Study Shows Most Doctors Get Positive Online Ratings
04 May 2015

The Internet is usually a place for anonymous negative comments and reviews, but new research has shown that most healthcare consumers consistently give their physicians high marks on the Internet. Vanguard Communications, a 20-year-old Denver marketing and public relations firm specializing in healthcare, developed special software to analyze Yelp.com and Google+ reviews of doctors, group medical practices, clinics and hospitals.

The software searched ratings of over 46,300 providers in the nation’s 100 largest cities and found that 56.8 percent of physicians get four stars or better. At the other end of the satisfaction scale, only one in eight doctors (12.1 percent) gets an average of less than two stars. More than three out of four (77.3 percent) earn three stars or better.

“From our findings, it appears that doctors tend to get much better reviews than hotels, restaurants and retail businesses,” said Vanguard CEO Ron Harman King. “While some doctors indisputably suffer from unjust online comments, our snapshot of American healthcare providers indicates doctors in general enjoy widespread respect and gratitude from patients.”

Patients in San Francisco and Oakland appear to be happiest with their doctors, while the least satisfied American healthcare consumers live in other California cities as well as in New York State locales, the study also revealed.

A similar 2013 study conducted by Vanguard revealed that unhappy patients most often complain about poor customer service and bedside manner four times more often than citing misdiagnoses and inadequate medical skills as cause for their dissatisfaction. The biggest source of complaints was perceived doctor indifference and bedside manner. 43.1 percent of the critics said their annoyance was because the doctor was rushed, late for the scheduled appointment, did not listen well or was otherwise dismissive of their concerns.

As medical consumers increasingly turn to physician rating sites to shop for healthcare providers, anxiety in the medical community is growing over online reviews, with some doctors suing their patients over Internet comments. Nevertheless, a recent study reports that among patients who utilize physician-review websites, 35 percent have selected doctors based on good reviews, while 37 percent avoided doctors based on bad reviews. Prior studies have shown that few physicians are reviewed on rating sites, however, an analysis of one rating site indicated that between 2005 and 2010 there was an increase in the number of physicians rated and the number of ratings per physician.

Now doctors can be satisfied that their patients are treating them well in online reviews.

Diabetes Testing at the Dentist’s Office
04 May 2015

According to a study published in the American Journal of Public Health in February, a visit to the dentist could be another opportunity to screen patients for diabetes. Doctors found that using gingival crevicular blood for hemoglobin A1c testing produced results nearly identical to those obtained using finger stick blood, the test generally used to diagnose diabetes.

“In light of findings from the study, the dental visit could be a useful opportunity to conduct diabetes screening among at-risk, undiagnosed patients — an important first step in identifying those who need further testing to determine their diabetes status,” Shiela Strauss, PhD, MA, BS, the study’s principal investigator and co-director of the Statistics and Data Management Core for NYU’s Colleges of Dentistry and Nursing, said.

The study, called “The Potential for Glycemic Control Monitoring and Screening for Diabetes at Dental Visits Using Oral Blood,” adds to the previous research that has considered the acceptability to use oral blood to screen for the disease. Dental visits could be potential opportunities for diabetes screening and monitoring glucose control, researchers said. Although many Americans visit their dental providers annually, they might not be seeing primary care providers as frequently. Patients who are at least 45 and older could particularly benefit from this type of screening.

The study included 408 adults with or at risk for diabetes and performed hemoglobin A1c (HbA1c) tests on dried blood samples of gingival crevicular blood and compared these with paired gold-standard HbA1c tests with dried finger-stick blood samples. They also examined differences in sociodemographics and diabetes-related risk and healthcare characteristics for three groups of at-risk patients.

Researchers estimate 8.1 million of the 29.1 million Americans living with diabetes are undiagnosed, with many who have diabetes also having inadequate glycemic control. One out of 3 adults has prediabetes, according to the CDC. Without weight loss and moderate physical activity, the CDC states, 15% to 30% of people with prediabetes will develop type 2 diabetes in five years.

