med monthly may 2013

Med MonthlyMAY 2013

the Your

PracticeStaffissue

Med Monthly

Medical PracticeStaffingAdvice

pg. 20

3

WHO IS THE MOST IMPORTANT PERSONIN A PRACTICE?pg. 40

Key Components to Growing Your Practice From WithinTHE POWER OF INTERNAL MARKETING

pg. 42

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

contents40 WHO IS THE MOST IMPORTANT PERSONIN A PRACTICE?

42 THE POWER OF INTERNAL MARKETING: 3 Key Components to Growing Your Practice From Within

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

legal

34 AFFORDABLE CARE ACT EXTENDED FREE PREVENTIVE CARE TO 71 MILLION AMERICANS WITH PRIVATE HEALTH INSURANCE36 WILL FEDERAL PROTECTION FOR ELECTRONIC HEALTH RECORDS (EHR) DONATIONS BE EXTENDED BEYOND DECEMBER 31, 2013?38 SOUTH CAROLINA SELECTS IBM SMARTER CITIES SOLUTION TO HELP MODERNIZE DELIVERY OF VITAL SOCIAL PROGRAMS

the arts48 ‘ART BY NURSES’

healthy living50 BLACK BEAN QUESADILLAS

features

in every issue4 editor’s letter8 news briefs

56 resource guide72 top 9 list

insight

10 NIH-SUPPORTED STUDY FINDS U.S. DEMENTIA CARE COSTS AS HIGH AS $215 BILLION IN 2010

12 PRIVATE AND PUBLIC SECTOR COLLABORATION IS CRITICAL FOR WOMEN’S HEALTH MARKET TO TRULY FLOURISH

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

practice tips

16 DESIRED QUALITIES WHEN STAFFING POSITIONS AT YOUR PRACTICE

18 ONE-THIRD OF DOCTORS MISS ELECTRONIC TEST RESULTS

20 MEDICAL PRACTICE STAFFING ADVICE

48

international24 INCREASING OBESITY LEVELS AND HIGH GENETIC VULNERABILITY DRIVING THE PREVALENCE OF DIABETES IN INDIA

research and technology

26 NEW GENETIC LINK FOUND BETWEEN NORMAL FETAL GROWTH AND CANCER

28 EHR TECHNOLOGY – No Surprises With Release of the Proposed Rule For Stage 2 Meaningful Use

30 SMART MOBILE TECHNOLOGY FOR YOUR PRACTICE AND YOUR PATIENTS

42

‘Art By Nurses’

We understand that most physicians cannot take valuable time away from seeing patients and managing their day-to-day operations of their practice to think about real estate. For over 100 years we have been helping clients find the best real estate solutions in the Triangle. Our combination of energetic young leaders, wisdom of established team members, and full range of real estate services have provided our healthcare clients with peace of mind, ideas and solutions.

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We understand that most physicians cannot take valuable time away from seeing patients and managing their day-to-day operations of their practice to think about real estate. For over 100 years we have been helping clients find the best real estate solutions in the Triangle. Our combination of energetic young leaders, wisdom of established team members, and full range of real estate services have provided our healthcare clients with peace of mind, ideas and solutions.

RALEIGHHeadquarters & Property Management (919) 821-1350


MOREHEAD CITY(252) 247-5772


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BROKERAGE LEASING PROPERTY MANAGEMENT INVESTMENT SECURITY MAINTENANCE LANDSCAPING

HELPING YOU WITH REAL ESTATE, SO YOU CAN FOCUS ON HELPING OTHERS.

4 | MAY 2013

editor’s letter

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

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

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

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

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

Managing Editor

Ashley Austin

Med Monthly

Publisher

Managing Editor

Creative Director

Contributors

Med Monthly is a national monthly magazine committed to providing

insights about the health care profession, current events, what’s

working and what’s not in the health care industry, as well as practical

advice for physicians and practices. We are currently accepting articles to

be considered for publication. For more information on writing for Med Monthly,

check out our writer’s guidelines at medmonthly.com/writers-guidelines

May 2013

P.O. Box 99488Raleigh, NC 27624

[email protected]

Online 24/7 at medmonthly.com

contributors

Philip Driver

Ashley Austin

Thomas Hibbard

Ashley Acornley, MS, RD, LDNPhilip DriverKelly FitzgeraldThomas HibbardAmanda KanaanKaren S. LovitchDenise Price ThomasFrank J. RoselloLisa Shock

MEDMONTHLY.COM |5

Lisa P. Shock, MHS, PA-Cis a PA who has practiced in pri-mary care and geriatrics. She enjoys part-time clinical practice and is the President and CEO of Utilization Solutions in Healthcare – a specialty consultant company for physician practices and hospitals, offering services to help implement and im-prove the utilization of PAs and NPs in the health care system. Contact

her with questions at [email protected]

Frank J. RoselloEnvironmental Intelligence, LLC, is a complete, full-service health-care IT solution provider. With a team having more than 10 years of proven clinical expertise in deliv-ering end-to-end health IT solu-tions, Environmental Intelligence provides medical practices and facilities onsite expert IT consulting,

installation, and implementation that is focused on physi-cians, their patients, and the quality of their care.

Ashley Acornley, RD, LDNholds a BS in Nutritional Sciences with a minor in Kinesiology from Penn State University. She com-pleted her Dietetic Internship at Meredith College and recently completed her Master’s Degree in Nutrition. She is also an AFAA certi-

fied personal trainer. Her blog can be found at: ashley-freshfromthefarm.wordpress.com

Amanda Kanaan is the Founder and President of WhiteCoat Designs – a medical marketing agency providing doc-tors with online marketing services as medical website design, search engine optimization (SEO), social media management, e-newslet-ters, blog writing, graphic design, referring physician outreach and

more. To contact Amanda or to learn more about WhiteCoat Designs, visit www.whitecoat-designs.com.

Denise Price Thomasretired in 2009 as a surgical prac-tice administrator where she was employed for 32 years. She is certi-fied in healthcare management through Pfeiffer College. Speaking invitations have taken her from NC to SC, Georgia, Florida, Chicago, Alaska and more. Website: www.denisepricethomas.com

Creative Director

Thomas Hibbard

6 | MAY 2013

designer's thoughts

Medical technologies and research are intended to improve the quality of health care delivered through earlier diagnosis, less invasive treatment options, reductions in hospital stays, reha-bilitation times and cost reductions. This includes the pharma-ceuticals, devices, procedures and organizational systems used in health care today.

This month, in the “Research and Technology” section of this month’s magazine, researchers at the National Institute of Health have discovered a new genetic link between the rapid growth of healthy fetuses and the uncontrolled cell division in cancer. Dr. Baron of the NICHD states “We’ve long known that some of the genes that promote rapid growth in prena-tal and early postnatal life become reactivated in cancer cells. Now we’ve identified a molecular switch that appears to turn on some of these genes, taking us a step forward in understanding normal body growth and the abnormal growth in some types of cancer.”

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

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

If there are topics or insights on advances in medical technol-ogy you would like to share with us for future issues, please contact us at [email protected].

From the Drawing Board

8 | MAY 2013

news briefs

It is the only glove approved with demonstrated ef-fective kill rates up to 99.999% against eight common gram-negative and gram-positive bacterial species, including drug resistant strains, as rapidly as one minute after exposure. Transmission of pathogens to patients occurs most frequently from contaminated hands or gloves of healthcare workers.3 The GAMMEX® Nitrile Antibacterial exterior glove coating reduces the risk of cross-contam-

ination between surfaces and patients, break-ing the chain of transmission from the environment to the patient through the hands of the healthcare worker, further re-ducing the poten-tial of Healthcare-

Associated Infection (HAI) and related costs. According to the World Health Organization, of every 100 hospitalized patients worldwide, seven in developed countries and ten in developing countries will acquire at least one HAI. These infections can lead to significant mortality and financial losses for health systems. “Ansell is dedicated to providing innovative and clini-cally relevant solutions to help reduce infections and the associated costs,” said Anthony B. Lopez, President and General Manager, Ansell Medical Solutions. “We are proud to introduce another first into the healthcare environment that will help protect patients and health-care workers globally.” Made of 100% nitrile material, GAMMEX® Nitrile An-tibacterial medical gloves are not manufactured with natural rubber latex, therefore protecting patients and healthcare workers against Type I (latex) allergies. Addi-tionally, the gloves are packaged in an innovative new vacuum-packed pouch to ensure a cleaner glove than cardboard dispensers. The GAMMEX® Nitrile Antibac-terial will first launch in Canada, with global roll-out to follow.

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

Ansell Launches First ofits Kind Medical Glove toProtect Against Infection

A new report from IMARC Group expects the biopharmaceutical market in the US to grow at a CAGR of around 5% during 2012-2017. This is significantly lower than the average 8-9% growth rate observed in this market in the last five years. According to an analyst at IMARC Group,“the rise of biosimilars in the US is expected to have a major impact on market growth. Recombinant proteins, which currently account for around 60% of the total US biopharmaceutical sales, are expected to be the worst hit during the forecast period. During 2012-2017, we expect nine biological brands in this segment to face biosimilar competition. Recombinant proteins are expected to witness a CAGR growth of less than 3% during this period. The growth of monoclonal antibodies, on the other hand, is expected to be significantly faster than recombinant proteins during the forecast period. The key factors driving the monoclonal antibodies will be a rich pipeline and approval of additional indications for currently marketed drugs. Although some monoclonal antibodies such as Rituxan and Humira may face biosimilar competition, we expect significantly lower biosimilar threat for monoclonal antibodies during the forecast period compared to recombinant proteins. IMARC’s new report “Global Biopharmaceutical Market Report & Forecast (2012-2017)” gives a deep insight into the global biopharmaceutical market. The research study serves as an analytical as well as a statistical tool to understand the strengths, weaknesses, opportunities, threats, market trends, geographical structure, therapeutic structure, competitive structure and the outlook of the global biopharmaceutical market till 2017. This report will serve as an excellent guide for investors, researchers, consultants, marketing strategists, and all those who are planning to foray into the global biopharmaceutical market in any form.

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

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

MEDMONTHLY.COM |9

Continuing its efforts to promote health and well-ness, the Aetna Foundation has awarded a $75,000 grant to FoodCorps. The funding aims to help transform eat-ing habits of children from low-income communities by promoting nutrition, teaching gardening and expanding healthful school food choices. To pursue its work, FoodCorps recruits emerging leaders for a year of full-time public service dedicated to improving child health in limited-resource communities. Working with partner organizations in K-12 public schools, these AmeriCorps service members use a three-ingredient recipe for healthy kids: teaching children what healthy food is and where it comes from, helping them grow fresh food in school gardens, and working with farmers, chefs and others to transform school meals. The Aetna Foundation grant will support team members leading FoodCorps’ activities in Arizona among children in the Navajo, White Mountain Apache, and Tohono O’odham reservation communities. Here, childhood overweight and obesity rates approach 50%, and children as young as six have been diagnosed with Type II diabetes. “We are pleased to support FoodCorps, and applaud their inspiring and productive approach to improving nutrition and reducing diet-related health problems in Arizona’s American Indian communities,” said Gillian Bar-clay, vice president of the Aetna Foundation and director of national grant making. “By combining nutrition educa-tion with hands-on activities, FoodCorps is giving children

AETNA FOUNDATION AWARDS $75,000 GRANT TO FOODCORPS

Funding supports nutrition program for American Indian children in Arizona

COMING SOON

IN MED MONTHLY

In the upcoming

June 2013 issue, Med

Monthly’s theme will

be Dermatology

the knowledge and tools to acquire or grow healthful foods and to effectively incorporate these foods into their diets at home and at school.” Beyond the quantitative measures of FoodCorps’ impact, the organization’s Arizona team reports children running to snatch up veggie snacks after they have spent a lesson learn-ing how vegetables are grown. Service members also cite the success of Family Feast nights and community workshops. At these events, parents talk about the quality of school food and ways to increase their communities’ access to fresh fruits and vegetables. “America’s obesity problem does not affect all parts of our country equally. In addition to geographic, demographic and environmental factors, ethnicity also plays a major role, such as in Arizona, where American Indian children suffer obesity at three times the rate of non-Hispanic Whites,” said Curt Ellis, executive director of FoodCorps. “We are grate-ful for the Aetna Foundation’s support in advancing better nutrition among children in American Indian communities in Arizona, and for its genuine interest in our organization and its mission.” FoodCorps currently operates in 61 sites across 12 states. Last year, its service members worked with more than 50,000 young people to improve their access to healthy food and increase their understanding of a healthy diet.

Source: hhttp://www.pressreleasepoint.com/aetna-founda-tion-awards-75000-grant-foodcorps

10 | MAY 2013

insight

T he costs of caring for people with dementia in the United States in 2010 were between $159 billion to $215 billion,

and those costs could rise dramati-cally with the increase in the numbers of older people in coming decades, according to estimates by researchers at RAND Corp. and the University of Michigan, Ann Arbor. The researchers found these costs of care comparable to, if not greater than, those for heart disease and cancer. The study, supported by the

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

behavior; the most common form is Alzheimer’s. The researchers first looked at care purchased in the health care market — formal costs for nursing homes, Medicare, and out-of-pocket expenses. The direct costs of dementia care purchased in the market were estimated to be $109 billion in 2010, exceeding direct health costs for heart disease ($102 billion) and cancer ($77 billion) that same year. Adding informal, unpaid care to the equation as much as doubled

NIH-supported Study Finds U.S. Dementia Care Costs

As High as $215Billion in 2010

Formal and UnpaidDementia Care Costs

Are Tallied

MEDMONTHLY.COM |11

the estimated total national costs for dementia care. The study estimated full costs per case of dementia in 2010 at $41,000 to $56,000. The lower number accounts for foregone wages among caregivers, while the higher figure valued hours of informal care as the equivalent of formal paid care. The range of national expenditures was tallied based on an estimated prevalence of dementia of 14.7 percent in the U.S. population older than 70. The researchers also project skyrocketing costs as the baby boom grows older; the Bureau of the Census estimates that the population age 65 and older will double to about 72 million over the next 20 years. Rates of dementia increase with age, and unless new ways are found to treat and effectively prevent it, national health expenditures for dementia could come close to doubling by 2040, as the aging population increases and assuming the rate of dementia remains the same. “These findings reveal that the enormous emotional and physical demands of caring for people with dementia are accompanied by the similarly imposing financial burdens of dementia care,” said Richard J. Hodes, M.D., director of the NIH’s National Institute on Aging (NIA), which funded the analysis. “The national costs further compel us to do all we can to find effective treatments for Alzheimer’s disease and related dementias as soon as possible.” The complex analysis is one of the most comprehensive yet to determine health care costs for dementia. It is based on a nationally representative sample from the Health and Retirement Study (HRS), a survey of people 51 years and older that is funded by the NIA with contributions from the Social Security Administration. Interest in national health expenditures for Alzheimer’s disease and related dementias has intensified with the January 2011 signing of the National Alzheimer’s Project Act (NAPA),which calls

for stepped up efforts to find new treatments and to improve care and services. Under NAPA, the Administration is leading development and implementation of a National Plan to Address Alzheimer’s Disease, under which new research studies, the new web portal www.alzheimers.gov, and new clinical training initiatives have moved forward. “We are just entering the second year of our national plan to fight Alzheimer’s disease,” said NIH Director Francis Collins, M.D. “It is a dedicated battle on many fronts, including capitalizing on research opportunities now before us. The new BRAIN initiative announced by the President just this week, for example, will use a new generation of tools to help us learn the secrets to many neurological disorders, including Alzheimer’s disease.” Identifying costs of dementia has been challenging. People with Alzheimer’s and other dementias are typically older and often have multiple medical conditions, such as stroke and depression, diseases commonly co-occurring with dementia. It is also difficult to capture the national costs of family-provided or other informal care. To overcome such barriers, the researchers focused on dementia rates and costs among volunteers aged 71 and older participating in a sub-study of the HRS, the Aging, Demographics, and Memory Study (ADAMS). For this analysis:

• Some856ADAMSvolunteersreceived a three– to four-hour in-home clinical assessment for dementia. An expert panel reviewed the test results to determine who was demented, cognitively impaired but not demented, and normal.

