December Edition 2019
Inside This Issue
A Shortage of Orthopedic Surgeons is Looming By Phillip Miller VP Merritt Hawkins
A
Does Legal Marijuana for Medical Purposes Lead to Improved Health? See pg. 10
INDEX Legal Matters....................... pg.3 Oncology Research......... pg.4 New Technology................ pg.8 Marketing Essentials....... pg.12
The One Nutrition Tip You Need this Holiday Season See pg. 13
ccording to the Centers for Disease Control and Prevention (CDC), the number of hip replacements among people 45 and over increased from 138,700 to 310,800 over the opening decade of this century, while the rate of these procedures increased from 142 per 100,000 people to 257 per 100,000. These numbers tell you all you need to know regarding why demand for orthopedic surgeons is rising. Population aging is driving the need for a wide range of specialists who treat conditions common to older citizens, including orthopedic surgeons. The Association of American Medical Colleges (AAMC) projects a shortage up of to 122,000 physicians by 2032. Of these, up to 55,000 will be primary care physicians, while an even larger number (up to 67,000) will be specialists. The AAMC projects a shortage of up to 23,000 surgeons. The supply of orthopedic surgeons is limited due to the relatively small number who complete residency each year – a number that is inhibited by the 1997 cap Congress placed on funding for physician graduate medical education (GME). Supply also will be increasingly limited by retirements in the specialty. Close to 60% of orthopedic surgeons in active practice are 55 years old or older, and a “retirement cliff” in the specialty
is looming. As a result, the Health Resources and Services Administration (HRSA) projects a shortage of 5,080 orthopedic surgeons by 2025. Given the current limited supply
the specific geographic location they prefer. Many orthopedic surgeons are electing to complete fellowships such as Sports Medicine and wish to focus their practice exclusively on their subspecialty in (typically) a suburban location. Prior to this trend, most candidates often would complete their general orthopedic surgery training and then specialize through experience rather than a fellowship. Many of these physicians would be willing to practice general orthopedics with a subspecialty emphasis. Today, they wish to concentrate exclusively on their subspecialty, and not all opportunities can offer this option. Offer a Competitive Practice Environment It is important to structure the practice opportunity to be as attractive as possible. Not all candidates are seeking the same thing, but in general a positive practice opportunity for many orthopedic surgeons might include an existing practice in which a physician is about to retire, so that the new physician will have an established
Close to 60% of orthopedic surgeons in active practice are 55 years old or older, and a “retirement cliff” in the specialty is looming... HRSA projects a shortage of 5,080 orthopedic surgeons by 2025. of orthopedic surgeons and the strong demand, hospitals, medical groups and others seeking physicians in this special should consider incorporating a variety of best practices to enhance their recruiting success. Some of these are reviewed below. More Sub-specialization A first factor to consider is that it is becoming increasingly difficult to recruit orthopedic surgeons because candidates are becoming more and more specific on the style of practice they are seeking and more committed to practicing in
see Orthopedic Shortage ... page 14
1 PERMIT #NO 1149 AUSTIN HOUSTONTX TX PRSRT STD US POSTAGE PAID
Austin Medical Times
Page 2
A team in healthcare law that’s the
PICTURE HEALTH of
Driving business, practicing law.
100 Congress Avenue, Suite 1800, Austin, TX 78701 Fletcher Brown: 512-685-6400
wallerlaw.com
December 2019
austinmedtimes.com
Austin Medical Times
Page 3
Legal Matters Are Medicare Conditions of Participation Now Material to Payment?
