findings or publications, please visit either NIA website.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.  Source: http://www.nih.gov/news/ health/apr2013/nia-03.htm MEDMONTHLY.COM |11

insight

Private and Public Sector Collaboration Is Critical for Women’s Health Market To Truly Flourish

‘‘

For the women’s health sector to truly profit, multiple partners from both private and public sectors need to collaborate and coordinate on issues ranging from financing infrastructure to services.

12 | MAY 2013

Venture capital (VC) firms are increasingly turning their attention to women’s health, the primary area of focus being breast cancer research. However, there is a slow but steady widening in focus to embrace new pathologies; efforts are progressing world over to improve women’s health.

New analysis from Frost & Sullivan’s (technicalinsights. frost.com) Emerging Technologies for Women’s Health Evaluation of Funding Prospects research finds that VC backed participants who were hit by the economic slowdown are recovering even as weak pipelines are slowly being strengthened.

“Company valuations reduced over the past few years, as companies were affected by the recession,” noted Frost & Sullivan Technical Insights Industry Analyst Saju John Mathew. “Most investors are now focusing on later-stage, less risky opportunities in the private segment to protect values and generate investor profits.”

VC investment is currently unevenly distributed.

This has resulted in a handful of companies dabbling in technology innovation, while the majority struggle to get by. Start-ups in women’s health face many hurdles such as sustaining innovation due to the low amount of VC money being pumped in. The dearth of evidence-based clinical trials also tends to discourage VC investments.

“Attracting VC funding will require start-ups to conduct extensive evidence-based clinical trials, the results of which can be used to substantiate their product or technology,” explained Mathew. “Moreover, the current economic scenario compels companies to work within a strict capital agenda to prove their technology potential.”

For the women’s health sector to truly profit, multiple partners from both private and public sectors need to collaborate and coordinate on issues ranging from financing infrastructure to services. Initiatives to propagate women’s health require cooperation from all stakeholders concerned.

New entrants can rely on government backed technology incubators to ease the path of their product/ technology, from the research to the commercialization stage. All companies active in women’s health also need to understand evolving market dynamics in order to tailor their product/technology to fill gaps. Apart from core healthcare issues, they can focus on advancing women’s health through synergies with other fields, such as wireless patient monitoring apps.

“Developing geographies are hotbeds for new VC investment,” concluded Mathew. “The healthcare sector is growing rapidly in BRIC nations and long-term capital of the kind provided by VCs will help in leveraging the plethora of investment opportunities in these geographies.”

Emerging Technologies for Women’s Health Evaluation of Funding Prospects, a part of the Technical Insights

subscription, offers a brief snapshot of the market. It analyzes the impact of major trends, drivers and challenges.

Furthermore, this research service tracks technology advancements and emerging trends evaluated following extensive interviews with market participants.

Technical Insights is an international technology analysis business that produces a variety of technical news alerts, newsletters and research services.

For more information on this research, please email Britni Myers, Corporate Communications, at britni. myers@frost.com, with your full name, company name, job title, telephone number, company email address, company website, city, state and country.

Connect with Frost & Sullivan on social media, including Twitter, Facebook, SlideShare, and LinkedIn, for the latest news and updates.  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/127132/

“Training Wheels in Heels” Denise Price Thomas Trainer for Health Care Professionals Focusing on Exceptional Customer Service, Effective Communication & Exemplary Compassion 34+ year career in health care and certified in health care management Undercover Patient Providing Insight to Your Practice Through the “Eyes of a Patient” Conference Speaker Presenting also as “Gladys Friday”, Health Care Comedienne

Home Grown/Nationally Known www.denisepricethomas.com denisepricethomas@gmail.com 704-747-8699 MEDMONTHLY.COM |13

insight

THE TOP FIVE THINGS YOU NEED TO KNOW ABOUT THE AFFORDABLE CARE ACT

A HealthCare.gov Factsheet The Affordable Care Act (ACA) was signed into law in March 2010.

You may have concerns about how ACA will affect you and your practice – your reimbursement, your independence, and the welfare of your patients.

You should know that ACA has the potential to bring considerable financial and clinical benefits for providers across the health care spectrum. The law enacts comprehensive reforms that will hold health insurance companies accountable, protect you and your patients, and guarantee choice and control.

14| MAY 2013

Here are 5 specific ways you and your practice can benefit: 1. New consumer protections hold health insurers accountable.

Insurers won’t be able to cancel coverage when a patient gets sick, and they won’t be able to set lifetime benefit limits that leave patients without coverage in times of catastrophic need. And if insurers don’t spend at least 80% of premium dollars on patient care, they’ll have to provide a rebate to consumers. These protections will end the worst insurance company abuses and put patients

and providers ahead of company profits.

2. Expanded insurance coverage to more than 34 million people.

In 2014, the law eliminates exclusions based on pre-existing conditions, and makes affordable health coverage accessible to more than 34 million uninsured Americans. This will reduce the burden of uncompensated care on physicians and hospitals and bring more patients into your practice.

Right now, the law already makes it possible for young adults to remain on their parents’ coverage

till age 26, and the Pre-Existing Condition Insurance Plan provides coverage for people who’ve been rejected by insurance companies.

3. Reduced administrative burdens and more time seeing patients.

The law invests in programs designed to help you and your practice transition to electronic record systems. We’re working with your professional organizations to support your efforts to adopt new payment and record-keeping systems, with the goal of reducing your administrative burdens. New rules are intended to help simplify claims and payment processes — we want you to be able to spend more time in the exam room, and less on administration.

4. New models create more opportunities to coordinate care. We’re working to develop new models of patientcentered, efficient, coordinated care designed to give you more support and control over the care you give: faster information flow across care sites, better consults, and provider support systems that help patients become active participants in their care. And Medicare will pay bonuses to qualified primary care doctors. Bonuses are available to general surgeons as well, particularly those who practice in underserved areas.

5. New protections strengthen patient coverage, your practice, and the entire health care system. The Affordable Care Act preserves guaranteed benefits under Medicare; makes recommended preventive services available for free; and provides patients with an annual wellness visit. The law also requires insurers to cover an expanded list of preventive services for free, including a number of services for children.

Patients will be able to afford both routine preventive care and necessary treatments. You got into the health care profession to serve patients — ACA protections are designed to help you keep serving them.

Visit http://www.HealthCare.gov/providers for more information.

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practice tips

“May I Please See Your List of Ingredients?�

Desired Qualities When Staffing Positions At Your Practice

By Denise Price Thomas www.denisepricethomas.com denisepricethomas@gmail.com

16 | MAY 2013

When searching for a new employee, wouldn’t it just be great if we could record the interview? It seems that anyone can be on their best behavior for the interview and their first 90 days of employment, but then on that ninety-first day, their true nature suddenly starts to surface. Wouldn’t it be great if you could invite them into your office, offer them some popcorn, hit the lights and the replay button, and together watch their initial interview? That would be the ideal time to ask where the “good twin” was, the one who interviewed for the position three months previously.

Imagine what it would be like if before you began an interview, you could ask for their list of “ingredients”.

Some desired ingredients for a medical practice front office position would be:

• Compassion • Positive Attitude • Knowledge • Credibility • Honesty • Integrity • Dependability • Accountability There have been times I have given my business card to a waitress or a salesperson that displayed these qualities and had a great attitude along with a smile.

In my opinion, you can hire someone with a terrific attitude and then teach them the necessary skills. It is challenging, and sometimes impossible, to teach a “positive attitude” to someone who does not have it in their core list of ingredients.

I’ll never forget the day when a young lady walked into my office for an interview, shook my hand and took the seat across from my desk. She proceeded to open a ‘Happy Meal’ and said, “I hope you don’t mind my eating lunch while we talk, I’m on my lunch hour.”

Of course I said, “No mam, I don’t mind at all.” Had she offered me some fries…..or the toy, she may have had a better chance at the job.

During my 34 + year career in health care, in addition to being an Undercover Patient, I have met numerous “characters” in medical practices to which I have given nicknames. I’ll share a few here starting with the less desirable characters:

“Ima Gossip” - works so hard at stirring the gossip, anything negative that she can think of, she will keep it going…all while on your clock!

“Shirley Knott” - will ‘surely not’ assist in another department because it is ‘surely not’ listed on her job description.

“Anita B. Wright” - is always right! She knows what you are going to say before you say it. She even finishes your sentences for you. She is always right, just ask her!

“Chip Monk” – loves to eat at the front desk. One “Chip” I knew was finishing his breakfast at the front desk as a new patient checked in. Handing her paperwork over, both noticed the crumbs along the counter. “Chip” brushed them from the counter with her paperwork and said, “I’m sorry, that’s just a few crumbs from my breakfast”, while he finished stuffing the rest of his breakfast snack in his mouth.

A positive character is: “Earl E. Byrd” – is always early. If there is a report you need ASAP, you can count on “Mr. Earl E. Byrd” to have it to you in plenty of time.

A facility can have the most competent and compassionate physicians yet with sub-standard employees, their expertise and professionalism will be lost. Your staff sets the stage each and every day for a live audience. It has been my experience that when you hire someone with a positive attitude, they are eager to learn the necessary skills for the job. Always make sure that every health care professional gets the proper training, knows what is expected of them and what they will be held accountable to accomplish.

While serving on the steering committee for a medical malpractice insurance company, I learned that statistics have proven patients are far less likely to sue when they have a good rapport with the staff and / or their physician.

Physicians and other health care professionals have the ability to create a most positive environment for their patients at no cost. The main ingredient should begin with compassion followed by a willingness to serve, making a positive difference each and every day.

Shine On!  Denise Price Thomas provides Undercover Patient Assessments followed by detailed reports and customer service training based upon her findings. She has been referred to as the “Healthcare Evangelist” because she tells it like it is.

practice tips

One-Third of Doctors Miss Electronic Test Results

By Kelly Fitzgerald Medical News Today

18 | MAY 2013

Electronic medical test results have turned out to be much like email: doctors receive a large volume of them, therefore some get lost by the wayside.

The new finding came from a study conducted by a group of researchers at the Michael E. DeBakey Veterans Affairs Medical Center in Houston and was published in the Journal of the American Medical Association.

The investigators issued a survey of 2,590 primary care practitioners and found that a third of them admitted to missing alerts about test results from an electronic health record notification system - made specifically to inform them when a patient has unusual test results.

The doctors reported getting approximately 63 alerts each day, which could be creating notification overload, resulting in a significant number of results that require doctors’ attention to go unnoticed.

Nearly 87 percent of the doctors said the number of alerts they received was too high. While 69.6 percent said they were receiving more alerts than they could effectively keep track of.

health records system is supposed to be. The aim of iPads replacing folders and health care systems using text messaging to track diseases, should make medical care easier to monitor and more accessible for all parties involved.

The doctors believe that the current system makes them susceptible to information overload.

Even other aspects of electronic medical records have yielded disappointing results for healthcare professionals and authorities. A report just last month revealed that the systems are not well integrated or userfriendly.

Study author Dr. Hardeep Singh of the DeBakey VA Medical Center said: “If you’re getting 100 emails a day, you are bound to miss a few. I study this area and I still sometimes miss emails. We have good intentions, but sometimes getting too many can be a problem.”

Electronic Health Records - Easier or Harder?

However, they note this could be a small price to pay for the greater advantages of digitizing medical files and results, allowing doctors to stay up-to-date with their workload.

An estimated 55.6 percent commented that the method in which electronic health records notify practitioners makes it possible for them to accidentally skip over important test results.