“Our study has considerable public health significance because we identify the value and importance of capitalizing on an opportunity at the dental visit (a) to screen at-risk, but as yet undiagnosed patients for diabetes (especially those 45 years or older), and (b) to monitor glycemic control in those already diagnosed so as to enable them to maintain their health to the greatest extent possible,” Strauss said.

Study recruitment, participation, and data collection took place in the comprehensive care clinics at the New York University College of Dentistry (NYUCD) from June 2013 to April 2014 and funding for this study was provided by the National Institute of Dental and Craniofacial Research.

The ICD-10 Compliance Deadline has been set as October 1, 2015 due to a regulation that was published by the Department of Health and Human Services (HHS) on August 4, 2014. What does this mean for physicians and general medical staff members all over the world? This means that they will need to adjust to new sets of codes and classifications if they are to advance in their medical careers. The compliance deadline is mandatory and all medical staffs will need to get familiar with ICD-10.

The introduction to ICD-10 was signed into law on April 1, 2014 as part of the Protecting Access to Medicare Act of 2014. ICD-10 is an abbreviation for the 10th Revision for International Classification of Diseases and there are core ICD skills that physicians need to have in order to function in the hospital. These core skills include having exceptional knowledge of anatomy, physiology, medical terminology, pharmacology and pathophysiology. Physicians must also be knowledgeable of the necessary procedures and the scientific applications relating to biomedical situations and clinical medicine.

There are some useful steps physicians should take that will aid groups such as the Clinical Documentation Improvement Team and all of these steps are practical. One step doctors should take when adjusting to ICD-10 would be to have proper awareness of the new system. Doctors must be able to memorize the new concepts, requirements and codes that will come with ICD-10. There are significant differences when comparing ICD-10 and its predecessor ICD-9. Considering that ICD-10 is the latest revision, there have been significant changes made to the overall format that doctors will have to adapt to.

Various groups and supporters of ICD-10 training provide bold solutions and the signs have been apparent that there is a need to make the transition to the new classification system. There are several new kinds of codes with ICD-10 that will make clinical documentation and general coding much more complex than the current ICD-9 system and doctors are recommended to start memorizing every notable detail of this new system to understand the updated terminology.

Another step physicians should take when preparing for ICD-10 would be to remain knowledgeable of the existing coding practices in clinical documentation. While ICD-10 will be officially implemented on October 1, 2015, medical staff members will, still be required to use ICD-9 until September 30, 2015, meaning that this current period of time would be most beneficial for the staff to compare the differences between ICD-9 and ICD-10. This studying process will help the staff better understand what they need to do when they submit reports going forward.

The President of the American Medical Association Steven. J. Stack had this to say. “The AMA has long considered ICD-10 to be a massive unfunded mandate that comes at a time when physicians are trying to meet several other technology requirements and risk penalties if they fail to do so.”

Another step for physicians to take would be to enhance communications and planning for ICD-10 training. Physicians need to be in the right mindset when they prepare for revisions such as ICD-10 and conducting simulations of applied ICD-10 schedules beforehand would be ideal. Establishing a routine of applying ICD-10 terminology ahead of the time of its actual implementation would give physicians an advantage in preparation. A smooth transition to this new system heavily depends on the initial steps that are taken, such as matching the solutions based on the needs of the organization.

When dealing with an important transition such as this, communication becomes more important than ever. Talking to practice management or a software vendor would help physicians since they need to know when software updates will be completed for the newly installed system. Talking to clearinghouses, billing service and payers would also help physicians because it needs to be determined when these parties complete their ICD-10 upgrades so that physicians can test with them. Healthcare clearinghouses and payers are also HIPAA covered entities, so they are also required to adjust to the ICD-10 system. Internal testing and external testing with payers is vital for physicians because transactions that carry ICD-10 codes are sent to and received by the payers.

Physicians should also identify the changes they need to make to resources such as coding diagnostic tools, public health reporting tools, “super bills” and the like. It is important for physicians prioritize coders and specialists that are capable of training the rest of the team when they finish the training program. Without the proper training to go around, medical teams may fall behind schedule, which could lead to significant problems as they approach the October 1, 2015 deadline. With proper training, medical staff members will be able to adjust and collaborate more fluently to develop flexible operations in the hospital.

