BMN Blog

Recently I have had conversations with clients about how hard it is to make the most of the revenue generated and keep the loyal but burned-out staff engaged so the practice can survive to work another day. Recovery from COVID for small businesses has been tough, but especially in healthcare where the demand for service remained high during the pandemic. Now, medical practices are looking to make the most of the revenue they can generate without overwhelming current employees. With that in mind, it’s time to work smarter, not harder.

Physician practices thrive on a continual stream of new patients for their long-term survival. Historically, a patient chose a primary care practice based on the proximity to their home or by recommendation from a list of providers given by their insurance company.

Mental healthcare in Alabama is changing. And it’s about time.

For too long, an Alabamian facing a mental health crisis had two primary options: the hospital emergency department or jail. Neither option is ideal, and neither fully addresses the deeper mental health or substance abuse issues at hand.

“If you want something done … give it to a busy woman.”

We have all heard that as professional women, right? Now, who has the time to add in the concept of building wealth for yourself or your family in addition to everything else you’ve already been asked to run with.

When I was four years old, Dr. Jacqueline Stewart, a pediatrician, inspired me to want to be a doctor. Born as a preemie, I battled asthma and bronchitis in my early years. My mother would take me to appointment after appointment with various symptoms. Coughing, wheezing, congestion, and chest pain plagued my little body.

Each day, we are learning more about the social impacts of COVID-19 and the mitigation strategies, and it should be no surprise that these impacts are deleterious. Over a few months in early 2020, most of our lives became completely reoriented in an effort to manage the unknown effects of the new illness. Families with schedules that were structured around school activities, sports, and church suddenly found themselves sequestered at home indefinitely. When schools reopened, they did so with disjointed schedules subject to the randomness of positive COVID cases. While families felt increased stress, people without children or partners experienced an even more crushing isolation. With remote working, holidays cancelled, churches closed, community activities suspended, and restaurants carry-out only, individuals endured this period through Zoom and social media.

“The Only Constant in Life Is Change.”- Heraclitus

As a healthcare administration professor with the recent global healthcare-related events in mind, I often think about the future of our healthcare industry.

Colon cancer is the third leading cause of cancer globally with approximately 1.8 million new cases per year. In the United States, the disease trails only lung cancer with 125,000 new cases per year and in Alabama, 2,470 new colon and rectal cancer cases were documented in 2021. 

When it comes to Medicare, billing under the wrong physician’s ID can cost doctors and hospitals – literally. Consider these three recent incidents that, taken together, resulted in more than $7 million in penalty payments to the government:

Overview

There is no doubt that technology has brought improvements to almost every professional field, including healthcare. While the medical field has been slower to adopt technology and software improvements, we are seeing the use of web-based software increase in place of using paper, which is due in part to mobile and tablet devices that have become commonplace. We should now focus on utilizing the technologies that we’ve created to set a new standard of secure but, accessible provider and patient data.

The Alabama Pediatric and Congenital Heart Center at Children’s of Alabama continues to achieve unsurpassed results and bring the latest technology and procedures to children and adults with congenital heart disease in Alabama and throughout the Southeast. Despite the challenges of the COVID pandemic, the volume of patients has remained steady, demanding adaptability among the 300 members of the Heart Center.

"Doc, I've got sinus" is a  phrase I often hear as we begin to interview a patient in my Otolaryngology (ENT) practice at ENT Associates of Alabama office at Grandview. And while I understand the patient's colloquial use of "sinus,” to an ENT doctor, sinusitis is a specific problem affecting the paranasal sinus' (air-filled bone spaces that surround the nasal cavity) as opposed to rhinitis, which involves inflammation and /or infection in the nasal cavity. So I want to take the opportunity to explain the differences between the two terms and  how we treat each entity.

The 21^st Century Cures Act is a landmark bipartisan healthcare innovation law that went into effect on April 5, 2021. Cures includes provisions to promote health information interoperability and prohibit information blocking by “Actors,” which include health information networks, HIEs, health information technology developers of certified health IT, and health care providers.

As a cardiologist, I have become accustomed to diagnosing and treating patients with congestive heart failure (CHF), seeing their leg edema, prescribing lasix, doing an evaluation en route to hopefully watching their recovery. 

Diabetes is the epitome of “an ounce of prevention is worth a pound of cure.” That was the driving force behind our division’s advocacy efforts that led to a change in Medicaid coverage requirements for continuous glucose monitors (CGM) for children with type 1 diabetes.

Drug testing is increasingly becoming an important part of responsible prescribing practices. Drug testing can alert medical providers to indications of drug abuse or misuse, as well as allow them to monitor for patient compliance with prescription regimens. However, while the medical utility of routine drug testing is becoming apparent, it is important to understand that many of its methodologies were initially developed for forensic and employment-testing applications. Accordingly, traditional approaches to drug testing do not always meet the demands of the clinical context.