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

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

“Dementia costs currently rival those of cancer and heart disease. But, within 30 years, dementia may be in a league of its own,” said Richard M. Suzman, Ph. D., director of NIA’s Division of Social and Behavioral Research. “Unless effective interventions are found to treat Alzheimer’s, formal long-term dementia care costs will escalate for the baby boom generation, as they have fewer children available to provide unpaid, informal care.” The NIA leads the federal government effort in conducting and supporting research on aging and the health and well-being of older people. It provides information on age-related cognitive change and neurodegenerative disease specifically at its Alzheimer’s Disease Education and Referral (ADEAR) Center at http://www.nia.nih.gov/Alzheimers. For expanded information on Alzheimer’s care and resources, please visit the federal government’s portal website http://www.Alzheimers.gov. Information on health and on aging generally can be found at http://www.nia.nih.gov. To sign up for e-mail alerts about new findings or publications, please visit either NIA website.

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

Source: http://www.nih.gov/news/health/apr2013/nia-03.htm

12 | MAY 2013

insight

Private and Public Sector

Collaboration Is Critical for

Women’s Health Market

To Truly Flourish

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

‘‘

MEDMONTHLY.COM |13

Venture capital (VC) firms are increasingly turning their attention to women’s health, the primary area of focus being breast cancer research. However, there is a slow but steady widening in focus to embrace new pathologies; efforts are progressing world over to improve women’s health. New analysis from Frost & Sullivan’s (technicalinsights.frost.com) Emerging Technologies for Women’s Health Evaluation of Funding Prospects research finds that VC backed participants who were hit by the economic slowdown are recovering even as weak pipelines are slowly being strengthened. “Company valuations reduced over the past few years, as companies were affected by the recession,” noted Frost & Sullivan Technical Insights Industry Analyst Saju John Mathew. “Most investors are now focusing on later-stage, less risky opportunities in the private segment to protect values and generate investor profits.” VC investment is currently unevenly distributed. This has resulted in a handful of companies dabbling in technology innovation, while the majority struggle to get by. Start-ups in women’s health face many hurdles such as sustaining innovation due to the low amount of VC money being pumped in. The dearth of evidence-based clinical trials also tends to discourage VC investments. “Attracting VC funding will require start-ups to conduct extensive evidence-based clinical trials, the results of which can be used to substantiate their product or technology,” explained Mathew. “Moreover, the current economic scenario compels companies to work within a strict capital agenda to prove their technology potential.” For the women’s health sector to truly profit, multiple partners from both private and public sectors need to collaborate and coordinate on issues ranging from financing infrastructure to services. Initiatives to propagate women’s health require cooperation from all stakeholders concerned. New entrants can rely on government backed technology incubators to ease the path of their product/technology, from the research to the commercialization stage. All companies active in women’s health also need to understand evolving market dynamics in order to tailor their product/technology to fill gaps. Apart from core healthcare issues, they can focus on advancing women’s health through synergies with other fields, such as wireless patient monitoring apps. “Developing geographies are hotbeds for new VC investment,” concluded Mathew. “The healthcare sector is growing rapidly in BRIC nations and long-term capital of the kind provided by VCs will help in leveraging the plethora of investment opportunities in these geographies.” Emerging Technologies for Women’s Health Evaluation of Funding Prospects, a part of the Technical Insights

subscription, offers a brief snapshot of the market. It analyzes the impact of major trends, drivers and challenges. Furthermore, this research service tracks technology advancements and emerging trends evaluated following extensive interviews with market participants. Technical Insights is an international technology analysis business that produces a variety of technical news alerts, newsletters and research services. For more information on this research, please email Britni Myers, Corporate Communications, at [email protected], with your full name, company name, job title, telephone number, company email address, company website, city, state and country. Connect with Frost & Sullivan on social media, including Twitter, Facebook, SlideShare, and LinkedIn, for the latest news and updates.

About Frost & SullivanFrost & Sullivan (frost.com), the Growth Partnership Company, works in collaboration with clients to leverage visionary innovation that addresses the global challenges and related growth opportunities that will make or break today’s market participants.

Source: http://www.newswiretoday.com/news/127132/

[email protected]

704-747-8699

“Training Wheels in Heels”

Trainer for Health Care Professionals Focusing on Exceptional Customer Service, Effective Communication & Exemplary Compassion 34+ year career in health care and certified in health care management

Undercover PatientProviding Insight to Your

Practice Through the“Eyes of a Patient”

Conference Speaker Presenting also as “Gladys Friday”, Health Care Comedienne

Home Grown/Nationally Known

Denise Price Thomas

insight

14| MAY 2013

THE TOP FIVE THINGS YOU NEED TO KNOW ABOUT THE AFFORDABLECARE ACT

A HealthCare.gov Factsheet

The Affordable Care Act (ACA) was signed into law in March 2010. You may have concerns about how ACA will affect you and your practice – your reimbursement, your independence, and the welfare of your patients. You should know that ACA has the potential to bring considerable financial and clinical benefits for providers across the health care spectrum. The law enacts comprehensive reforms that will hold health insurance companies accountable, protect you and your patients, and guarantee choice and control.

Here are 5 specific ways you and your practice can benefit:

1. New consumer protections hold health insurers accountable. Insurers won’t be able to cancel coverage when a patient gets sick, and they won’t be able to set lifetime benefit limits that leave patients without coverage in times of catastrophic need. And if insurersdon’tspendatleast80%ofpremium dollars on patient care, they’ll have to provide a rebate to consumers. These protections will end the worst insurance company abuses and put patients

and providers ahead of company profits.

2. Expanded insurance coverage to more than 34 million people. In 2014, the law eliminates exclusions based on pre-existing conditions, and makes affordable health coverage accessible to more than 34 million uninsured Americans. This will reduce the burden of uncompensated care on physicians and hospitals and bring more patients into your practice. Right now, the law already makes it possible for young adults to remain on their parents’ coverage

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

3. Reduced administrative burdens and more time seeing patients. The law invests in programs designed

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

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

5. New protections strengthen patient coverage, your practice, and the entire health care system. The Affordable Care Act preserves guaranteed benefits under Medicare; makes recommended preventive services available for free; and provides patients with an annual wellness visit. The law also requires insurers to cover an expanded list of preventive services for free, including a number of services for children. Patients will be able to afford both routine preventive care and necessary treatments. You got into the health care profession to serve patients — ACA protections are designed to help you keep serving them.

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

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practice tips

16 | MAY 2013

“May I Please See Your List of Ingredients?”Desired Qualities When Staffing Positions

At Your Practice By Denise Price Thomas

[email protected]

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

There have been times I have given my business card to a waitress or a salesperson that displayed these qualities and had a great attitude along with a smile. In my opinion, you can hire someone with a terrific attitude and then teach them the necessary skills. It is challenging, and sometimes impossible, to teach a “positive attitude” to someone who does not have it in their core list of ingredients. I’ll never forget the day when a young lady walked into my office for an interview, shook my hand and took the seat across from my desk. She proceeded to open a ‘Happy Meal’ and said, “I hope you don’t mind my eating lunch while we talk, I’m on my lunch hour.” Of course I said, “No mam, I don’t mind at all.” Had she offered me some fries…..or the toy, she may have had a better chance at the job. During my 34 + year career in health care, in addition to being an Undercover Patient, I have met numerous “characters” in medical practices to which I have given nicknames. I’ll share a few here starting with the less desirable characters:

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

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

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

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

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

A facility can have the most competent and compassionate physicians yet with sub-standard employees, their expertise and professionalism will be lost. Your staff sets the stage each and every day for a live audience. It has been my experience that when you hire someone with a positive attitude, they are eager to learn the necessary skills for the job. Always make sure that every health care professional gets the proper training, knows what is expected of them and what they will be held accountable to accomplish. While serving on the steering committee for a medical malpractice insurance company, I learned that statistics have proven patients are far less likely to sue when they have a good rapport with the staff and / or their physician. Physicians and other health care professionals have the ability to create a most positive environment for their patients at no cost. The main ingredient should begin with compassion followed by a willingness to serve, making a positive difference each and every day. Shine On!

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

• Compassion• Positive Attitude• Knowledge• Credibility• Honesty• Integrity• Dependability• Accountability

One-Third of DoctorsMiss ElectronicTest Results

By Kelly Fitzgerald Medical News Today

18 | MAY 2013

practice tips

The new finding came from a study conducted by a group of researchers at the Michael E. DeBakey Veterans Affairs Medical Center in Houston and was published in the Journal of the American Medical Association. The investigators issued a survey of 2,590 primary care practitioners and found that a third of them admitted to missing alerts about test results from an electronic health record notification system - made specifically to inform them when a patient has unusual test results. The doctors reported getting approximately 63 alerts each day, which could be creating notification overload, resulting in a significant number of results that require doctors’ attention to go unnoticed. Nearly87percentofthedoctorssaid the number of alerts they received was too high. While 69.6 percent said they were receiving more alerts than they could effectively keep track of.

Electronic Health Records - Easier or Harder?

An estimated 55.6 percent commented that the method in which electronic health records notify practitioners makes it possible for them to accidentally skip over important test results. This is not how the electronic

health records system is supposed to be. The aim of iPads replacing folders and health care systems using text messaging to track diseases, should make medical care easier to monitor and more accessible for all parties involved. The doctors believe that the current system makes them susceptible to information overload. Even other aspects of electronic medical records have yielded disappointing results for healthcare professionals and authorities. A report just last month revealed that the systems are not well integrated or user-friendly. Study author Dr. Hardeep Singh of the DeBakey VA Medical Center said:“If you’re getting 100 emails a day, you are bound to miss a few. I study this area and I still sometimes miss emails. We have good intentions, but sometimes getting too many can be a problem.”

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

New Policies Needed For Electronic Test Results

Singh and his colleagues have previously documented eight aspects

of the electronic health care system that could be improved. For example: creating simpler ways for doctors to access the information and correctly training personnel to use the systems effectively could help. Singh said, “We all want the alerts to look like our smartphones and apple products, but the interface is not always clear and you can miss results quite easily.” There needs to be an established system to determine who is responsible for taking action when tests results appear that require immediate attention. This would avoid missing crucial opportunities for helping patients - similar to when an email is sent to several recipients and they all assume someone else will respond. Putting into place more detailed and stricter policies regarding how these responses should occur can eliminate confusion. Singh also points out that patients have a responsibility to follow-up and be active in their care. He concludes, “We need to dispel the myth of ‘no news is good news from the doctor. In fact, if patients don’t hear back about the results, they should actively seek them out.”

Source: http://www.medicalnewstoday.com/articles/257227.php

Electronic medical test results have turned out to be much like email: doctors receive a large

volume of them, therefore some get lost by the wayside.

MEDMONTHLY.COM |19

practice tips

20 | MAY 2013

MEDICALPRACTICESTAFFING ADVICE

By Thomas HibbardCreative Director, Med Monthly

MEDMONTHLY.COM |21

continued on page 22

Hiring MedicalOffice Staff Hiring medical office staff involves filling positions that aren’t part of a typical business environment and determining which positions are mandatory and which ones are optional. Let’s take a look at some of the most important positions in a medical practice. In a typical small business, hiring requirements are based on the expertise and work capacity that is required to maintain daily operations and achieve strategic business goals. A medical practice works much the same way, but instead of hiring staff to answer the phones or sell your products, you are hiring dedicated specialists who are responsible for providing the best possible care for your patients. The number and type of staff you hire will depend on your patient load and area of specialization. However, most medical practices demand a select few positions to maintain quality care and smooth office procedures.

Essential Medical Office Staff PositionsOffice manager: A good office manager increases efficiency and boosts your practice’s productivity. Office managers are responsible for making sure the practice runs smoothly, and everything from service contracts to marketing falls under their job description. The learning curve is steep, so always look for candidates who have prior office management experience.Insurance biller: In smaller medical practices, the office manager usually handles in-surance billing directly, but in larger practices, insurance billing could be a separate position. Since you’re putting your practice’s revenue in their hands, it’s critical to make sure your insur-ance biller is familiar with the claims process for insurers in your geographic area.

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

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

Optional Medical Office Staff PositionsThese positions are not nearly as common as the medical staffing positions, but can be a valuable asset to any medical practice under the right circumstances.Records clerk: These individuals maintain patient records or manage a recordkeeping database. EHR experience is a major plus for this position.Scheduler: High-volume practices often employ people who handle scheduling and other office tasks.Transcriptionist: If you are averse to the idea of using a transcription service, you will need to hire either a part-time or full-time transcriptionist.

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

position. If more than one person will be interviewing each candidate, you’ll have to decide whether to do sequential or group interviews. Although sequential interviews may seem easier, interviewers often obtain more information by interviewing candidates together and observing their responses to all other questions and interpersonal interactions with other interviewers. Either way, the questions to be asked by each interviewer should be coordinated ahead of time. Choosing the best candidate for your practice depends a lot on selecting the right interview questions. There are two types of interview questions, traditional and behavioral.