This is not how the electronic

New Policies Needed For Electronic Test Results Singh and his colleagues have previously documented eight aspects

of the electronic health care system that could be improved.

For example: creating simpler ways for doctors to access the information and correctly training personnel to use the systems effectively could help.

Singh said, “We all want the alerts to look like our smartphones and apple products, but the interface is not always clear and you can miss results quite easily.”

There needs to be an established system to determine who is responsible for taking action when tests results appear that require immediate attention.

This would avoid missing crucial opportunities for helping patients similar to when an email is sent to several recipients and they all assume someone else will respond.

Putting into place more detailed and stricter policies regarding how these responses should occur can eliminate confusion.

Singh also points out that patients have a responsibility to follow-up and be active in their care.

He concludes, “We need to dispel the myth of ‘no news is good news from the doctor. In fact, if patients don’t hear back about the results, they should actively seek them out.”  Source: http://www.medicalnewstoday. com/articles/257227.php

MEDMONTHLY.COM |19

practice tips

MEDICAL

PRACTICE

STAFFING ADVICE

By Thomas Hibbard Creative Director, Med Monthly

20 | MAY 2013

Hiring Medical Office Staff Hiring medical office staff involves filling positions that aren’t part of a typical business environment and determining which positions are mandatory and which ones are optional. Let’s take a look at some of the most important positions in a medical practice.

In a typical small business, hiring requirements are based on the expertise and work capacity that is required to maintain daily operations and achieve strategic business goals.

A medical practice works much the same way, but instead of hiring staff to answer the phones or sell your products, you are hiring dedicated specialists who are responsible for providing the best possible care for your patients.

The number and type of staff you hire will depend on your patient load and area of specialization. However, most medical practices demand a select few positions to maintain quality care and smooth office procedures.

Essential Medical Office Staff Positions Office manager: A good office manager increases efficiency and boosts your practice’s productivity. Office managers are responsible for making sure the practice runs smoothly, and everything from service contracts to marketing falls under their job description. The learning curve is steep, so always look for candidates who have prior office management experience.

Insurance biller: In smaller medical practices, the office manager usually handles insurance billing directly, but in larger practices, insurance billing could be a separate position. Since you’re putting your practice’s revenue in their hands, it’s critical to make sure your insurance biller is familiar with the claims process for insurers in your geographic area.

Front office receptionist: Your receptionist is your patients’ first point of contact with your practice. In addition to competency, it helps to orient your search toward individuals who have demographic compatibility with the majority of your patient base.

Nurse/physician’s assistant: A reliable nurse or physician’s assistant (PA) is worth their weight in gold. You will rely on them to handle routine medical procedures as well as patient callbacks. While medical knowledge and certification are obvious prerequisites, compassion and interpersonal skills are just as important.

position. If more than one person will be interviewing each candidate, you’ll have to decide whether to do sequential or group interviews.

Although sequential interviews may seem easier, interviewers often obtain more information by interviewing candidates together and observing their responses to all other questions and interpersonal interactions with other interviewers. Either way, the questions to be asked by each interviewer should be coordinated ahead of time.

Choosing the best candidate for your practice depends a lot on selecting the right interview questions.

There are two types of interview questions, traditional and behavioral.

Optional Medical Office Traditional Interview Staff Positions Questions These positions are not nearly as common as the medical staffing positions, but can be a valuable asset to any medical practice under the right circumstances.

Records clerk: These individuals maintain patient records or manage a recordkeeping database. EHR experience is a major plus for this position.

Scheduler: High-volume practices often employ people who handle scheduling and other office tasks.

Transcriptionist: If you are averse to the idea of using a transcription service, you will need to hire either a part-time or full-time transcriptionist.

The Interviewing Process If you are in charge of setting up interviews, make sure to coordinate who will conduct the interviews and how they will be organized. The senior administrator or nurse should be involved in interviews for positions in their areas, and physicians should be included if they’re likely to have significant contact with a particular

Traditional interview questions allow the interviewee to share their employment history, abilities, salary history, strengthens and weaknesses, and general questions about themselves. The flaw in asking only traditional interview questions is instead of evaluating applicants on the skills and abilities they need to succeed in your practice, it focuses too much on responses memorized by candidates.

As a result, you get canned answers; responses that have been rehearsed over and over again, not getting a true feel for what the applicant is capable of.

Some samples of traditional interview questions are: General knowledge: “Describe why you’re qualified for this position and explain why you’d fit within our practice doing this job.”

Work ethic: “How do you feel about working extra hours or being given extra responsibilities as needed?”

Computer competence: “We have a program for [registration, billing, lab result retrieval, etc.] called ____. Tell me about your experience with that program or programs like it.” continued on page 22 MEDMONTHLY.COM |21

continued from page 21

Behavioral Interview Questions Behavioral interview questions will be more focused than traditional interview questions and responds will require specific examples of how the interviewee handled various situations in the workplace. This form of interviewing is more conversational and will allow you to get a deeper insight into the interviewee and how they will fit in your practice’s culture.

Customer service attitude: “Consider the following scenario: An obviously annoyed patient calls to complain that he just waited more than half an hour in the pharmacy only to find out that his refill had not been called in. How would you respond?”

Conflict management: “Describe a conflict you’ve had with other staff members and how you resolved it.”

Respect for patient privacy: “A patient calls in and notes that his wife is there at the office seeing the doctor, and he asks how she is doing. How would you respond?”

Motivation: “Tell me about a time when you saw room for improvement in some area of your work environment or a process that could be more efficient. What did you do to change the status quo?”

Priority management: “Describe an occasion when you had two doctors or bosses ask you to do conflicting tasks.

How did you handle this dilemma?”

Problem-solving strategies: “Tell me about a time when your job required you to perform a task that you didn’t know how to do. How did you respond?”

Consider asking the following questions during a behavioral interview to ensure your new hires fit with your practice’s culture: How was the relationship between you and your last boss?

This question will hopefully give you an idea of what the applicant expects from his or her supervisor. He or she may prefer to see their supervisor as a friend, rather than an authority figure. Or, if the interviewee had a negative relationship with his or her previous boss, try to get more information on their dynamic. An unhappy relationship could be the result of poor communication skills.

Sometimes an absence is unavoidable. However, what do you feel qualifies as an excessive number of absences in a year?

Staff attendance is a part of a culture. Make sure their views on attendance and punctuality fit with that of your organization.

What type of people do you thrive with?

The interviewee may work better in a group where they thrive off of brainstorming and frequent feedback from their peers, or they may prefer to work individually and solve problems on their own. Determine which is more conducive for your practice.

Tell me about a time you dealt with an irate patient.

Hearing the applicant describe a patient encounter and how they managed the situation will help you understand how patient-centered they are. Every staff member will have to deal with unhappy patients, but if they can handle the situation in a professional manner while still staying focused on patient care, that gives you a better sense of how they approach their job.

It may be helpful to preface these questions by telling the interviewee that there is no right or wrong answer to any of them. This could put them more at ease and encourage honest responses.

22 | MAY 2013

What’s Off Limits?

A number of personal attributes cannot be legally addressed in an employment interview, including age, religion, national origin, marital status and whether the candidate has children, among others.

After the Interview You should write down specific answers and general impressions of each candidate immediately after the interview. It is amazing how quickly your memories of three or four candidates can run together.

The last question in any interview should always be “May I contact your previous employers for a reference?”

If the candidate says they don’t want a current employer contacted, get their permission to contact two or three previous employers or co-workers, and ask the references about the issues that are difficult to assess in an interview. These may include patient service, work habits, enthusiasm or any potential weaknesses that might hinder that person’s performance. If the references say they cannot share any information, this might be a red flag. A good follow-up question to this response is, “If you had a position open, would you hire this person?”

Although this task may be timeconsuming, it will give you a more complete picture of the candidate and discussions with references are often more beneficial than interviews.

The interview process is a very important navigating tool on your quest to find the perfect staff member. Taking time to define the attributes and skills desired, prepare questions and check references is an excellent long-term investment in the contentment and quality of your entire medical practice.  Sources: http://www.gaebler.com/ Hiring-Medical-Office-Staff.htm http://www.mgma.com/blog/5interview-questions-to-help-you-hirefor-cultural-fit/ http://www.aafp.org/fpm/2003/0600/ p46.html

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international

G OBESITY N I S A E R C N I D HIGH LEVELS AN Y NERABILIT L U V C I T E GEN E DRIVING TH CE PREVALEN ES OF DIABET

IN INDIA

As a result of a higher percentage of body fat to muscle, Indians are more vulnerable to type-2 diabetes compared to other population groups.

IMARC Group, one of the world’s leading research and advisory firms, finds that the total number of diabetes patients in India grew at CAGR of nearly 3% during 2004 - 2012. Estimates from their latest report entitled “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics”, suggests that the total number of diabetes patients in India is expected to reach 107 million by 2032.

Findings from the report suggest that a major driver of the diabetes epidemic in India is the increasing levels of obesity. The Indian population that had faced under nutrition for a long time is now exposed to high fat diets and sedentary lifestyles. As a result of increasing disposable incomes and flourishing fast food chains, there were around 157 million overweight and 24 million obese people living in India in 2010. The report expects these levels to increase significantly by 2015.

Apart from the increasing obesity levels, the report also found that Indians are genetically more vulnerable to diabetes compared to other population groups.

According to an analyst at IMARC Group “As a result of a higher percentage of body fat to muscle, Indians are more vulnerable to type-2 diabetes compared to other population groups. This fat increases the sugar levels as it 24| MAY 2013

gets deposited around the abdomen and interferes with insulin. As a result, Indians get diabetes at a much younger age compared to other population groups”.

IMARC’s new report “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics” provides an analytical and statistical insight into the Indian diabetes market. The report provides both current and future trends in the prevalence, demographical breakup, diagnosis and treatment of diabetes in India. The report has segmented the Indian diabetes market into three segments - Oral Antidiabetics, Insulin and Diabetes Diagnostics. For each of the aforementioned categories, the report provides historical and future market sales, performance of key classes and the performance of top players.

The research study serves as an exceptional tool to understand the epidemiology, market trends, therapeutic structure, competitive structure and the outlook of the Indian diabetes market. This report can serve as an excellent guide for investors, researchers, consultants, marketing strategists and all those who are planning to foray into the Indian diabetes market in some form or the other.  Source: http://www.pressreleasepoint.com/increasingobesity-levels-and-high-genetic-vulnerability-drivingprevalence-diabetes-india

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research & technology

By the National Institutes of Health (NIH) 26 | MAY 2013

New Genetic Link Found Between Normal Fetal Growth And Cancer

NIH Study Identifies a Protein That Helps Trigger Both Processes Two researchers at the National Institutes of Health discovered a new genetic link between the rapid growth of healthy fetuses and the uncontrolled cell division in cancer. The findings shed light on normal development and on the genetic underpinnings of common cancers.

The work, conducted using mouse and human tissue, appears in today’s issue of the Proceedings of the National Academy of Sciences.

The authors, Julian C. Lui, Ph.D., and Jeffrey Baron, M.D., work at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

“We’ve long known that some of the genes that promote rapid growth in prenatal and early postnatal life become reactivated in cancer cells,” said Dr. Baron. “Now we’ve identified a molecular switch that appears to turn on some of these genes, taking us a step forward in understanding normal body growth and the abnormal growth in some types of cancer.”