The notable differences between the codes used in ICD-10 and the codes used in ICD-9 include added digits. ICD-10-CM codes are designated for use in documentation diagnoses. These codes are 3 to 7 characters in length and 68,000 in total, whereas with ICD-9 there are only 3 to 5 characters in codes that total up to 14,000. ICD-10-PCS are designated as procedure codes and are alphanumeric, having codes that are 7 characters long that amount to 87,000 codes. Procedure codes in ICD-9 would only have 3 to 4 characters and only amounted to 4,000 codes.

Physicians also need to know what kinds of testing are actually conducted for ICD-10. There are two procedures. One is called Acknowledge Testing where it will be determined whether or not ICD-10 coded claims will make it through Medicare’s claims processing front door. The other is called End To End Testing where claims from submission go through to the receipt of remittance advice. These tests will contain thorough-detailed information. In general terms, these procedures will affect how claims will process and be paid by Medicare with the ICD-10 codes.

One practical thing to summarize from the emergence of ICD-10 would be for physicians to focus on what really matters. The most complex and intricate parts of this new system need to be memorized and figured out first and foremost and the less important factors need to be put aside for the time being. At some point before October 1, 2015 all medical staff members should be able to get in the proper amounts of training and education on this new system because if they get familiar with how the new system works, they will be able to move along and perform their jobs at the hospital as they normally would.

Plenty of changes are coming to your healthcare plan in 2015, but the changes that you are about to experience will be more significant than the changes you have experienced in this past year of 2014. The main changes to healthcare plans dwell in financial avenues, meaning that some of the costs will go up for healthcare subscribers.

Let’s review some of the changes that were made to healthcare plans in this year of 2014 first. Some of the changes included a guaranteed issuance of coverage. Health plans had to sell coverage, regardless of pre-existing conditions, and health plans couldn’t charge consumers more based on their health or gender. 2014 also saw the establishment of health insurance marketplaces. Every state in America was mandated to have insurance exchanges, organized marketplaces where individuals and small business owners could select from all the qualified private health plans that were made available in their area. Consumers were allowed to make any changes to their health plans via online, through brokers, on the phone, or with the help of Navigators who serve as personal assistants.

An individual mandate was put in place in 2014. Everyone had to own some form of health insurance by registering for one of the available programs, which varied from Medicare and Medicaid to Veterans Affairs, Tricare and Indian Health Service. If an individual did not own any form of health insurance by a certain deadline then they would be forced to pay a penalty. Another change was the act of establishing premium rebates. Insurers were ordered to spend at least 80% of premiums on medical care for their individual and small group (under 50 employees) plans. The cut-off was 85% for large group plans and if insurers were unable to reach this mandate, then they were to refund the difference to consumers by way of direct refunds or reduced costs to their plans.

2014 also experienced the inclusion of standard disclosure forms. All health plans were required to use a standardized consumer-friendly form to provide a uniform summary of benefits and coverage, such as information on copayments, deductibles and out-of-pocket limits. This made it easier to compare plans. Insurers could calculate and disclose a patient’s out-of-pocket cost when it specifically related to issues like having a baby or treating Type 2 Diabetes.

Caps were also placed on flexible spending accounts. Employers could previously set limits on their FSAs at any level they chose (mainly from $2,500 to $5,000), which could be set aside tax-free for expenses (mainly around $2,500), with the cap increasing by the annual inflation rate in following years. Patients could not use FSAs to pay for over-the-counter drugs unless they had prescriptions from their doctors. Lastly, a new Medicare tax for high earners was implemented in 2014, which featured individuals who earned more than $200,000 (or $250,000 for couples), the Medicare payroll tax increased from 1.45% to 2.35%. Individuals also paid a new 3.8% Medicare tax on unearned income, which included investments, interest, dividends, veteran’s benefits, and qualified retirement plan distributions such as those from 401 (k) and IRA.