By Ann McCullough, Jd and Ryan Mcateer, Jd Polsinelli, PC
P
rior to the 2016 United States Supreme Court decision in Universal Health Services v. United States ex rel. Escobar, False Claims Act (FCA) liability could largely be assessed by determining whether there was an underlying violation of a Medicare Condition of Participation or Condition of Payment related to a payment in connection with Federal health care programs. Under the implied certification theory, a provider could be liable under the FCA if it submitted a claim to the federal government that implicitly certified compliance with applicable statutes, regulations, and contract requirements,
because the “act of submitting a claim for reimbursement itself implies compliance.”1Nevertheless, there was little risk of FCA liability due to a failure to comply with a Condition of Participation, whereas such liability was more likely due to non-compliance with a Condition of Payment. Following Escobar, assessment of FCA liability has shifted to a determination of whether non-compliance with applicable statutes, regulations, and contract requirements would be material to the government’s payment decision, as opposed to whether non-compliance related to a Condition of Participation or Condition of Payment. This is to say that the non-compliance would be material if the government agency would not have paid the claim had it known of non-compliance. However, although the implied certification theory for FCA liability remains post-Escobar, the Supreme Court described the materiality standard as “rigorous” and “demanding,” ensuring
that the FCA does not become “an all-purpose antifraud statute or a vehicle for punishing garden-variety breaches of contract.” So, should providers review applicable statutes and regulations, particularly the Conditions of Payment and Conditions of Participation, to determine the specific basis for non-compliance and associated FCA liability? Or, should providers instead focus on the likelihood that the government agency would have paid a claim even if it had knowledge of the specific instance of non-compliance (i.e., the non-compliance was insubstantial and not material)? The answer is both. When evaluating materiality under the FCA, a statute or regulation expressly identifying a condition of payment
austinmedtimes.com
is relevant, but not automatically dispositive. Proof of materiality can include evidence that the government agency consistently refuses to pay claims based on non-compliance with a particular statutory, regulatory or contractual requirement. Conversely, if the government agency regularly pays a particular claim in full despite its actual knowledge that certain requirements were violated, such certain Conditions of Participation, it is likely such requirements were not material. The ruling in Escobar likely will result in new and different bases for FCA violations due to the ambiguity of the implied certification theory. Therefore, providers must be diligent in identifying and immediately addressing non-compliance in order to avoid or limit FCA liability.
December 2019
Austin Medical Times
Page 4
Oncology Research When it Comes to Cancer, It’s a Family Affair By Krishna Patel, M.D., Texas Cancer Registry. For every new Texas Oncology case, countless family members and Round Rock North loved ones are impacted.
F
or all the many ways that cancer patients engage with healthcare providers, the reality is that patients walk most of the miles of their cancer journey alongside family members – outside of the clinic or hospital. Parodies poking fun at the family dysfunction that rears its head around the holidays make us laugh as well as perhaps sting with a bit of truth. Indeed, for better or worse, family dynamics shape how we approach life and life’s big challenges like cancer. When it comes to cancer, there is a reverberating effect that is seen, heard, and felt in families. More than 1.76 million new cases of cancer are expected to be diagnosed in the United States in 2019 – and more than 124,000 of those will be in Texas, according to the American Cancer Society and the
Whether you are a patient, caregiver, or love someone with cancer, it’s important to remember that you can cultivate an environment of care and support within your family. Communicate as openly and honestly as you are comfortable. Often while patients are coming to terms with their cancer diagnoses, their family members also are struggling with their feelings. With everyone grappling with emotions ranging from fear and devastation to determination, communication is critical. It’s normal to feel fear, loss of control, disbelief, and guilt. Be as open as you are comfortable and set boundaries if you need to. Recognize that people often have diverse reactions to a diagnosis. Keep in mind that negative reactions are often focused on the diagnosis, not loved ones. Discuss expectations early and often. A patient’s expectations and wellbeing should be at the forefront. Adult children who don’t agree
about their parent’s treatment plan, family members who live far away and don’t know how they can help, unanticipated changes to younger children’s daily activities that they don’t understand – the opportunities for unmet expectations abound when not adequately addressed. This friction can last well beyond the initial diagnosis. Talk to a patient navigator or physician about the benefits of advance care planning to better understand the patient’s wishes and to ensure they’re followed throughout the cancer journey. Take time to connect as a family. The American Cancer Society reports that three out of four families have at least one member who is a
cancer survivor. Beyond daily activities, cancer impacts relationships, shifts family roles, impacts finances, and sometimes living arrangements. As everyone adjusts to the circumstances, spend quality time together doing something enjoyable – where cancer is not the topic of the conversation. Ask for – and be willing to accept – support. Supporting a family member with cancer comes with a lot of responsibility that at times may feel overwhelming. The American Society of Clinical Oncologists (ASCO) defines “informal caregivers” as family see Oncology Research...page 14
Women in Media Psychology Dorothy Andrews (at right in front) is joined by her Fielding Graduate University professors. Dorothy is currently working on a PhD in Media Psychology where she is studying how media technologies are affecting perceptions of risk aversion, neutrality, and affinity. Dorothy Andrews is the Chief Behavioral Data Scientist and Actuary for Insurance Strategies Consulting LLC.