Traditional Interview Questions Traditional interview questions allow the interviewee to share their employment history, abilities, salary history, strengthens and weaknesses, and general questions about them-selves. The flaw in asking only tradi-tional interview questions is instead of evaluating applicants on the skills and abilities they need to succeed in your practice, it focuses too much on responses memorized by candidates. As a result, you get canned answers; re-sponses that have been rehearsed over and over again, not getting a true feel for what the applicant is capable of.Some samples of traditional interview questions are:

General knowledge: “Describe why you’re qualified for this position and explain why you’d fit within our practice doing this job.” Work ethic: “How do you feel about working extra hours or being given extra responsibilities as needed?” Computer competence: “We have a program for [registration, billing, lab result retrieval, etc.] called ____. Tell me about your experience with that program or programs like it.”

continued from page 21

22 | MAY 2013

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

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

Conflict management: “Describe a conflict you’ve had with other staff members and how you resolved it.” Respect for patient privacy: “A patient calls in and notes that his wife is there at the office seeing the doctor, and he asks how she is doing. How would you respond?” Motivation: “Tell me about a time when you saw room for improvement in some area of your work environ-ment or a process that could be more efficient. What did you do to change the status quo?” Priority management: “Describe an occasion when you had two doctors or bosses ask you to do conflicting tasks. How did you handle this dilemma?” Problem-solving strategies: “Tell me about a time when your job required you to perform a task that you didn’t know how to do. How did you respond?”

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

After the Interview You should write down specific answers and general impressions of each candidate immediately after the interview. It is amazing how quickly your memories of three or four candidates can run together. The last question in any interview should always be “May I contact your previous employers for a reference?” If the candidate says they don’t want a current employer contacted, get their permission to contact two or three previous employers or co-workers, and ask the references about the issues that are difficult to assess in an interview. These may include patient service, work habits, enthusiasm or any potential weaknesses that might hinder that person’s performance. If the references say they cannot share any information, this might be a red flag. A good follow-up question to this response is, “If you had a position open, would you hire this person?” Although this task may be time-consuming, it will give you a more complete picture of the candidate and discussions with references are often more beneficial than interviews. The interview process is a very important navigating tool on your quest to find the perfect staff member. Taking time to define the attributes and skills desired, prepare questions and check references is an excellent long-term investment in the contentment and quality of your entire medical practice.

Consider asking the following questions during a behavioral interview to ensure your new hires fit with your practice’s culture:How was the relationship between you and your last boss?This question will hopefully give you an idea of what the applicant expects from his or her supervisor. He or she may prefer to see their supervisor as a friend, rather than an authority figure. Or, if the interviewee had a negative relationship with his or her previous boss, try to get more information on their dynamic. An unhappy relationship could be the result of poor communication skills.

Sometimes an absence is unavoidable. However, what do you feel qualifies as an excessive number of absences in a year?Staff attendance is a part of a culture. Make sure their views on attendance and punctuality fit with that of your organization.

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

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

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

Sources: http://www.gaebler.com/Hiring-Medical-Office-Staff.htm http://www.mgma.com/blog/5-interview-questions-to-help-you-hire-for-cultural-fit/ http://www.aafp.org/fpm/2003/0600/p46.html

THINKING ABOUT SELLING YOUR PRACTICE?

Medical Practice Listings can help you sell your practice online!

919.848.4202 | medicalpracticelistings.com

The Standard Listing offers you the opportunity to gain national exposure by posting your listing on our website which is viewed daily by our network of professionals. This option also includes a brief practice consultation to explain the benefits of marketing through the Medical Practice Listings website.

In addtion to the benefits in the standard listing our Professional Listing affords you access to services provided by our expert legal and marketing team and a Bizscore Practice Valuation. This valuation compares your practice with other practices in your area, provides projections and determines what your practice is worth.

Now offering two types of listings to better serve all practice specialties and budgets.

Standard Listing Professional Listing

Visit us today at www.medicalpracticelistings.com to learn more.

international

24| MAY 2013

As a result of a higher percentage of body fat to muscle, Indians are more vulnerable to type-2 diabetes compared to other population groups. IMARC Group, one of the world’s leading research and advisory firms, finds that the total number of diabetes patients in India grew at CAGR of nearly 3% during 2004 - 2012. Estimates from their latest report entitled “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics”, suggests that the total number of diabetes patients in India is expected to reach 107 million by 2032. Findings from the report suggest that a major driver of the diabetes epidemic in India is the increasing levels of obesity. The Indian population that had faced under nutrition for a long time is now exposed to high fat diets and sedentary lifestyles. As a result of increasing disposable incomes and flourishing fast food chains, there were around 157 million overweight and 24 million obese people living in India in 2010. The report expects these levels to increase significantly by 2015. Apart from the increasing obesity levels, the report also found that Indians are genetically more vulnerable to diabetes compared to other population groups. According to an analyst at IMARC Group “As a result of a higher percentage of body fat to muscle, Indians are more vulnerable to type-2 diabetes compared to other population groups. This fat increases the sugar levels as it

gets deposited around the abdomen and interferes with insulin. As a result, Indians get diabetes at a much younger age compared to other population groups”. IMARC’s new report “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics” provides an analytical and statistical insight into the Indian diabetes market. The report provides both current and future trends in the prevalence, demographical breakup, diagnosis and treatment of diabetes in India. The report has segmented the Indian diabetes market into three segments - Oral Anti-diabetics, Insulin and Diabetes Diagnostics. For each of the aforementioned categories, the report provides historical and future market sales, performance of key classes and the performance of top players. The research study serves as an exceptional tool to understand the epidemiology, market trends, therapeutic structure, competitive structure and the outlook of the Indian diabetes market. This report can serve as an excellent guide for investors, researchers, consultants, marketing strategists and all those who are planning to foray into the Indian diabetes market in some form or the other.

Source: http://www.pressreleasepoint.com/increasing-obesity-levels-and-high-genetic-vulnerability-driving-prevalence-diabetes-india

INCREASING OBESITY

LEVELS AND HIGH

GENETIC VULNERABILITY

DRIVING THE

PREVALENCE

OF DIABETES

IN INDIA

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26 | MAY 2013

New Genetic Link Found

Between Normal Fetal Growth And

Cancer

By the National Institutes of Health (NIH)

research & technology

Two researchers at the National Institutes of Health discovered a new genetic link between the rapid growth of healthy fetuses and the uncontrolled cell division in cancer. The findings shed light on normal development and on the genetic underpinnings of common cancers. The work, conducted using mouse and human tissue, appears in today’s issue of the Proceedings of the National Academy of Sciences. The authors, Julian C. Lui, Ph.D., and Jeffrey Baron, M.D., work at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “We’ve long known that some of the genes that promote rapid growth in prenatal and early postnatal life become reactivated in cancer cells,” said Dr. Baron. “Now we’ve identified a molecular switch that appears to turn on some of these genes, taking us a step forward in understanding normal body growth and the abnormal growth in some types of cancer.” Before birth, a team of more than 200 growth-promoting genes is highly active, fueling the fetus’ explosive growth. After birth, these genes are gradually switched off, apparently to slow body growth as we age and approach adult size. In cancer cells, some of these genes can be switched back on. One of the major growth-promoting genes is called IGF2. This gene is critical for normal prenatal body growth and is reactivated in many types of cancer, showing remarkably high activity in bladder and prostate cancer and some childhood cancers. For years, scientists did not know what turned IGF2 on and off. Now, using a variety of techniques and tissue types, Drs. Lui and Baron found

evidence that a protein known as E2F3 activates the IGF2 gene in normal development and in cancer — in particular, in bladder and metastatic prostate cancers. More broadly, E2F3 appears to regulate not just IGF2, but also many other genes on the body-growth team. When E2F3 levels are high, these genes are active. When E2F3 takes a dive, so do these genes. The upshot is that E2F3 may function as one of the master switches that limit body growth. As such, it is of great interest as researchers seek to understand the complex genetic choreography responsible for normal growth and the diseases that result when it goes awry.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website at http://www.nichd.nih.gov/. About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

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

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NIH Study Identifies a Protein That Helps TriggerBoth Processes

26 | MARCH 2013


28 | MAY 2013

by Frank J. Rosello,CEO, Environmental

Intelligence LLC

EHR Technology –No Surprises With

Release of the Proposed Rule

For Stage 2 Meaningful Use

‘‘MEDMONTHLY.COM |29

After much anticipation among providers and health IT vendors throughout the U.S. health care landscape, The Centers for Medicare and Medicaid Services (CMS) finally released its proposed rule for Stage 2 Meaningful Use of electronic health records (EHR) on February 23, 2012. The release of the proposed rule for Stage 2 provides details of how CMS is raising the expectation for healthcare providers to achieve meaningful use of EHR technology in order to qualify for future incentive payments. As expected, Stage 2 Meaningful Use takes the criteria of Stage 1 to the next level by increasing the performance threshold of existing measures and motivating providers to utilize their record sharing capability to actually exchange information in a variety of transactions to drive incremental quality and care improvement. With greater focus on health information exchange, the measure is now a key component in the “robust transitions of care” core objective, and the measure to provide patients with an electronic copy of their data in Stage 1 is replaced by “electronic/online access” as a requirement in Stage 2. The proposed rule for Stage 2 also addresses a primary concern voiced

by many providers pertaining to the challenges of reporting out quality measures. Starting in 2014, the reporting of quality measures will be easier for providers now that clinical quality measures for Stage 2 will align with existing quality programs, such as those used for the Physician Quality Reporting System and CMS’ Shared Savings Program. The same ease of reporting also applies to hospitals now that clinical quality measures will align with the Hospital Inpatient Quality Reporting and the Joint Commission’s Hospital Quality Measures. CMS will keep the same core menu structure for required measures for Stage 2 Meaningful Use. Eligible providers will have to meet seventeen core objectives, three of the five menu options, and will report on twelve clinical quality measures. Hospitals will have to meet sixteen core measures, two of the four menu options, and will report on twenty-four clinical quality measures. CMS also outlines in the proposed rule how providers may electronically submit the quality measures and the agency is looking for public feedback on methods for submission. CMS is specifically interested in feedback regarding aggregate-level and group reporting options leveraging existing quality reporting systems. Some of the core measures providers will have to meet during the reporting period for Stage 2 Meaningful Use include:

l Providers will have to supply a summary of care record for more than sixty-five percent of the patients the provider transitions or refers a patient to another care setting or provider.

l Providers will have to perform medication reconciliation for more than sixty-five percent of transitions of care in which patient moves into care of another provider or admitted to hospital or emergency room.

l More than fifty percent of patients seen during the Stage 2 reporting

period are provided online access to their information within four business days of their visit subject to provider’s discretion to withhold certain information.

l Providers will have to use computerized physician order entry (CPOE) for more than sixty percent of medication, lab and radiology orders created.

l Providers will have to implement five clinical decision support interventions for five or more clinical quality measures at relevant point in care and use functionality for drug-drug and drug-allergy interaction checks.

l More than fifty-five percent of clinical lab test results whose results are positive/negative or of numerical format are incorporated into the EHR of patients as structured data.

l Medical organizations will have to conduct or review security risk analysis, address encryption or security of data at rest and execute security updates as necessary and correct identified security deficiencies.

The proposed rule confirms that CMS will delay the start of Stage 2 until 2014 instead of the originally planned start of 2013. CMS decided to delay the start of the reporting period by one year because the original 2013 time frame does not give vendors enough time to design, develop, and test new functionality so that providers can successfully deploy and attest to meeting Stage 2 requirements over the one year reporting period. The one hundred thirty-two page proposed rule for Stage 2 Meaningful Use was officially posted in the Federal Register on March 7, 2012. This action officially launched the countdown for public comments for sixty days and CMS encouraged the public to comment on the proposed rule online prior to the May 6, 2012 deadline. CMS released the final rule for Stage 2 Meaningful Use in the summer of 2012.

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


30 | MAY 2013

Smart Mobile Technology forYour Practice and Your Patients

By Thomas HibbardCreative Director, Med Monthly

MEDMONTHLY.COM |31

W hether they have chronic ailments like diabetes or heart disease, or just want to watch their weight, Americans are increasingly tracking their health using

smartphone applications and other devices that collect personal data automatically, according to health industry researchers. 21 percent of people who track their health use some form of technology. More than 500 companies were making or developing self-management tools by last fall, up 35 percent from January 2012. Nearly 13,000 health and fitness apps are now available for little or no expense.

Technology for Doctors Many physicians are already connected by mobile smartphones and tablets with accessibility to lab results, prescription information, digital medical textbooks, internet access to the Center for Disease Control, text messaging to other doctors and patients, and real time communication via Skype, instant messaging, GoToMeeting, and other wireless services. For some practices, FaceTime—a video calling software feature for iPhone 4 and the fourth generation iPod Touch—is replacing face-to-face office visits for minor complaints like cold and flu, headaches, and muscle strains. Follow up visits and lab test result reviews are often easier for the patient and doctor when done long distance. A lot of patient support used to happen in a doctor’s waiting room. Patients shared views and exchanged information that helped them, and gave warnings for drugs or treatments that harmed them. They were also provided support and sympathy, something that doctors can be in short supply of in a fast paced medical practice. The waiting room chat is being replaced by websites like CureTogether, http://www.crunchbase.com/company/curetogether, and PatientsLikeMe, http://www.patientslikeme.com/. These sites provide information on what’s working for patients. They provide ratings and real

information on different diseases and treatments with no marketing hype or ads. Doctors are beginning to adopt the iPad into their workflow at their practices and the hospital, with many apps enabling doctors to be more efficient. WebMD is a great reference app for doctors and it’s free at https://itunes.apple.com/US/app/id373185673?mt=8&ign-mpt=uo%3D4.Theappincludesa symptom checker to help remind you what may be wrong with a certain patient. The app also includes first aid essentials, conditions, drugs and treatments, a pill identification tool, and local health listings. Microdex, https://itunes.apple.com/US/app/id390211464?mt=8&ign-mpt=uo%3D4,isafreeappthatprovides drug information for the iPad. The app includes over 4,500 search terms. These results include: generic names, trade names, black box warnings, dosage info, administration, monitoring, precautions, adverse effects, and much more. If you are a doctor prescribing drugs day in and day out, then this is a great app.

Many physicians need to create custom forms for their patients. Tap Forms HD is an app that allows you to do just that. The app includes 17 different field types including: link to form, file attachment, email address, GPS info, contact, text, date, time, date/time, number, rating, URL, check mark, note, audio recording, photo and phone number. The app can also search through your forms allowing you to pull up past information quickly. The app is password protected ensuring your patients’ data is safe. The app also includes 25 different built-in forms. The app integrates with Dropbox to allow easy file transfers. The app can also export your information as a CSV file to be opened up in Excel or Numbers. If you need custom forms,

Micromedex screenshots

continued on page 32PatientsLikeMe Homepage

32 | MAY 2013

then Tap Forms HD is a great app for that. It’s available at https://itunes.apple.com/US/app/id410500116?mt=8&ign-mpt=uo%3D4for$8.99

Technology for Patients The explosion of mobile devices means that more patients have an opportunity to start tracking health data in an organized way and many of the people surveyed said the experience had changed their overall approach to health. A very effective mobile app for patients to record health information is My Medical,https://itunes.apple.com/us/app/my-medical/id347860026?mt=8.Itis a comprehensive record-keeping app for personal medical information and is the perfect replacement for unreliable paper records or various electronic systems that hold bits and pieces of medical history. With My Medical, any and all information that is important to the patient is kept together in one place. And it’s secure because the information is kept on their device, not on a remote server.

