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Li KD, Hakam N, Sadighian MJ, Holler JT, Nabavizadeh B, Amend GM, Fang R, Meeks W, Makarov D, Breyer BN. Evaluating Quality Improvement and Patient Safety Amongst Practicing Urologists: Analysis of the 2018 American Urological Association Census. Urology 2021; 156:117-123. [PMID: 34331999 DOI: 10.1016/j.urology.2021.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/17/2021] [Accepted: 07/18/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe factors associated with Quality improvement and patient safety (QIPS) participation using 2018 American Urological Association Census data. QIPS have become increasingly important in medicine. However, studies about QIPS in urology suggest low levels of participation, with little known about factors predicting non-participation. METHODS Results from 2339 census respondents were weighted to estimate 12,660 practicing urologists in the United States. Our primary outcome was participation in QIPS. Predictor variables included demographics, practice setting, rurality, fellowship training, QIPS domains in practice, years in practice, and non-clinical/clinical workload. RESULTS QIPS participants and non-participants significantly differed in distributions of age (P = .0299), gender (P = .0013), practice setting (P <.0001), employment (employee vs partner vs owner vs combination; P <.0001), and fellowship training (P <.0001). QIPS participants reported fewer years in practice (21.3 vs 25.9, P = .018) and higher clinical (45.2 vs 39.2, P = .022) and non-clinical (8.76 vs 5.28, P = .002) work hours per week. Non-participation was associated with male gender (OR = 2.68, 95% CI 1.03-6.95) and Asian race (OR = 2.59, 95% CI 1.27-5.29) for quality programs and private practice settings (ORs = 8.72-27.8) for patient safety initiatives. CONCLUSION QIPS was associated with academic settings. Interventions to increase rates of quality and safety participation should target individual and system-level factors, respectively. Future work should discern barriers to QIPS engagement and its clinical benefits.
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Affiliation(s)
- Kevin D Li
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Nizar Hakam
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Michael J Sadighian
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Jordan T Holler
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Behnam Nabavizadeh
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Gregory M Amend
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Raymond Fang
- Department of Data Management and Statistical Analysis, American Urological Association, Linthicum, MD
| | - William Meeks
- Department of Data Management and Statistical Analysis, American Urological Association, Linthicum, MD
| | - Danil Makarov
- Population Health and Health Policy, New York University School of Medicine Veterans Affairs New York Harbor Healthcare System-Brooklyn, Brooklyn, NY
| | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, CA; Department of Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA.
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Romeo M, Gonzalez-Peinado D, Duran H. Will private plastic surgeons survive the pandemic? Analyzing the impact of COVID-19 on private practice. J Plast Reconstr Aesthet Surg 2021; 74:1633-1701. [PMID: 33736963 PMCID: PMC7944743 DOI: 10.1016/j.bjps.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/17/2021] [Accepted: 02/26/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Marco Romeo
- Private practice, Hospital Moncloa. Madrid, Spain.
| | - David Gonzalez-Peinado
- Department of Plastic and Reconstructive Surgery, Hospital Universitario La Paz. Madrid, Spain
| | - Hector Duran
- Práctica privada Merida Yucatan México, ASPS, ASAPS, SAPS, AMCPER Mexico
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Abstract
Over the last fifteen years, official texts regulating nursing practice have expanded the scope of nurses' functions. The prescribing of medical devices for dressings and the monitoring of oral chemotherapy at home illustrate this evolution for private practice nurses. However, while these technical skills are recognised, the private practice nurse's coordination role still needs to be acknowledged.