Online & Hybrid
PhD, MASTER’S & Certificate Programs
December 2019
Fielding.edu/MediaPsych For 45 years, Fielding has been educating scholars and leaders in pursuit of a more just and sustainable world.
austinmedtimes.com
Austin Medical Times
Page 5
Advancing the practice of good medicine.
NOW AND FOREVER.
ANNOUNCING THE 2018 DIVIDEND FOR TEXAS MEMBERS The Doctors Company has returned more than $415 million to our members through our dividend program—and that includes approximately 7.5% to qualified Texas members. We’ve always been guided by the belief that the practice of good medicine should be advanced, protected, and rewarded. So when our insured physicians keep patients safe and claims low, we all win. That’s malpractice without the mal.
Join us at thedoctors.com
6805_TX_HoustonMedTimes_Div_May2018.indd 1
4/12/18 8:59 AM
austinmedtimes.com
December 2019
Austin Medical Times
Page 6
Novel Nanogels Hold Promise for Improved Drug Delivery to Cancer Patients
R
esearchers at The University of Texas at Austin have developed new guidelines for fabricating nanoscale gel materials, or nanogels, that can deliver numerous therapeutic treatments to treat cancer in a precise manner. In addition to enabling the delivery of drugs in response to tumors, their nanogels can target malignant cells (or biomarkers), degrade into nontoxic components and execute multiple clinical functions. The most important characteristic of the engineering researchers’ nanogels is their ability to be chemically modified or “decorated” with many bioactive molecules. These modifications give the decorated nanogels more diverse physical and chemical properties than any other existing technique, despite their identical origin. Such systems, which have the potential of being tailored to specific diseases or even individual patients, could be a useful tool for oncologists in the future. In a study published in the
latest issue of Science Advances, researchers in the Department of Biomedical Engineering and the McKetta Department of Chemical Engineering in the Cockrell School of Engineering outline the development of these multipurpose nanogels for cancer treatment. Following a series of chemical modifications, the nanogels are capable of performing the following simultaneously or in sequence: loading and releasing drugs, responding to unique pH environments, identifying biomarkers, converting light into therapeutic heating and exhibiting degradation characteristics. The research team, led by drug delivery pioneer Nicholas Peppas, Sc.D. — a professor in the departments of biomedical engineering and chemical engineering, the UT Austin College of Pharmacy and the Department of Pediatrics and Department of Surgery and Perioperative Care at Dell Medical School — conducted the study over four years at UT’s Institute for Biomaterials, Drug Delivery and
Regenerative Medicine, which Peppas directs. They synthesized and purified nanogels containing carboxylic acids, chemical functional groups that are common in natural biological molecules. These functional groups allowed the researchers to modify, or chemically couple, the nanogels to bioactive molecules, such as small molecules, peptides and proteins. A combination of modifications was needed to tailor the nanogels for targeted and environmentally sensitive drug delivery. “One way to think of our nanogel is like a blank canvas,” said John Clegg, who was a Ph.D. candidate in the Cockrell School when he worked on the study and is currently a postdoctoral fellow at Harvard University. “Untouched, a blank canvas is nothing more than some wood and fabric. Likewise, the nanogel is a simple structure (made of polymer-joining agents and water). When it is modified, or decorated, with different bioactive groups, it retains the activity of each added group. So, the system can be quite simple or quite sophisticated.” The team’s modular approach
— combining many useful parts into a single, greater whole — is frequently applied to other engineering systems, including but not limited to robotics and manufacturing. The Texas Engineering researchers have applied similar logic, except on the nanoscale, to develop their nanogels. The researchers indicate their work could also serve as a blueprint for “precision medicine” approaches. In precision medicine, a patient is treated with finely tuned doses of targeted therapeutics, prescribed in amounts that correspond to the known characteristics of a patient and the see Nanogels...page 14
Subscribe to Our Digital Issue Now you can get the Austin Medical Times delivered straight to your inbox. Never miss an Issue of Austin’s Leading Local Healthcare News Online.