Before birth, a team of more than 200 growth-promoting genes is highly active, fueling the fetus’ explosive growth. After birth, these genes are gradually switched off, apparently to slow body growth as we age and approach adult size. In cancer cells, some of these genes can be switched back on.

One of the major growth-promoting genes is called IGF2. This gene is critical for normal prenatal body growth and is reactivated in many types of cancer, showing remarkably high activity in bladder and prostate cancer and some childhood cancers.

For years, scientists did not know what turned IGF2 on and off. Now, using a variety of techniques and tissue types, Drs. Lui and Baron found

evidence that a protein known as E2F3 activates the IGF2 gene in normal development and in cancer — in particular, in bladder and metastatic prostate cancers.

More broadly, E2F3 appears to regulate not just IGF2, but also many other genes on the body-growth team.

When E2F3 levels are high, these genes are active. When E2F3 takes a dive, so do these genes. The upshot is that E2F3 may function as one of the master switches that limit body growth. As such, it is of great interest as researchers seek to understand the complex genetic choreography responsible for normal growth and the diseases that result when it goes awry.  About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website at http://www.nichd.nih.gov/.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www. nih.gov.

Source: http://www.nih.gov/news/ health/apr2013/nichd-09.htm

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research & technology

EHR Technology –

No Surprises With Release of the Proposed Rule For Stage 2 Meaningful Use

by Frank J. Rosello, CEO, Environmental Intelligence LLC

26 | MARCH 28 MAY 2013 2013

After much anticipation among providers and health IT vendors throughout the U.S. health care landscape, The Centers for Medicare and Medicaid Services (CMS) finally released its proposed rule for Stage 2 Meaningful Use of electronic health records (EHR) on February 23, 2012.

The release of the proposed rule for Stage 2 provides details of how CMS is raising the expectation for healthcare providers to achieve meaningful use of EHR technology in order to qualify for future incentive payments.

As expected, Stage 2 Meaningful Use takes the criteria of Stage 1 to the next level by increasing the performance threshold of existing measures and motivating providers to utilize their record sharing capability to actually exchange information in a variety of transactions to drive incremental quality and care improvement.

With greater focus on health information exchange, the measure is now a key component in the “robust transitions of care” core objective, and the measure to provide patients with an electronic copy of their data in Stage 1 is replaced by “electronic/ online access” as a requirement in Stage 2.

The proposed rule for Stage 2 also addresses a primary concern voiced

‘‘

CMS decided to delay the start of the reporting period by one year because the original 2013 time frame does not give vendors enough time to design, develop, and test new functionality so that providers can successfully deploy and attest to meeting Stage 2 requirements over the one year reporting period.

by many providers pertaining to the challenges of reporting out quality measures. Starting in 2014, the reporting of quality measures will be easier for providers now that clinical quality measures for Stage 2 will align with existing quality programs, such as those used for the Physician Quality Reporting System and CMS’ Shared Savings Program. The same ease of reporting also applies to hospitals now that clinical quality measures will align with the Hospital Inpatient Quality Reporting and the Joint Commission’s Hospital Quality Measures.

CMS will keep the same core menu structure for required measures for Stage 2 Meaningful Use. Eligible providers will have to meet seventeen core objectives, three of the five menu options, and will report on twelve clinical quality measures.

Hospitals will have to meet sixteen core measures, two of the four menu options, and will report on twentyfour clinical quality measures. CMS also outlines in the proposed rule how providers may electronically submit the quality measures and the agency is looking for public feedback on methods for submission. CMS is specifically interested in feedback regarding aggregate-level and group reporting options leveraging existing quality reporting systems.

Some of the core measures providers will have to meet during the reporting period for Stage 2 Meaningful Use include: l Providers

will have to supply a summary of care record for more than sixty-five percent of the patients the provider transitions or refers a patient to another care setting or provider. l Providers will have to perform medication reconciliation for more than sixty-five percent of transitions of care in which patient moves into care of another provider or admitted to hospital or emergency room. l More than fifty percent of patients seen during the Stage 2 reporting

period are provided online access to their information within four business days of their visit subject to provider’s discretion to withhold certain information. l Providers will have to use computerized physician order entry (CPOE) for more than sixty percent of medication, lab and radiology orders created. l Providers will have to implement five clinical decision support interventions for five or more clinical quality measures at relevant point in care and use functionality for drug-drug and drug-allergy interaction checks. l More than fifty-five percent of clinical lab test results whose results are positive/negative or of numerical format are incorporated into the EHR of patients as structured data. l Medical organizations will have to conduct or review security risk analysis, address encryption or security of data at rest and execute security updates as necessary and correct identified security deficiencies.

The proposed rule confirms that CMS will delay the start of Stage 2 until 2014 instead of the originally planned start of 2013. CMS decided to delay the start of the reporting period by one year because the original 2013 time frame does not give vendors enough time to design, develop, and test new functionality so that providers can successfully deploy and attest to meeting Stage 2 requirements over the one year reporting period.

The one hundred thirty-two page proposed rule for Stage 2 Meaningful Use was officially posted in the Federal Register on March 7, 2012. This action officially launched the countdown for public comments for sixty days and CMS encouraged the public to comment on the proposed rule online prior to the May 6, 2012 deadline.

CMS released the final rule for Stage 2 Meaningful Use in the summer of 2012.  MEDMONTHLY.COM |29

research & technology

Smart Mobile Technology for

Your Practice and Your Patients

By Thomas Hibbard Creative Director, Med Monthly 30 | MAY 2013

W

hether they have chronic ailments like diabetes or heart disease, or just want to watch their weight, Americans are increasingly tracking their health using smartphone applications and other devices that collect personal data automatically, according to health industry researchers. 21 percent of people who track their health use some form of technology.

More than 500 companies were making or developing self-management tools by last fall, up 35 percent from January 2012. Nearly 13,000 health and fitness apps are now available for little or no expense.

Technology for Doctors Many physicians are already connected by mobile smartphones and tablets with accessibility to lab results, prescription information, digital medical textbooks, internet access to the Center for Disease Control, text messaging to other doctors and patients, and real time communication via Skype, instant messaging, GoToMeeting, and other wireless services.

For some practices, FaceTime—a video calling software feature for iPhone 4 and the fourth generation iPod Touch—is replacing face-to-face office visits for minor complaints like cold and flu, headaches, and muscle strains.

Follow up visits and lab test result reviews are often easier for the patient and doctor when done long distance.

A lot of patient support used to happen in a doctor’s waiting room. Patients shared views and exchanged information that helped them, and gave warnings for drugs or treatments that harmed them. They were also provided support and sympathy, something that doctors can be in short supply of in a fast paced medical practice.

The waiting room chat is being replaced by websites like CureTogether, http://www.crunchbase.com/ company/curetogether, and PatientsLikeMe, http://www. patientslikeme.com/. These sites provide information on what’s working for patients. They provide ratings and real

information on different diseases and treatments with no marketing hype or ads.

Doctors are beginning to adopt the iPad into their workflow at their practices and the hospital, with many apps enabling doctors to be more efficient.

WebMD is a great reference app for doctors and it’s free at https://itunes.apple.com/US/app/ id373185673?mt=8&ign-mpt=uo%3D4. The app includes a symptom checker to help remind you what may be wrong with a certain patient. The app also includes first aid essentials, conditions, drugs and treatments, a pill identification tool, and local health listings.

Microdex, https://itunes.apple.com/US/app/ id390211464?mt=8&ign-mpt=uo%3D4, is a free app that provides drug information for the iPad. The app includes over 4,500 search terms. These results include: generic names, trade names, black box warnings, dosage info, administration, monitoring, precautions, adverse effects, and much more. If you are a doctor prescribing drugs day in and day out, then this is a great app.

Micromedex screenshots

Many physicians need to create custom forms for their patients. Tap Forms HD is an app that allows you to do just that. The app includes 17 different field types including: link to form, file attachment, email address, GPS info, contact, text, date, time, date/time, number, rating, URL, check mark, note, audio recording, photo and phone number. The app can also search through your forms allowing you to pull up past information quickly. The app is password protected ensuring your patients’ data is safe.

The app also includes 25 different built-in forms. The app integrates with Dropbox to allow easy file transfers. The app can also export your information as a CSV file to be opened up in Excel or Numbers. If you need custom forms, PatientsLikeMe Homepage

continued on page 32 MEDMONTHLY.COM |31

continued from page 31

then Tap Forms HD is a great app for that. It’s available at https://itunes.apple. com/US/app/id410500116?mt=8&ign-mpt=uo%3D4 for $8.99

Technology for Patients The explosion of mobile devices means that more patients have an opportunity to start tracking health data in an organized way and many of the people surveyed said the experience had changed their overall approach to health.

A very effective mobile app for patients to record health information is My Medical, https://itunes.apple.com/us/app/my-medical/id347860026?mt=8. It is a comprehensive record-keeping app for personal medical information and is the perfect replacement for unreliable paper records or various electronic systems that hold bits and pieces of medical history. With My Medical, any and all information that is important to the patient is kept together in one place. And it’s secure because the information is kept on their device, not on a remote server.

Often the worst part of a visit to the doctor isn’t the awkward hospital gown, needle sticks or embarrassing physical exams — it’s the drawnout wait, camped out in the reception room in the company of sick patients and old magazines.

This realization led to creation of Appointment Status, https://www. appointmentstatus.com/, a web site devoted to improving appointment efficiency and providing My Medical screenshots patients with information to avoid long waits. The site is designed to make it easier for patients to schedule appointments — and to find out how far behind the doctor may be before settling into a waiting room chair.

These are several innovations meant to help physicians and patients. While many digital developments — electronic medical records and mobile medical encyclopedias — have streamlined doctors’ work, new tools for patients are starting to hit cell phones and the Internet at a rapid rate with no slowdown in sight.  Sources: http://www.nytimes.com/2013/01/28/health/electronic-health-trackingincreasingly-common-researchers-say.html?partner=rss&emc=rss&_r=4& http://renegadehealth.com/blog/2012/08/31/doctor-visit-theres-an-app-for-that http://appadvice.com/applists/show/apps-for-doctors-with-ipads http://well.blogs.nytimes.com/2012/10/15/the-doctor-can-see-you-now-reallyright-now/ https://itunes.apple.com/us/app/my-medical/id347860026?mt=8 32 | MAY 2013

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legal

Affordable Care Act Extended Free Preventive Care to 71 Million Americans With Private Health Insurance

Health Care Law’s Third Anniversary Sees Health Costs Slowing Down, More Value For Consumers Health and Human Services (HHS) Secretary Kathleen Sebelius announced that about 71 million Americans in private health insurance plans received coverage for at least one free preventive health care service, such as a mammogram or flu shot, in 2011 and 2012 because of the Affordable Care Act.

U.S. Department of Health & Human Services 34 |MAY 2013

Additionally, an estimated 34 million Americans in traditional Medicare and Medicare Advantage plans have received at least one preventive service, such as an annual wellness visit at no out of pocket cost because of the health care law.

Taken together, this means about 105 million Americans with private health plans and Medicare beneficiaries have been helped by the Affordable Care Act’s prevention coverage improvements.

Preventive services, consumer protections, and other reforms under the Affordable Care Act are giving millions of Americans of all ages more value for their health care dollars and contributing to the slowest growth in health care costs in 50 years.

“Preventing illnesses before they become serious and more costly to treat helps Americans of all ages stay healthier,” Secretary Sebelius said. “No longer do Americans have to choose between paying for preventive care and groceries.”

