‘Do as much as you can’ to address challenges, improve patient care, expert says

Key takeaways:

• Getting involved in practice management and advocacy work can combat challenges in the field.
• This includes joining a practice or network that supports your vision and practice style.

Since entering the allergy field, Priya J. Bansal, MD, FAAAAI, FACAAI, has seen positive changes, including the entry of more women and an increase in innovation.

However, she also is aware that many challenges remain, including prior authorizations and documentation burden.

“One of the biggest challenges we face in our field is prior authorization and the burden that it places on physicians as well as patients,” Bansal, allergist/immunologist at the Asthma and Allergy Wellness Center in Saint Charles, Illinois, faculty member at Northwestern Feinberg School of Medicine, and consulting medical editor for Healio’s Women in Allergy, told Healio. “Every insurance company comes up with its own rules for authorization ... we have to guess what they need for approval.”

As the allergy field continues to evolve, physicians face more and more barriers when it comes to maintaining quality care for patients while still making ends meet and providing a good experience to staff.

Healio spoke with Bansal about how she became interested in practice management, the challenges that she’s faced along the way and her solutions to these common challenges.

‘Out of necessity’

Bansal said she began learning about practice management “out of necessity” before realizing her genuine interest in it.

“In fellowship, the billing, coding and practical aspects of management don’t come high on the list of things you’re taught because they’re trying to cram as much medical knowledge into you as they can,” she said.

After attending a practice management workshop, Bansal realized that learning even one new thing about managing her practice could make a huge difference in the way she approached her patients and taught others in the allergy field.

As Bansal continued to learn about practice management and gained recognition as an expert, she became more involved in advocacy work. She started by working with the Illinois Society of Allergy, Asthma & Immunology, then went on to hold positions in the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma & Immunology, both of which have practice management committees and advocacy councils.

“Practice management and advocacy can be accomplished on multiple levels; it just depends on how much time and energy you have, as well as where you want to be active,” she said. “Even if all you can accomplish is sending an email to alert your congressman, the AAAAI or the ACAAI [of] an issue, that’s fine. Maybe that’s all you can handle right now, and that’s OK. Do as much as you can.”

Navigating prior authorization

One way to navigate the challenge of prior authorization is to install benefits checkers in clinic, according to Bansal.

“You’ll also be able to tell whether your patients tried the drugs that the insurance company wanted them to,” she said. “Having uniform practices that are guideline-based for the approval and denial of drugs would help tremendously.”

Bansal additionally recommended obtaining electronic prior authorizations when possible and ensuring that staff are creating phrases to show that the tried and failed medications are documented correctly.

“The system needs an overall fix,” she said. “However, there are a few things we can do right now to make prior authorization easier.”

Combating documentation burden

Bansal said that another practice management struggle physicians face today is documentation burden.

“Years ago, all you had to do was write, ‘Gave them amoxicillin,’ and then you were done. Now, insurance companies want your documentation to be very detailed and clear but not too similar to the last or else they’ll think you’re just copying it,” she said. “That high burden, along with the lack of education on how to properly document, compounds the issue.”

Bansal recommended robustly building out electronic medical records or investing in a scribe to combat documentation burden.

“Invest time into your EMR to regularly check on updates and determine how they can help make things easier for you,” she said. “For individuals who aren’t as tech savvy, consider investing in an AI scribe or virtual assistant to help with your documentation so that you can free up more time to take care of patients.”

Finding balance

Bansal said that one of the things that keeps her up at night as an allergist is the shift from a quality-of-care model to a value-based care model.

“Hospitals or employee-based systems are demanding higher and higher volume,” Bansal told Healio. “Even in private practice, you have to have a certain volume to be able to make ends meet, pay staff and provide quality care to patients.”

To balance maintaining a high volume of patients and providing quality care, Bansal suggested joining a practice or network that supports your vision and practice style.

“This includes having management that you can brainstorm and create solutions with,” she said. “It’s also helpful to create a team atmosphere where the patients know that you have their best interests in mind. I know my patients understand that if I need to spend more time with someone else today, they’re going to get that time when they need it tomorrow.”

She also emphasized the importance of giving yourself grace and prioritizing personal wellness.

“On days that are a little bit rougher, just telling yourself, ‘I’m doing the best I possibly can,’ and setting aside time for self-care is important,” Bansal said.

For more information:

Priya J. Bansal, MD, FAAAAI, FACAAI, can be reached at asthmaallergywellness@gmail.com.