austinmedtimes.com December 2019
austinmedtimes.com
Austin Medical Times
austinmedtimes.com
Page 7
December 2019
Austin Medical Times
Page 8
New Technology Holiday Technology Gifts That Are Improving Healthcare By Mark Johnson President, Xtrii
I
t’s that time a year. You are looking for the right gift for the special people on you holiday shopping list. And technology and gadgets are frequently listed on the gift lists. In the past, technology items were often just neat gadgets or novelties that were entertaining. But now, technology gifts can provide significant healthcare benefits. So, as you look for that special technology gift, consider one the options listed in this article that has a healthcare benefit. Smartwatch: Smartwatches continue to evolve and provide new and improved health and t r a c k i n g features. For example, the new Apple Watch 4 has many beneficial healthcare features, such as: • Heart rate tracking – tracks your heart rate throughout the day and provides a history that can show heart rate ranges and anomalies. • ECG functionality that is endorsed by the American Heart Association and approved by the FDA. While it won’t replace a doctor’s visit, it does add valuable insight. • Activity monitoring – tracks your activity level and provides a history. How often are you working out? How long did you walk on the treadmill? What was your heart rate during the workout? It provides this helpful information that can help you monitor your workouts and overall activity level. It even provides healthy reminders to stand-up throughout the day, or to relax and take some deep breathes.
MARINE MILITARY ACADEMY
REPARE FOR COLLEGE
CONQUER LIFE! At Marine Military Academy, challenge leads to growth, and growth leads to success. By providing a college-preparatory curriculum in a structured, disciplined and focused setting, our cadets rise to new heights as scholars and leaders. No other school can unlock a boy’s potential like MMA.
NOW ENROLLING FOR 2019-2020
MMA-TX.ORG »» 956.423.6006 ADMISSIONS@MMA-TX.ORG MMA »» A College-Prep Boarding School for Boys in Grades 7-12 MMA »» 320 Iwo Jima Blvd. »» Harlingen, TX 78550 December 2019
All these features combine to provide a very helpful tool that can promote better health. There
austinmedtimes.com
are numerous reports of people losing weight and improving their overall health by adding this technology into their life. Voice assistants: Voice Assistants, such as Amazon Alexa and Google Assistant, are changing the way you input and request information. They are more than just a convenience. They can also provide a lifestyle improvement for people that experience mobility or dexterity challenges. The ability to request help, retrieve information, and interact using voice can be life changing for those with disabilities or elderly that are not able to use keyboards or traditional technology methods. If you need help or want to look up healthcare information, just ask your new Voice Assistant. Amazon offers a line of varies Amazon Echo devices. Google and Apple have similar offerings. Improve Communications: Need to check on an elderly family member or someone with a disability. Video conferencing technology makes it easier to communicate with them, and visually see their health status. The new video communication offerings are very affordable and easy to operate. Here’s a few options to consider: • Modern smartphones have built-in video calling capabilities, such as Apple Facetime on iOS phones, or Google Duo for Android phones. • Amazon Show – Voice assistant that also provides video conferencing and a “drop-in” feature. • Desktop video conferencing: Just simply use the webcam built into your laptop or add a webcam to your PC. Then use a video see New Technology...page 14
Austin Medical Times
Page 9
Take one tablet daily to view the CME courses you want. FEATURED COURSES
CULTURALLY EFFECTIVE HEALTH CARE: Get tips and tools for increasing cultural effectiveness in your practice. This course is an essential guide for pediatric health-care providers in Texas.
CHILDHOOD AND ADOLESCENT DEPRESSION: Depression affects up to 20 percent of youth and can have serious consequences. Learn about risk factors, screening, referral, and effective management options for this common mental health problem.
Join more than 100,000 medical professionals who get free CME with Texas Health Steps Online Provider Education. Choose from a wide range of courses relevant to your practice, including short tutorials and podcasts on topics like Medicaid guidelines, ethics and mental health — all available 24/7. Learn more at TXHealthSteps.com.