Drug testing is increasingly becoming an important part of responsible prescribing practices. Drug testing can alert medical providers to indications of drug abuse or misuse, as well as allow them to monitor for patient compliance with prescription regimens. However, while the medical utility of routine drug testing is becoming apparent, it is important to understand that many of its methodologies were initially developed for forensic and employment-testing applications. Accordingly, traditional approaches to drug testing do not always meet the demands of the clinical context.

Through ongoing advancements in healthcare technology, healthcare providers and patients can now access broader communication applications thanks to advances in data storage. These advancements have improved collaboration, increased communication outlets and have transformed the way data is stored and shared.

Not that long ago, before phones with GPS, it was fairly common to become lost in a different city (or even a different part of your own city) and help was needed to become “un-lost.” We could keep driving or stop and ask for directions.

For years, medical professionals have discussed the need to transform the healthcare system, while also keeping it available to all people. There are many different ways of doing this including government programs, fee-for-service, Medicare programs, waivers, etc.

For many physicians, the practice retirement plan can result in providing one of their most significant assets to be used after retirement. These plans are called qualified retirement plans because they fall under requirements of IRS Internal Revenue Code and are eligible to receive certain tax benefits, unlike non-qualified plans. These plans are governed by the Employee Retirement Income Security Act (ERISA).

Obesity is no longer considered a cosmetic issue caused by overeating and a lack of self-control. The World Health Organization (WHO), along with national and international medical and scientific societies, now recognizes obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.

In its latest report, the Centers for Disease Control and Prevention (CDC) estimates that 42.4 percent of U.S. adults were obese with 9.2 percent of these severely obese, which is the highest incidence ever recorded in America. 

It is back to school time. Although it is still hot outside, many schools have opened, we have taken first day of school pictures, and football practice is underway. As we enter this new season, it’s a good time for physicians to review some practice fundamentals. To that end, I offer ten reminders about regulatory compliance fundamentals that can help to avoid legal liability and an unwanted invitation to Montgomery.

Hernia is a problem which has plagued humankind since the beginning of written history. From the Greek word “hernios” meaning “bud” or “offshoot”, it was originally thought to be a problem that was created and exacerbated by coughing. Treatments originally consisted of stooping and bending, which were erroneously thought to reduce the bulging and improve the symptoms. Surgical fixation was poorly understood and attempts to perform surgery were messy affairs that were frequently fatal.

[This is the first of a three-part series. By the end of the series, I hope to have covered national, regional, local, and personal realities of the medical malpractice market so that the reader (especially physicians, practice administrators, office managers, and hospital executives) has a sense of the current disturbing developments they may be experiencing.]

Mogul, mogul, mogul, drop off. It didn’t take long for the widowmaker, a black diamond trail on Snowshoe Mountain, to send me to the emergency room of Pocahontas Memorial Hospital. Snowshoe Mountain in West Virginia has some of the best snow east of the Mississippi and as a first-time

Multiple Myeloma is a hematologic cancer of the plasma cells, which are found in the bone marrow. Early symptoms of Multiple Myeloma include fatigue, back pain and bone pain. Because these symptoms are non-specific, patients often go first to their primary care physician which can delay diagnosis, resulting in a more progressive disease. This year alone, the American Cancer Society predicts 34,920 new cases and 12,410 expected deaths from Multiple Myeloma.

The physician owners of Alabama Allergy & Asthma Center and Clinical Research Center of Alabama have partnered with an investment group and have received an infusion of growth capital leading to the creation of AllerVie Health, a national network of board-certified allergists and immunologists. Alabama Allergy & Asthma Center locations will be rebranding to AllerVie Health this fall. At present, Clinical Research Center of Alabama will not be rebranding and will retain its name as an affiliate of AllerVie Health.

With the imminent emergency of the Covid virus subsiding, discussions have shifted from the physical dangers to concern about its lasting psychological effects. Healthcare organizations report alarming levels of stress, burnout, anxiety, and depression in employees, especially clinicians. This sharp rise should bring another equally troubling issue to the conversation: substance use disorders and addiction among healthcare providers and professionals.

When the Birmingham Medical News asked me to write a blog, they told me I could write about anything. Anything? Anything. 

What a year we’ve had. This time last year, we were starting to transition out of stay-at-home orders, attempting to find balance between a return to work and life, and trying to keep ourselves and loved ones safe.  In a year’s time, Alabamans lost 11,043 friends and loved ones. Many also lost jobs, personal connections, and much more. Now, vaccines are widely available, giving us all an opportunity to regain some normalcy. All over the country, individuals aged 12+ can be vaccinated, which allows us to protect ourselves, but also others.

