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Hawaii 2003 speakers: Question, innovate ... and relax
Speakers brought a broad range of expertise to the Hawaii 2003 Practice Management sessions.
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MAUI, Hawaii — The practice management section of Hawaii 2003: The Royal Hawaiian Eye Meeting held as much practical information for physicians as the clinical sessions. Nationally and internationally known experts in practice and lifestyle management shared tips on how to lead an ophthalmic practice more efficiently, how to use an attorney more effectively and, perhaps most important, how to relax and relieve the pressures of practice.
This article briefly summarizes some of the experts’ remarks at the meeting. Look for more information from these practice management experts’ Hawaii 2003 presentations in a special supplement to be mailed with the April 15 issue of Ocular Surgery News.
Use your attorney
Frequently asking questions on business and practice-related issues is the best way to develop and secure a symbiotic relationship with your attorney, according to Alan E. Reider, JD.
Mr. Reider illustrated how physicians can make the most efficient use of their attorneys by comparing and contrasting use of a physician with use of an attorney.
“Physicians should be as inquisitive as their patients are about their health when asking questions that affect their business, monetary funds and success,” Mr. Reider said. “Think of the lawyer as your ‘doctor’ who can help you understand the risks, benefits and alternatives to a business venture or obligatory litigation.”
Most important, he said, physicians should ask their attorneys what monetary losses or gains they may face in a new business venture or litigation.
“There is a good chance that the attorney’s estimate of fees, hourly rates and total costs for a new business endeavor will turn out to be on target,” Mr. Reider said.
He said the estimated cost for litigation can rise or fall depending on a number of variables, including initial disclosure and willingness of the other party to settle.
According to Mr. Reider, another important question to ask is, “How long will attorney services take?”
“The length of time for a particular issue depends on the time spent getting accurate facts and documentation. Also, the physicians’ disclosure and compliance from all parties involved can influence the time spent on the case,” Mr. Reider said.
By working closely with an attorney — getting a thorough explanation of the process and the factors involved in new ventures — surgeons can go into new financial experiences with improved consent and understanding.
Ups and downs in billing
Having a physician become Senate majority leader was one of the good things that took place on the reimbursement front in 2002, according to consultant Kevin J. Corcoran, COE, CPC, FNAO.
Mr. Corcoran cited several good – and not so good – developments in billing and coding issues in 2002.
He cited the election of Sen. Bill Frist, R-Tenn., to Senate majority leader in late 2002 as one of the good things. He said Medicare is one of Sen. Frist’s priorities. Mr. Corcoran also described as “positive” Sen. Frist’s relationship with the American Society of Cataract and Refractive Surgeons.
Also among the positive points in 2002 was a slight increase of 2% to 3% in payment rates for ambulatory surgery centers, he said.
Mr. Corcoran described the 2003 Medicare fee schedule as bad news. If implemented in its current form, it will mean a 4.4% decrease in reimbursement for physicians.
However, he noted, House Ways and Means chairman Bill Thomas, R-Calif., introduced legislation in January to halt implementation of the 2003 fee schedule and prevent the cuts, which are slated to take effect March 1.
Mr. Corcoran described the Medicare conversion factor as a “roller coaster ride, with 2002 on the downward part.”
Leisure activities critical
This year’s Lifestyles session of Hawaii 2003: the Royal Hawaiian Eye Meeting focused on leisure-time activities and the ways physicians can get away from the pressures of medicine.
Spencer P. Thornton, MD, moderator for this session, explained to attendees that physicians need to achieve happiness and “to inspire confidence and motivate action among our colleagues.”
Elizabeth A. Davis, MD, compared her hobbies and her career to the “long and winding road to Hana,” a destination on Maui. “The road is full of twists and turns. But like the road to Hana, life is not about the destination, it’s about the journey,” she said.
Dr. Davis said she was involved in sailing, classical ballet and jazz dance as hobbies as a young person, and she has recently turned her interests to cooking and to exercising with a personal trainer.
“I can bench press one-eighth of what he can,” she joked.
Dr. Davis initially began her training as a cardiac surgeon but turned to ophthalmology. She said her godfather, I. Howard Fine, MD, was “a famous and fortunate influence” on her and ophthalmology came to be “a natural fit.”
Dr. Davis said she has no regrets about leaving cardiac surgery and said that her goal in life is to achieve “balance and peace.” She is a partner at Minnesota Eye Consultants in Minneapolis.
Don Ham, MD, also described a hobby he recently took up. He and two of his physician colleagues attended a camp in West Virginia to learn to play the steel drum. The camp was mainly attended by high school and college band members, music teachers and amateur and professional musicians, and he commented that the other musicians were intrigued by their presence.
He said that taking up such a hobby showed him that “we shouldn’t be intimidated by something totally different from what we normally do.”
Observations lead to innovation
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The perception of clinical observations and their relevance to physicians in their daily practice needs to be changed, said Arthur Jampolsky, MD.
Dr. Jampolsky, founding director and co-executive director of the Smith-Kettlewell Eye Research Institute at the California Pacific Medical Center in San Francisco, was this year’s recipient of the Philip M. Corboy Memorial Award for Distinguished Service to Ophthalmology.
“Terminology creates attitudes,” he told the audience. “What is the difference between clinical research and basic research? Or the difference between lab scientists and clinicians?”
Dr. Jampolsky reminded the audience how many scientific breakthroughs, including the discovery of penicillin, the invention of the IOL and the idea of using aspirin as a blood thinner, have happened because of simple observations.
“We need to fault the lab people for not putting forward what will benefit patients,” he said. “When you read an article, ask yourself, what’s the usefulness in everyday practice?”
People who are interested in research excel, Dr. Jampolsky said, because of what he called the “Aha! feeling.”
“There’s a joy that comes with doing research,” he said. “It’s the thrill of discovering something, when eyes pop open and eyebrows rise up. The feeling of Aha! is reward enough.”
There are two types of observations, Dr. Jampolsky said, new observations and the finishing touches that become the final building blocks of real science.
“Patients are nature’s experiments. We use observations to detect problems and solutions,” he said.
Dr. Jampolsky offered advice to physicians and surgeons in any specialty: “Recount all the good things that clinical observations have done for science. When a lab researcher is presenting, ask him or her what is the relevance of his discovery. What problem was he trying to solve? Why did he choose to solve it that way? Simple questions yield the best and most useful responses.”
Always question the significance of any research, he advised. “Challenge people, especially if you’re in the position to change attitudes. Do not be afraid.”
The Philip M. Corboy, MD, Perpetual Award for Distinguished Service to Ophthalmology became the Memorial Award when Dr. Corboy died of cancer in 1992. The Hawaiian Eye Foundation and the organizers of Hawaii 2003 thanked Bausch & Lomb for its continued support of the Philip M. Corboy Award.