MSSPNexus Blog

Physicians at Risk

Most physicians live each day in a high-stress, goal-oriented, deadline-driven, atmosphere. They live with the realization that one mistake, one overlooked detail, could cost a patient’s life. Sadly, they know that admission of weakness of any kind may cause them to be ostracized by peers and employers.

All of that leads to a deadly, but not unexpected result: For decades doctors have been killing themselves at a far higher rate than other people.

Female doctors kill themselves at a rate 130 percent higher than other adult women, while the rate among male physicians is 40 percent higher than men in general.

This issue was brought to the fore late last year with the suicide of well-known pediatric heart surgeon Dr. Jonathan Drummond-Webb. Press accounts at the time of his death portrayed him as a man tormented by a sense of failure because he could not save every sick child.

We want our doctors to show respect and compassion toward us, and rightly so.  Let’s make sure that we, especially those of us who work closely with physicians every day, return the favor.

Medical community begins to address physician suicide from the June 28th Boston Globe

Female Physicians Face Higher Suicide Risk from Women's E-News

Physician Depression and Suicide Prevention Project - American Foundation for Suicide Prevention

The Power of Compassion

From a Medical Staff Coordinator in Ohio:

Those of us who work in healthcare have the opportunity to interact on a daily basis with professionals from various disciplines. Sometimes in the midst of all the paperwork it's easy to forget that caring for patients is the end result. This is a story about a nurse who touched my life. I don't know her name.

The memories are still clear after nearly a decade. The doctor entered the curtained off post-op area where I calmly waited to be discharged.

Grand Rounds XL

Grand Rounds XL - the best of the medical blogosphere, is up at the Health Business Blog. 

I'm happy to report that MSSPNexus Blog got the nod this week on this post.

Quick Stop for Groceries and a Medical Exam?

It's a growing trend in health care — thousands of people are bypassing the doctor's office and going straight to the mall, pharmacy, or grocery store, when they come down with minor ailments.

ABC News reports that "Walk-in clinics could do for medicine what fast food did for dining: provide cheap, efficient service without the wait."

Here is an ad I found online that features a walk-in kiosk opening this month in a national department store chain:

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You're Sick. We're Quick.™  Walk right in.

Our Certified Family Nurse Practitioners and Physician Assistants evaluate, diagnose and recommend treatments, including appropriate prescriptions for common family illnesses.

• No appointment needed      

• Conveniently located in select stores, near the pharmacy 

• Visits take approximately 15 minutes

• Covered by most insurance plans 

• Open extended hours and weekends 

• Serving those 18 months and older. Patients 16 and 17 years old may be seen without an adult if they have written permission from a parent/guardian.

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I have mixed feelings about this, the "patient" side of me thinks great idea!  I'll be far more likely to get that sore throat or sprained thumb checked out if I can do it this conveniently.  And I've been to my share of physician's offices where a 40 minute wait beyond your scheduled appointment time is the norm, not the exception.

The "credentialer" side of me however, says hold on.  How do we know that the advanced practice nurse or physician assistant seeing patients in a grocery store is qualified, competent and licensed?  What level of interest and involvement do their collaborating or supervising physicians have? And perhaps most importantly, do these APNs and PAs understand and accept the limits of their license and training?

So, would you be willing to make a stop at the local "medical quick-lube?"
      
ABC News Story:
http://abcnews.go.com/WNT/Health/story?id=868775

Interview Questions to Avoid

Planning to interview a potential new staff member for your department?  Here's a scenario you'll want to avoid:

Glad to meet you and thanks for applying to XYZ Healthcare.  Let's get started. What's your date of birth?  So, were you born in the U.S.?  You won't need to take any "cultural holidays" off will you?  How many children do you have?  Planning on any more?  Wow, if I had that many kid's I'd probably be on prescription drugs, are you by the way? 

Well, you get the idea.    

To help you stay on the right side of employment law, HRHero.com has posted a rather lengthy list of interview questions to avoid:
http://www.hrhero.com/q&a/061705-questions.shtml?home

Five Rules for Better PowerPoint Presentations from Working Smart

Michael Hyatt from Thomas Nelson Publishers shares a few tips on effective use of PowerPoint on his Working Smart Blog. 

To them I would add:  Don't pace back and forth between the projector and the screen unless you plan to entertain your audience with some really interesting shadow puppets along the way...

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PowerPoint can be a wonderful tool if used correctly. It can also be a dangerous distraction that interferes with communication rather than facilitating it...