Often the worst part of a visit to the doctor isn’t the awkward hospital gown, needle sticks or embarrassing physical exams — it’s the drawn-out wait, camped out in the reception room in the company of sick patients and old magazines. This realization led to creation of Appointment Status, https://www.appointmentstatus.com/, a web site devoted to improving appointment efficiency and providing patients with information

to avoid long waits. The site is designed to make it easier for patients to schedule appointments — and to find out how far behind the doctor may be before settling into a waiting room chair. These are several innovations meant to help physicians and patients. While many digital developments — electronic medical records and mobile medical encyclopedias — have streamlined doctors’ work, new tools for patients are starting to hit cell phones and the Internet at a rapid rate with no slowdown in sight.

Sources:http://www.nytimes.com/2013/01/28/health/electronic-health-tracking-increasingly-common-researchers-say.html?partner=rss&emc=rss&_r=4&

http://renegadehealth.com/blog/2012/08/31/doctor-visit-theres-an-app-for-that

http://appadvice.com/applists/show/apps-for-doctors-with-ipads

http://well.blogs.nytimes.com/2012/10/15/the-doctor-can-see-you-now-really-right-now/

https://itunes.apple.com/us/app/my-medical/id347860026?mt=8


My Medical screenshots

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34 |MAY 2013

legal

Affordable Care Act Extended Free Preventive Care

to 71 Million Americans WithPrivate Health Insurance

Health Care Law’s Third Anniversary Sees Health Costs Slowing Down, More ValueFor Consumers

Health and Human Services (HHS) Secretary Kathleen Sebelius announced that about 71 million Americans in private health insurance plans received coverage for at least one free preventive health care service, such as a mammogram or flu shot, in 2011 and 2012 because of the Affordable Care Act.

U.S. Department ofHealth & Human Services

MEDMONTHLY.COM |35

Additionally, an estimated 34 mil-lion Americans in traditional Medi-care and Medicare Advantage plans have received at least one preventive service, such as an annual wellness visit at no out of pocket cost because of the health care law. Taken together, this means about 105 million Americans with private health plans and Medicare beneficia-ries have been helped by the Afford-able Care Act’s prevention coverage improvements. Preventive services, consumer protections, and other reforms under the Affordable Care Act are giving millions of Americans of all ages more value for their health care dollars and contributing to the slowest growth in health care costs in 50 years. “Preventing illnesses before they become serious and more costly to treat helps Americans of all ages stay healthier,” Secretary Sebelius said. “No longer do Americans have to choose between paying for preventive care and groceries.”

Secretary Sebelius released the preventive services report as HHS celebrates the Affordable Care Act’s third anniversary this week. The law is keeping down costs and providing more value for consumers and taxpay-ers through new consumer protec-tions, holding insurance companies accountable, building a smarter health care system, and providing seniors with vital savings on their prescription drugs. The Affordable Care Act is giving Americans better value for their health insurance plans by:• Eliminatinglifetimedollarcaps

on essential health benefits, and phasing out annual caps. About 105 million Americans no longer have to fear their benefits will disappear when they need them most because their insurer put a lifetime cap on the amount it would pay.

• Prohibitinghealthinsurancecom-panies from denying coverage to children based on a pre-existing condition, such as asthma or cancer.

• Andin2014,itwillbeillegalforhealth insurance companies to deny coverage to any American or to charge more because of a pre-existing condition. No longer will 129 million Americans with health conditions have to fear seeing their premiums increased or getting locked out of the insurance market.

• Thelawwillalsomakeitillegalfora health insurer to charge women more simply because they are wom-en. “That means,” Secretary Sebelius said, “being a woman will no longer be a pre-existing condition.”

The full report on expanded preven-tive care for Americans with private health insurance is available at http://aspe.hhs.gov/health/reports/2013/Pre-ventiveServices/ib_prevention.cfm.

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

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

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

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

36| MAY 2013

legal

Providing customized,

simple

NUTRITION SOLUTIONS

to ENHANCE

HEALTH and

OPTIMIZE SPORTS

PERFORMANCE

Blue Cross Blue Shield of North Carolina and

Cigna insurance provider.

Tracy Owens, MPH, RD, CSSD, LDN Ashley Acornley, MS, RD, LDN

6200 Falls of Neuse Road, Suite 200 Raleigh, NC 27609

919-876-9779

R umors are circulating that the Centers for Medicare & Medicaid Services (CMS) and the Office of

Inspector General for the Depart-ment of Health and Human Ser-vices (OIG) will continue to allow the donation of electronic health records (EHR) items and services to physicians past the current deadline of December 31, 2013. CMS recently submitted to the Office of Manage-ment and Budget (OMB) a proposed rule entitled “Physicians’ Referrals to Health Care Entities with which They have Financial Relationships; Amending the Exception for Certain Electronic Health Records Arrange-ments (CMS-1454-P),” and the OIG has submitted a similarly titled pro-posal. Speculation is circulating that these proposals seek to extend the exception to the Stark Law and the safe harbor under the Anti-Kickback Statute that permit certain donors, including laboratories and hospitals, to donate EHR items and services to physicians if certain requirements are met. Theresa Carnegie and I previously outlined the history and requirements of the exception and safe harbor in an article published in the G-2 Compliance Report. The EHR donation exception and safe harbor have generated considerable controversy since their publication in 2006. While everyone in the health care industry would agree that widespread adoption of EHR technology is an important goal, there is disagreement regarding whether the exception and safe harbor are a good idea. For example, the College of American Pathologists has previously urged OIG to reconsider its inclusion of laboratories as protected donors, and the American Clinical Laboratory Association has questioned whether

the safe harbor and exception are needed now that physicians who engage in “meaningful use” of EHR technology can qualify to receive incentive payments from the federal government. In contrast, the Federation of American Hospitals supports extension of the safe harbor and exception through 2016. Representative Jim McDermott (D-Wash.) contributed to the debate this week by writing a letter asking the OIG’s Chief Counsel to renew the safe harbor for EHR donations. He noted that “Congress is particularly interested in developing and continuing initiatives that are designed to reduce health care costs” and that care coordination through use of EHR technology can decrease such costs. This letter is interesting given that in November 2012 the Attorney General of Washington issued an opinion stating that a clinical laboratory violates Washington’s kickback prohibition if it shares the cost of EHR software with a Washington physician and subsequently receives orders for testing from the physician. The opinion made clear that the federal safe harbor does not preempt similar state laws. Washington is not the only state to place limitations on EHR donations even though they are permitted under federal law. Agencies in states such as Missouri, New Jersey, New York, Pennsylvania, Tennessee, and West Virginia also have spoken on this issue. If CMS and OIG decide to extend federal protection for EHR donations, other states may follow suit.

Source: http://www.natlawreview.com/article/will-federal-protection-electronic-health-records-ehr-donations-be-extended-beyond-d

legal

38 | MAY 2013

IBM announced that the State of South Carolina has selected IBM software, part of IBM’s Smarter Cities portfolio, to help modernize its statewide Medicaid eligibility system, transforming the delivery of vital health and social programs to its citizens. The solution is expected to improve program efficiencies while meeting big data challenges and opportunities as the State migrates from a largely paper-based approach to a more open, automated platform to manage eligibility requirements. The South Carolina Medicaid program serves nearly one million citizens. In replacing its current eligibility system, the South Carolina Department of Health and Human Services (SCDHHS) will streamline and improve access to citizens by providing 24/7 online self-service, and enhancing support for a mobile and community-based workforce. The goal is to make it easier to administer and manage eligibility for Medicaid and other social service programs. States, like South Carolina, are making their health and social service program systems smarter to get vital services to those who need them. South Carolina will also integrate its Medicaid eligibility system with

the federally run health insurance marketplace. “Our updated Medicaid eligibility system will make it easier for all South Carolinians to access the State’s programs,” said John Supra, deputy director & chief information officer for SCDHHS. “Our current manual paper-driven approach limits flexibility in our processes and impacts speed and consistency. We expect the new system to provide us a platform to improve our eligibility performance and be able to more quickly and cost-effectively respond to future changes to the Medicaid programs.” South Carolina’s decision to implement IBM software was based on the State’s strategy to utilize commercial off-the-shelf software and the solution’s out-of-the-box capabilities to meet the Medicaid program’s eligibility needs. Extending a unique partnership between SCDHHS and Clemson University, Clemson is supporting the State’s implementation and will host the solution. SCDHHS, Clemson and IBM are collaborating to develop a flexible environment in a way that makes the best use of existing State investments. “States like South Carolina are leading the way in transforming how

they interact with their citizens,” said Craig Hayman, general manager, Industry Solutions, at IBM. “IBM supports South Carolina’s goal of delivering citizen-centric services, including those social programs that involve healthcare and related services where timely access to the right programs and benefits is the driving factor. In IBM, South Carolina has chosen a solution built and developed by healthcare and social services industry experts — a solution that can manage all the Big Data challenges and evolve as eligibility requirements change without service delivery interruptions to those citizens who need it most.” The IBM Cúram solution, the major component to South Carolina’s new eligibility system, is part of IBM’s Smarter Cities portfolio. These capabilities make access to government services easier for the citizen and, more importantly, more effective in achieving desired social outcomes. Several other states, including Maryland and Minnesota, also have selected IBM for similar initiatives.

Source: http://www.pressreleasepoint.com/south-carolina-selects-ibm-smarter-cities-solution-help-modernize-and-improve-delivery-vital-social

South Carolina Selects IBM Smarter

Cities Solution to Help Modernize and Improve Delivery of

Vital Social Programs to Citizens

40 | MAY 2013

features

By Philip DriverCEO, Physician Solutions, Inc.

WHO IS THE MOST IMPORTANT PERSON INA PRACTICE?

MEDMONTHLY.COM |41

Every practice is made up of different personalities with diverse skills and responsibilities. Of course the doctor sets the tone for care and procedures and is ultimately responsible for the income of the practice. Arguments can be made that the physician is surely the most important person in any practice. The practice billing person is certainly worthy of consideration as well. If the CPT and ICD-10 codes and modifiers don’t match the medical procedure, the claims are not processed and you must resubmit your corrected medical bills to various insurance companies or clearing houses. Surely your billing professional deserves kudos. I have owned several practices and managed many others in my working career. During my time in practices as an owner or manager, I have had exceptional physicians, PA’s and nurse practitioners. I have enjoyed the professionalism of nurses, X-Ray techs, and triage staff. There is no denying that it takes a village to make the successful practice. At the end of the day, the one person that every patient talks to coming and going is your front desk staff. The front desk staff checks patients in, greets every patient and has a kind word and smile to the sick and well patients. The practice front desk professionals have a tremendous influence on the type patients your practice attracts, the referrals you receive from existing patients and the total organization of your practice. Your front desk person could very well be your best marketing asset. If you are fortunate to hire a front desk person that is attractive, always dresses sharply, has a friendly personality and big smile, you will reap the benefits. Now if you can add marketing skills, keep your practice web site current and respond to your practice emails, you may have identified the most important person in your practice. When I was in the business of owning practices, I would spend a lot of time interviewing experienced front desk professionals that could multi-task and be cross-trained. Some of the duties that your front desk should can handle are: checking patients in and out, practice web site management, assisting in the triage of patients, phone duties, answering patient emails, keeping the lobby organized and clean, acting as your administrative assistant by sending out letters and correspondence to patients and vendors while acting as the gate-keeper for the doctors or providers. When a prospective client sees your website and decides to call your practice, the front desk staff holds the key to whether or not they make an appointment to see the doctor. Therefore it’s essential that your front desk staff is

friendly, confident, professional and knowledgeable. Placing a caller on hold may, on occasion, be unavoidable. But being unwelcoming, not listening carefully or failing to ask for appointments are all avoidable mistakes. The front desk staff plays a critical role in your practice’s success. They do more than just answer the phone and greet clients; they ‘build relationships’ and represent your practice to both current and prospective patient-clients.Be sure your staff has the resources it needs to answer questions and to provide clear, concise pricing and policy information. It’s important to educate all staff members so that they can describe the equipment, facilities and medical care you provide that set your practice apart from others in your community. While your medical village must have several well organized pros, don’t skimp when it comes to your front desk personal, the first and last face your patients see in your practice.

Your Front Desk Person Could Very Well Be YOUR BEST MARKETING ASSET

CALLING ALL WRITERS

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

To become a contributing writerin Med Monthly magazine,contact MedMedia9 [email protected]

Med MonthlyContact us:

[email protected]

medmonthly.com

Editorial Calendar: June 2013 - Dermatology l July 2013 - Procedures to Enhance Your Practice

42 | MAY 2013

features

The Power of Internal Marketing: 3 Key Components to Growing Your Practice from WithinBy Amanda KanaanWhiteCoat Designs

MEDMONTHLY.COM |43

A lthough the word “marketing” may evoke visions of print ads and television spots, when it comes to growing your practice

don’t forget your most powerful resource of all – current patients (i.e. walking and talking billboards). The goal of external marketing (such as advertising) is to get patients to your door, however it’s inter-nal marketing that not only pulls them through the door but keeps them knocking time and again. Internal marketing is a strategy that focuses on maximizing patient retention through consistent communication and of course, good patient care. Tools such as social media and online review sites make it easier than ever for practices to reap the rewards of investing in internal marketing in order to earn the illustrious patient-to-patient referral. Most business owners, whether they run a restaurant or a clothing boutique, will agree that it’s more expensive to acquire new customers than it is to retain current ones. The same goes for patients. Make no mistake, your practice is a business and that means treating your patients as valuable customers. Here are three key components of implementing a successful internal marketing strategy for your practice:

1. Stay Top of Mind: You’ve probably heard the saying “out of sight, out of mind”. Staying top of mind with patients is the best way to keep them (1) thinking about you so there’s a greater chance they’ll come in for more than the once a year visit, and/or (2) talking about you so they’re more likely to make a referral.

For good or for bad, we’ve entered a new age in medicine where patients will Google just about anything. In fact, 59 percent of U.S. adults searched online for health information in the past year according to a 2012 study by Pew Research Center. Because patients are so digitally savvy (also known as e-patients), this presents a unique opportunity for doctors to now communicate with patients in a way that’s convenient, cost-effective, and timely.

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

E-newsletters can be used in the same way. Now with either free or extremely inexpensive e-newsletter programs like Mail Chimp, Constant Contact and iContact, it makes it easy for practices to send out monthly or quarterly communications to patients. Just be sure to get permission to use patient emails first. For those practices with a patient portal, you can also use the messaging feature to blast out announcements.