Now what about the year that is ahead of us? What changes will be made to healthcare in 2015? For starters, there will be a change in payment rates. Centers for Medicare and Medicaid (CMS) announced an increase of 1.7% in Medicare reimbursements to hospital outpatient departments (HOPD). Reimbursements for inpatient payment rates will also increase by 1.4% with an opportunity to increase by an additional 2.2% depending on individual hospital standards. All of these increases are intended to translate into a $1 Billion increase in hospital revenues.

Another change coming to healthcare in 2015 would be the Employer Mandate. Full implementation of this mandate will not occur until January 1, 2016, but partial implementation of this mandate is set to begin on January 1, 2015. This mandate mainly affects employers that have over 100 active employees and the healthcare coverage’s that they have for that company.

There are requirements that employers must meet in order to avoid penalties. They first need to offer coverage to 70% of full-time employees, and secondly, the coverage must meet the minimum value and the affordability guidelines. Employees working 30 hours per week are considered to be full-time workers and 60% actuarial value is along the lines of the minimum value. Maximum penalties include $2,000 a year per employee if fewer than 70% of full-time employees are offered coverage, and $3,000 a year per employee if the coverage doesn’t provide the minimum value.

When it comes to coverage affordability, employees will pay no more than 9.5% of wages for self-only coverage for the lowest possible cost plan. There are time periods to look at when reviewing financial statistics and health plans. The Measurement (or Look Back) Period involves employers checking on health insurance availability on a 6 to 12 month time period to evaluate which employees must be offered health insurance in 2015. This must be done to avoid potential financial penalties. The Administrative Period is an up to 90 day time period to evaluate the data collected by the Measurement Period. The Stability Period is the length of time health insurance must be offered to employees that are deemed full-time to avoid penalties. This must be at least of the duration used for the Measurement Period.

If a patient’s plan no longer exists in 2015, the patient will be enrolled in another product offered by the same insurer whenever it becomes available. Even if patients have the same plan, 1,700 of 2,800 healthcare plans of 2014 will exist in the same form in 2015. However, patients will not be guaranteed to receive the same benefits with these stable plans. Insurers cannot increase all charges since that would make general spending on health plans completely unbalanced. Some plans have changed the wording of their benefits, such as adding a newly made term called “Copay After Deductible”, which means that insurers will not pay for any portion of an ER visit until customers meet their deductible, which would be thousands of dollars.

There are 3 tiers of health plans that people need to be aware of. Bronze health plans account for 60% of their members’ overall health services, whereas silver plans account for 70% and gold plans account for 80%. For example, the Coventry Health Care silver plan in the Kansas City, Kansas region is decreasing costs of primary care visits from $10 to $5, however on the flip side, medical deductibles have been increased from $2,000 to $2,750, out-of-pocket minimum payments have been increased from $6,350 to $6,600, and the cost of generic drugs have been increased from $10 to $15. Premiums are also slated to increase in 2015.

There is controversy surrounding emergency department operations, and particularly when it involves HCA Holdings. HCA experienced such controversy and according to an investigation held by the Tampa Bay Times newspaper, HCA Holdings has been overcharging its patients in the 6 Level II trauma centers in the state of Florida. The company charges an average of $40,000 more per patient than the average at other trauma centers. The Tampa Bay Times also claims that the hospital overcharges for services like scans, lab tests and drugs. These charges specifically fall under the description of “trauma response fees”.

Despite this controversy, HCA Holdings has established 160 Urgent Care Clinics in California, 100 clinics in both Florida and Indiana, 85 clinics in Texas and 80 in Georgia and has captured the market share in the $15 Billion urgent care clinic market field by focusing on acquiring or establishing standalone urgent care clinics.
Most of the issues regarding healthcare are reliant on adjusting financial figures and it’s important for everyone who has health plans to stay up to date on the changes that are made to their health plans. Some health plans cease to exist from one year to the next, and more significant changes need to be made to acquire a stable health plan in this scenario. Properly calculating payments will go a long way in determining which coverage is best suited for various kinds of patients and consumers. It depends largely on how much a consumer is willing to spend in order to get the kind of coverage that fits their needs.

