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Jay Weatherly of Salient Health Ventures, (far right) confers with his business partner Steve Nyquist (left) and Dr. Bob Nesbith (center). |
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Doctors Become Businessmen to Control Costs and Quality of Care
We all remember the 19th Century image of the physician who based all of his recommendations strictly on medical science and the needs of the patient, but today's economic reality of high-cost healthcare resources has forced many doctors to find ways to cut costs without compromising the quality of patient care. Many are taking on the additional role of businessmen and investing in entrepreneurial ventures.
Cost containment is one reason for the doctor-turned-investor, but according to Jay Weatherly of Salient Health Ventures in Cullman, it's not the only reason. Some physicians are simply taking advantage of good investment opportunities while others are seeking more control over their practice and their income, he said.
BY ANN B. DEBELLIS |
UAB Critical Care Transport Team evacuated seven babies from the gulf region. |
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Hospitals Aid Katrina Victims
Hospitals across Alabama have been generous in aiding Katrina victims. In Birmingham, the Baptist Health System provided medical assistance to evacuees sheltered at the Birmingham-Jefferson convention center, while doctors and nurses from Princeton, Walker, Citizens, Shelby and Montclair Baptist Medical Centers volunteered at the airport to triage patients brought in by plane. The Baptist Health Foundation established a Hurricane Katrina relief fund designed as a donation vehicle for Baptist employees, as well as the general public.
In addition to admitting a large number of evacuees and existing patients from Mississippi and Louisiana, Brookwood Medical Center is assisting displaced Tenet employees with community placement. Brookwood has also collected food and clothing, while helping people find temporary housing.
BY STEVE SPENCER |
After patients have been discharged from therapy, they can continue their recovery with a |
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Local Hospitals Offer Innovative Therapy Facilities
Whether it's inpatient or outpatient care, some local hospitals offer innovative treatment facilities for therapy and rehabilitation.
The new Regional Care Center at Medical Center East helps patients take the next step after their therapy with an exercise/fitness program.
"It's given us the opportunity to have a larger, nicer facility with better equipment," says Bill Huber, administrative director for MCE rehab. At one end of the facility is outpatient rehab, with physical therapy and occupational therapy. At the other end there's a cardiac rehab area. And in the center is an exercise area, where exercise trainers can help patients progress after they're discharged from therapy in what Huber calls a "step-down" program.
BY DEBORAH LOCKRIDGE |
Physician Spotlight: Dr. David DeAtkine
Growing up in coastal Texas, Dr. David DeAtkine skimmed the waves as a surfer and skimmed the pavement as a skateboarder, but he refused to apply the same technique to his medical practice.
"In the summer of 2003, I had 4,300 active patients," he says. "I was seeing 150 new cases each month and adding on the order of 1,500 patients a year. I felt like I was still doing a good job but if it went further, I would be 'skimming the surface' of thousands of patients rather than doing a really good job with a smaller number. I was thinking there had to be a different way."
BY JUNE MATHEWS |
Richard Brockman |
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Balancing Cost Control and Patient Care
The need to control healthcare costs is an ongoing issue and one that every state works diligently to balance with quality patient care. To help facilitate this need, many U.S. states, including Alabama, are governed by Certificate of Need (CON) laws, which are designed to help control healthcare costs by regulating supply and by requiring advance approval by state agencies for most hospital expansions and major equipment purchases.
"In Alabama, we have measured healthcare because of the CON process," said Birmingham attorney Richard Brockman of the law firm of Johnston, Barton, Proctor and Powell LLP. "CON has been a mandatory program in our state since 1972. When used properly, it ensures that the right amount of healthcare services are used in local communities and that licensed providers provide services correctly. Those states without CON end up with a lot of empty hospital beds and services that are not being provided."
BY ANN B. DEBELLIS |
Aaron Krupp, MGMA Senior Counsel for Government Affairs |
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A Year After Stark, The Bright Line Test Has Dimmed
Healthcare is scrutinized by the government like no other industry, and medical professionals rely on their contingent relationship with attorneys to keep them informed and well within regulations. The federal physician self-referral law, referred to as the Stark law, dictates much of what legal professionals consider in their daily workings with medical clients. Now, over a year after Stark II, Phase II, a look into the medical-legal world paints the picture of an ever increasing rift between hospitals and physician practices and the realities of structuring business deals in the healthcare industry. In addition, new stipulations are making the law more convoluted. Since early last year, the designated health services (DHS) had become finalized, with CMS ensuring that physicians could not benefit from self-referring Medicare or Medicaid beneficiaries to an entity in which they or an immediate family member hold a financial interest, from employment contracts to lease agreements. The law also laid some important exceptions, namely the in-office ancillary exception and one excluding nuclear medicine from the DHS list.
BY HOLLI W. HAYNIE |
Alice H. Martin, U.S. Attorney for the Northern District of Alabama |
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Healthcare Crime Doesn't Pay
Every U.S. president's administration focuses on certain initiatives. Under the Bush Administration, the Department of Justice has cracked down on healthcare fraud, in particular the physicians who commit fraudulent crimes.