Secretary Sebelius released the preventive services report as HHS celebrates the Affordable Care Act’s third anniversary this week. The law is keeping down costs and providing more value for consumers and taxpayers through new consumer protections, holding insurance companies accountable, building a smarter health care system, and providing seniors with vital savings on their prescription drugs.

The Affordable Care Act is giving Americans better value for their health insurance plans by: • Eliminating lifetime dollar caps on essential health benefits, and phasing out annual caps. About 105 million Americans no longer have to fear their benefits will disappear when they need them most because their insurer put a lifetime cap on the amount it would pay.

• Prohibiting health insurance companies from denying coverage to children based on a pre-existing condition, such as asthma or cancer.

• And in 2014, it will be illegal for health insurance companies to deny coverage to any American or to charge more because of a preexisting condition. No longer will 129 million Americans with health conditions have to fear seeing their premiums increased or getting locked out of the insurance market.

• The law will also make it illegal for a health insurer to charge women more simply because they are women. “That means,” Secretary Sebelius said, “being a woman will no longer be a pre-existing condition.”  The full report on expanded preventive care for Americans with private health insurance is available at http:// aspe.hhs.gov/health/reports/2013/PreventiveServices/ib_prevention.cfm.

Learn more about the key features of the Affordable Care Act at http://www. healthcare.gov/law/timeline/full.html.

Source: http://www.hhs.gov/news/ press/2013pres/03/20130318a.html

MEDMONTHLY.COM |35

legal

Will Federal Protection for Electronic Health Records (EHR) Donations Be Extended Beyond December 31, 2013?

By Karen S. Lovitch Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.

36| MAY 2013

R

umors are circulating that the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General for the Department of Health and Human Services (OIG) will continue to allow the donation of electronic health records (EHR) items and services to physicians past the current deadline of December 31, 2013. CMS recently submitted to the Office of Management and Budget (OMB) a proposed rule entitled “Physicians’ Referrals to Health Care Entities with which They have Financial Relationships; Amending the Exception for Certain Electronic Health Records Arrangements (CMS-1454-P),” and the OIG has submitted a similarly titled proposal. Speculation is circulating that these proposals seek to extend the exception to the Stark Law and the safe harbor under the Anti-Kickback Statute that permit certain donors, including laboratories and hospitals, to donate EHR items and services to physicians if certain requirements are met. Theresa Carnegie and I previously outlined the history and requirements of the exception and safe harbor in an article published in the G-2 Compliance Report.

The EHR donation exception and safe harbor have generated considerable controversy since their publication in 2006. While everyone in the health care industry would agree that widespread adoption of EHR technology is an important goal, there is disagreement regarding whether the exception and safe harbor are a good idea. For example, the College of American Pathologists has previously urged OIG to reconsider its inclusion of laboratories as protected donors, and the American Clinical Laboratory Association has questioned whether

the safe harbor and exception are needed now that physicians who engage in “meaningful use” of EHR technology can qualify to receive incentive payments from the federal government. In contrast, the Federation of American Hospitals supports extension of the safe harbor and exception through 2016.

Representative Jim McDermott (D-Wash.) contributed to the debate this week by writing a letter asking the OIG’s Chief Counsel to renew the safe harbor for EHR donations.

He noted that “Congress is particularly interested in developing and continuing initiatives that are designed to reduce health care costs” and that care coordination through use of EHR technology can decrease such costs. This letter is interesting given that in November 2012 the Attorney General of Washington issued an opinion stating that a clinical laboratory violates Washington’s kickback prohibition if it shares the cost of EHR software with a Washington physician and subsequently receives orders for testing from the physician. The opinion made clear that the federal safe harbor does not preempt similar state laws.

Washington is not the only state to place limitations on EHR donations even though they are permitted under federal law. Agencies in states such as Missouri, New Jersey, New York, Pennsylvania, Tennessee, and West Virginia also have spoken on this issue. If CMS and OIG decide to extend federal protection for EHR donations, other states may follow suit.  Source: http://www.natlawreview. com/article/will-federal-protectionelectronic-health-records-ehrdonations-be-extended-beyond-d

Providing customized, simple

NUTRITION SOLUTIONS to

ENHANCE HEALTH and

OPTIMIZE SPORTS PERFORMANCE Tracy Owens, MPH, RD, CSSD, LDN Ashley Acornley, MS, RD, LDN 6200 Falls of Neuse Road, Suite 200 Raleigh, NC 27609 919-876-9779

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

legal

South Carolina Selects IBM Smarter Cities Solution to Help Modernize and Improve Delivery of Vital Social Programs to Citizens IBM announced that the State of South Carolina has selected IBM software, part of IBM’s Smarter Cities portfolio, to help modernize its statewide Medicaid eligibility system, transforming the delivery of vital health and social programs to its citizens. The solution is expected to improve program efficiencies while meeting big data challenges and opportunities as the State migrates from a largely paper-based approach to a more open, automated platform to manage eligibility requirements.

The South Carolina Medicaid program serves nearly one million citizens. In replacing its current eligibility system, the South Carolina Department of Health and Human Services (SCDHHS) will streamline and improve access to citizens by providing 24/7 online self-service, and enhancing support for a mobile and community-based workforce. The goal is to make it easier to administer and manage eligibility for Medicaid and other social service programs.

States, like South Carolina, are making their health and social service program systems smarter to get vital services to those who need them.

South Carolina will also integrate its Medicaid eligibility system with 38 | MAY 2013

the federally run health insurance marketplace.

“Our updated Medicaid eligibility system will make it easier for all South Carolinians to access the State’s programs,” said John Supra, deputy director & chief information officer for SCDHHS. “Our current manual paperdriven approach limits flexibility in our processes and impacts speed and consistency. We expect the new system to provide us a platform to improve our eligibility performance and be able to more quickly and cost-effectively respond to future changes to the Medicaid programs.”

South Carolina’s decision to implement IBM software was based on the State’s strategy to utilize commercial off-the-shelf software and the solution’s out-of-the-box capabilities to meet the Medicaid program’s eligibility needs. Extending a unique partnership between SCDHHS and Clemson University, Clemson is supporting the State’s implementation and will host the solution. SCDHHS, Clemson and IBM are collaborating to develop a flexible environment in a way that makes the best use of existing State investments.

“States like South Carolina are leading the way in transforming how

they interact with their citizens,” said Craig Hayman, general manager, Industry Solutions, at IBM. “IBM supports South Carolina’s goal of delivering citizen-centric services, including those social programs that involve healthcare and related services where timely access to the right programs and benefits is the driving factor. In IBM, South Carolina has chosen a solution built and developed by healthcare and social services industry experts — a solution that can manage all the Big Data challenges and evolve as eligibility requirements change without service delivery interruptions to those citizens who need it most.”

The IBM Cúram solution, the major component to South Carolina’s new eligibility system, is part of IBM’s Smarter Cities portfolio. These capabilities make access to government services easier for the citizen and, more importantly, more effective in achieving desired social outcomes.

Several other states, including Maryland and Minnesota, also have selected IBM for similar initiatives.  Source: http://www.pressreleasepoint. com/south-carolina-selects-ibmsmarter-cities-solution-help-modernizeand-improve-delivery-vital-social

features

WHO IS THE MOST IMPORTANT PERSON IN A PRACTICE?

By Philip Driver CEO, Physician Solutions, Inc.

40 | MAY 2013

Your Front Desk Person Could Very Well Be

YOUR BEST MARKETING ASSET

Every practice is made up of different personalities with diverse skills and responsibilities. Of course the doctor sets the tone for care and procedures and is ultimately responsible for the income of the practice. Arguments can be made that the physician is surely the most important person in any practice. The practice billing person is certainly worthy of consideration as well. If the CPT and ICD-10 codes and modifiers don’t match the medical procedure, the claims are not processed and you must resubmit your corrected medical bills to various insurance companies or clearing houses. Surely your billing professional deserves kudos.

I have owned several practices and managed many others in my working career. During my time in practices as an owner or manager, I have had exceptional physicians, PA’s and nurse practitioners. I have enjoyed the professionalism of nurses, X-Ray techs, and triage staff. There is no denying that it takes a village to make the successful practice.

At the end of the day, the one person that every patient talks to coming and going is your front desk staff. The front desk staff checks patients in, greets every patient and has a kind word and smile to the sick and well patients.

The practice front desk professionals have a tremendous influence on the type patients your practice attracts, the referrals you receive from existing patients and the total organization of your practice. Your front desk person could very well be your best marketing asset. If you are fortunate to hire a front desk person that is attractive, always dresses sharply, has a friendly personality and big smile, you will reap the benefits. Now if you can add marketing skills, keep your practice web site current and respond to your practice emails, you may have identified the most important person in your practice.

When I was in the business of owning practices, I would spend a lot of time interviewing experienced front desk professionals that could multi-task and be crosstrained. Some of the duties that your front desk should can handle are: checking patients in and out, practice web site management, assisting in the triage of patients, phone duties, answering patient emails, keeping the lobby organized and clean, acting as your administrative assistant by sending out letters and correspondence to patients and vendors while acting as the gate-keeper for the doctors or providers.

When a prospective client sees your website and decides to call your practice, the front desk staff holds the key to whether or not they make an appointment to see the doctor. Therefore it’s essential that your front desk staff is

friendly, confident, professional and knowledgeable.

Placing a caller on hold may, on occasion, be unavoidable. But being unwelcoming, not listening carefully or failing to ask for appointments are all avoidable mistakes.

The front desk staff plays a critical role in your practice’s success. They do more than just answer the phone and greet clients; they ‘build relationships’ and represent your practice to both current and prospective patient-clients.

Be sure your staff has the resources it needs to answer questions and to provide clear, concise pricing and policy information. It’s important to educate all staff members so that they can describe the equipment, facilities and medical care you provide that set your practice apart from others in your community.

While your medical village must have several well organized pros, don’t skimp when it comes to your front desk personal, the first and last face your patients see in your practice. 

CALLING ALL WRITERS

Are you educated in the medical and health care field and looking to showcase your exceptional writing skills?

To become a contributing writer in Med Monthly magazine, contact MedMedia9 at medmedia9@gmail.com

Med Monthly

Contact us:

919.747.9031 medmedia9@gmail.com medmonthly.com

Editorial Calendar: June 2013 - Dermatology l July 2013 - Procedures to Enhance Your Practice MEDMONTHLY.COM |41

features

The Power of Internal Marketing: 3 Key Components to Growing Your Practice from Within

By Amanda Kanaan WhiteCoat Designs

42 | MAY 2013

A

lthough the word “marketing” may evoke visions of print ads and television spots, when it comes to growing your practice don’t forget your most powerful resource of all – current patients (i.e. walking and talking billboards). The goal of external marketing (such as advertising) is to get patients to your door, however it’s internal marketing that not only pulls them through the door but keeps them knocking time and again.

Internal marketing is a strategy that focuses on maximizing patient retention through consistent communication and of course, good patient care. Tools such as social media and online review sites make it easier than ever for practices to reap the rewards of investing in internal marketing in order to earn the illustrious patient-topatient referral.

Most business owners, whether they run a restaurant or a clothing boutique, will agree that it’s more expensive to acquire new customers than it is to retain current ones. The same goes for patients.

Make no mistake, your practice is a business and that means treating your patients as valuable customers. Here are three key components of implementing a successful internal marketing strategy for your practice: 1. Stay Top of Mind: You’ve probably heard the saying “out of sight, out of mind”. Staying top of mind with patients is the best way to keep them (1) thinking about you so there’s a greater chance they’ll come in for more than the once a year visit, and/or (2) talking about you so they’re more likely to make a referral.