There are a number of metrics to use when grading the quality of a physician.  Whether it is comprehensive knowledge of medical expertise, technical skill in surgery or bedside manner, there are a number of qualitative standards to use when determining what constitutes one of the Leading Physicians in the World.  While few physicians can boast superlative ratings in every category, the members of LPW are among the most respected and trusted figures in their fields because of broad professional excellence.

One of the primary bases for determining excellence is academic achievement.  While all physicians are academically superior to the majority of their educational counterparts, Leading Physicians of the World boasts members from the most prestigious universities in the world including Harvard University, Cambridge, the Sorbonne and many others. Many of LPW’s members continued their medical education through prestigious internships and fellowships at the most celebrated hospitals and research institutions including the National Institutions of Health, Massachusetts General and the Mayo Clinic.

Following formal education and training, members of LPW have made pioneering contributions to medical body of knowledge through teaching, publishing and speaking.  Many of these doctors serve as lecturers and professors at educational institutions, sharing their hard earned expertise with new generations of medical students.  Many of LPW’s members also are eager to dispense their knowledge to the medical community and the general public through keynote addresses at major conferences and published articles in esteemed publications like the New England Journal of Medicine and the Journal of the American Medical Association.  Many of these articles are available at http://www.lpwonline.com as well as the website of its parent organization, the International Association of Healthcare Professionals.

Perhaps one of the most important metrics for medical excellence is the ability to utilize this expertise within a clinical setting.  Most LWP members diagnose illnesses and injuries, identify health issues, provide preventive health advice and implement the latest technologies and healthcare products to remedy health issues.  While some of these activities occur at world renowned medical facilities, others happen within the settings of private clinics which are owned and operated by these successful doctors.  Most members of the Leading Physicians of the World are in high demand with patients traveling enormous distances to receive their advice.  Needless to say, almost all members receive impeccable reviews from patients, medical associates and professional organizations.

Another measure of professional excellence is the honors and awards that members receive.  Almost all of LPW’s members have distinguished themselves well enough to receive recognition from the medical community.  These honors come from regional, national and international associations that are aware of the latest contributions by leaders in the field.  These include Nobel prizes, Lasker awards, and the AMA Foundation Excellence in Medicine awards.  These accolades often provide generous monetary awards and enormous publicity on the scientific and clinical achievements of deserving members.

The International Association of Healthcare Professionals (IAHCP) has long stood by the tenet that a healthy community is a happy community.  This is why IAHCP has maintained the utmost vigilance in dedicating themselves to community outreach.  Especially within the healthcare community, outreach is a way for doctors and physicians and other allied healthcare professionals to come together and begin to treat their local community’s healthcare needs.  It’s also an excellent way for charities to contribute and learn about ways in which they can positively affect society.

In order to keep healthcare professionals, charity organizers, and all the support branches that go into outreach all on the same page, the International Association of Healthcare Professionals sends out regular e-mail newsletters.  These simple reminders and informative brochures help keep doctors and healthcare professionals abreast of current issues while also facilitating discussion with other adjacent practices and organizations.  The IAHCP tries to begin the conversation about health initiatives in order to better make that initiative a reality.

Finding out about what initiatives are active in a particular healthcare professional’s area is as simple as going over to the International Association of Healthcare Professionals’ website (www.iahcp.org) and joining.  Simply joining IAHCP is a first step to helping hundreds of global efforts to eradicate diseases, organize local community healthcare services, and even participate in larger charity events.  Global initiatives are taking place every single day to spread awareness, join discussions in treatment options, and actively treat diseases and conditions.

The greater healthcare and medical community has a vested interest in seeking out and participating in local community efforts.  The International Association of Healthcare Professionals (IAHCP) values this initiative and seeks to promote it through aggressive communication efforts.  The internet has allowed a great body of medical knowledge to be pooled for the benefit of medical practitioners operating in remote communities.  This is a great facet that the IAHCP seeks to promote and make others aware of.