MEDICAL TRANSPORTATION PROGRAM TUTORIAL: Help reduce missed appointments by guiding eligible patients to free transportation. This tutorial is an essential resource for medical and dental office staff.
Content on the Texas Health Steps Online Provider Education website has been accredited by the Texas Medical Association, American Nurses Credentialing Center, National Commission for Health Education Credentialing, Texas State Board of Social Worker Examiners, Accreditation Council for Pharmacy Education, UTHSCSA Dental School Office of Continuing Dental Education, Texas Academy of Nutrition and Dietetics, Texas Academy of Audiology, and the International Board of Lactation Consultant Examiners. Continuing Education for multiple disciplines will be provided for some online content.
austinmedtimes.com
December 2019
Austin Medical Times
Page 10
Does Legal Marijuana for Medical Purposes Lead to Improved Health? Researchers Investigate How Medical Marijuana Laws and Dispensaries Affect Self-Reported Health By Rae Lynn Mitchell
O
ver the past two decades, 29 states have enacted laws allowing medical marijuana use. During that span, researchers have investigated the potential health effects—both positive and negative—of medical marijuana laws (MML). Studies have found varying degrees of improvements to self-reported health and other benefits along with little evidence of harm. Additionally, research has documented the importance of legally protected medical marijuana dispensaries in enabling access; however, the specific impacts of dispensaries on self-reported health are somewhat unclear. To gain a clearer picture of
the effects of dispensaries, Elena Andreyeva, PhD, and Benjamin Ukert, PhD, both assistant professors in the Department of Health Policy and Management at the Texas A&M School of Public Health, analyzed data from a nationwide health behaviors survey covering a 20-year period of changing MMLs. Their study, published in the journal Forum for Health Economics & Policy, analyzed the effect of MMLs on self-reported health, separately measured effects for MMLs that provide for dispensaries and those that do not, investigated potential changes to risky behaviors such as smoking and heavy drinking and further broke down the various effects based on characteristics such as
race, age and chronic pain status. Advocates of MMLs have highlighted the potential benefits of medical marijuana to chronic pain patients and people who are experiencing nausea due to cancer treatments. Some research has found that MMLs could reduce deaths from opioid overdoses by substituting prescription opioid medications with medical marijuana. Opponents of MMLs have pointed to cardiovascular and respiratory problems that could arise from smoking marijuana, as well
as increases in various risky behaviors. However, strong evidence of increased harm has not been found. From their analysis, Andreyeva and Ukert found that MMLs that include legally protected dispensaries are associated with better self-reported health among people from non-white ethnicities, those with only a high school education and chronic pain patients. Self-reported health improvements were much stronger see Marijuana...page 14
HELP US BUILD A HEALTHIER AUSTIN
Access to nutritious food is essential for a healthy, thriving community. Learn about how we’re leading the fight against hunger at centraltexasfoodbank.org. December 2019
austinmedtimes.com
Austin Medical Times
austinmedtimes.com
Page 11
December 2019
Austin Medical Times
Page 12
Marketing Essentials Long Patient Wait Times Are Costing You By Stewart Gandolf Chief Executive Officer Healthcare Success
P
atience is a virtue, but patients don’t always feel the need to practice it. And that makes sense; as more practices offer shorter wait times and more one-on-one time with the doctor, why would they want to put up with long patient wait times? Attitudes towards patient wait times are changing If you’ve worked in the healthcare field for quite a while, you’ve probably heard the term “healthcare consumerism.” While the term encompasses many different things, the big idea is that patients expect their healthcare experience to be more like a customer service experience. This retail mindset means
options out there. And while they may not be able to turn back the clock and choose another office, they can prevent other people from making the same mistake. Your reputation is on the line Wouldn’t it be great if a doctor or hospital’s reputation was based solely on their professional merits? Of course, you strive to provide the best level of healthcare you can. But in this day and age, that’s not enough to earn a strong patient referral. And patient referrals are not just limited to someone’s family and friends. A recent Vitals study showed that healthcare facilities with long wait times tend to receive much poorer reviews than those with shorter waits. The highest reviewed practices had average wait times of 13 minutes, while
THE STRENGTH TO HEAL and get back to what I love about family medicine Do you remember why you became a family physician? When you practice in the Army or Army Reserve, you can focus on caring for our Soldiers and their Families. You’ll practice in an environment without concerns about your patients’ ability to pay or overhead expenses. Moreover, you’ll see your efforts making a difference.