For good or for bad, we’ve entered a new age in medicine where patients will Google just about anything. In fact, 59 percent of U.S. adults searched online for health information in the past year according to a 2012 study

by Pew Research Center. Because patients are so digitally savvy (also known as e-patients), this presents a unique opportunity for doctors to now communicate with patients in a way that’s convenient, cost-effective, and timely.

‘‘

Your staff needs to understand that they are not just part of the administrative or clinical departments but that they are a part of marketing as well.

Social media is one example of how practices can take advantage of this e-patient revolution. Start simple by just trying one platform at a time such as Facebook. Doctors are often intimidated by concerns of HIPAA and other legalities but with thousands of practices now using social media to communicate with patients, there are plenty of resources out there to help minimize such risks. Use social media to stay top of mind with patients by posting links to educational articles, helpful health tips and practice news.

E-newsletters can be used in the same way. Now with either free or extremely inexpensive e-newsletter programs like Mail Chimp, Constant Contact and iContact, it makes it easy for practices to send out monthly or quarterly communications to patients.

Just be sure to get permission to use patient emails first. For those practices with a patient portal, you can also use the messaging feature to blast out announcements.

In order to reach patients who aren’t so digitally connected, try ideas like mailing a postcard that contains a magnet for the refrigerator or a letter wishing them a New Year and reminding them of annual health checks. The options are endless but the point is to find ways to keep your patients connected beyond the waiting room.

2. Give Patients a Reason to Come Back: Communication tools like social media continued on page 44 MEDMONTHLY.COM |43

continued from page 43

and e-newsletters are also a great way to spread the word about new or existing services within your practice. When it comes to marketing, if you’re not saying it then you’re not doing it. That means if you aren’t telling patients about your other services then they probably don’t know they even exist.

Sometimes patients need a service but don’t realize your practice performs it (such as mole removals at a family practice), and sometimes you offer a service that patients don’t know they need (such as NovaSure at an OB/GYN practice). This is when you have to put on your marketing hat and take the opportunity to upsell patients on other services you offer.

I see many medical practices investing in ancillary services in order to increase revenue (from weight loss to in-office x-ray), but I’m surprised how few actually market these services. If you take the mentality of “if you build it, they will come”, you may be waiting a very long time. Healthcare has become increasingly competitive and the days of simply hanging a sign over your door are long gone.

You already have a captive audience in your current patients so take the opportunity to better communicate your services. Don’t make the mistake of sharing your message only once though.

Sometimes doctors think if they told their patients once then they already know. If that were the case, then we wouldn’t see the same commercials play on TV over and over. Patients need to hear a message several times before they commit it to memory. Don’t be afraid to repeat yourself.

3. Make it a Positive Experience: Ok, so you probably knew this one was coming… the patient experience.

It’s a waste of time and funds to implement an internal marketing 44| MAY 2013

plan if you have no hope of retaining patients because their experience at your office was negative. From the way your staff answers the phone to color of your walls, it’s all part of the patient experience.

Your staff needs to understand that they are not just part of the administrative or clinical departments but that they are a part of marketing as well. Whether your staff is checking a patient out or drawing their blood, every interaction shapes the patient experience. And with the internet, every experience is up for scrutiny.

I’ve seen far too many great doctors lose patients due to bad staffing. Invest in customer training for your staff, don’t put up with negative attitudes, and you may even want to consider an incentive plan. I’ve seen plenty of practices incentivize their staff for scoring certain levels on patient satisfaction surveys and even for upselling services to patients.

Finally, listen to your patients.

Your patients can be the best source of ideas to make your practice better. Whether the ideas come from patient surveys, your social media page or even online review sites, take the feedback to heart and be open to change.

Customer service is the new public relations. That means that by responding to complaints online with practical solutions, patients will be far more impressed that you took action than the fact that the complaint happened in the first place.

A good marketing strategy starts from the inside out. By staying top of mind with patients, giving them a reason to come back for other services, and making their experience positive, you’ll create an effective internal marketing strategy that will enhance the ROI on your external marketing campaigns, and thus make the most impact on the growth of your practice. 

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

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

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

features

PA/NP WORKFORCE – Will the Market Supply Meet Your Practice Demand?

By Lisa P. Shock, MHS, PA-C President/CEO Utilization Solutions in Healthcare, Inc. 46 | MAY 2013

P

hysician Assistants (PAs) and Nurse Practitioners (NPs) are skilled medical professionals who play an integral part in health care delivery.

Especially in primary care, PAs and NPs attract and manage a significant following of patients, especially in rural communities. Recruitment is challenging in more underserved areas, however, retention is often more important as practices and patients invest in an individual with the hope that they will stay and practice for a considerable amount of time.

In the 1960’s studies began to indicate we would not have enough primary care physicians, particularly in rural areas. As primary care demands grew, so did the demand for primary care PAs and NPs. As physician specialties were “stressed” by a flat supply but increasing demand, opportunities grew for extenders not only in primary care, but across more specialties as well.

Cooper et al (see reference 1) projected “provider shortages” in the range of 150,000 to 200,000 by 2020.

The AAMC (American Association of Medical Colleges) predicts a shortfall of “91,500” by 2020. NP & PA programs have not been able to ramp up and fully supplement the decreasing physician supply (in this case provider supply) even when you add in the increasing numbers of PAs & NPs in training.

A recent 2011 Physician Retention Survey by the American Group Medical Association (AGMA) shows that the turnover rate for nurse practitioners and physician assistants is 12.6 percent, more than twice the combined, adjusted physician turnover rate of 6 percent.

So how do you attract a great PA or NP to your practice?

Obviously a PA or NP who is passionate about your clinical need

is important. Highlighting the type of duties you need performed as well as the type of patient population is critical to the messaging. For example, don’t just say family practice PA/NP wanted in Xyz town, NC. Instead, say: Dynamic PA/NP wanted for charming rural underserved area in Xyz, NC. Interested providers will be responsible for health care delivery to an appreciative population that has limited resources. Medicare and Medicaid credentialing are a must.

Suburban, rural and smaller practices all have the same complaint that they cannot recruit to their area because they cannot pay as much in salary as their competition. However, often these groups are missing the mark as they often qualify for loan repayment within the state, or they might offer flexibility within a clinical work schedule that is appreciated by the provider. For example, if a PA/NP lives in town where they work, it might be agreeable that they can leave at 3 to pick up a child from school and then come back to wrap up the clinical day.

Such flexibility is not easily achievable in a larger hospital or health system.

Highlighting those “extras” will be important as you list all the reasons why your office is a great place to work.

At the community level there remains a Physician and PA and NP shortage. How will educational programs meet the demand? In 2012, 17,000 Physician Assistant student applicants are estimated to be competing for 5,550 seats nationwide.

There is a significant proliferation of PA programs all across the country, and North Carolina is no exception, with 7 programs currently accepting applications and up to 11 are projected to matriculate students by 2014.

You can help by encouraging and supporting clinical providers to precept students. Ensuring quality health care education for learners is critical to the success of this overall system expansion. All of us currently

in established clinical roles gained valuable and critical raining and experience from our teachers and clinical preceptors.

Redesigning teams to include increased numbers of primary care providers, not just physicians but also PAs and NPs, is a significant part of the solution to alleviate the well-known shortage in primary care. Improving utilization of Physician Assistants (PAs) and Nurse Practitioners (NPs) will be an integral part of the primary care delivery solution. Often, the addition of a PA/NP to a medical practice offers enhanced patient satisfaction, improved physician worklife balance, improved revenues and greater access to care for patients.  Read more here: http://www.smartmoney.com/plan/ health-care/your-surgeon-may-not-bea-doctor-1346970593986/ Cooper, Richard A. New Directions for Nurse Practitioners and Physician Assistants in the Era of Physician Shortages. Academic Medicine, Vol. 82, No. 9 / September 2007. http://www.healthcarefinancenews. com/news/managing-doctornurse-practitioner-turnover-rateskey-delivery-collaborative-caremodel?topic=24 About the Author: Lisa P. Shock, MHS, PA-C, is a seasoned PA who has worked with clients to expand health care teams in both large and small settings. She enjoys part time clinical primary care practice and is the President and CEO of Utilization Solutions in Healthcare – a specialty consultant company for physician practices and hospitals, offering a wide range of services to help implement and improve upon the utilization of PAs and NPs in the health care system. Contact her at lisa@pushpa.biz

MEDMONTHLY.COM |47

the arts

‘Art By Nurses’ Just Behind You by Lynda McLeod

C

reative interventions are not just for patients…they should be experienced by health care professionals too. Caring for the sick is demanding work, and at times, thankless.

Health professionals need a reprieve to rejuvenate themselves, and engaging in creative activities does exactly this.

Self-care principles and theory applies not only to patients and their families, but to health care professionals as well.

Who benefits? Everyone that health care professionals interacts with – nurses, doctors, ancillary nursing personnel, social workers, OT, PT, managers and executive staff, academicians, etc. By experiencing and expanding your own definition of creativity, it will ultimately benefit you, your patients and everyone else.

Lynda McLeod of Victoria, British Columbia has applied these self-care principles into action. Lynda talks about her background in nursing and interest in the arts. Lynda is a nurse educator, artist and founder of ‘Art By Nurses’, an online gallery of artwork for sale created by nurse-artists.

With no further ado, here’s Lynda…

“Since the beginning of my nursing practice I have always used art as a reflective process to help me make sense of the experiences I encounter as

48| MAY 2013

Toes Tugging Toes #2 by Lynda McLeod

a nurse. In fact, I attribute the process of art as the only reason I am still involved in nursing. Being a highly sensitive, creative person, I found some of my nursing experiences, mainly bearing witness, difficult to unravel.

As an effort to maintain balance and meaning I connect with nature and my family by going on long canoe and kayaking trips along the west coast of BC. The meditative act of painting these moments became my vehicle to transcend the sorrow and arrive at another plane of understanding. I have no formal art education in technique, color or brushwork; instead, I draw on my passion for nursing and the transformational relationships formed while teaching the next generation of registered nurses.

I started the web site company based on a belief that many nurses engage in the meditative process of art in order to make meaning of the experiences they encounter as healers.

By creating art and sharing their artistic visions, nurses work to maintain their health and support each other in a very rewarding, yet demanding profession.

ArtbyNurses.com brings nurses together using art. We share the healing qualities of art with the wider community to spotlight our profession, illustrate the benefits of art as a self-care process and celebrate our artistic talents.

We encourage nurses to join Art

by Nurse to sell their art in a virtual gallery. Support your colleagues and join Art by Nurses as an artist or an associate member.”  Sources: http://creativityinhealthcare. com/2010/01/20/art-by-nurses-bylynda-mcleod/ http://www.artbynurses.com/

Welcome to Art by Nurses.

As part of my commitment to maintaining balance and meaning in my life as a nurse, I use art to express the inexpressible to come to another plane of understanding. I believe nurses are natural creative thinkers and there are many, many nurse artists among us. When we connect using art/ creativity, I believe magical things happen.

I am the founder of Artbynurses.com a not-forprofit website. It is the underground railway that connects creative, innovative thinkers who are passionate about self-care. This community embraces both the art and science of nursing using our creativity to bring us together. Art by nurses members are now sharing the healing qualities of art with the wider community to spotlight their profession, illustrate the benefits of art as a self-care process, and celebrate their artistic talents.