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Desprès C. [How information on a patient's social status is gathered. An anthropological analysis of the discourses employed in private medical practice]. Rev Epidemiol Sante Publique 2020; 68:235-242. [PMID: 32631664 DOI: 10.1016/j.respe.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/16/2020] [Accepted: 06/12/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A number of studies have highlighted differences and even discrimination in health care offer according to social category, and shown that they contribute to the production of inequality. On the other hand, when the health care system treats every patient equally, and does not take personal difficulties into consideration, some authors have suggested inequality "by omission". That is why public health actors at different levels have recommended systematic collection of information on patients' social status. The objective of this article is to analyze data gathering on patients' socio-economic condition and its repercussions. METHODS The survey is based on more than 50 semi-structured face-to-face interviews with doctors and dentists in private practice. Their answers were subjected to socio-anthropological analysis. RESULTS While some practitioners collect information on patients' social status proactively by systematic interrogation, others proceed indirectly and in accordance with subjective criteria. Quite often, patient status remains ignored, usually due to lack of interest, and less frequently because practitioners wish to guard against any risk of stigmatizing underprivileged patients. Different rationales may explain these attitudes: need to prioritize relevant information, wish to observe equity and equality, determination to refrain from social labeling, desire to protect patient self-esteem and to reinforce the practitioner-patient relationship. When identification does occur, it is essentially justified by a desire to adapt the care pathway to potential socio-economic obstacles. CONCLUSION When a patient's social situation is sought out by private doctors and dentists, they are mainly concerned with customizing care pathways by taking financial impediments into close consideration. In most cases, their justifications for asking questions are subjective; by doing so, they inadvertently introduce arbitrariness in an area where the French state endeavors to produce social justice via provisions such as "CMU" ("universal", across the board health coverage). Systematic questioning on a patient's social status can represent a form of supplementary if unconscious symbolic violence toward frequently disqualified persons; what is more, it runs the risk of inducing stereotypes and manifesting prejudice. Only when contextualized does such questioning seem appropriate. On the other hand, when a practitioner misses out on social issues liable to impede care and treatment, he will probably have no "second chance" to address these concerns. Some practitioners have emphasized a need for suitable timing and contextualizing of questions on a patient's social status, and for putting them forward in a climate of trust.
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Affiliation(s)
- C Desprès
- Centre de recherche des Cordeliers, équipe d'accueil ÊTRES, université de Paris René-Descartes, 45, rue des Saints-Pères, 75006 Paris, France.
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Sadananda Naik B. Medical referrals in private practice: Need to keep the fine fabric intact. Indian Heart J 2019; 71:425. [PMID: 32035528 PMCID: PMC7013204 DOI: 10.1016/j.ihj.2019.11.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/25/2019] [Indexed: 11/29/2022] Open
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Affiliation(s)
- V Raman Muthusamy
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California.
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Malbon E, Alexander D, Carey G, Reeders D, Green C, Dickinson H, Kavanagh A. Adapting to a marketised system: Network analysis of a personalisation scheme in early implementation. Health Soc Care Community 2019; 27:191-198. [PMID: 30151934 DOI: 10.1111/hsc.12639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 06/12/2018] [Accepted: 07/18/2018] [Indexed: 06/08/2023]
Abstract
As governments worldwide turn to personalised budgets and market-based solutions for the distribution of care services, the care sector is challenged to adapt to new ways of working. The Australian National Disability Insurance Scheme (NDIS) is an example of a personalised funding scheme that began full implementation in July 2016. It is presented as providing greater choice and control for people with lifelong disability in Australia. It is argued that the changes to the disability care sector that result from the NDIS will have profound impacts for the care sector and also the quality of care and well-being of individuals with a disability. Once established, the NDIS will join similar schemes in the UK and Europe as one of the most extensive public service markets in the world in terms of numbers of clients, geographical spread, and potential for service innovation. This paper reports on a network analysis of service provider adaptation in two locations-providing early insight into the implementation challenges facing the NDIS and the reconstruction of the disability service market. It demonstrates that organisations are facing challenges in adapting to the new market context and seek advice about adaptation from a stratified set of sources.
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Affiliation(s)
- Eleanor Malbon
- Centre for Social Impact, School of Business, University of New South Wales
| | - Damon Alexander
- School of Arts and Social Sciences, Swinburne University, Hawthorn, Vic., Australia
| | - Gemma Carey
- Centre for Social Impact, School of Business, University of New South Wales
| | - Daniel Reeders
- Centre for Social Impact, School of Business, University of New South Wales
| | - Celia Green
- Centre for Social Impact, School of Business, University of New South Wales
| | - Helen Dickinson
- Public Service Research Group, School of Business, University of New South Wales, Canberra, Australia
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Abstract
Rheumatology has evolved rapidly over the past 20 years. The availability of numerous treatment interventions has dramatically altered patient outcomes and revitalized the specialty. At the same time, the economics of medical practice is challenging the practicing rheumatologist to seek more efficient and more attractive models of care delivery. These models of care must be attractive not only to rheumatologists and their patients but also to other interested parties as well, such as payers, government agencies, and accreditation bodies.
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Affiliation(s)
- Gerald M Eisenberg
- Illinois Bone and Joint Institute, 9000 Waukegan Road, Morton Grove, IL 60053, USA.