Local community medical efforts are also a great way to inform the community about the services your practice has to offer them.  Preventative medicine and diagnostics are some of the easiest ways to capture a potentially life-threatening ailment before it becomes a major problem.  Successful treatment options usually begin before a medical condition becomes readily apparent.  This is why the IAHCP strongly encourages practices to network and maintain an active awareness about events and effort going on in their respective areas.  This function serves to both strengthen the health of your neighbors as well as strengthen the standing of your business.

The added bonus of working with an organization like the International Association of Healthcare Professionals is that you are also extending out your expertise to areas farther than your normal patient reach.  This helps promote your services and also accentuates your expertise in a particular field.  Whether that field is oncology or epidemiology, the IAHCP stands ready to support you in your endeavors.  Let the community know that you are a trusted voice in their medical concerns!

And as we all know, healthcare is a team effort and no one can do everything alone.  Join a growing global team of networked medical professionals and find out more about how you can help at www.iahcp.org.

If you’re a seasoned healthcare professional with specialized experience in a particular field, it’s time you used that experience to your benefit.  With an ever-growing body of scientific and medical literature emerging online in the form of electronic publications, there has never been a greater time to use your experience to its fullest.  The International Association of Healthcare Professionals (IAHCP) specializes in providing an online gateway for doctors and physicians: The Waiting Room Magazine. 

Whether it’s a complex topic such as Nuclear Radiology or an interrogative look at Human Sexuality, IAHCP always stands ready to ensure your contribution is acknowledged and received by the larger scientific community.  The Waiting Room is also an excellent way to stay connected to your patients while they wait to see you.  This magazine lets you explore topics ranging from humorous to informative.

Don’t let your work be left in the dark!

Over seventy-five publications are already being vigorously distributed to their target audiences in the healthcare community and even more doctors and physicians are submitting written articles to The Waiting Room Magazine.  With other regular publications also coming out, such as The Leading Physicians of the World, there has never been a better time than now to feature your written work through the IAHCP.

The International Association of Healthcare Professionals actively participates with online distributors and printed publishers to find the audience that would best benefit from your medical work – whether it be in the form of a regularly printed magazine, such as The Waiting Room Magazine, or through intuitive and in-depth literature such as The Leading Physicians of the World.  Many of IAHCP’s members have gone on to write their very own books and have them distributed through our extensive network of medical practices and institutions.

You have already put your time, effort, and research into writing a good piece of medical literature – now enjoy the revenue and the pride of knowing the rest of the healthcare community is noticing your accomplishments.

With topics ranging from epidemiology to psychology, IAHCP (www.iahcp.org) has become a growing online space for medical scientists and practitioners to exchange notes, research, and book ideas.  The International Association of Healthcare Professionals values your contributions to healthcare and wants to promote your work to healthcare professionals who can benefit most by it.

The Advantage of Publishing through IAHCP

Who better understands the value of your research than the healthcare community?  Allied healthcare workers, from all over the world, benefit in the exchange of ideas and research to improve the lives of the people they serve.  IAHCP takes your finished literature and broadcasts it to healthcare communities that may most benefit from it.  Through a variety of channels, such as the Waiting Room Magazine and The Leading Physicians of the World publication, IAHCP ensures that no matter where a medical practice is located, they have access to cutting-edge medical research and literature.

Normally, when you have placed the finishing touches on your medical literature, it is up to you to correctly identify which healthcare professionals would most greatly benefit from it in the international community.  This can be a time-intensive process and laboriously expensive if done incorrectly.  The International Association of Healthcare Professionals (www.iahcp.org) is an already established online medium for ensuring that doctors and physicians can release their medical literature onto the internet without worrying about piracy, networking, and finding an interested audience.

It’s also a great tool to point your colleagues to when you wish to point them in the direction of your work!

Because the International Association of Healthcare Professionals is committed to assisting the medical community at large, there has never been a better time to publish your medical literature with us.