To learn more about the Army or Army Reserve, call MAJ Tamela Mitchenor at 210-692-7376, or tamela.l.mitchenor.mil@mail.mil
©2010. Paid for by the United States Army. All rights reserved.
December 2019
patients are no longer willing to put up with long wait times at the doctor’s office—just as they wouldn’t wait a half-hour in line at the store to buy an item. Reasons for shifting patient attitudes The truth is that patients have never enjoyed long wait times in the office. In many cases, they simply accepted it as the norm. While some offices have always attempted to streamline processes, we all know that practices and hospitals have a reputation for scheduling appointments that rarely begin on time. So what’s different now? Patients have become empowered to take control of the situation. They know that there are other
austinmedtimes.com
those receiving low star ratings had wait times of 34 minutes. Patient reviews have greater reach than ever before 90% of patients have researched a doctor or hospital before visiting. Chances are high that most of your patients have looked you up online. They may have been pleased with your reviews, or they may have decided you were worth a shot despite them—but after a visit, they could change their mind. This fact is not just limited to primary care. Even patients who receive a referral from another doctor are likely to research that referral online. And if they don’t see Marketing Essentials...page 13
Austin Medical Times
Page 13
The One Nutrition Tip You Need this Holiday Season By Denise Hernandez, MS, RD, LD Austin Medical Times
R
eading over my social media accounts and online articles has brought about a revelation: there is an overload of tips being shared on how to prevent holiday weight gain. The holidays are indeed a time of the year where most people overindulge in high-calorie, high-fat, and high-sugar foods. Physical activity may also take a backseat to
holiday events, parties, and travel. The one tip I will offer is to honor your hunger. What does that mean? Honoring hunger is a principle of mindful eating. It means that you should aim to stay nourished throughout the day. The chaos that arises from the holidays may lead you to overschedule yourself. When you are overscheduled or stressed, you may ignore the subtle hunger cues leading you to skip meals. Skipping meals allows your primal hunger to take over once you’ve slowed down or your hunger cues become too strong to ignore. By this time you are ravenous and will
overeat whatever is in front of you. Honor your hunger by adhering to your usual eating patterns and times. If my day looks like it’s going to be hectic, I set alarms on my Apple watch to remind me to eat. I know it sounds silly to have to remind yourself to eat but I can’t stress how it’s saved me countless
times. Pack healthy snacks that you can keep in your purse or in your car, such as portion-packed nuts. And whatever you do, don’t make the mistake of trying to compensate for holiday treats by skipping lunch or dinner. This practice will only backfire causing you to overindulge in those holiday treats.
Heart Hospital of Austin Names New Chief Operating Officer
H
eart Hospital of Austin has named Megan Drake as its new chief operating officer. Drake will assume her role on Nov. 11. Drake joins Heart Hospital of Austin from Shelby Baptist Medical Center—a 252-bed hospital in Birmingham, Alabama. As its chief operating officer, she oversaw surgical services, wound care, dietary, environmental, biomedical, security, respiratory therapy, imaging, pharmacy, laboratory and more. Drake also managed several significant capital projects, including a surgical
suite expansion that encompassed a new hybrid operating room, as well as construction of an electrophysiology lab to expand cardiovascular services. “Megan brings extensive experience in operations and business development to this role,” David Laird, chief executive officer of Heart Hospital of Austin, said. “I am confident she’ll play a key role in helping us continue to provide the highest level of cardiovascular care.” Prior to her time with Shelby Baptist Medical Center, Drake served as the western region chief business
development officer for Prospect Medical Holdings in Los Angeles, which owns 20 acute care and behavioral hospitals in six states. She also served as the market chief strategy officer for Valley Baptist Health System in Harlingen and Brownsville, Texas. Earlier in her career, she served as the assistant chief executive officer and the acting chief operating officer at Cedar Park Regional Medical Center. Drake earned a master’s degree in health administration
Marketing Essentials
those in retail locations like a CVS. Urgent care clinics now compete with telehealth apps on mobile devices. If you want to keep patients in your practice or hospital, you have to create an experience of care that keeps them coming back and is competitive with these modern healthcare environments. Losing a patient is expensive According to Vitals, 30% of patients have simply left a doctor’s office because they were dissatisfied with the wait time. In some cases, the cost of acquiring a new patient can be a couple hundred dollars—
worth it when you consider the lifetime value of that patient, but not if you lose them! And when one patient leaves, you miss out on the opportunity for several more patients. This includes their family and friends and, of course, several people reading your negative reviews. What can you do to reduce the wait? It may be time for an audit of your systems and processes. Think about what you could do to really streamline appointments and make sure everyone is in and out in as
Continued from page 12 like what they see, they may seek out a second option. Your competition is changing Depending on your area of specialty, the competition surrounding your practice or hospital is likely a lot different than it was just 10 or 15 years ago. Primary care doctors and some other specialties are competing with urgent care clinics, including
austinmedtimes.com
from the Medical University of South Carolina in Charleston and a bachelor’s degree in biology from The College of Charleston.