The www.artbynurses.com web site has been up and running since 2007. There are thirty-three nurse artist’s on-line galleries. We have held over ten art shows in framing shops and coffee shops here in Victoria BC. Three art shows celebrated Nurse’s week.

We are now connecting with Health Care Communities by hanging our art in hospitals as The Art by Nurses Healing Hallways.

• 2010 Art by Nurses Healing Hallways St. Pauls Hospital, Vancouver, BC. • 2011 Art by Nurses Healing Hallways Royal Jubilee Hospital, Victoria, BC. • 2012 Art by Nurses Healing Hallways Health Clinic, Victoria, BC. • Three more Art by Nurses Healing Hallways to come in the New Year 2013

My dream is to hang Art by Nurses Healing Hallways exhibits across Canada in every province.

As part of each exhibit I would offer Creativity workshops and set up coaching networks for RNs in each province. My hope is to connect nurses across the country unleashing creative energy and joy.

I invite you to join artbynurses.com to help make a better workplace for healthier nurses.

Cheers to you all,

Lynda McLeod MEDMONTHLY.COM |49

healthy living

Black Bean Quesadillas

By Ashley Acornley, MS, RD, LDN

Happy Cinco de Mayo! Typically, Mexican style food is high in calories, particularly because of the large quantity of cheese, oil, sour cream, and guacamole placed on top of each entrĂŠe. However, in celebration of this festive holiday, try this recipe for black bean quesadillas These satisfying quesadillas take just 15 minutes to make! If you like a little heat or spice, be sure to use pepper Jack cheese in the filling. This recipe is low in calories and cholesterol, and high in calcium, folate, fiber, and potassium! Serve with a dollop of sour cream, salsa, and a mixed green salad for a well balanced meal!

Servings: 4 servings

Ingredients: 1 15-ounce can black beans, rinsed 1/2 cup shredded Monterey Jack or Pepper Jack cheese 1/2 cup prepared fresh salsa (see Tip), divided 4 8-inch whole-wheat tortillas 2 teaspoons canola oil, divided 1 ripe avocado, diced 50| MAY 2013

Preparation: 1. Combine beans, cheese and 1/4 cup salsa in a medium bowl. Place tortillas on a work surface.

Spread 1/2 cup filling on half of each tortilla. Fold tortillas in half, pressing gently to flatten.

2. Heat 1 teaspoon oil in a large nonstick skillet over medium heat. Add 2 quesadillas and cook, turning once, until golden on both sides, 2 to 4 minutes total. Transfer to a cutting board and tent with foil to keep warm. Repeat with the remaining 1 teaspoon oil and quesadillas.

3. Serve the quesadillas with avocado and the remaining salsa.

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

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

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

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

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

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

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

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

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

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

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

MEDMONTHLY.COM |51

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

Dover, DE 19904 (302)744-4500 http://1.usa.gov/t0mbWZ Florida 4052 Bald Cypress Way Bin C-08 Tallahassee, FL 32399 (850)245-4474 http://bit.ly/w1m4MI 52 | MAY 2013

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Texas 333 Guadeloupe St. Suite 3-800 Austin, TX 78701 (512)463-6400 http://www.tsbde.state.tx.us/ Utah 160 E. 300 South Salt Lake City, UT 84111 (801)530-6628 http://1.usa.gov/xMVXWm Vermont National Life Building North FL2 Montpelier, VT 05620 (802)828-1505 http://bit.ly/zSHgpa Virginia Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4538 http://www.dhp.virginia.gov/dentistry Washington 310 Israel Rd. SE P.O. Box 47865 Olympia, WA 98504 (360)236-4700 http://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/Dentist.aspx West Virginia 1319 Robert C. Byrd Dr. P.O. Box 1447 Crab Orchard, WV 25827 1-877-914-8266 http://www.wvdentalboard.org/ Wisconsin P.O. Box 8935 Madison, WI 53708 1(877)617-1565 http://dsps.wi.gov/Default. aspx?Page=90c5523f-bab0-4a45-ab943d9f699d4eb5 Wyoming 1800 Carey Ave., 4th Floor Cheyenne, WY 82002 (307)777-6529 http://plboards.state.wy.us/dental/index.asp MEDMONTHLY.COM |53

U.S. MEDICAL BOARDS Alabama P.O. Box 946 Montgomery, AL 36101 (334)242-4116 http://www.albme.org/ Alaska 550 West 7th Ave., Suite 1500 Anchorage, AK 99501 (907)269-8163 http://bit.ly/zZ455T Arizona 9545 E. Doubletree Ranch Rd. Scottsdale, AZ 85258 (480)551-2700 http://www.azmd.gov Arkansas 1401 West Capitol Ave., Suite 340 Little Rock, AR 72201 (501)296-1802 http://www.armedicalboard.org/ California 2005 Evergreen St., Suite 1200 Sacramento, CA 95815 (916)263-2382 http://www.mbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7690 http://www.dora.state.co.us/medical/ Connecticut 401 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/site/default.asp Delaware Division of Professional Regulation Cannon Building 861 Silver Lake Blvd., Suite 203 Dover, DE 19904 (302)744-4500 http://dpr.delaware.gov/ District of Columbia 899 North Capitol St., NE Washington, DC 20002 (202)442-5955 http://www.dchealth.dc.gov/doh 54| MAY 2013

Florida 2585 Merchants Row Blvd.

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

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

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

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

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

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

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

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

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

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

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

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

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

Montana 301 S. Park Ave. #430 Helena, MT 59601 (406)841-2300 http://bit.ly/obJm7J p

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

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

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

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

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

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

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

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

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

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/

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

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

MEDMONTHLY.COM |55

medical resource guide ACCOUNTING

Ajishra Technology Support

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

ADVERTISING

PO Box 15130 Scottsdale, AZ 85267 (602)370-0303 www.findurgentcare.com

MedMedia9

www.medmedia9.com

Ring Ring LLC

6881 Maple Creek Blvd, Suite 100 West Bloomfield, MI 48322-4559 (248)819-6838 www.ringringllc.com

ANSWERING SERVICES Corridor Medical Answering Service

3088 Route 27, Suite 7 Kendall Park, NJ 08824 (866)447-5154 www.corridoranswering.net

Docs on Hold

14849 West 95th St. Lenexa, KS 66285 (913)559-3666 www.soundproductsinc.com

BILLING & COLLECTION Advanced Physician Billing, LLC

PO Box 730 Fishers, IN 46038 (866)459-4579 www.advancedphysicianbillingllc.com

56| MAY 2013

Applied Medical Services 4220 NC Hwy 55, Suite 130B Durham, NC 27713 (919)477-5152 www.ams-nc.com

Sweans Technologies 501 Silverside Rd. Wilmington, DE 19809 (302)351-3690 www.medisweans.com

VIP Billing

PO Box 1350 Forney, TX 75126 (214)499-3440 www.vipbilling.com

Axiom Business Solutions

Find Urgent Care

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

3562 Habersham at Northlake, Bldg J Tucker, GA 30084 (866)473-0011 www.ajishra.com

4704 E. Trindle Rd. Mechanicsburg, PA 17050 (866)517-0466 www.axiom-biz.com

Frost Arnett 480 James Robertson Parkway Nashville, TN 37219 (800)264-7156 www.frostarnett.com

CAREER CONSULTING Doctor’s Crossing 4107 Medical Parkway, Suite 104 Austin, Texas 78756 (512)517-8545 http://doctorscrossing.com/

Gold Key Credit, Inc. PO Box 15670 Brooksville, FL 34604 888-717-9615 www.goldkeycreditinc.com

Horizon Billing Specialists 4635 44th St., Suite C150 Kentwood, MI 49512 (800)378-9991 www.horizonbilling.com

CODING SPECIALISTS The Coding Institute LLC 2222 Sedwick Drive Durham, NC 27713 (800)508-2582 http://www.codinginstitute.com/

Management Services On-Call 200 Timber Hill Place, Suite 221 Chapel Hill, NC 27514 (866)347-0001 www.msocgroup.com

Marina Medical Billing Service 18000 Studebaker Road 4th Floor Cerritos, CA 90703 (800)287-8166 www.marinabilling.com

Mediserv 6451 Brentwood Stair Rd. Ft. Worth, TX 76112 (800)378-4134 www.mediservltd.com

Practice Velocity 1673 Belvidere Road Belvidere, IL 61008 (888)357-4209 www.practicevelocity.com

COMPUTER, SOFTWARE American Medical Software

1180 Illinois 157 Edwardsville, IL 62025 (618) 692-1300 www.americanmedical.com

CDWG

300 N. Milwaukee Ave Vernon Hills, IL 60061 (866)782-4239 www.cdwg.com/

Instant Medical History

4840 Forest Drive #349 Columbia, SC 29206 (803)796-7980 www.medicalhistory.com

medical resource guide CONSULTING SERVICES, PRACTICE MANAGEMENT

DENTAL Biomet 3i

Medical Credentialing

(800) 4-THRIVE www.medicalcredentialing.org

Medical Practice Listings

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

myEMRchoice.com

24 Cherry Lane Doylestown, PA 18901 (888)348-1170 www.myemrchoice.com

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

Synapse Medical Management

18436 Hawthorne Blvd. #201 Torrance, CA 90504 (310)895-7143 www.synapsemgmt.com

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

Dental Management Club

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

DocuTAP 4701 W. Research Dr. #102 Sioux Falls, SD 57107-1312 (877)697-4696 www.docutap.com

Integritas, Inc. 2600 Garden Rd. #112 Monterey, CA 93940 (800)458-2486 www.integritas.com

The Dental Box Company, Inc.

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

FINANCIAL CONSULTANTS Sigmon Daknis Wealth Management

DIETICIAN Triangle Nutrition Therapy 6200 Falls of Neuse Road, Suite 200 Raleigh, NC 27609 (919)876-9779 http://trianglediet.com/

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

Sigmon & Daknis Williamsburg, VA Office 325 McLaws Circle, Suite 2 Williamsburg, VA 23185 (757)258-1063 http://www.sigmondaknis.com/

ELECTRONIC MED. RECORDS

Urgent Care America

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

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

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

www.pushpa.biz

ABELSoft 1207 Delaware Ave. #433 Buffalo, NY 14209 (800)267-2235 www.abelmedicalsoftware.com

Acentec, Inc 17815 Sky Park Circle , Suite J Irvine, CA 92614 (949)474-7774 www.acentec.com

AdvancedMD

INSURANCE, MED. LIABILITY Aquesta Insurance Services, Inc.

Michael W. Robertson 3807 Peachtree Avenue, #103 Wilmington, NC 28403 Work: (910) 794-6103 Cell: (910) 777-8918 www.aquestainsurance.com

Medical Protective

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

5814 Reed Rd. Fort Wayne, In 46835 (800)463-3776 http://www.medpro.com/ medical-protective

CollaborateMD

MGIS, Inc.