As many as one out of three women experience urinary leaking with cough, sneeze, exercise or certain activities that increase abdominal pressure. Until the mid-1990’s, most treatments had either poor success rates or increased morbidity with complications like urinary retention, severe postoperative pain or protracted recovery. In 1996, the Tension-free Vaginal Tape (TVT), also known as the midurethral sling, was introduced to treat stress urinary incontinence (SUI). These devices offered physicians a resource to treat SUI in the context of a procedure that could provide high success rates (95 percent) and low risk rates (one percent).

Did you grow up thinking you were allergic to penicillin?

In recent years, we have seen robust growth in the use of orthobiologics for a number of orthopedic injuries. Orthobiologics are organic materials, including cells, tissue, blood components and growth factors, that are used to replace lost tissue, stimulate regeneration and healing, reduce pain and inflammation and/or improve joint function.

Most medical practices have permitted key business partners to access critical IT systems remotely. This is usually done to provide fast and efficient support of these systems. It could be an EMR vendor that needs to access a database, or perhaps a third-party IT service provider that will access systems for updates. Regardless of the requirement, every form of remote access that is provided to an outside party is a potential risk.  

It took a trip to a textile store… yes, a textile store. It was late 1940s, and Michael DeBakey (who would later become the most innovative and most distinguished cardiovascular surgeon in the world) was thinking how to address a major clinical need for a deadly disease – ruptured aortic aneurysm.

Albert Einstein just died of one, with echoes of his sudden death reverberating in the world and in the medical community. Einstein consulted doctors, including DeBakey, but no treatment options existed at that time.

Currently, Alabama ranks toward the bottom in the country in regard to the number of citizens receiving the vaccine on a per capita basis. Why does Alabama seem to be trailing behind the rest of the country in vaccination rates?

Patients and friends often ask me if the pain in their hand could be from carpal tunnel syndrome. I find that, while many people have heard of carpal tunnel or have known someone who has dealt with it, there is a lot of misinformation about the condition and how it is best treated.

Gastroesophageal Reflux Disease (GERD) Awareness Week occurs annually around the week of Thanksgiving and is intended to increase awareness about GERD and its potential health risks when left undiagnosed or untreated, potential adverse effects of long-term proton pump inhibitor (PPI) medication use, and the links between chronic heartburn and adenocarcinoma, the most common type of esophageal cancer in the U.S.

Many practices are currently leveraging Microsoft Office 365 for e-mail, file storage, and internal collaboration. Unsurprisingly, the number of threats targeting this information (phishing attacks, compromised credentials, etc.) continues to grow at a rapid rate.

Everyone should have a developed, thoughtful, and unique financial plan. However, newly practicing physicians face more unique financial challenges than most recent graduates due to many having considerable accumulation of student loan debt. Once physicians begin earning income, there are pressures to play catch-up with peers who have had longer to establish their careers and savings accounts.

Throughout training, physicians are taught how to prescribe medications. How does the medication work within the body? Which patients will benefit? What is the appropriate dose? What are the side effects? The cost? We spend years honing our expertise on how to prescribe medications safely and correctly. Great care is taken to prescribe the best medication for each situation in each patient. We become comfortable prescribing medications early in training. Over the course of a patient’s lifetime, the number of these medications can build, leading to polypharmacy.

September is Atrial Fibrillation (AF) Awareness Month, which reminds us that even in the midst of the pandemic, cardiovascular and other diseases progress unabated. As a result, we welcome this opportunity to review some of the important approved developments in AF therapeutics and assess their validity when subjected to scientific scrutiny.

The COVID 19 pandemic has thrown a wrench into all of our day to day routines, including going to work, taking our children to school, running household errands, exercising, and even going to see our doctors or dentists.

Over the past few years, you may have heard about companies, app makers, and service providers launching two-factor verification or two-factor authentication.

The importance of a having well-designed website and creating an online presence is crucial to your medical practice now more than ever, regardless of how the pandemic affects your marketing outcomes. You don’t want to risk deterring new and current patients from using your practice.

In 1968, the Green Bay Packers won the Super Bowl, the first Hot Wheels toy car made its debut, and Richard Nixon was elected President of the U.S. It was also the year that the first knee replacement surgery was performed. Today, more than 600,000 total knee replacements are performed in the U.S. each year to help relieve pain and decrease disability in people with knee problems.

Pediatric office visits have declined by half during the COVID-19 pandemic, according to the American Academy of Pediatrics (AAP). Not only are children missing well-child checks, but also the vaccines that are given during these visits. Manufacturers are reporting a decline in vaccine orders and vaccine doses distributed through the Vaccines for Children program.

In this day and age of advanced technology, physicians have access to abundant clinical information at their fingertips. Electronic medical record (EMR) systems can provide physicians with the data they need to care for their patients at virtually any time or place (whether or not these systems are user-friendly is another story).

