John Nelson writes…

If you’re a hospitalist, you’re probably asked periodically to describe what a hospitalist does, and have probably developed a fairly standard response.  When in a social setting my response is that I’m a doctor that provides non-surgical care of adult hospitalized patients, like those with pneumonia, heart failure, stroke and other such problems.  When asked by a patient or family in the hospital, I usually give an answer that is more customized to the patient’s particular medical problem.

In November 2009 the SHM Board of Directors approved a new definition of a hospitalist and Hospital Medicine. Read the rest of this entry »

Troy Ahlstrom writes…

As I’m sure you’re aware, CMS has eliminated consult codes for 2010.  (We’ve discussed this topic on this blog previously with Drs. Nelson and Bessler.)  Interestingly, our practice ran an analysis on the effect of changing these inpatient consultation codes (99251-55) over to new patient history and physical codes (99231-33) and found that we might actually do a bit better financially with the conversion.  Welcome findings, no doubt…

However, what about the impact on our colleagues with traditional practice models? Read the rest of this entry »

Public Policy Contributor Ron Angus writes…

Well, it’s time to raise the white flag in reference to the current healthcare reform process winding its way through Washington, DC.  Not the white flag of surrender, but the white flag signaling the last lap of the race!  The most recent lap in this race was completed when the Senate finalized work on HR 3590. SHM formally commented on many provisions of HR 3590 and forwarded those thoughts to key Senators several weeks before the final bill was passed.  The bill passed on the morning of Christmas Eve without a single Republican vote.  It is an interesting historical footnote that the time and date of this vote were dictated respectively by imminent severe winter weather in Washington and the Senate’s impending Christmas Holiday. Read the rest of this entry »

Mike Radzienda writes…

Remember that commercial, “Hey, you got your chocolate in my peanut butter!?”   Those two great tastes that go great together…

How about, “With a name like SMUCKERS you know it’s got to be good?”  If one had never eaten Smuckers jelly, one might have guessed otherwise.

Any-hoo…

Last week I read an article entitled “So You Want To Be An Academic Hospitalist?”  I was disappointed and I submit that the article missed an opportunity to make an important point.  Please indulge me and my lame metaphors: Read the rest of this entry »

Troy Ahlstrom writes…

I don’t know about you, but I don’t understand health care reform.  That’s not to say that I don’t think we need a helping of regulatory medicine to fix what ails the country’s cobbled together healthcare “system.”  I just can’t work the pieces into a functioning whole.

The basic tenets of health care reform debate, 2009-2010 edition, have been:
1)    Provision of universal, or near universal, healthcare to the citizenry of the U.S.
2)    Limiting the costs of healthcare in the U.S. by reducing the growth rate of health care costs to the U.S. government, and thereby, the American taxpayer.
3)    There shall be no rationing of healthcare in the new system.

Given that I can’t model the platitudes and punditry into a functional system for further examination, I’ll just cast them aside and look at the practical aspects in the healthcare economy.  Read the rest of this entry »

John Nelson writes….

Fortunately, the reality isn’t nearly so grim.  In fact, there is some good news here.  If you fell for my intentionally misleading headline, then you might benefit by catching up on the latest news on these two issues.
Read the rest of this entry »

Rob Bessler writes…

Happy holidays to all.

While working the slow nights over the holidays, or while on the beach, I encourage you to take the time to get involved in the challenge of our times centered around meaningful improvements to healthcare delivery in the U.S. The best place to start is to get educated.

One of the great challenges facing our nation is healthcare reform.  The enormity of our system, the complexity of all the different stake holders and the spiraling costs make the situation seem almost helpless. In the book, Read the rest of this entry »

Robert Chang writes…

I was standing in the elevator with four other people, on call during my residency.  It was late but I had finally picked up my burger with fries on my third try to get down to the cafeteria without getting interrupted, so I was happy.  I started to grumble inwardly as the elevator slowed before my floor, my fries leaking heat as the door opened.  A patient was sitting in a wheelchair with a transporter at his back.  The elevator people waited but Read the rest of this entry »

Mike Radzienda writes…

Hospitalists’ certitude number one-hundred-one: “It is never a good thing to be speaking with the chairman of Emergency Medicine at 1:00 AM on a Monday.”

And there I was trying to explain why the admitting medical officer hadn’t returned a page to the emergency department (ED) for thirty minutes; and why, when he did, he seemed “so overwhelmed.”

This was not flu pandemic season; it was just one of those busy “full moon” nights. Our hospitalists Read the rest of this entry »

Rob Bessler writes…

Currently consult codes go away. This will lead to hospitalists having to use the admission codes selectively combined with using more follow up codes for times when they assume care of patients.

Admission codes rvu’s and hence payment are less than the high level consult codes which mean less revenue. Some practices use the prolonged service codes to obtain additional revenue for services performed. Some payers pay for this and most don’t. Currently there is a 21% cut that goes into effect January one. All experts seem to think a patch will get passed to prevent this. Some say Read the rest of this entry »