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

1849 W. North Temple Salt Lake City, UT 84116 (800)969-6447 www.mgis.com

MEDMONTHLY.COM |57

medical resource guide INSURANCE, MED. LIABILITY

Nicholas Down http://bit.ly/yHwxb0

Martin Fried

www.martindfried.com

Professional Medical Insurance Services

16800 Greenspoint Park Drive Houston, TX 77060 (877)583-5510 www.promedins.com

Wood Insurance Group

4835 East Cactus Rd., #440 Scottsdale, AZ 85254-3544 (602)230-8200 www.woodinsurancegroup.com

LOCUM TENENS Physician Solutions

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

Bank of America

Barry Hanshaw 18 Bay Path Drive Boylston MA 01505 508 - 869 - 6038 JHans76271@aol.com www.barryhanshaw.com

MMA Medical Architects

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

Laura Maask 262-308-1300 Laura@medimagery.com

medimagery.com

Marianne Mitchell (215)704-3188 http://www.mariannemitchell.com http://www.colordrop.blogspot.com

MEDICAL EQUIPMENT

1295 Walt Whitman Road Melville, NY 11747 (888)862-4050 www.allproimaging.com

Biosite, Inc

9975 Summers Ridge Road San Diego, CA 92121 (858)805-8378

www.artisanprinter.com

Deborah Brenner

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

800 Shoreline, #900 Corpus Christi, TX 78401 (888)246-3928

www.cryopen.com

Pia De Girolamo

58| MAY 2013

www.piadegirolamo.com

391 Technology Way Winston Salem, NC 27101 (336)722-8910 www.carolinachemistries.com

Robert Sayre Marketing Adviser/Business Coach http://www.linkedin.com/pub/robsayre/2/977/355/

MedMedia9

PO Box 98313 Raleigh, NC 27624 (919)747-9031 www.medmedia9.com WhiteCoat Designs Web, Print & Marketing Solutions for Doctors (919)714-9885 www.whitecoat-designs.com

www.dicomsolutions.com

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

Medical Practice Listings

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

MEDICAL PRACTICE VALUATIONS

Dicom Solutions 548 Wald Irvine, CA 92618 (800)377-2617

High Performance Network

MEDICAL PRACTICE SALES

Carolina Liquid Chemistries, Inc. Brian Allen

MEDICAL MARKETING

www.biosite.com

Cryopen

MEDICAL ART

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

MedImagery

ALLPRO Imaging

MEDICAL ARCHITECTS

MEDICAL EQUIPMENT FINANCING

www.thetps.com

BizScore

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

medical resource guide

MEDICAL PUBLISHING

PRACTICE FINANCING Bank of America

Greenbranch Publishing

info@greenbranch.com 800-933-3711 www.greenbranch.com

MEDICAL RESEARCH

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

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

Dermabond

Ethicon, Route 22 West Somerville, NJ 08876 (877)984-4266 www.dermabond.com

DJO

1430 Decision St. Vista, CA 92081 (760)727-1280

REAL ESTATE

www.djoglobal.com

Arup Laboratories

500 Chipeta Way Salt Lake City, UT 84108 (800)242-2787

www.aruplab.com

Chimerix, Inc. 2505 Meridian Parkway, Suite 340 Durham, NC 27713 (919) 806-1074 www.chimerix.com Clinical Reference Laboratory 8433 Quivira Rd. Lenexa, KS 66215 (800)445-6917

www.crlcorp.com

Sanofi US

55 Corporate Drive Bridgewater, NJ 08807 (800) 981-2491

Scynexis, Inc.

ExpertMed

York Properties, Inc.

www.sanofi.us

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

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

31778 Enterprise Dr. Livonia, MI 48150 (800)447-5050

www.expertmed.com

Gebauer Company

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

Scarguard

15 Barstow Rd. Great Neck, NY 11021 (877)566-5935 www.scarguard.com

WEBSITE DESIGN

SUPPLIES, GENERAL

3501 C Tricenter Blvd.

Durham, NC 27713 (919) 933-4990

MedMedia9 www.scynexis.com

BSN Medical 5825 Carnegie Boulevard Charlotte, NC 28209 (800)552-1157 www.bsnmedical.us

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

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NC OPPORTUNITIES

Woman’s Practice in Raleigh, North Carolina.

LOCUMS OR PERMANENT

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

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

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

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

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

Medical Practice Listings; 919-848-4202

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

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

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

Medical Practice Listings Selling and buying made easy

MedicalPracticeListings.com | medlisting@gmail.com | 919.848.4202 60| MAY 2013

classified listings

Classified To place a classified ad, call 919.747.9031

Physicians needed North Carolina

Immediate need for full time GP/FP for urgent cares in eastern NC. Urgent care centers from Raleigh to the eastern coast of NC seek immediate primary care physician. Full time opportunity with possibility for permanent placement. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

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

Averages 25 patients per day with no call and shift hours from 8:30 am to 5:30 pm. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

General Practitioner Needed in Greensboro. Occupational health care clinic seeks general practitioner for disability physicals ongoing 1-3 days a week. Adults only. 8 am-5 pm. No call required. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

3-5 days per week in Durham, NC . Geriatric physician needed immediately 3-5 days per week, on-going at nursing home in Durham. Nursing home focuses on therapy and nursing after patients are released from the hospital. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

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

The chosen physician will need to be credentialed through the hospital, please email your CV, medical license and DEA so we can fill this position immediately.

GP Needed Immediately On-Going 1-3 Days Per Week at Addictive Diease Clinics located in Charlotte, Hickory, Concord & Marion North Carolina. General Practitioner with a knowledge or interest in addictive disease.

Needed in October on-going 1-3 times per week. This clinic requires training so respond to post before October 1st. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Primary Care Physician in Northwest NC (multiple locations). Primary care physician needed immediately for ongoing coverage at one of the largest substance abuse treatment facilities in NC. Doctor will be responsible for new patient evaluations and supportive aftercare. Counseling and therapy are combined with physician’s medical assessment and care for the treatment of adults, adolescents and families. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Pediatrician or Family Medicine Doctor in Fayetteville Comfortable with seeing children. Need is immediate - Full time ongoing for maternity leave. 8 am - 5 pm.

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

County Health Department in Fayetteville, NC seeks GP/IM/FP Full-Time, On-Going Shifts. GP/IM/FP Needed Immediately at County Health Department in Fayetteville, NC. Approximately 20 patients per day with hours from 8 am -5 pm. Call or email for more information. 919-845-0054 physiciansolutions@gmail.com Occupational Clinic in Greensboro, NC seeks FP/GP for On-Going Shifts. Locum tenens position (4-5 days a week) available for an occupational, urgent care and walk in clinic. The practice is located in Greensboro NC. Hours are 8 am-5 pm. Approximately 20 patients/ day. Excellent staff. Outpatient only.

Diabetic Clinic 1 hour from Charlotte seeks FP/GP/ IM for On-Going Shifts.Primary care physician needed immediately for outpatient diabetic clinic one hour outside Charlotte, NC On-going. Hours are 8 am -5 pm with no call. Approximately 15-20 patients a day.

Clinic between Fayetteville and Wilmington seeks FP/ GP/IM Mar 22 FT ongoing. A small hospital’s outpatient clinic located within an hour of both Fayetteville and Wilmington seeks PA to work FT ongoing beginning March 22. Shifts can be either 8 or 12 hours. No call.

continued on page 62 MEDMONTHLY.COM |61

classified listings

Classified

continued from page 61

To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

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

Child Health Clinic in Statesville, NC seeks pediatrician or Family Physician comfortable with peds for on-going, full-time shifts. Physician will work M-F 8 am - 5 pm, ongoing. Qualified physician will know EMR or Allscripts software. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Peds Clinic near Raleigh seeks Mid-Level Provider for on-going coverage 4x/wk. Health Department pediatrics clinic 45 min from Raleigh needs coverage 4 days a week from January through June. Provider will see about 20 patients daily, hours are 8am-5pm with an hour for lunch.

Employee Health Clinic seeks Mid-Level Provider for FT on-going coverage near Charlotte. Health Department 45 minutes from Charlotte seeks on-going coverage for employee health clinic beginning in January. Provider will see about 20-24 patients daily, hours are 8am-5pm with an hour for lunch.

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

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

62| MAY 2013

Employee Health Clinic seeks Mid-Level Provider for FT on-going coverage near Charlotte. Health Department 45 minutes from Charlotte seeks on-going coverage for employee health clinic beginning in March.

Provider will see about 20-24 patients daily, hours are 8am-5pm with an hour for lunch.

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

Possible permanent placement.

Western North Carolina Health Department needs continuing physician coverage. County Health Department seeks coverage for their walk in clinic which sees all ages. Ongoing, 8am-5pm, no call. 35-40 patients a day. Well established clinic located in a beautiful area.

Asheboro Family Practice and Urgent Care seeks GP for intermittent coverage. Family Practice and Urgent Care seeks general practitioner for intermittent days beginning in March from 8a-8p. Provider will see about 35 patients with no call.

Greensboro occupational health care clinic seeks general practitioner for intermittent shifts. Primary care physicians needed for occupational medicine. Adults only. Hours are 8am-5pm. Large corporation, no call required.

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

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

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

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

Must have geriatric experience. 8-5p. Other facilities in Fayetteville and Rocky Mount.

Classified To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

COLUMBUS IM FT/PT Mid-Level Provider needed for practice near Wilmington. Small internal medicine private practice 45 minutes outside Wilmington seeks mid-level provider starting immediately. FT/PT. M-F 8-5p. Possible permanent placement.

Fayetteville occupational health care clinic seeks GP for May 5-9. Primary care physicians needed for occupational medicine. Adults only. 8-5p. Large corporation, no call required. Intermittent dates in the future and second office in Greensboro with ongoing scheduling.

Health Dept 45 min NE of Raleigh seeks MD coverage Tues/Thurs ongoing May 14. GP/FP/IM/Peds doctor needed for the following clinics in Louisburg: Adult, Family Planning, Peds, STD for ongoing scheduling or intermittent shifts. 8-5p.

Community Health Dept in Washington, NC (1 h 45 min E of Raleigh) seeks FP for coverage June 15 FT/PT ongoing. Family practitioner sought for eastern Carolina community health center in Washington, NC. Must see all ages, 8-5p. Start June 15 ongoing.

Nursing home in Durham seeks PT/FT Geriatrics doctor for immediate ongoing scheduling. Durham nursing home seeks part time or full time MD for ongoing locums. Must have geriatric experience. 8-5p. Other facilities in Fayetteville and Rocky Mount.

Family Practice 1 h SE of Raleigh seeks July 6-7 coverage. Goldsboro FP seeks MD for July 6-7 and intermittent shifts. 8-5p.

Pediatric clinic near Greensboro needs 10 weeks of 3 day a week coverage beginning June 1. Burlington pediatric clinic seeks coverage June 1 3 days a week for 10 weeks. 8-5p.

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

Clinic between Fayetteville and Wilmington seeks FP/ GP/IM Mar 22 FT ongoing . A small hospital’s outpatient clinic located within an hour of both Fayetteville and Wilmington seeks PA to work FT ongoing beginning March 22. Shifts can be either 8 or 12 hours. No call.

Western North Carolina Health Department needs continuing physician coverage. County Health Department seeks coverage for their walk in clinic which sees all ages. Ongoing, 8am-5pm, no call. 35-40 patients a day. Well established clinic located in a beautiful area.

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

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

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

Greenville Clinic seeks GP May 20-22. GP/IM needed for May 20-22 and intermittent shifts. Must have experience or be willing to do pain management and trigger point injections. 8-5p. continued on page 64 MEDMONTHLY.COM |63

classified listings

Classified

continued from page 63

To place a classified ad, call 919.747.9031

Physicians needed Virginia Pediatric Locums Physician needed in Harrisonburg, Danville and Lynchburg, VA. These locum positions require 30 to 40 hours per week, on-going. If you are seeking a beautiful climate and flexibility with your schedule, please consider one of these opportunities. Send copies of your CV, VA. medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Urgent Care opportunities throughout Virginia. We have contracts with numerous facilities and eight to 14-hour shifts are available. If you have experience treating patients from pediatrics to geriatrics, we welcome your inquires. Send copies of your CV, VA medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com Virginia practice outside of Washington DC seeks IM doctor FT/PT now – June 1. IM physician needed immediately FT/PT for Virginia clinic near Washington DC. 8-5p

Health Dept near Raleigh seeks mid-level coverage Tues/Thurs ongoing beginning May 14. NP/PA needed for the following clinics 45 min NE of Raleigh: Adult, Family Planning, Peds, STD for ongoing scheduling or intermittent shifts. 8-5p.

