BMN Blog

Over the past couple of years, many of us have been overwhelmed with chronic stressors related to work, parenting, relationships, and everything in between. Although we recently had a break in the number of rising Covid-19 infections in the United States, stress continues to show up in our day to day. In addition, numerous studies indicate job-related stress among healthcare workers exceeds other occupations. We cannot show up for our patients, as parents or in other relationships if we don’t manage stress before it manages us. 

Problems with your erections or “erectile dysfunction (ED)” affects over 50 million men in the US. It remains an embarrassing topic for those who are affected.

Necessity is the mother of invention according to Plato. No truer words could apply to the pandemic. And it has led to a litany of “inventions” or rather, innovations or adaptations. Now the question is which ones will stick? And what must be done to avoid any potential setbacks since most of these adaptations were put forth in haste? 

May was Mental Health Awareness month. Awareness encourages us to be informed and focuses our attention to clarify experience and perceptions. I would like you to consider your perception of the following two patients:

Patient One: 28-year old male with a history of Bipolar II disorder but with poor medication compliance. He has twice failed out of college and now relies heavily on financial support from his parents. He has limited employment experience and he generally cannot keep a job more than a couple months. He has been arrested on a few occasions for minor thefts involving shoplifting and breaking into cars.

Patient Two: Has the exact same history except that he is also a frequent user of heroin, fentanyl, and alcohol.

As with a lot of practitioners, you likely view Patient One as a victim of chronic mental illness, deserving of our understanding as well as all the resources our community can muster to support him in achieving a healthier lifestyle.

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.

When it comes to selecting a name for a medical practice, the final choice, or actual name is meaningful. In 2021 our group, formerly Shelby OB-GYN, moved our Obstetric services to Grandview Medical Group. We also opened a new office location at Grandview.

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.

After a painful odyssey of more than 20 months, the one thing all Americans can agree on is that the CORONAVIRUS-19 pandemic has disrupted every facet of life. Everything from the global supply chain to the educational system have been forced to adapt.

Fall has arrived, and with the cooler temperatures, many of us want to get outdoors and enjoy the weather, including taking to our local hiking trails. But, as peaceful as a Saturday afternoon hike can be, this activity does come with risks – read on to learn about the six most common hiking injuries and how Southlake Orthopaedics can help if you are experiencing an injury from your favorite fall pastime

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.

Because of the stress we have all been under in the past year, this is a good time to take stock of your mental health. I want to provide information that may help you or someone you love.

[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

Children’s of Alabama marks an important milestone with the celebration of its Asthma Clinical Pathway’s 10th Anniversary. The quality improvement initiative began in March 2011 with an aim to reduce inpatient asthma length of stay through the delivery of evidence-based excellent acute asthma care.

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. 

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 the past year, most physicians have been so busy with all the complications and changes in approach to care that resulted from the pandemic that they haven’t had time to examine aspects of their practice that aren’t part of the daily work. If you haven’t performed a recent review of the potential threats to your practices’ financial health, I recommend doing that, starting with your commercial insurance plan.

Partnering with an experienced agent who specializes in the healthcare arena can provide you with multiple carrier options to compare while helping you negotiate more favorable terms than some companies will offer to clients who work directly with the carrier only. Let’s take a look at a few of the items my team is focused on for our healthcare clients and the emerging threats that are continuing to impact more medical businesses. 

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.

The journey toward mental health parity began in 1961, when President Kennedy directed the Civil Service Commission (now known as the Office of Personnel Management) to implement mental health parity. The Strengthening Behavioral Health Parity Act (“SBHPA”), which was signed into law on December 27, 2020 as part of the Consolidated Appropriations Act of 2021, represents a major milestone in that journey by adding ERISA plans to the plans that are covered by the Mental Health Parity Act of 1996 and by working to achieve parity in physical and mental health care management processes.

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.

Varicose veins appear as bulging, enlarged, bumpy, purple veins. Symptoms can include restless legs, swelling, aches, and cramps. Varicose veins occur more frequently with age but anyone can get them at any time. The American Academy of Dermatology estimates that about 80 million people in the United States have leg vein problems.

The city of Marion is an old town rich in Alabama history that pre-dates the Civil War. It’s home to many antebellum homes, Judson College and Marion Military Institute, the nation’s oldest military junior college. Few people may know that a young Coretta Scott, born and raised in Marion, wed her husband, Rev. Dr. Martin Luther King Jr., on the front lawn of her mother’s home just north of Marion in 1953. It’s this small town’s amazing history that called out to Dr. Shane Lee when he was looking to set up a practice.