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Nuffer W, Harmon C, Dye L, Nishiyama M. A novel advanced pharmacy practice experience training model focused on medication therapy management delivery within provider offices. Curr Pharm Teach Learn 2018; 10:1288-1294. [PMID: 30497633 DOI: 10.1016/j.cptl.2018.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 04/02/2018] [Accepted: 06/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND PURPOSE Pharmacist-delivered medication therapy management (MTM) services are an important part of practice, and students should be trained in MTM provision. Current MTM utilization falls short of the potential benefits that pharmacists could provide, and there are barriers to successful MTM completion. New MTM models need to be explored to demonstrate the pharmacist's role on the medical team and to provide models for cost saving to insurers. EDUCATIONAL ACTIVITY AND SETTING This manuscript describes a novel grant-funded MTM model supported by fourth year pharmacy students in partnership with several medical clinics. Qualifying patients receive MTM services in the provider office. Students are responsible for maintaining day-to-day operations of the MTM program. FINDINGS Twe pharmacy students completed their MTM training through this model between April 2016 and September 2017. 123 patients received MTM services, with the average time spent with patients estimated at 41 min. A total of 238 patient encounters were provided. Poor adherence, inappropriate drug dose/dosage form or frequency, and patient side effects were the most common problems addressed. Students reported high satisfaction with this model. DISCUSSION Providing MTM services, directly in the medical clinic, represents an innovative model of care where students have multiple interprofessional interactions. The extended period of time spent with patients is not supported by reimbursement rates, suggesting an expansion may be appropriate. Further cost analyses and health outcomes need to be collected to justify this increased expense. SUMMARY This MTM model represents an important alternative to current practice and promotes interprofessional collaboration.
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Affiliation(s)
- Wesley Nuffer
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences, 12850 E Montview Blvd., C238-V20-1116J, Aurora, CO 80045, United States.
| | - Christy Harmon
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences, 12850 E Montview Blvd., C238-V20-1116J, Aurora, CO 80045, United States.
| | - Leigh Dye
- Contract Public Health Pharmacist with Tri-County Health Department, 4857 S Broadway, Englewood, CO 80113, United States.
| | - Masayo Nishiyama
- Tri-County Health Department, 15400 E. 14th Place, Suite 115, Aurora, CO 80011, United States.
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Wegrzyniak LM, Hedderly D, Chaudry K, Bollu P. Measuring the effectiveness of patient-chosen reminder methods in a private orthodontic practice. Angle Orthod 2018; 88:314-318. [PMID: 29376734 PMCID: PMC8288327 DOI: 10.2319/090517-597.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/01/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of patient-chosen appointment reminder methods (phone call, e-mail, or SMS text) in reducing no-show rates. MATERIALS AND METHODS This was a retrospective case study that determined the correlation between patient-chosen appointment reminder methods and no-show rates in a private orthodontic practice. This study was conducted in a single office location of a multioffice private orthodontic practice using data gathered in 2015. The subjects were patients who self-selected the appointment reminder method (phone call, e-mail, or SMS text). Patient appointment data were collected over a 6-month period. Patient attendance was analyzed with descriptive statistics to determine any significant differences among patient-chosen reminder methods. RESULTS There was a total of 1193 appointments with an average no-show rate of 2.43% across the three reminder methods. No statistically significant differences ( P = .569) were observed in the no-show rates between the three methods: phone call (3.49%), e-mail (2.68%), and SMS text (1.90%). CONCLUSIONS The electronic appointment reminder methods (SMS text and e-mail) had lower no-show rates compared with the phone call method, with SMS text having the lowest no-show rate of 1.90%. However, since no significant differences were observed between the three patient-chosen reminder methods, providers may want to allow patients to choose their reminder method to decrease no-shows.
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Affiliation(s)
- Dhruv Khullar
- Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | | | - Lawrence P Casalino
- Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York
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Abstract
OBJECTIVE To establish the percentage of Catalonian rheumatologists who attended to private patients, to understand the most common processes in private practice, to determine the dedication to patient care and the necessary activities to guarantee proper care, such as continuing education and office management, and to know what techniques were most widely used. MATERIAL AND METHODS A personalized survey of Catalonian rheumatologists whose e-mail addresses were made available to us. Fifty-two responses were analyzed. RESULTS The percentage of men (52%) and women (48%) was similar; 33% worked exclusively in private rheumatology (PR), most of them in hospitals or medical teams; 11% worked alone; 27% were in training. The disease most frequently treated was osteoarthritis; 51% were involved in studies or clinical trials in the field of RP. CONCLUSIONS The concept of RP as a private business is changing and is progressively being transformed into working units with a structure similar to public hospitals with formal training. This report provides new data on the activities and characteristics of private rheumatologists.