little time as possible. Could you… • Automate check-ins or keep these online? • Keep better estimates of the amount of time needed for certain times of appointments? • Text patients when you’re running behind and allow them the option to reschedule? Best of all, listen to your patients and their needs. Even if you fall behind in scheduling, your patients will appreciate transparency and your willingness to fix the issues over time. https:// healthcaresuccess.com December 2019
Page 14
Orthopedic Shortage
Continued from page 1 referral network and patient base. Many orthopedic surgeons would prefer to join a private group in which they can receive ancillary revenue from an ambulatory surgery center (ASC). Like other physicians, orthopedic surgeons prefer a controllable lifestyle, and a call schedule of 1:4 or better is preferred
Oncology Research
Continued from page 4 members who play an important role in the management of cancer and perform tasks that may be physically, emotionally, and socially demanding.
Austin Medical Times
by most. Few candidates are seeking a solo practice. They prefer to have at least four or five colleagues for call and for comradery. ORS trauma call is a major negative for many candidates, particularly if they are focusing on a subspecialty. For example, a foot and ankle orthopedic surgeon usually does not want to have to be called into the ED for a fractured hip on an 80 year old. The compensation must be competitive, with the majority of candidates seeking a potential of $750,000 annually, and often considerably more if they are
Asking for help isn’t a sign of weakness – it’s a sign of strength. Family members can reach out for support to other family members, friends, or even community or church groups. If you’re a patient receiving care from a loved one, encourage them to find support and rest. Families play an integral role
fellowship trained in total joints, spine, surgery, etc. The other reality is that location makes a significant difference to today’s candidates. Because there are a lot of options in a competitive market, and because orthopedic surgeons earn high incomes regardless of location, it may be difficult to attract candidates to traditionally challenging locations with just a high income potential. It therefore is important to make all other aspects of the practice as positive as possible.
in cancer care whether it’s helping patients get to appointments, ensuring medications are taken as directed, or providing a needed meal or hug. At Texas Oncology, we recognize families as essential members of the care team, joining with us in their loved one’s fight against cancer.
Published by Texas Healthcare Media Group Inc. Director of Media Sales Richard W DeLaRosa Senior Designer Jamie Farquhar-Rizzo Web Development Lorenzo Morales Distribution Brad Jander Accounting Liz Thachar Office: 512-203-3987
Nanogels
Continued from page 6 disease that are identified in diagnostic tests. “If nanoparticle carriers like our nanogels are to be useful for precision medicine applications, they will need to be adaptable enough to match each patient’s needs,” Clegg said. “We believe
New Technology
Continued from page 8 conferencing service such as Skype or Zoom to connect you with one or more family and friends. Both Skype and Zoom offer free service options.
Marijuana
Continued from page 10 in states with protected dispensaries than those without. They also found that medical marijuana use is associated with reduced alcohol consumption, though dispensaries may be associated with increased heavy drinking. People who report having pain that limits daily activities showed major improvements in self-reported health; however, non-Hispanic whites between the ages of 20 and 54 reported only small
December 2019
that our approach, where a base nanogel is adapted to the unique characteristics of an individual patient and facilitates multiple therapeutic modalities, is advantageous in comparison to developing many separate platforms, which each deliver a single therapy.”