Rule #1: Don’t give PowerPoint center stage
Rule #2: Create a logical flow to your presentation
Rule #3: Make your presentation readable
Rule #4: Remember, less is more
Rule #5: Distribute a handout

Working Smart - Five Rules for Better Power Point Presentations

Major New Case Will Impact Credentialing

Posted below is an e-mail I received from Barbara Blackmond of Horty, Springer & Mattern regarding a case that she and Charlotte Jefferies will cover during the NAMSS Advanced Legal Workshop September 18th in Phoenix. Reprinted here with permission:

A federal court in Louisiana recently held that a Louisiana hospital had a duty to disclose information about their medical staff members to a hospital in Washington in order to protect future patients. Kadlec Med. Ctr. (E.D.La. May 19, 2005). The defendant hospital in that case informed the inquiring hospital that a particular physician had served on the staff for four years, but that, "due to the large volume of inquiries" received by its medical staff office, no further information could be provided.

The physician was appointed to the inquiring hospital's medical staff, but later was successfully sued for malpractice along with the hospital. The inquiring hospital came back against the hospital refusing to give a reference claiming that, had that hospital been more candid, the physician in question would never have been appointed and the adverse incident that triggered the suit would not have happened. The court let the suit go forward.

This case will have profound implications for hospitals throughout the country. Charlotte (Jefferies) and I will discuss the case in depth (at the NAMSS Advanced Legal Workshop).

Barbara Blackmond
Horty, Springer & Mattern
4614 Fifth Avenue
Pittsburgh, PA 15213
phone: 412-687-7677
fax: 412-687-7692
www.hortyspringer.com

Original case:
http://seattlepi.nwsource.com/local/165467_coma19.html

Not a Doctor's Dating Service After All

A few people have asked why I developed the MSSPNexus web site and Blog.

First and foremost, the site was created to support and publicize the vital work of the medical staff services profession. 

Unless you're a hospital administrator, or a physician or allied health provider who has applied for membership or privileges at a healthcare organization, (hospital, managed care panel, ambulatory surgery center, etc.) you probably don't know there is such a thing as a Medical Staff/Professional Affairs Office.  We're often a "behind the scenes" department, at least until something goes dreadfully wrong and suddenly everyone is trying to figure out what failed in the organization's credentialing process.   

When people ask about my job at the hospital, I sometimes jokingly reply that I work for Professional Staff Affairs - a dating service for doctors.  For the most part, listeners aren't sure whether to take me seriously.

In other words, as a profession, we don't have to worry much about identity theft - even we have trouble explaining who we are.

Identity problems aside, medical staff service professionals provide an intrinsically important role in their organizations.  By working closely with medical and administrative leadership to provide thorough and efficient credentials and competency verification, we help get good providers on staff or on panel quickly so that patients' needs can be met, and we act as a firewall to help block access by unsafe or unqualified practitioners.

We help our organizations attain and maintain accreditation, meet licensing requirements, abide by state and federal laws, etc.  As a rule, we can actually quote citations from the Bylaws, the Federal Regs, and the Revised Code. (Obviously, we're really fun at parties!) We're also usually pretty familiar with our in-house counsel, quality officers, the CEO, and Chief-of-Staff.  Sometimes they love us, and sometimes, when we're obstinately arguing an inconvenient standard or regulation, they don't.

If someone needs to know how many members of the medical staff are over the age of 50, have laparoscopic privileges, and speak Spanish, they come to the Medical Staff Office for answers.  If a question arises about a 1998 decision of the Medical Executive Committee, or the year that Dr. Jones retired, we dig through our office archives and come up with the data.

It's an interesting, challenging, sometimes exhausting job.  Most of us who have been in the field for a while have trouble imagining ourselves doing anything else.

Medical Staff Service Professionals - A Vital Part of Your Healthcare Team

Healthiest US Cities - Where Does Your Town Rank?

Under the headline "California Shines, Ohio Aches" Sperling and Centrum have released the results of their "Healthiest US Cities" list.

To create the study, Sperling's BestPlaces culled data on 50 U.S. cities from both public and private sources and tested each city against 50 select measures in five major categories: Physical Activity, Health Status, Nutrition, Lifestyle Pursuits, and Mental Wellness.

Complete list:
http://www.bestplaces.net/docs/studies/healthy_list.aspx

This is not a bill... yet

According to Kevin M.D., the paper trail from a simple doctor's visit can be so labyrinthine that some people simply wait for an envelope from a collection agency before cutting a check.

Having recently received a stack of those "this is not a bill" statements myself, I can empathize.  Glad I'm not sick often, it's just too complicated.