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

2. Give Patients a Reason to Come Back: Communication tools like social media


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

44| MAY 2013

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

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

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

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

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

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


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

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

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

You already have a captive audience in your current patients so take the opportunity to better communicate your services. Don’t make the mistake of sharing your message only once though. Sometimes doctors think if they told their patients once then they already know. If that were the case, then we wouldn’t see the same commercials play on TV over and over. Patients need to hear a message several times before they commit it to memory. Don’t be afraid to repeat yourself.

3. Make it a Positive Experience: Ok, so you probably knew this one was coming… the patient experience. It’s a waste of time and funds to implement an internal marketing

Adult & pediAtric integrAtive medicine prActice for sAle

This Adult and Pediatric Integrative Medicine practice, located in Cary, NC, incorporates the latest conventional and natural therapies for the treatment and prevention of health problems not requiring surgical intervention. It currently provides the following therapeutic modalities:

There is a Compounding Pharmacy located in the same suites with a consulting pharmacist working with this Integrative practice. Average Patients per Day: 12-20

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

• Conventional Medicine• Natural and Holistic

Medicine• Natural Hormone

Replacement Therapy• Functional Medicine• Nutritional Therapy

• Mind-Body Medicine• Detoxification• Supplements• Optimal Weigh Program• Preventive Care

Wellness Program• Diagnostic Testing

Call 919-848-4202 or email [email protected]

This is an outstanding opportunity to acquire one of the most organized and profitable primary care practices in the area. Grossing a million and a half yearly, the principal physician enjoys ordinary practice income of over $300,000 annually. Hickory is located in the foot-hills of North Carolina and is surrounded by picturesque mountains, lakes, upscale shopping malls and the school systems are excellent. If you are looking for an established practice that runs like a well oiled machine, request more information.

The free standing building that houses this practice is available to purchase or rent with an option. There are 4 exam rooms with a well appointed procedure room. The owning physician works 4 to 5 days per week and there is a full time physician assistant staffed as well.

For the well qualified purchasing physician, the owner may consider some owner-financing. Call us today.

List price: $425,000 | Year Established: 2007 | Gross Yearly Income: $1,500,000

PRIMARY CARE PRACTICE - Hickory, North Carolina

MedicalPracticeListings.com | [email protected] | 919-848-4202

Medical Practice ListingsSelling and buying made easy

features

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

By Lisa P. Shock, MHS, PA-CPresident/CEO Utilization Solutions in Healthcare, Inc.

46 | MAY 2013

P hysician Assistants (PAs) and Nurse Practitioners (NPs) are skilled medical professionals who play an

integral part in health care delivery. Especially in primary care, PAs and NPs attract and manage a significant following of patients, especially in rural communities. Recruitment is challenging in more underserved areas, however, retention is often more important as practices and patients invest in an individual with the hope that they will stay and practice for a considerable amount of time. In the 1960’s studies began to indicate we would not have enough primary care physicians, particularly in rural areas. As primary care demands grew, so did the demand for primary care PAs and NPs. As physician specialties were “stressed” by a flat supply but increasing demand, opportunities grew for extenders not only in primary care, but across more specialties as well. Cooper et al (see reference 1) projected “provider shortages” in the range of 150,000 to 200,000 by 2020. The AAMC (American Association of Medical Colleges) predicts a shortfall of “91,500” by 2020. NP & PA programs have not been able to ramp up and fully supplement the decreasing physician supply (in this case provider supply) even when you add in the increasing numbers of PAs & NPs in training. A recent 2011 Physician Retention Survey by the American Group Medical Association (AGMA) shows that the turnover rate for nurse practitioners and physician assistants is 12.6 percent, more than twice the combined, adjusted physician turnover rate of 6 percent.

So how do you attract a great PA or NP to your practice? Obviously a PA or NP who is passionate about your clinical need

is important. Highlighting the type of duties you need performed as well as the type of patient population is critical to the messaging. For example, don’t just say family practice PA/NP wanted in Xyz town, NC. Instead, say: Dynamic PA/NP wanted for charming rural underserved area in Xyz, NC. Interested providers will be responsible for health care delivery to an appreciative population that has limited resources. Medicare and Medicaid credentialing are a must. Suburban, rural and smaller practices all have the same complaint that they cannot recruit to their area because they cannot pay as much in salary as their competition. However, often these groups are missing the mark as they often qualify for loan repayment within the state, or they might offer flexibility within a clinical work schedule that is appreciated by the provider. For example, if a PA/NP lives in town where they work, it might be agreeable that they can leave at 3 to pick up a child from school and then come back to wrap up the clinical day. Such flexibility is not easily achievable in a larger hospital or health system. Highlighting those “extras” will be important as you list all the reasons why your office is a great place to work. At the community level there remains a Physician and PA and NP shortage. How will educational programs meet the demand? In 2012, 17,000 Physician Assistant student applicants are estimated to be competing for 5,550 seats nationwide. There is a significant proliferation of PA programs all across the country, and North Carolina is no exception, with 7 programs currently accepting applications and up to 11 are projected to matriculate students by 2014. You can help by encouraging and supporting clinical providers to precept students. Ensuring quality health care education for learners is critical to the success of this overall system expansion. All of us currently

in established clinical roles gained valuable and critical raining and experience from our teachers and clinical preceptors. Redesigning teams to include increased numbers of primary care providers, not just physicians but also PAs and NPs, is a significant part of the solution to alleviate the well-known shortage in primary care. Improving utilization of Physician Assistants (PAs) and Nurse Practitioners (NPs) will be an integral part of the primary care delivery solution. Often, the addition of a PA/NP to a medical practice offers enhanced patient satisfaction, improved physician work-life balance, improved revenues and greater access to care for patients.

Read more here:http://www.smartmoney.com/plan/health-care/your-surgeon-may-not-be-a-doctor-1346970593986/

Cooper, Richard A. New Directions for Nurse Practitioners and Physician Assistants in the Era of Physician Shortages. Academic Medicine, Vol.82,No.9/September2007.

http://www.healthcarefinancenews.com/news/managing-doctor-nurse-practitioner-turnover-rates-key-delivery-collaborative-care-model?topic=24

About the Author:Lisa P. Shock, MHS, PA-C, is a seasoned PA who has worked with clients to expand health care teams in both large and small settings. She enjoys part time clinical primary care practice and is the President and CEO of Utilization Solutions in Healthcare – a specialty consultant company for physician practices and hospitals, offering a wide range of services to help implement and improve upon the utilization of PAs and NPs in the health care system. Contact her at [email protected]

MEDMONTHLY.COM |47

ArtbyNurses.combrings nurses together using art. We share the healing qualities of art with the wider community to spotlight our profession, illustrate the benefits of art as a self-care process and celebrate our artistic talents. We encourage nurses to join Art by Nurse to sell their art in a virtual gallery. Support your colleagues and join Art by Nurses as an artist or an associate member.”

Sources: http://creativityinhealthcare.com/2010/01/20/art-by-nurses-by-lynda-mcleod/

http://www.artbynurses.com/

the arts

‘Art By Nurses’

C reative interventions are not just for patients…they should be experienced by health care professionals

too. Caring for the sick is demand-ing work, and at times, thankless. Health professionals need a reprieve to rejuvenate themselves, and engaging in creative activities does exactly this. Self-care principles and theory applies not only to patients and their families, but to health care professionals as well. Who benefits? Everyone that health care professionals interacts with – nurses, doctors, ancillary nursing per-sonnel, social workers, OT, PT, manag-ers and executive staff, academicians, etc. By experiencing and expanding your own definition of creativity, it will ultimately benefit you, your patients and everyone else. Lynda McLeod of Victoria, British Columbia has applied these self-care principles into action. Lynda talks about her background in nursing and interest in the arts. Lynda is a nurse educator, artist and founder of ‘Art By Nurses’, an online gallery of artwork for sale created by nurse-artists.

With no further ado, here’s Lynda…

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

a nurse. In fact, I attribute the process of art as the only reason I am still involved in nursing. Being a highly sensitive, creative person, I found some of my nursing experiences, mainly bearing witness, difficult to unravel. As an effort to maintain balance and meaning I connect with nature and my family by going on long canoe and kayaking trips along the west coast of BC. The meditative act of painting these moments became my vehicle to transcend the sorrow and arrive at another plane of understanding. I have no formal art education in technique, color or brushwork; instead, I draw on my passion for nursing and the transformational relationships formed while teaching the next generation of registered nurses. I started the web site company based on a belief that many nurses engage in the meditative process of art in order to make meaning of the experiences they encounter as healers. By creating art and sharing their artistic visions, nurses work to maintain their health and support each other in a very rewarding, yet demanding profession.

Just Behind You by Lynda McLeod Toes Tugging Toes #2 by Lynda McLeod

48| MAY 2013

Welcome to Art by Nurses.

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

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

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

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

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

My dream is to hang Art by Nurses Healing Hallways exhibits across Canada in every province. As part of each exhibit I would offer Creativity workshops and set up coaching networks for RNs in each province. My hope is to connect nurses across the country unleashing creative energy and joy.

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

Lynda McLeod

MEDMONTHLY.COM |49

By Ashley Acornley, MS, RD, LDN

Servings: 4 servings

Ingredients:1 15-ounce can black beans, rinsed1/2 cup shredded Monterey Jack or Pepper Jack cheese1/2 cup prepared fresh salsa (see Tip), divided4 8-inch whole-wheat tortillas2 teaspoons canola oil, divided1 ripe avocado, diced

Preparation:1. Combine beans, cheese and 1/4 cup salsa in a

medium bowl. Place tortillas on a work surface. Spread 1/2 cup filling on half of each tortilla. Fold tortillas in half, pressing gently to flatten.

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

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

healthy living

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

Black Bean Quesadillas

50| MAY 2013

MEDMONTHLY.COM |51

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

Arizona1400 W. Washington, Rm. 230Phoenix, AZ 85007(602)542-3095http://www.do.az.gov

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

California2005 Evergreen St., Ste. 1200Sacramento, CA 95815(916)263-2382www.medbd.ca.gov

Colorado1560 Broadway St. #1310Denver, CO 80202(303)894-7750http://www.dora.state.co.us/optometry/

Connecticut410 Capitol Ave., MS #12APPP.O. Box 340308Hartford, CT 06134(860)509-7603 ext. 4http://www.dph.state.ct.us/

Florida4052 Bald Cypress Way, Bin C08Tallahassee, FL 32399(850)245-4474doh.state.fl.us

Georgia237 Coliseum Dr.Macon, GA 31217(478)207-1671www.sos.state.ga.us

HawaiiP.O. Box 3469Honolulu, HI 96801(808)[email protected]

Idaho450 W. State St., 10th FloorBoise , ID 83720(208)334-5500 www2.state.id.us/dhw

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

Massachusetts239 Causeway St.Boston, MA 02114(617)727-5339http://1.usa.gov/zbJVt7

NevadaP.O. Box 70503Reno, NV 89570(775)853-1421http://nvbdo.state.nv.us/

New Hampshire129 Pleasant St.Concord, NH 03301(603)271-5590www.state.nh.us

New JerseyP.O. Box 45011Newark, NJ 07101(973)504-6435http://www.njconsumeraffairs.gov/ophth/

New York89 Washington Ave., 2nd Floor W.Albany, NY 12234(518)402-5944http://www.op.nysed.gov/prof/od/

North CarolinaP.O. Box 25336Raleigh, NC 27611(919)733-9321http://www.ncoptometry.org/

Ohio77 S. High St.Columbus, OH 43266(614)466-9707http://optical.ohio.gov/

Oregon3218 Pringle Rd. SE Ste. 270Salem, OR 97302(503)373-7721 www.obo.state.or.us

Rhode Island3 Capitol Hill, Rm 104Providence, RI 02908(401)222-7883http://sos.ri.gov/govdirectory/index.php? page=DetailDeptAgency&eid=260

South CarolinaP.O. Box 11329Columbia, SC 29211(803)896-4665www.llr.state.sc.us

TennesseeHeritage Place Metro Center227 French Landing, Ste. 300Nashville, TN 37243(615)253-6061http://health.state.tn.us/boards/do/

TexasP.O. Box 149347Austin, TX 78714(512)834-6661www.roatx.org

Vermont National Life Bldg N FL. 2 Montpelier, VT 05620(802)828-2191http://vtprofessionals.org/opr1/opticians/

Virginia3600 W. Broad St.Richmond, VA 23230(804)367-8500www.state.va.us/licenses

Washington300 SE Quince P.O. Box 47870Olympia, WA 98504(360)236-4947http://www.doh.wa.gov/LicensesPermit-sand Certificates/ProfessionsNewRene-worUpdate/DispensingOptician.aspx

U.S. DENTAL BOARDSAlabamaAlabama Board of Dental Examiners 5346 Stadium Trace Pkwy., Ste. 112 Hoover, AL 35244(205) 985-7267http://www.dentalboard.org/

AlaskaP.O. Box 110806Juneau, AK 99811-0806(907)465-2542http://bit.ly/uaqEO8

Arizona4205 N. 7th Ave. Suite 300Phoenix, AZ 85103(602)242-1492http://azdentalboard.us/ Arkansas101 E. Capitol Ave., Suite 111Little Rock, AR 72201(501)682-2085http://www.asbde.org/

California2005 Evergreen Street, Suite 1550 Sacramento, CA 95815877-729-7789http://www.dbc.ca.gov/

Colorado1560 Broadway, Suite 1350Denver, CO 80202(303)894-7800http://www.dora.state.co.us/dental/

Connecticut410 Capitol Ave. Hartford, CT 06134(860)509-8000http://www.ct.gov/dph/site/default.asp

DelawareCannon Building, Suite 203861 Solver Lake Blvd.Dover, DE 19904(302)744-4500http://1.usa.gov/t0mbWZ

Florida4052 Bald Cypress WayBin C-08Tallahassee, FL 32399 (850)245-4474http://bit.ly/w1m4MI

Georgia237 Coliseum DriveMacon, GA 31217(478)207-2440http://sos.georgia.gov/plb/dentistry/

HawaiiDCCA-PVLAtt: DentalP.O. Box 3469Honolulu, HI 96801(808)586-3000http://1.usa.gov/s5Ry9i

IdahoP.O. Box 83720Boise, ID 83720(208)334-2369http://isbd.idaho.gov/

Illinois320 W. Washington St.Springfield, IL 62786(217)785-0820http://bit.ly/svi6Od

Indiana402 W. Washington St., Room W072Indianapolis, IN 46204(317)232-2980http://www.in.gov/pla/dental.htm

Iowa400 SW 8th St. Suite DDes Moines, IA 50309(515)281-5157http://www.state.ia.us/dentalboard/

Kansas900 SW Jackson Room 564-STopeka, KS 66612(785)296-6400http://www.accesskansas.org/kdb/

Kentucky312 Whittington Parkway, Suite 101Louisville, KY 40222(502)429-7280http://dentistry.ky.gov/