"I think [the Bush] administration is appropriate in its aggressive stance against healthcare fraud," said Alice H. Martin, U.S. Attorney for the Northern District of Alabama. "Sometimes people do things without knowing they've crossed legal boundaries. Others willfully violate the law. We're taking aggressive action against the willful offenders."
Over the past several years, the case load in Alabama's Northern District has increase 250 percent, Martin said. Of the 93 districts in the United States, her district is eighth in the nation based on the number of civil healthcare cases filed. Some of the areas that have filed more cases include Manhattan, Philadelphia, New York City and Dallas. "We're high on the list for the size of our city, but we do have a large medical community here so these crimes are a considerable focus in our office," Martin added.
BY ANN B. DEBELLIS |
New Cycle Activates Paralyzed Muscles
Even after his death, paralyzed actor Christopher Reeve is still contributing to rehabilitation advances. That's according to Dr. John McDonald, who directs the International Center for Spinal Cord Injury at Kennedy Krieger Institute in Baltimore. The latest advance taking advantage of work done with Reeve and others is a breakthrough medical device to help restore motor functions to previously paralyzed muscles.
"Part of that concept really bore through with the work that we did with Christopher Reeve, demonstrating that he could recover major function many years out from his injury. That kind of shattered the old myth that most of the recovery is in the first year, and then after that it's finished. It's just not true," says McDonald, who was Reeve's lead neurologist.
BY SHARON H. FITZGERALD |
Jay Segal, PT, agrees that patients benefit when physicians and therapists work together. |
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Physicians, Therapists Can Work Together to Benefit Patients
,C,*?y that's home to some of the nation's top sports orthopedists and one of the nation's largest providers of rehabilitative healthcare services, physical therapy and rehabilitation probably enjoy a higher profile than in Birmingham than in many cities. But at the same time, those factors could obscure the fact that therapy offers benefits for many different patients and conditions, not just athletes and joint replacement patients. We spoke to several local therapists for some thoughts on how patients could benefit from a visit to a physical therapist.
Emmett Parker, PT, ATC, owner of Accelerated Physical Therapy in Trussville, explains how therapy differs from the practice of medicine. "If someone breaks their arm, we don't treat a fractured humerus," he says. "We treat the loss of motion, the loss of strength, the loss of function [that results from that fracture]."
BY DEBORAH LOCKRIDGE |
Dave Mason, American Physical Therapy Association |
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Medicare Beneficiaries May Face Therapy Reimbursement Cap
Have you ever really wanted to do something and just didn't have the money? According to Dave Mason with the American Physical Therapy Association, that's the position Congress is in when it comes to the reimbursement cap on physical therapy benefits for Medicare beneficiaries. Of course, that may not help those elder Americans who depend on Medicare benefits to receive the therapy they need.
"It's just a very problematic policy — one of those that for the best of intentions just kind of runs into the budget rules, and Congress has been struggling to figure out a good way out of the situation," says Mason, vice president of government affairs for the American Physical Therapy Association. Should Congress fail to act by the end of the year, Medicare therapy benefits will be capped at about $1,750 per calendar year for all Medicare recipients, no matter the nature of their malady, the nature of their therapy or where they receive that therapy.
BY SHARON H. FITZGERALD |
Lakeshore Foundation's many group exercise classes are adapted for individuals who may be either seated or standing throughout the class. |
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Lakeshore Foundation: Healthy Living After Rehab
Chances are, you know about Lakeshore Foundation for its sports programs for the disabled. After all, much of the critically acclaimed movie "Murderball," about the 2004 U.S. Paralympic quadriplegic wheelchair rugby team, was shot at Lakeshore's renowned facilities. The U.S. Olympic Committee chose Lakeshore as the first combined training site for Olympic and Paralympic sports.
What you may not know is that the non-profit organization offers exercise and recreational opportunities for people with a wide variety of disabilities and chronic conditions. One of the most comprehensive fitness facilities for the disabled in the country, Lakeshore can benefit patients with severe arthritis, chronic back pain, diabetes, cardiac conditions, spinal cord injury, stroke, spina bifida, cerebral palsy, amputation, MS, MD, visual impairment, Parkinson's Disease, cancer, fibromyalgia and more.
BY DEBORAH LOCKRIDGE |
Jerry Stone |
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ReDoc Simplifies the Lives of Therapists
Who better to help design a software package for physical therapists than a physical therapist? That's the logic Jerry Stone applied 10 years ago when he founded ReDoc, his Nashville-based medical software company. After two decades as a physical therapist and frustrated by the overwhelming documentation requirements of the job, Stone decided to tackle the problem himself.
"I saw there was a need to alleviate the paperwork involved," he recalls. "Having a lot of experience in that field, I was able to work with some software developers and develop a tool that automates all of this paperwork and decreases the paperwork time by about 50 to 60 percent for the treating therapist." The ReDoc Suite of software modules answers the needs of physical therapists, occupational therapists and speech language pathology therapists.