Obesity is a growing disease both in the US and around the world. It is a major cause of many diseases including diabetes, hypertension, heart disease, cancer, cerebrovascular disease and stroke, gastroesophageal reflux disease, bone and joint damage and respiratory disorders. It also places individuals at increased risk of developing serious complications from COVID-19.

Approximately every 40 seconds someone in the United States has a stroke and roughly every four minutes someone dies of a stroke. It causes about one in 20 deaths annually – making it the fifth-leading cause of death – and the primary reason for long-term disability. Moreover, Alabama has the second-highest stroke mortality rate in the United States, behind Mississippi, according to the Centers for Disease Control and Prevention (CDC). This high incidence of stroke has earned Alabama a spot in the stroke belt, dubbed so by the medical community.

Valentine’s Day was last month, and as usual, stores were filled with candy hearts while customers snapped up flowers and greeting cards. With Valentine’s Day now in the rear view mirror, while thinking about the holiday, I realized that we tend to overlook the opportunities we have every day to genuinely impact someone else. I found myself wondering how I could turn the seasonal attempts to show someone appreciation into a day-to-day routine. If I carried this mentality with me throughout the year, what downstream effects would follow? How would this impact not only my personal life, but my career and the culture of my organization?

Information Technology now dominates almost every part of our daily lives and in most cases, we do not have to think or worry the outcomes. We trust that what we input on our phones, keyboards and tablets will result in the right answer. With these repetitive motions it has allowed our business to grow and flourish. But what happens when those items break?

Over the last few years, cell phones have become computers, capable of much of the functionality that your office computer has. This is also true for small portable devices such as iPads, Windows and Android tablets. Are these devices and applications as secure as those you use from your clinic? In most cases, the answer is no.

As our society transitioned to mobile phones, a frequently overheard question and related advertising theme was “Can you hear me now?”

In 2016 Forrester Research analysts focused their attention on emerging social phenomenon in consumer behavior. They identified several key social trends that are impacting our industry’s ability to adapt to changing policy, market trends and patient needs. One trend they observed was the rapid adoption of new solutions and the abandonment of solutions that didn’t immediately provide value. This trend was seen across all industries.

Regulation Background

The False Claims Act (“FCA” or “Act”) is a federal anti-fraud statute that protects against persons and companies defrauding the government. The Act has been dubbed the government’s “primary litigation tool for recovering losses resulting from fraud.”[1] The FCA imposes civil liability on any one who “knowingly presents…a false or fraudulent claim for payment or approval” to the federal government.[2] It is used extensively to protect against fraud in healthcare.[3]

As the summer months are a time when many people take vacations, it is a good time to get veins treated. So, today, we are decoding the facts about one of the latest minimally invasive technology offerings at the Alabama Vein Center: VenaSeal™ closure system.

Malware are created with the intent to damage or disable our mobile devices, computers or servers. These attempts can include disrupting computing or communication operations, trying to steal sensitive data, accessing our private networks, or hijacking our systems to exploit their resources. With the tremendous growth in email and internet use over the last couple of decades, we have seen a corresponding explosion of growth in malware

If “Varithena” sounds like the latest Marvel or DC superhero, there’s good reason. When it comes to treating varicose veins, such an idea isn’t so far fetched!

Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk.  A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.

Did you know a single patient health record can earn cybercriminals 10 times the price of a stolen credit card number on the black market?

The Office of Civil Rights is auditing small and large healthcare providers alike, imposing multi-million dollar fines in some cases. Meanwhile, the same electronic storage, mobile devices, and cloud-based applications that patients, doctors, and healthcare staff want to use often compromise a practice’s ability to keep that patient data safe.

It has now been two years since the implementation of ICD-10, everyone survived! While denials have been minimal, the goal of implementing ICD 10 to acquire more specificity and a complete picture of health has not been fully achieved.  Physicians and managers have created a new set of shortcuts to assure payment of claims, relying on paper superbills or inappropriate conversions from ICD 9 to ICD 10.

The Mobile area has many sites for tourists to visit during a stay. From the Gulf Coast Exploreum Science Center & IMAX Theater, the USS Alabama Battleship, the beautiful flowers of Bellingrath Gardens, dipping your toes in the warm Gulf waters of Dauphin Island, to celebrating Mardi Gras at the Mobile Carnival Museum, there’s one attraction in Mobile that may not immediately catch your attention, but you surely should not miss…the Mobile Medical Museum.

Physicians Giving Back with Lee Irvin, M.D.

You probably don’t know Lee Irvin, M.D., of Mobile, and he’s fine with that. He’s the kind of gentleman you’d love to hang out with and have a drink or dinner with…swap stories with. But it’s easy to see that his medical mission over the last couple of years wears heavy on his heart.