Louisiana365 Canal St., Suite 2680New Orleans, LA 70130(504)568-8574http://www.lsbd.org/

Maine143 State House Station161 Capitol St.Augusta, ME 04333(207)287-3333http://www.mainedental.org/

Maryland55 Wade Ave.Catonsville, Maryland 21228(410)402-8500http://dhmh.state.md.us/dental/

Massachusetts1000 Washington St., Suite 710Boston, MA 02118(617)727-1944http://www.mass.gov/eohhs/provider/licensing/occupational/dentist/about/

MichiganP.O. Box 30664Lansing, MI 48909(517)241-2650http://www.michigan.gov/lara/0,4601,7-154-35299_28150_27529_27533---,00.html

Minnesota2829 University Ave., SE. Suite 450Minneapolis, MN 55414(612)617-2250http://www.dentalboard.state.mn.us/

Mississippi600 E. Amite St., Suite 100Jackson, MS 39201(601)944-9622http://bit.ly/uuXKxl

Missouri3605 Missouri Blvd.P.O. Box 1367Jefferson City, MO 65102(573)751-0040http://pr.mo.gov/dental.asp

MontanaP.O. Box 200113Helena, MT 59620(406)444-2511http://bsd.dli.mt.gov/license/bsd_boards/den_board/board_page.asp

52 | MAY 2013

OhioRiffe Center77 S. High St.,17th FloorColumbus, OH 43215(614)466-2580http://www.dental.ohio.gov/

Oklahoma201 N.E. 38th Terr., #2Oklahoma City, OK 73105(405)524-9037http://www.dentist.state.ok.us/

Oregon1600 SW 4th Ave. Suite 770Portland, OR 97201(971)673-3200http://www.oregon.gov/Dentistry/

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

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

South CarolinaP.O. Box 11329Columbia, SC 29211(803)896-4599http://www.llr.state.sc.us/POL/Dentistry/ South DakotaP.O. Box 1079105. S. Euclid Ave. Suite CPierre, SC 57501(605)224-1282https://www.sdboardofdentistry.com/

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

Texas333 Guadeloupe St. Suite 3-800Austin, TX 78701(512)463-6400http://www.tsbde.state.tx.us/

Utah160 E. 300 SouthSalt Lake City, UT 84111(801)530-6628http://1.usa.gov/xMVXWm

VermontNational Life BuildingNorth FL2Montpelier, VT 05620(802)828-1505http://bit.ly/zSHgpa

VirginiaPerimeter Center9960 Maryland Dr., Suite 300Henrico, VA 23233(804)367-4538http://www.dhp.virginia.gov/dentistry

Washington310 Israel Rd. SEP.O. Box 47865Olympia, WA 98504(360)236-4700http://www.doh.wa.gov/LicensesPermit-sandCertificates/ProfessionsNewRene-worUpdate/Dentist.aspx West Virginia1319 Robert C. Byrd Dr.P.O. Box 1447Crab Orchard, WV 258271-877-914-8266http://www.wvdentalboard.org/

WisconsinP.O. Box 8935Madison, WI 537081(877)617-1565http://dsps.wi.gov/Default.aspx?Page=90c5523f-bab0-4a45-ab94-3d9f699d4eb5 Wyoming1800 Carey Ave., 4th FloorCheyenne, WY 82002(307)777-6529http://plboards.state.wy.us/dental/index.asp

MEDMONTHLY.COM |53

Nebraska301 Centennial Mall SouthLincoln, NE 68509(402)471-3121http://dhhs.ne.gov/publichealth/Pages/crl_medical_dent_hygiene_board.aspx

Nevada6010 S. Rainbow Blvd. Suite A-1Las Vegas, NV 89118(702)486-7044http://www.nvdentalboard.nv.gov/

New Hampshire2 Industrial Park Dr. Concord, NH 03301(603)271-4561http://www.nh.gov/dental/

New JerseyP.O Box 45005Newark, NJ 07101(973)504-6405http://bit.ly/uO2tLg New MexicoToney Anaya Building2550 Cerrillos Rd.Santa Fe, NM 87505(505)476-4680http://www.rld.state.nm.us/boards/Den-tal_Health_Care.aspx

New York89 Washington Ave.Albany, NY 12234(518)474-3817http://www.op.nysed.gov/prof/dent/

North Carolina507 Airport Blvd., Suite 105Morrisville, NC 27560(919)678-8223http://www.ncdentalboard.org/

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

AlabamaP.O. Box 946 Montgomery, AL 36101 (334)242-4116http://www.albme.org/

Alaska550 West 7th Ave., Suite 1500Anchorage, AK 99501(907)269-8163http://bit.ly/zZ455T

Arizona9545 E. Doubletree Ranch Rd. Scottsdale, AZ 85258(480)551-2700http://www.azmd.gov

Arkansas1401 West Capitol Ave., Suite 340Little Rock, AR 72201(501)296-1802http://www.armedicalboard.org/

California2005 Evergreen St., Suite 1200Sacramento, CA 95815(916)263-2382 http://www.mbc.ca.gov/

Colorado1560 Broadway, Suite 1350Denver, CO 80202(303)894-7690http://www.dora.state.co.us/medical/

Connecticut401 Capitol Ave. Hartford, CT 06134(860)509-8000http://www.ct.gov/dph/site/default.asp

DelawareDivision of Professional Regulation Cannon Building 861 Silver Lake Blvd., Suite 203 Dover, DE 19904(302)744-4500http://dpr.delaware.gov/

District of Columbia899 North Capitol St., NE Washington, DC 20002 (202)442-5955http://www.dchealth.dc.gov/doh

Florida2585 Merchants Row Blvd.Tallahassee, FL 32399(850)245-4444http://www.stateofflorida.com/Portal/DesktopDefault.aspx?tabid=115

Georgia2 Peachtree Street NW, 36th Floor Atlanta, GA 30303 (404)656-3913http://bit.ly/vPJQyG

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

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

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

Indiana402 W. Washington St. #W072Indianapolis, IN 46204(317)233-0800http://www.in.gov/pla/

Iowa400 SW 8th St., Suite C Des Moines, IA 50309(515)281-6641http://medicalboard.iowa.gov/

Kansas800 SW Jackson, Lower Level, Suite ATopeka, KS 66612(785)296-7413http://www.ksbha.org/

Kentucky310 Whittington Pkwy., Suite 1B Louisville, KY 40222(502)429-7150http://kbml.ky.gov/default.htm

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

Maine161 Capitol Street 137 State House Station Augusta, ME 04333 (207)287-3601http://bit.ly/hnrzp

Maryland4201 Patterson Ave.Baltimore, MD 21215(410)764-4777http://www.mbp.state.md.us/

Massachusetts200 Harvard Mill Sq., Suite 330 Wakefield, MA 01880 (781)876-8200http://www.mass.gov/eohhs/gov/de-partments/borim/

MichiganBureau of Health Professions P.O. Box 30670 Lansing, MI 48909(517)335-0918http://www.michigan.gov/lara/0,4601,7-154-35299_28150_27529_27541-58914--,00.html

MinnesotaUniversity Park Plaza 2829 University Ave. SE, Suite 500 Minneapolis, MN 55414 (612)617-2130 http://bit.ly/pAFXGq

Mississippi1867 Crane Ridge Drive, Suite 200-B Jackson, MS 39216(601)987-3079http://www.msbml.state.ms.us/

MissouriMissouri Division of Professional Registration 3605 Missouri Blvd. P.O. Box 1335 Jefferson City, MO 65102 (573)751-0293 http://pr.mo.gov/healingarts.asp

U.S. MEDICAL BOARDS

54| MAY 2013

Montana301 S. Park Ave. #430Helena, MT 59601(406)841-2300http://bit.ly/obJm7J p

NebraskaNebraska Department of Health and Human ServicesP.O. Box 95026Lincoln, NE 68509(402)471-3121http://www.mdpreferredservices.com/state-licensing-boards/nebraska-board-of-medicine-and-surgery

NevadaBoard of Medical ExaminersP.O. Box 7238Reno, NV 89510 (775)688-2559 http://www.medboard.nv.gov/

New HampshireNew Hampshire State Board of Medicine 2 Industrial Park Dr. #8 Concord, NH 03301 (603)271-1203http://www.nh.gov/medicine/

New JerseyP. O. Box 360Trenton, NJ 08625 (609)292-7837http://bit.ly/w5rc8J

New Mexico2055 S. Pacheco St. Building 400 Santa Fe, NM 87505 (505)476-7220http://www.nmmb.state.nm.us/

New YorkOffice of the ProfessionsState Education Building, 2nd FloorAlbany, NY 12234(518)474-3817http://www.op.nysed.gov/

North CarolinaP.O. Box 20007Raleigh, NC 27619(919)326-1100http://www.ncmedboard.org/

North Dakota418 E. Broadway Ave., Suite 12Bismarck, ND 58501(701)328-6500http://www.ndbomex.com/

Ohio30 E. Broad St., 3rd FloorColumbus, OH 43215(614)466-3934http://med.ohio.gov/

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

Oregon1500 SW 1st Ave., Suite 620Portland, OR 97201(971)673-2700http://www.oregon.gov/OMB/

Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)787-8503 http://www.dos.state.pa.us/portal/server.pt/community/state_board_of_medi-cine/12512

Rhode Island3 Capitol HillProvidence, RI 02908(401)222-5960http://1.usa.gov/xgocXV

South CarolinaP.O. Box 11289Columbia, SC 29211(803)896-4500http://www.llr.state.sc.us/pol/medical/

South Dakota101 N. Main Ave. Suite 301Sioux Falls, SD 57104(605)367-7781http://www.sdbmoe.gov/

Tennessee425 5th Ave. NorthCordell Hull Bldg. 3rd FloorNashville, TN 37243(615)741-3111http://health.state.tn.us/boards/me/

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

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

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

VirginiaVirginia Dept. of Health ProfessionsPerimeter Center9960 Maryland Dr., Suite 300Henrico, VA 23233(804)367-4400http://1.usa.gov/xjfJXK

WashingtonPublic Health Systems DevelopmentWashington State Department of Health101 Israel Rd. SE, MS 47890Tumwater, WA 98501(360)236-4085http://www.medlicense.com/washington-medicallicense.html

West Virginia101 Dee Dr., Suite 103Charleston, WV 25311(304)558-2921http://www.wvbom.wv.gov/

WisconsinP.O. Box 8935Madison, WI 53708(877)617-1565http://drl.wi.gov/board_detail.asp?boardid=35&locid=0

Wyoming320 W. 25th St., Suite 200Cheyenne, WY 82002(307)778-7053http://wyomedboard.state.wy.us/

MEDMONTHLY.COM |55

medical resource guide

Find Urgent CarePO Box 15130Scottsdale, AZ 85267(602)370-0303

www.findurgentcare.com

MedMedia9PO Box 98313Raleigh, NC 27624(919)747-9031

www.medmedia9.com

Ring Ring LLC6881 Maple Creek Blvd, Suite 100West Bloomfield, MI 48322-4559(248)819-6838

www.ringringllc.com

ADVERTISING

BILLING & COLLECTION

Advanced Physician Billing, LLCPO Box 730Fishers, IN 46038(866)459-4579

www.advancedphysicianbillingllc.com

56| MAY 2013

ANSWERING SERVICES

Corridor Medical Answering Service3088 Route 27, Suite 7Kendall Park, NJ 08824(866)447-5154

www.corridoranswering.net

Docs on Hold14849 West 95th St. Lenexa, KS 66285(913)559-3666

www.soundproductsinc.com

CODING SPECIALISTS

The Coding Institute LLC2222 Sedwick DriveDurham, NC 27713(800)508-2582

http://www.codinginstitute.com/

CAREER CONSULTING

Doctor’s Crossing4107 Medical Parkway, Suite 104 Austin, Texas 78756 (512)517-8545

http://doctorscrossing.com/

COMPUTER, SOFTWARE

American Medical Software1180 Illinois 157Edwardsville, IL 62025(618) 692-1300

www.americanmedical.com

CDWG300 N. Milwaukee AveVernon Hills, IL 60061(866)782-4239

www.cdwg.com/

Instant Medical History4840 Forest Drive #349Columbia, SC 29206(803)796-7980

www.medicalhistory.com

ACCOUNTING

Boyle CPA, PLLC3716 National Drive, Suite 206Raleigh, NC 27612(919) 720-4970

www.boyle-cpa.com

Ajishra Technology Support3562 Habersham at Northlake, Bldg JTucker, GA 30084(866)473-0011

www.ajishra.com

Applied Medical Services4220 NC Hwy 55, Suite 130BDurham, NC 27713(919)477-5152

www.ams-nc.com

Axiom Business Solutions4704 E. Trindle Rd.Mechanicsburg, PA 17050(866)517-0466

www.axiom-biz.com

Frost Arnett480 James Robertson ParkwayNashville, TN 37219(800)264-7156

www.frostarnett.com

Gold Key Credit, Inc.PO Box 15670Brooksville, FL 34604888-717-9615

www.goldkeycreditinc.com

Horizon Billing Specialists4635 44th St., Suite C150Kentwood, MI 49512(800)378-9991

www.horizonbilling.com

Management Services On-Call200 Timber Hill Place, Suite 221Chapel Hill, NC 27514(866)347-0001

www.msocgroup.com

Marina Medical Billing Service18000 Studebaker Road4th FloorCerritos, CA 90703(800)287-8166

www.marinabilling.com

Mediserv6451 Brentwood Stair Rd.Ft. Worth, TX 76112(800)378-4134

www.mediservltd.com

Practice Velocity1673 Belvidere RoadBelvidere, IL 61008(888)357-4209

www.practicevelocity.com

Sweans Technologies501 Silverside Rd.Wilmington, DE 19809(302)351-3690

www.medisweans.com

VIP BillingPO Box 1350Forney, TX 75126(214)499-3440

www.vipbilling.com

ELECTRONIC MED. RECORDS

INSURANCE, MED. LIABILITY


FINANCIAL CONSULTANTS

Sigmon Daknis Wealth Management701 Town Center Dr. , Ste. #104Newport News, VA 23606(757)223-5902

www.sigmondaknis.com

Sigmon & DaknisWilliamsburg, VA Office325 McLaws Circle, Suite 2Williamsburg, VA 23185 (757)258-1063

http://www.sigmondaknis.com/

MEDMONTHLY.COM |57

Biomet 3i4555 Riverside Dr.Palm Beach Gardens, FL 33410(800)342-5454

www.biomet3i.com

Dental Management Club4924 Balboa Blvd #460Encino, CA 91316

www.dentalmanagementclub.com

The Dental Box Company, Inc.PO Box 101430Pittsburgh, PA 15237(412)364-8712

www.thedentalbox.com

ABELSoft1207 Delaware Ave. #433Buffalo, NY 14209(800)267-2235

www.abelmedicalsoftware.com

Acentec, Inc17815 Sky Park Circle , Suite JIrvine, CA 92614(949)474-7774

www.acentec.com

AdvancedMD 10011 S. Centennial PkwySandy, UT 84070(800) 825-0224

www.advancedmd.com

CollaborateMD201 E. Pine St. #1310Orlando, FL 32801(888)348-8457

www.collaboratemd.com

Aquesta Insurance Services, Inc.Michael W. Robertson3807 Peachtree Avenue, #103Wilmington, NC 28403Work: (910) 794-6103Cell: (910) 777-8918

www.aquestainsurance.com

Medical Protective5814 Reed Rd.Fort Wayne, In 46835(800)463-3776

http://www.medpro.com/medical-protective

MGIS, Inc.1849 W. North TempleSalt Lake City, UT 84116(800)969-6447www.mgis.com

Medical Credentialing(800) 4-THRIVE

www.medicalcredentialing.org

Medical Practice Listings8317 Six Forks Rd. Suite #205Raleigh, NC 27624(919)848-4202

www.medicalpracticelistings.com

myEMRchoice.com24 Cherry LaneDoylestown, PA 18901(888)348-1170

www.myemrchoice.com

Physician Wellness Services5000 West 36th Street, Suite 240Minneapolis, MN 55416888.892.3861

www.physicianwellnessservices.com

Synapse Medical Management18436 Hawthorne Blvd. #201Torrance, CA 90504(310)895-7143

www.synapsemgmt.com

Urgent Care America17595 S. Tamiami TrailFort Meyers, FL 33908(239)415-3222

www.urgentcareamerica.com

Urgent Care & Occupational Medicine ConsultantLawrence Earl, MDCOO/CMO ASAP UrgentcareMedical Director, NADME.org908-635-4775 (m)866-405-4770 (f )