The researchers believe that their study can serve as a practical guide and proof of concept for scientists who are developing nanoscale materials for precision medicine applications.
Bring the whole family together for a face to face conversation this holiday season with this easy to use technology. Telemedicine To provide convenient access to medical care for someone that is remote or is challenged with traveling to a physician’s office, check out
the rapidly improving telemedicine options. Offerings such as Teladoc. com bring the doctor to you. When you are shopping for the right gifts this holiday season, consider these technology ideas that can bring better health and convenience to your loved ones. Happy Holidays!
changes in self-reported health. This demographic is likely to use prescription opioids, so the smaller effects might be due to medical marijuana not being significantly better at managing chronic pain. Additionally, medical marijuana may have provided a treatment option for other demographic groups who are less likely to use opioid medications, thus leading to stronger health effects. Although this study helps clarify the effects of MMLs and the role of legally protected dispensaries, the authors caution that it has some limitations. First, their study focused on short-term
effects of MMLs on self-reported health and long-term effects remain unknown. They note that it may be possible that the long-term effects of substituting opioids with medical marijuana may be more notable over a longer period as medical marijuana carries little risk of overdose deaths. However, over the long term, smoking marijuana could lead to lung damage like tobacco does, reducing overall health benefits. Further research using follow-up studies and investigating long-term effects will help to further clarify the roles MMLs and protected dispensaries play.
austinmedtimes.com
For Advertising advertising@ medicaltimesnews.com Editor editor@medicaltimesnews.com
Austin Medical Times is Published by Texas Healthcare Media Group, Inc. All content in this publication is copyrighted by Texas Healthcare Media Group, and should not be reproduced in part or at whole without written consent from the Editor. Austin Medical Times reserves the right to edit all submissions and assumes no responsibility for solicited or unsolicited manuscripts. All submissions sent to Austin Medical Times are considered property and are to distribute for publication and copyright purposes. Austin Medical Times is published every month P.O. Box 57430 Webster, TX 77598-7430
Austin Medical Times
Page 15
The Offices at Gateway to Falconhead PROFESSIONAL & MEDICAL OFFICE CONDOS - FOR SALE OR FOR LEASE
IDEALLY LOCATED BETWEEN THE HILL COUNTRY GALLERIA AND BAYLOR SCOTT AND WHITE OFF RANCH ROAD 620 AND FALCONHEAD BLVD. RETAIL AMENITIES LOCATED IN PHASE 1 OF THE PROJECT. BEAUTIFUL HILL COUNTRY AND LAKE TRAVIS VIEWS FROM EXTERIOR PATIOS SPACE AVAILABLE: 80,000 SF total Building A
5,000 SF – Stand-alone building
Building B
5,000 SF – Stand-alone building
Building C
5,000 SF – Stand-alone building
Building D
5,000 SF – Stand-alone building
Building E
Building F
30,000 SF (2-15,000 SF floor plates)
30,000 SF (2-15,000 SF floor plates)
- All buildings are delivered in warm shell condition. TI materials stocked in each building - Buildings E & F – have a 43.47 KW roof mounted solar system installed - Covered Parking - Energy efficient design using VRF HVAC, LED lighting and spray foam insulation JOHN W. COLLINS IV Executive Director C 512.565.9626 jcollins@stcroixca.com
STEPHEN DEPIZZO Managing Director C 614.570.1260 sdepizzo@stcroixca.com
ST. CROIX CAPITAL REALTY ADVISORS, LLC 9 0 1 S M O P A C E X P R E S S WAY, B A R T O N O A K S P L A Z A 1 , S U I T E 1 6 0
|
A U S T I N , T X 7 8 74 6
austinmedtimes.com
|
5 1 2-3 9 1 - 07 1 8
|
w w w. s t c r o x c a . c o m
December 2019
Austin Medical Times
cookiedelivery.com
Warm cookies, baked-to-order, delivered to your door. cookiedelivery.com
austinmedtimes.com