BY SHARON H. FITZGERALD |
St. Vincent's Neurosurgical Center operating rooms feature all-digital, state-of-the-art equipment. |
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Joint Venture Results in New Outpatient Neurosurgical Center at St. Vincent's
A collaboration between two different neurosurgery groups and St. Vincent's has led to the opening of a new neurosurgical outpatient center which is housed in the hospital's new North Tower.
"St. Vincent's Neurosurgical Center is a first for Alabama and one of few such facilities throughout the country, dedicated to the provision of outpatient neurosurgical and interventional pain procedures," says Scott Goggins of St. Vincent's. "This unique focus, coupled with the compassion and competency of the professional staff in the Center, should lead to an outstanding patient experience."
Several local neurosurgeons began discussing the idea a couple of years ago when they heard of a similar venture in Nashville. Benjamin B. Fulmer, MD, a neurosurgeon with Birmingham Neurosurgery and Spine Group, says they were impressed with the efficiency of the Nashville center, and they felt it would take two different groups working together to have enough cases to make the project work. Colleagues with Neurosurgical Associates were interested, and they began to search for a hospital that would work with them.
BY MARTI WEBB SLAY |
CytoViva 150 adaptor and light source installed on a microscope. |
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New Microscope Technology Offers Real-Time Nano View
A new adapter to traditional microscopes is expected to take light microscopy to a new level. Developed by a professor at Auburn University, the CytoViva allows resolutions below 100 nanometers and detection capability below 10 nanometers. The resolution of traditional microscopy is limited to only about 240 nanometers.
"What this really does is provide a very focused and a very directed beam of light to a very, very tiny target," explains Charles T. Ludwig, president and chief executive officer of Aetos Technologies Inc., a privately held technology development company in partnership with Auburn. The CytoViva "fills the gap," he says, between a conventional light microscope and an electron microscope.
BY SHARON H. FITZGERALD |
How Can Relationships Between Physicians and Hospitals Improve?
Though strained relationships between physicians and hospitals get the most attention, many are finding ways to work to their mutual benefit. There is no one solution, but everyone can benefit from good communications and creative thinking.
"Hospitals and physicians can improve their relationships if they do nothing more than just communicate more effectively with one another," says Jay Weatherly, principal and co-founder of Cullman-based Salient Health Ventures. He admits this is not always easy.
"You have two very busy parties who know they need one another and have great intentions of communicating with one another," says Weatherly. He says one way to open lines of communication is finding important and tangible things to do together. "That's why we encourage hospitals to develop proactive strategies for working with their doctors."
BY ANN HALPERN |
Companies Getting Aggressive in Putting Lid on Insurance Hikes
Largely by assessing steadily rising co-pays for employees, companies have been able to ratchet down next year's increases in healthcare premiums to the lowest level in five years, says employee benefits consultant Hewitt Associates. But with average premiums still shooting up an average of 12.4 percent, the march of double-digit rate hikes continues and greatly outpaces inflation.
In addition, a new survey by the nonprofit Kaiser Family Foundation found that rising premiums are forcing a growing number of small businesses out of the market altogether, with the percentage of such companies offering group coverage sliding from 69 percent in 2000 to 60 percent this year.
BY TRACY STATON |
Dr. Ted Chan |
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Study Finds new ER Procedures Reduces Numbers Who Leave Without Being Seen
In emergency departments around the country, many of the patients who show up needing help never get it — and leave before ever seeing a doctor. According to the General Accounting Office, leave-without-being-seen rates may be as high as 7 percent nationally, and some experts say individual hospitals may have an unexplained departure rate as high as 15 percent.
For many patients, crowded ED departments have made the wait for a doctor simply too long to be endured.
"There were increasingly long stays for a number of reasons," says Dr. Ted Chan, who works in the ED at the University of California, San Diego, Medical Center, where the average wait times for emergency patients hits two hours during peak demand periods. And it wasn't possible just to expand the amount of space given to the department, either.
BY JOHN CARROLL |
FDA Approves Xeloda® Oral Chemotherapy for Colon Cancer Treatment
After a two-year long international clinical trial involving 2000 patients, the FDA approved the first oral chemotherapy drug for the adjuvant treatment of Dukes' C colon cancer. The innovative new drug, Xeloda® (capecitabine) by Roche Pharmaceuticals in New Jersey, was given to half of the patients while the others received intravenous fluorouracil plus leucovorin or 5-FU/LV, the foundation for chemotherapy for the last 40 years. The X-ACT trial, which stands for "Xeloda® in Adjuvant Colon Cancer Therapy" showed that Xeloda® not only met its primary endpoint of non-inferiority to 5-FU/LV but surpassed it by 15 percent according to Dr. Howard A. Burris III, FACP, Director of Drug Development at the Sarah Cannon Research Institute in Nashville, Tenn., one of the lead American accruers in the study.
BY NICK CHARLES |
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