ASAP-Urgentcare.comUrgentCareMentor.com

Utilization [email protected](919) 289-9126

www.pushpa.biz

DENTALCONSULTING SERVICES,PRACTICE MANAGEMENT

Triangle Nutrition Therapy6200 Falls of Neuse Road, Suite 200Raleigh, NC 27609(919)876-9779

http://trianglediet.com/

DIETICIAN

DocuTAP4701 W. Research Dr. #102Sioux Falls, SD 57107-1312(877)697-4696

www.docutap.com

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

www.integritas.com

58| MAY 2013


MEDICAL ART

Brian Allenwww.artisanprinter.com

Deborah Brenner877 Island Ave #315San Diego, CA 92101(619)818-4714

www.deborahbrenner.com

Pia De Girolamowww.piadegirolamo.com

MEDICAL EQUIPMENT

ALLPRO Imaging1295 Walt Whitman RoadMelville, NY 11747(888)862-4050

www.allproimaging.com

Biosite, Inc9975 Summers Ridge RoadSan Diego, CA 92121(858)805-8378

www.biosite.com

Cryopen800 Shoreline, #900Corpus Christi, TX 78401(888)246-3928

www.cryopen.com

Carolina Liquid Chemistries, Inc.391 Technology WayWinston Salem, NC 27101(336)722-8910

www.carolinachemistries.com

Dicom Solutions548 WaldIrvine, CA 92618(800)377-2617

www.dicomsolutions.com

Tarheel Physicians Supply1934 Colwell Ave. Wilmington, NC 28403 (800)672-0441

www.thetps.com

MEDICAL PRACTICE SALES

Medical Practice Listings8317 Six Forks Rd. Ste #205Raleigh, NC 27624(919)848-4202


BizScorePO Box 99488Raleigh, NC 27624(919)846-4747

www.bizscorevaluation.com

MEDICAL PRACTICE VALUATIONS

MEDICAL MARKETING

High Performance NetworkRobert SayreMarketing Adviser/Business Coach

http://www.linkedin.com/pub/rob-sayre/2/977/355/


www.medmedia9.com

WhiteCoat DesignsWeb, Print & Marketing Solutions for Doc-tors(919)714-9885

www.whitecoat-designs.com

MMA Medical Architects520 Sutter StreetSan Francisco, CA 94115(415) 346-9990

http://www.mmamedarc.com

MEDICAL ARCHITECTS

LOCUM TENENS

Physician SolutionsPO Box 98313Raleigh, NC 27624(919)845-0054

www.physiciansolutions.com

Nicholas Downhttp://bit.ly/yHwxb0

Martin Friedwww.martindfried.com

Barry Hanshaw 18 Bay Path DriveBoylston MA 01505508 - 869 - [email protected]

www.barryhanshaw.com

MedImageryLaura Maask 262-308-1300 [email protected]

medimagery.com

Marianne Mitchell(215)704-3188

http://www.mariannemitchell.comhttp://www.colordrop.blogspot.com

Professional Medical Insurance Services16800 Greenspoint Park DriveHouston, TX 77060(877)583-5510

www.promedins.com

Wood Insurance Group4835 East Cactus Rd., #440Scottsdale, AZ 85254-3544(602)230-8200

www.woodinsurancegroup.com

INSURANCE, MED. LIABILITY MEDICAL EQUIPMENTFINANCING

Bank of AmericaMark MacKinnon, Regional Sales Manager3801 Columbine CircleCharlotte, NC 28211(704)[email protected]

www.bankofamerica.com/practicesolutions


MEDMONTHLY.COM |59

MEDICAL RESEARCH

Arup Laboratories500 Chipeta WaySalt Lake City, UT 84108(800)242-2787

www.aruplab.com

Chimerix, Inc.2505 Meridian Parkway, Suite 340Durham, NC 27713(919) 806-1074

www.chimerix.com

Clinical Reference Laboratory8433 Quivira Rd.Lenexa, KS 66215(800)445-6917

www.crlcorp.comSanofi US55 Corporate DriveBridgewater, NJ 08807(800) 981-2491

www.sanofi.usScynexis, Inc.3501 C Tricenter Blvd.Durham, NC 27713(919) 933-4990

www.scynexis.com

MEDICAL PUBLISHING

Greenbranch Publishing [email protected]

www.greenbranch.com

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

Astaffinggroup.com

SUPPLIES, GENERAL

BSN Medical5825 Carnegie BoulevardCharlotte, NC 28209(800)552-1157

www.bsnmedical.us

STAFFING COMPANIES

CNF Medical1100 Patterson AvenueWinston Salem, NC 27101(877)631-3077

www.cnfmedical.comDermabondEthicon, Route 22 WestSomerville, NJ 08876(877)984-4266

www.dermabond.com DJO1430 Decision St.Vista, CA 92081(760)727-1280

www.djoglobal.com ExpertMed31778 Enterprise Dr.Livonia, MI 48150(800)447-5050

www.expertmed.com

Gebauer Company4444 East 153rd St. Cleveland, OH 44128-2955(216)581-3030

www.gebauerspainease.com

Scarguard15 Barstow Rd.Great Neck, NY 11021(877)566-5935

www.scarguard.com


www.medmedia9.com

REAL ESTATE

York Properties, Inc.Headquarters & Property Management 1900 Cameron StreetRaleigh, NC 27605(919) 821-1350



WEBSITE DESIGN

PRACTICE FINANCING

Bank of AmericaMark MacKinnon, Regional Sales Manager3801 Columbine CircleCharlotte, NC 28211(704)[email protected]

www.bankofamerica.com/practicesolutions

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Visit us online anytime at medmonthly.com

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

Contact Cara or Philip for detailsregarding this very successful practice.

Medical Practice Listings; 919-848-4202

Woman’s Practice in Raleigh, North Carolina.

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

accommodations provided.

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

Please contact Physican Solutions at 919-845-0054 or [email protected]

NC OPPORTUNITIES LOCUMS OR PERMANENT

For more information about Physician Solutions or to see all of our locums and permanent listings,

please visit physiciansolutions.com

60| MAY 2013

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

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

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

FAMILY PRACTICE FOR SALEA beautiful practice located in Seattle, Washington

MedicalPracticeListings.com | [email protected] | 919.848.4202

Medical Practice ListingsSelling and buying made easy

To place a classified ad, call 919.747.9031

classified listings

Classified

MEDMONTHLY.COM |61

Physicians needed

North Carolina

GP Needed Immediately On-Going 3 Days Per Week at Occupational Clinic . General Practictioner needed on-going 3 days per week at occupational clinic in Greensboro, NC. Numerous available shifts for October. Averages 25 patients per day with no call and shift hours from 8:30 am to 5:30 pm. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected]

3-5 days per week in Durham, NC . Geriatric physi-cian needed immediately 3-5 days per week, on-going at nursing home in Durham. Nursing home focuses on therapy and nursing after patients are released from the hospital. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected] GP Needed Immediately On-Going 1-3 Days Per Week at Addictive Diease Clinics located in Charlotte, Hick-ory, Concord & Marion North Carolina. General Practi-tioner with a knowledge or interest in addictive disease. Needed in October on-going 1-3 times per week. This clinic requires training so respond to post before Octo-ber 1st. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected]

Primary Care Physician in Northwest NC (multiple locations). Primary care physician needed immediately for ongoing coverage at one of the larg-est substance abuse treatment facilities in NC. Doctor will be responsible for new patient evaluations and supportive aftercare. Counseling and therapy are combined with physician’s medical assessment and care for the treatment of adults, adolescents and families. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected]

Pediatrician or Family Medicine Doctor in Fayetteville Comfortable with seeing children. Need is immediate - Full time ongoing for maternity leave. 8 am - 5 pm. Outpatient only. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected]


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

General Practitioner Needed in Greensboro. Occupa-tional health care clinic seeks general practitioner for disability physicals ongoing 1-3 days a week. Adults only. 8 am-5 pm. No call required. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, andPH: (919) 845-0054, email: [email protected]

Pediatrician or Family Physician Needed Immediately at clinic in Roanoke Rapids, NC. Pediatric clinic in Ro-anoke Rapids, NC seeks Peds physician or FP comfort-able with children for 2-3 months/on-going/full-time. The chosen physician will need to be credentialed through the hospital, please email your CV, medical license and DEA so we can fill thisposition immediately.

County Health Department in Fayetteville, NC seeks GP/IM/FP Full-Time, On-Going Shifts. GP/IM/FP Need-ed Immediately at County Health Department in Fay-etteville, NC. Approximately 20 patients per day with hours from 8 am -5 pm. Call or email for more informa-tion. 919-845-0054 [email protected]

Occupational Clinic in Greensboro, NC seeks FP/GP for On-Going Shifts. Locum tenens position (4-5 days a week) available for an occupational, urgent care and walk in clinic. The practice is located in Greensboro NC. Hours are 8 am-5 pm. Approximately 20 patients/day. Excellent staff. Outpatient only.

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

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


classified listings

Classified

62| MAY 2013

Physicians needed

North Carolina (cont.)

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

Child Health Clinic in Statesville, NC seeks pediatri-cian or Family Physician comfortable with peds for on-going, full-time shifts. Physician will work M-F 8 am - 5 pm, ongoing. Qualified physician will know EMR or Allscripts software. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected]

Peds Clinic near Raleigh seeks Mid-Level Provider for on-going coverage 4x/wk. Health Department pediat-rics clinic 45 min from Raleigh needs coverage 4 days a week from January through June. Provider will see about 20 patients daily, hours are 8am-5pm with an hour for lunch.

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

FT Mid-Level Provider needed for Wilmington practice immediately. Small private practice 45 minutes outside Wilmington seeks mid-level provider starting January. M-F 8:00-5:00, PT or FT. This practice also is looking for a PA permanently in April. Accommodations, PLI, and mileage provided. Please contact Physician Solutions at 919-845-0054 or [email protected].


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

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

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

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

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

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

Geriatric physician needed immediately 2 to 5 days per week, on-going eastern NC. Nursing homes in Durham, Fayetteville and Rocky Mount seek GP/IM/FP with geriatric experience to work full or part time. Nursing home focuses on therapy and nursing after patients are released from the hospital. 8a-5p, no call.

Nursing home in Durham seeks PT/FT NP/PA for imme-diate ongoing scheduling. Durham nursing home seeks part time or full time mid-level for ongoing locums. Must have geriatric experience. 8-5p. Other facilities in Fayetteville and Rocky Mount.


MEDMONTHLY.COM |63

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

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

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

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

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

Family Practice 1 h SE of Raleigh seeks July 6-7 cover-age. Goldsboro FP seeks MD for July 6-7 and intermit-tent shifts. 8-5p.

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

Greenville Clinic seeks GP May 20-22. GP/IM needed for May 20-22 and intermittent shifts. Must have experi-ence or be willing to do pain management and trig-ger point injections. 8-5p.

Raleigh practice seeks BC FP for permanent place-ment in new facility summer 2013. Board Certified Family Practitioner sought for FT permanent place-ment in new clinic in Raleigh to start summer of 2013. Clinic between Fayetteville and Wilmington seeks FP/GP/IM Mar 22 FT ongoing . A small hospital’s outpa-tient clinic located within an hour of both Fayetteville and Wilmington seeks PA to work FT ongoing begin-ning March 22. Shifts can be either 8 or 12 hours. No call.

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

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


Classified

South Carolina

A family and urgent care in Little River, SC seeks an FP/EM physician for 1 to 2 days per week, on-going shifts. The practice is a one-physician facility and is looking for a physician to come in regularly. The prac-tice is small and does not have a large patient load. The qualified physician will have experience in Family or Emergency medicine. If you have any availability and a SC medical license contact us today and we will do our best to work around your schedule. Physi-cian Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected]

Physicians needed

Physicians needed


Pediatric Locums Physician needed in Harrisonburg, Danville and Lynchburg, VA. These locum positions re-quire 30 to 40 hours per week, on-going. If you are seek-ing a beautiful climate and flexibility with your schedule, please consider one of these opportunities. Send copies of your CV, VA. medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: [email protected]

Urgent Care opportunities throughout Virginia. We have contracts with numerous facilities and eight to 14-hour shifts are available. If you have experience treating pa-tients from pediatrics to geriatrics, we welcome your in-quires. Send copies of your CV, VA medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solu-tions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: [email protected]

Virginia practice outside of Washington DC seeks IM doctor FT/PT now – June 1. IM physician needed immedi-ately FT/PT for Virginia clinic near Washington DC. 8-5p

Physicians needed

Virginia

Practice wanted

Pediatric Practice Wanted in Raleigh, NCMedical Practice Listings has a qualified buyer for a pediatric practice in Raleigh, Cary or surrounding area. If you are retiring, relocating or considering your options as a pediatric practice owner, contact us and review your options. Medical Practice Listings is the leading seller of practices in the US. When you list with us, your practice re-ceives exceptional national, regional and local exposure. Contact us today at (919) 848-4202.