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

Contact us today at (919) 848-4202.

Practice for sale North Carolina

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

8a-5p ongoing full time or part time.

Permanent NP needed immediately for FT Raleigh practice. Raleigh clinic seeks full time permanent nurse practitioner immediately. 8-5p Health Dept 1 hour 30 min E of Raleigh seeks NP FT immediately locums to perm. Nurse Practitioner needed in health department for locums to permanent position starting immediately. 8-5p.

64| MAY 2013

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

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

Classified To place a classified ad, call 919.747.9031

Practice for sale North Carolina (cont.)

Impressive Internal Medicine Practice in Durham, NC: The City of Medicine. Over 20 years serving the community, this practice is now listed for sale. There are four wellequipped exam rooms, new computer equipment and a solid patient following. The owner is retiring and willing to continue with the new owner for a few months to assist with a smooth transition. Contact Medical Practice Listings at (919) 848-4202 for more information. View additional listings at: www.medicalpracticelistings.com Primary Care Practice specializing in women’s care. The owning female physician is willing to continue with the practice for a reasonable time to assist with smooth ownership transfer. The patient load is 35 to 40 patients per day, however that could double with a second provider.

Exceptional cash flow and profitable practice that will surprise even the most optimistic practice seeker. This is a remarkable opportunity to purchase a well-established woman’s practice. Spacious practice with several wellappointed exam rooms throughout. New computers and medical management software add to this modern front desk environment. This practice is being offered for $435,000. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or send an email to medlistings@gmail.com Internal Medicine Practice located just outside Fayetteville, NC is now being offered. The owning physician is retiring and is willing to continue working for the new owner for a month or two assisting with a smooth transaction. The practice treats patients four and a half days per week with no call or hospital rounds. The schedule accommodates 35 patients per day. You will be hard pressed to find a more beautiful practice that is modern, tastefully decorated and well appointed with vibrant art work. The practice, patient charts, equipment and good will is being offered for $415,000 while the free standing building is being offered for $635,000. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or email: medlistings@gmail.com

Modern Vein Care Practice located in the mountains of NC. Booking seven to 10 procedures per day, you will find this impressive vein practice attractive in many ways.

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

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

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

MEDMONTHLY.COM |65

Hospice Practice Wanted Hospice Practice wanted in Raleigh/ Durham area of North Carolina.

Medical Practice Listings has a qualified physician buyer that is ready to purchase. If you are considering your hospice practice options, contact us for a confidential discussion regarding your practice.

Practice for Sale in South Denver Neurofeedback and Psychological Practice Located in South Denver, Colorado, this practice features high patient volume and high visibility on the internet. Established referral sources, owner (psychologist) has excellent reputation based on 30 years experience in Denver. Private pay and insurances, high-density traffic, beautifully decorated and furnished offices, 378 active and inactive clients, corporate clients, $14,000 physical assets, good parking, near bus and rapid transit housed in a well-maintained medical building.

Live and work in one of the most healthy cities in the U.S. List Price: $150,000 | Established: 2007 | Location: Colorado

To find out more information call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

For more information contact Dr. Jack McInroy at 303-929-2598 or Shrink1324@gmail.com

Woman's Practice A vailable for Sale Available for purchase is a beautiful boutique women’s Internal Medicine and Primary Care practice located in the Raleigh area of North Carolina.

The physician owner has truly found a niche specializing in women’s care. Enhanced with female-related outpatient procedures, the average patient per day is 40+. The owner of the practice is an Internal Medicine MD with a Nurse Practitioner working in the practice full time. Modern exam tables, instruments and medical furniture.

Gross Yearly Income: $585,000 | List Price: $365,000

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

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

Practice for Sale in Raleigh, NC

PEDIATRICIAN

or family medicine doctor needed in

FAYETTEVILLE, NC

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

List price: $435,000

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

Comfortable seeing children. Needed immediately.

Call 919- 845-0054 or email: physiciansolutions@gmail.com www.physiciansolutions.com MEDMONTHLY.COM |67

MODERN MED SPA AVAILABLE Located in beautiful coastal North Carolina

Modern, well-appointed med spa is available in a picturesque part of the state. This practice is positioned in a highly traveled area with positive demographics adding to the business appeal and revenue stream. A sampling of the services and procedures offered are: BOTOX, facial therapy and treatments, laser hair removal, eye lash extensions and body waxing as well as a menu of anti-aging options.

If you are currently a med spa owner and looking to expand or considering this high profile med business, this is the perfect opportunity.

Highly profitable and organized, you will find this spa poised for success.

The qualified buyer can obtain detailed information by contacting Medical Practice Listings at 919-848-4202.

MedicalPracticeListings.com | medlisting@gmail.com | 919.848.4202

ADVERTISE YOUR PRACTICE BUILDING IN MED MONTHLY By placing a professional ad in Med Monthly, you're spending smart money and directing your marketing efforts toward qualified clients.

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

medmonthly.com | 919.747.9031

Primary Care Practice For Sale 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

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

PEDIATRICIAN

OR FAMILY MEDICINE DOCTOR NEEDED IN

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

Credentialing at the hospital is necessary.

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

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

Primary Care Practice for Sale

NC MedSpa For Sale

Hickory, North Carolina

MedSpa Located in North Carolina Established primary care practice in the beautiful foothills of North Carolina The owning physician is retiring, creating an excellent opportunity for a progressive buyer.

There are two full-time physician assistants that see the majority of the patients which averages between 45 to 65 per day.

There is lots of room to grow this already solid practice that has a yearly gross of $1,500,00.

You will be impressed with this modern and highly visible practice.

Call for pricing and details.

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

We have recently listed a MedSpa 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.

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

PRACTICE FOR SALE

OCCUPATIONAL HEALTH CARE PRACTICE FOR SALE

Pediatrics Practice Wanted

Greensboro, North Carolina

Pediatrics practice wanted in NC

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

Considering your options regarding your pediatric practice? We can help.

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

Contact us today to discuss your options confidentially.

Asking price: $385,000

To view more listings visit us online at medicalpracticelistings.com

Med Monthly Med Monthly is the premier health care magazine for medical professionals.

By placing an ad in Med Monthly you’ll reach: family medicine, internal medicine, physician assistants and more!

Call us today to place your classified!

919.747.9031

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

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

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

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

Medical Practice Listings Buying and selling made easy

Also available online 24/7

medmonthly.com

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

Unfortunately, its motor is inside playing video games.

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

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

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

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

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

American Council on Exercise

®

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

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

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PARAMOUNT

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DRIVE,

8 2 5 - 3 6 3 6

SAN

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|

DIEGO,

CA

92123

USA

WWW.ACEFITNESS.ORG

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

MD STAFFING AGENCY FOR SALE IN NORTH CAROLINA

Comprehensive Ophthalmic and Neuro-Ophthalmic Neuro-Ophthalmic Practice

The perfect opportunity for anyone who wants to purchase an established business.

This is a great opportunity to purchase an established ophthalmic practice in the heart of Raleigh. Locate on a major road with established clients and plenty of room for growth; you will appreciate the upside this practice offers.

This practice performs comprehensive ophthalmic and neuro-ophthalmic exams with diagnosis and treatment of eye disease of all ages.

l One

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

Please direct all correspondence to driverphilip@gmail.com.

Only serious, qualified inquirers.

Raleigh North Carolina

Surgical procedures include no stitch cataract surgery, laser treatment for glaucoma and diabetic eye disease. This practice offers state-of-the-art equipment and offer you the finest quality optical products with contact lens fitting and follow-up care & frames for all ages.

List Price: $75,000 | Gross Yearly Income: $310,000

Contact Cara or Philip 919-848-4202 for more information or visit MedicalPracticeListings.com

TM

the top

1

REGISTERED NURSE

One of the fastest growing health care occupations through to 2018 is a registered nurse, with excellent career opportunities for aspiring candidates in physicians’ offices, home health care services, hospitals, and nursing care facilities. Across the entire United States, the career is highly in demand, with more than 580,000 new registered nurses’ jobs being created through 2016.

3

Health care administrators handle administrative responsibilities in the medical profession and are in great demand.

Currently hospitals and practices require administrators trained in a variety of skills to manage patient care, including marketing, accounting, and human resources. Around 43,000 new jobs in health care administration will be added by the year 2016.

4 2 PHYSICIAN ASSISTANT

As demands on doctors increase, the physician’s assistant is becoming an effective way for patients to receive timely care.

A physician assistant is trained to offer diagnostic advice, provide some preventative health care, and even take a look at clinical testing results. As we continue to see a shortage of trained MDs in the US, the PA is quickly becoming part of frontline medical care and 148,000 new PA positions will be created by the year 2016.

72 | MAY 2013

HEALTH CARE ADMINISTRATOR

Health

The health care in few career fields economic woe alarming rate jobs are exp faster than industry 22%, or 3 new jo 2018.

MEDICAL RECORDS & HEALTH CARE INFORMATION TECHNOLOGY

A lot of documentation work goes on in the health care industry and health care IT and medical records professionals have the very confidential responsibility of keeping documents including treatment plans, laboratory tests, x ray reports, and patient histories. Medical record technician jobs are expected to grow faster than all other medical occupations with around 30,000 new jobs being added by the year 2016.

5

MEDICAL SECRETARY

Another top health care career is a medical secretary, responsible for performing a variety of administrative tasks. To perform their work efficiently, secretaries need to have a good understanding of medical procedures within medical practices or hospitals.

According to the US Bureau of Labor Statistics, around 13,000 new jobs will be created in this health care occupation.

Care Careers for the Future

ndustry is one of the s that, despite hard es, is hiring at an e. Health care pected to grow n any other — roughly 3.2 million obs, by .

7

PHARMACY TECHNICIAN

The major role of technicians is to assist pharmacists and they are responsible for providing medication products to patients and advice them on the appropriate dosage. They also count tablets, label bottles and perform a number of administrative tasks under the supervision of licensed pharmacists. Approximately 91,000 new jobs will be created in this occupation by 2016.

8

PHYSICAL THERAPIST

Physical Therapists help people recover physical mobility, find relief from pain, and prevent longterm injury from accidents or disabilities. This very hands-on world of medical care requires professionals specialized in working with different age groups and conditions. This occupation is growing fast, with approximately 47,000 new jobs being added by the 2016.

DENTAL ASSISTANT

6

Candidates who have a passion for working in the field of dentistry can consider a dental assistant’s career. Job duties of these health care professionals include performing x-rays, sterilizing instruments and informing patients on how to take care of their teeth and gums. Around 82,000 new jobs will be added in this field.

9

EMT & PARAMEDIC

Paramedics are first on the scene in emergencies and disasters. They are trained specifically in caring for patients between the site of a crisis and a hospital. A current national shortage of paramedics make this a high entry on future career lists.

The projected employment growth for EMT and paramedic jobs is well above average and 39,000 new jobs will be added in this field of health care.

MEDMONTHLY.COM | 73

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