North Carolina

Practice for sale

North Carolina

Family Practice located in Hickory, NC. Well-established and a solid 40 to 55 patients split between an MD and physician assistant. Experienced staff and outstanding medical equipment. Gross revenues average $1,500,000 with strong profits. Monthly practice rent is only $3,000 and the utilities are very reasonable. The practice with all equipment, charts and good will are priced at $625,000. Contact Medical Practice Listings for additional informa-tion. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or email: [email protected]

Impressive Internal Medicine Practice in Durham, NC: The City of Medicine. Over 20 years serving the community, this practice is now listed for sale. There are four well-equipped exam rooms, new computer equipment and a solid patient following. The owner is retiring and willing to continue with the new owner for a few months to assist with a smooth transition. Contact Medical Practice Listings at (919) 848-4202 for more information. View additional list-ings at: www.medicalpracticelistings.com

Nurse Practitioners needed

North Carolina

Charlotte Occupational clinic seeks NP in March for ongoing coverage. Nurse practitioner needed in em-ployee health clinic for large corporation in Charlotte. 8a-5p ongoing full time or part time.

Permanent NP needed immediately for FT Raleigh practice. Raleigh clinic seeks full time permanent nurse practitioner immediately. 8-5p

Health Dept 1 hour 30 min E of Raleigh seeks NP FT im-mediately locums to perm. Nurse Practitioner needed in health department for locums to permanent posi-tion starting immediately. 8-5p.


classified listings

Classified continued from page 63

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

64| MAY 2013

Practice for sale

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

South Carolina



Classified

Family Practice located in Bainbridge Island, WA has recently been listed. Solid patient following and cash flow makes this 17-year-old practice very attractive. Con-tact Medical Practice Listings for more details. email: [email protected] or (919) 848-4202.

Washington

Impressive Internal Medicine Practice in Durham, NC: The City of Medicine. Over 20 years serving the community, this practice is now listed for sale. There are four well-equipped exam rooms, new computer equipment and a solid patient following. The owner is retiring and willing to continue with the new owner for a few months to assist with a smooth transition. Contact Medical Practice Listings at (919) 848-4202 for more information. View additional list-ings at: www.medicalpracticelistings.com

Primary Care Practice specializing in women’s care. The owning female physician is willing to continue with the practice for a reasonable time to assist with smooth own-ership transfer. The patient load is 35 to 40 patients per day, however that could double with a second provider. Exceptional cash flow and profitable practice that will surprise even the most optimistic practice seeker. This is a remarkable opportunity to purchase a well-established woman’s practice. Spacious practice with several well-appointed exam rooms throughout. New computers and medical management software add to this modern front desk environment. This practice is being offered for $435,000. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or send an email to [email protected]

Internal Medicine Practice located just outside Fayette-ville, NC is now being offered. The owning physician is retiring and is willing to continue working for the new owner for a month or two assisting with a smooth transac-tion. The practice treats patients four and a half days per week with no call or hospital rounds. The schedule accom-modates 35 patients per day. You will be hard pressed to find a more beautiful practice that is modern, tastefully decorated and well appointed with vibrant art work. The practice, patient charts, equipment and good will is being offered for $415,000 while the free standing building is be-ing offered for $635,000. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or email: [email protected]

MEDMONTHLY.COM |65

Modern Vein Care Practice located in the mountains of NC. Booking seven to 10 procedures per day, you will find this impressive vein practice attractive in many ways. Housed in the same practice building with an internal medicine, you will enjoy the referrals from this as well as other primary care and specialties in the community. We have this practice listed for $295,000 which includes charts, equipment and good will. Contact Medical Practice List-ings at (919) 848-4202 for more information. View addition-al listings at www.medicalpracticelistings.com

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

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

Hospice Practice Wanted

To find out more information call 919-848-4202 or e-mail [email protected]



Woman's Practice Available for SaleAvailable for purchase is a beautiful boutique women’s Internal Medicine and Primary Care prac-tice located in the Raleigh area of North Carolina.

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

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

Located in South Denver, Colorado, this practice features high patient volume and high visibility on the internet. Established referral sources, owner (psychologist) has excellent reputa-tion based on 30 years experience in Denver. Private pay and insurances, high-density traffic, beautifully decorated and furnished offices, 378 active and inactive clients, corporate clients, $14,000 physical assets, good parking, near bus and rapid transit housed in a well-maintained medical building. Live and work in one of the most healthy cities in the U.S.

List Price: $150,000 | Established: 2007 | Location: Colorado

Practice for Sale in South Denver

For more information contact Dr. Jack McInroy at 303-929-2598 or [email protected]

Neurofeedback and Psychological Practice

Comfortable seeing children. Needed immediately.

Call 919- 845-0054 or email: [email protected]

PEDIATRICIAN

FAYETTEVILLE, NCor family medicine doctor needed in

Primary care practice specializing in women’s careRaleigh, North Carolina

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

List price: $435,000

Practice for Sale in Raleigh, NC

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


PHYSICIANS NEEDED: Mental health facility in Eastern North Carolina seeks:

PA/FT ongoing, start immediatelyPhysician Assistant needed to work with physicians to provide primary care for resident patients. FT ongoing 8a-5p. Limited inpatient call is required. The position is responsible for performing history and physicals of patients on admission, annual physicals, dictate discharge summaries, sick call on unit assigned, suture minor lacerations, prescribe medications and order lab work. Works 8 hour shifts Monday through Friday with some extended work on rotating basis required. It is a 24 hour in-patient facility that serves adolescent, adult and geriatric patients.

FT ongoing Medical Director, start immediatelyThe Director of Medical Services is responsible for ensuring all patients receive quality medical care. The director supervises medical physicians and physi-cian extenders. The Director of Medical Services also provides guidance to the following service areas: Dental Clinic, X-Ray Department, Laboratory Services, Infection Control, Speech/Language Services, Employee Health,

Send copies of your CV, NC medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624

PH: (919) 845-0054 | email: [email protected]

Pharmacy Department, Physical Therapy and Telemedicine. The Medical Director reports directly to the Clinical Director. The position will manage and participate in direct patient care as required; maintain and participate in an on-call schedule ensuring that a physician is always available to hospitalized patients; and maintain privileges of medical staff.

Permanent Psychiatrist needed FT, start immediatelyAn accredited State Psychiatric Hospital serving the eastern region of North Carolina, is recruiting for permanent full-time Psychiatrist. The 24 hour in-patient facility serves adolescent, adult and geriatric patients. The psychiatrist will serve as a team leader for multi-disciplinary team to ensure quality patient care/treatment. Responsibilities include:

evaluation of patient on admission and development of a comprehensive treatment plan, serve on medical staff committees, complete court papers, documenta-tion of patient progress in medical record, education of patients/families, provision of educational groups for patients.

MEDMONTHLY.COM |67

By placing a professional ad in Med Monthly, you're spending smart money and directing your marketing efforts toward qualified clients. Contact one of our advertising agents and find out how inexpensive yet powerful your ad in Med Monthly can be.

medmonthly.com | 919.747.9031

ADVERTISE YOUR PRACTICE BUILDING IN MED MONTHLY

Wilmington, NC

Established primary care on the coast of North Carolina’s beautiful beaches. Fully staffed with MD’s and PA’s to treat both appointment and walk-in patients. Excellent exam room layout, equipment and visibility.

Contact Medical Practice Listings for more information.

Primary Care Practice For Sale

Medical Practice Listings919.848.4202 | [email protected]


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

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

Highly profitable and organized, you will find this spa poised for success. The qualified buyer can obtain detailed information by contacting Medical Practice Listings at 919-848-4202.

MODERN MED SPA AVAILABLELocated in beautiful coastal North Carolina

MedicalPracticeListings.com | [email protected] | 919.848.4202

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

Call 919- 845-0054 or email: [email protected]

PEDIATRICIANOR FAMILY MEDICINEDOCTOR NEEDED IN

ROANOKE RAPIDS, NC

MedSpa Located in North Carolina

We have recently listed a MedSpa in NC

This established practice has staff MDs, PAs and nurses to assist patients. Some of the procedures performed include: Botox, Dysport, Restylane, Perian, Juvederm, Radiesse, IPL Photoreju Venation, fractional laser resurfacing as well as customized facials. There are too many procedures to mention in this very upscale practice. The qualified buyer will be impressed with the $900,000 gross revenue. This is a new listing, and we are in the valuation process.

Contact Medical Practice Listings today to discuss the practice details.

NC MedSpa For Sale

For more information call Medical Practice Listings at919-848-4202 or e-mail [email protected]


Internal Medicine Practice for Sale


Located in the heart of the medical community in Cary, North Carolina, this Internal Medicine practice is accepting most private and government insurance payments.

The average patients per day is 20-25+, and the gross yearly income is $555,000.

Listing Price: $430,000

Primary Care Practice for SaleHickory, North Carolina

The owning physician is retiring, creating an excellent opportunity for a progressive buyer.

There are two full-time physician assistants that see the majority of the patients which averages

between 45 to 65 per day.

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

You will be impressed with this modern and highly visible

practice.

Call for pricing and details.

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

Established primary care practice in the beautiful foothills of North Carolina

Urgent care practice wanted in North Carolina.

Qualified physician is seeking to purchase an established urgent care within 100 miles of Raleigh, North Carolina. If you are considering retiring, relocations or closing your practice for personal reasons, contact us for a confidential discussion regarding your urgent care. You will receive cash at closing and not be required to carry a note.

Wanted:Urgent Care Practice

Call 919-848-4202 or e-mail [email protected]

Medical Practice ListingsBuying and selling made easy

Med MonthlyMed Monthly is the premier health care

magazine for medical professionals.

By placing an ad in Med Monthly you’ll reach: family medicine, internal

medicine, physician assistants and more!

Call us today to place your classified!

919.747.9031

Also available online 24/7medmonthly.com

OCCUPATIONAL HEALTH CARE PRACTICE FOR SALEGreensboro, North Carolina

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

PRACTICE FOR SALE

Asking price: $385,000

To view more listings visit us online at medicalpracticelistings.com

Pediatrics practice wanted in NCConsidering your options regarding your pediatric prac-tice? We can help. Medical Practice Listings has a well qualified buyer for a pediatric practice anywhere in central North Carolina.

Contact us today to discuss your options confidentially.

Pediatrics Practice Wanted

Medical Practice ListingsCall 919-848-4202 or e-mail [email protected]


American Council on Exercise®

4 8 5 1 P A R A M O U N T D R I V E , S A N D I E G O , C A 9 2 1 2 3 U S A

( 8 0 0 ) 8 2 5 - 3 6 3 6 X 6 5 3 | W W W . A C E F I T N E S S . O R G

A Public Service Message brought to you by the American Council on Exercise,

a not-for-profit organization committed to the promotion of safe and effective exercise

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

ACE Certified: The Mark of QualityLook for the ACE symbol of excellence

in fitness training and education.For more information, visit our website:

www.ACEfitness.org

Kids spend several hours a day playing video games and

less than 15 minutes in P.E. Most can’t do two push-ups.

Many are obese, and nearly half exhibit risk factors of

heart disease. The American Council on Exercise and

major medical organizations consider this situation a

national health risk. Continuing budget cutbacks have

forced many schools to drop P.E.—in fact, 49 states no

longer even require it daily.

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

Swim with your kids. Play catch. Show them exercise is

fun and promotes a long, healthy life. And call ACE. Find

out more on how you can get these young engines fired

up. Then maybe the video games will get dusty.

Unfortunately, its motor is inside playing video games.

Ophthalmic and Neuro-Ophthalmic PracticeRaleigh North Carolina

This is a great opportunity to purchase an established ophthalmic practice in the heart of Raleigh. Locate on a major road with established clients and plenty of room for growth; you will appreciate the upside this practice offers. This practice performs comprehensive ophthalmic and neuro-ophthalmic exams with diagnosis and treatment of eye disease of all ages.

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

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

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

Comprehensive Neuro-Ophthalmic Practice

Please direct all correspondence to [email protected] serious, qualified inquirers.

lOne of the oldest Locums companieslLarge client listlDozens of MDs under contractlExecutive office settinglModern computers and equipmentlRevenue over a million per yearlRetiring owner

MD STAFFING AGENCY FOR SALEIN NORTH CAROLINA

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

72 | MAY 2013

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REGISTERED NURSEOne of the fastest growing health care occupations through to 2018 is a registered nurse, with excellent career opportunities

for aspiring candidates in physi-cians’ offices, home health care services, hospitals, and nursing care facilities. Across the en-tire United States, the career is highly in demand, with more than 580,000 new registered nurses’ jobs being created through 2016.

MEDICAL RECORDS & HEALTH CARE INFORMATION TECHNOLOGYA lot of documentation work goes on in the health care industry and

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

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PHYSICIAN ASSISTANTAs demands on doctors increase, the physician’s assistant is becoming an effective way for patients to receive timely care. A physician assistant is trained to offer diagnostic advice, provide some preventative health care, and even take a look at clinical testing results. As we continue to see a shortage of trained MDs in the US, the PA is quickly becoming part of frontline medical care and 148,000 new PA positions will be created by the year 2016.

MEDICAL SECRETARYAnother top health care career is a medical secretary, responsible for performing a variety of administrative tasks. To perform their work

efficiently, secretaries need to have a good understanding of medical procedures within medical practices or hospitals. According to the US Bureau of Labor Statistics, around 13,000 new jobs will be created in this health care occupation.

HEALTH CARE ADMINISTRATORHealth care administrators handle administrative responsibilities in the medical profession and are in great demand.

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

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the topThe health care industry is one of the

few career fields that, despite hard economic woes, is hiring at an

alarming rate. Health care jobs are expected to grow

faster than any other industry — roughly

22%, or 3.2 million new jobs, by

2018.

Health Care Careers for the Future

The health care industry is one of the few career fields that, despite hard

economic woes, is hiring at an alarming rate. Health care

jobs are expected to grow faster than any other

industry — roughly 22%, or 3.2 million

new jobs, by 2018.

PHARMACY TECHNICIANThe major role of technicians is to assist pharmacists and they are responsible for providing medication products to patients and advice them on the appropriate dos-age. They also count tablets, label bottles and perform a number of administrative tasks under the supervision of

licensed pharmacists. Approximately 91,000 new jobs will be cre-ated in this occupation by 2016.

EMT & PARAMEDICParamedics are first on the scene in emergencies and disasters. They are trained specifically in caring for patients between the site of a crisis and a hospital. A current national shortage of paramedics make this a high entry on future career lists. The projected employment growth for EMT and paramedic jobs is well above average and 39,000 new jobs will be added in this field of health care.

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PHYSICAL THERAPISTPhysical Therapists help people recover physical mobility, find relief from pain, and prevent long-term injury from accidents or disabilities. This very hands-on world of medical care requires profes-sionals specialized in working with different age groups and conditions. This occupation is grow-

ing fast, with approximately 47,000 new jobs being added by the 2016.

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

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Health Care Careers for the Future

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