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Anand AC. Medical Practice Management: An update. Natl Med J India 2017; 30:163-166. [PMID: 28937007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- A C Anand
- Senior Consultant Hepatology and Gastroenterology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110076, India
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Walle M. [Takeover of Cross-Sectoral Care by Private Providers? - Pro]. Psychiatr Prax 2017; 44:125-126. [PMID: 28399598 DOI: 10.1055/s-0043-102407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Längle G. [Takeover of Cross-Sectoral Care by Private Providers? - Contra]. Psychiatr Prax 2017; 44:126-127. [PMID: 28399599 DOI: 10.1055/s-0043-101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Gerhard Längle
- Kliniken für Psychiatrie und Psychotherapie, Südwürttembergische Zentren für Psychiatrie
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Iacobucci G. GP leaders in Northern Ireland to begin collecting resignation letters from practices. BMJ 2017; 356:j503. [PMID: 28130244 DOI: 10.1136/bmj.j503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dyer C. Gynaecologist is struck off for lying about indemnity cover. BMJ 2017; 356:j72. [PMID: 28057702 DOI: 10.1136/bmj.j72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sanders DL. Due Diligience for Independent Practice: an introductory overview. MD Advis 2017; 10:13-18. [PMID: 29286597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Denise L Sanders
- Esq., shareholder in the Health Law Department of Capehart Scatchard, P.A. in Mount Laurel, New Jersey, and heads the firm's Privacy, Security and Data Breach Practice
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Bark L. What I've Learned from 46 Years in Private Practice. Beginnings 2016; 36:14-28. [PMID: 29772125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Strickler K. OPENING A PRIVATE PRACTICE. Iowa Med 2016; 106:8-9. [PMID: 30157320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Meehan TP, Tate JP, Holmboe ES, Teeple EA, Elwell A, Meehan RR, Petrillo MK, Huot SJ. A Collaborative Initiative to Improve the Care of Elderly Medicare Patients With Hypertension. Am J Med Qual 2016; 19:103-11. [PMID: 15212315 DOI: 10.1177/106286060401900303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Qualidigm, the Connecticut Quality Improvement Organization (QIO), collaborated with 17 primary care physicians (PCPs) in private practice to improve the care of elderly patients with hypertension. Patients were identified from Medicare billing data and care was assessed from medical records. Improvement interventions included feedback of baseline performance data and provision of a variety of practice enhancing materials. Care was assessed for 590 patients in 1997 (16-47 patients/PCP) and 547 patients in 1999 (7-51 patients/PCP). Patient characteristics were similar in both periods. Use of recommended therapies and blood pressure control, ie, percent < 140/90 mm Hg, was low and did not improve significantly between the 2 periods (aggregate 39% in 1997 versus 42% in 1999; P = .24). Care of elderly patients with hypertension was not improved with a multifaceted QIO intervention. Additional study is required to determine incentives, barriers, and facilitating factors for quality improvement in the private practice primary care setting.
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Campbell J. Succession planning for private practices. Med Econ 2016; 93:39-40. [PMID: 27526412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
The aim of this review was to assess the benefits and drawbacks of conducting neurological clinical trials and research in private practice for the patients, clinician, Practice Manager, sponsors/Clinical Research Organisations (CROs) and Clinical Trial Coordinator (CTC) to determine if this is justified for all involved. A combination of literature reviews, original research articles and books were selected from 2005 to 2015. Provided that the practice has sufficient number of active trials to prevent financial loss, support staff, adequate facilities and equipment and time, the benefits outweigh the drawbacks. Clinical trials provide patients with more thorough monitoring, re-imbursement of trial-related expenses and the opportunity to try an innovative treatment at no charge when other options have failed. For the clinician, clinical trials provide more information to ensure better care for their patients and improved treatment methods, technical experience and global recognition. Trials collect detailed and up-to-date information on the benefits and risks of drugs, improving society's confidence in clinical research and pharmaceuticals, allow trial sponsors to explore new scientific questions and accelerate innovation. For the CTC, industry-sponsored clinical trials allow potential entry for a career in clinical research giving CTCs the opportunity to become Clinical Research Associates (CRAs), Study Start-Up Managers or Drug Safety Associates.
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Affiliation(s)
- R G Beran
- Liverpool Hospital, Sydney, NSW, Australia
- Griffith University, Gold Coast and Brisbane, Qld, Australia
- Strategic Health Evaluators, Sydney, NSW, Australia
| | - D Stepanova
- Strategic Health Evaluators, Sydney, NSW, Australia
| | - M E Beran
- Strategic Health Evaluators, Sydney, NSW, Australia
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Edlow RC. Practice Consolidation: Forces Not of Nature, but of Government, Demographics, Economics, and Technology. J Med Pract Manage 2016; 31:313-316. [PMID: 27249885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The demand for healthcare services is increasing more rapidly than the supply of providers, while reimbursement levels ignore the free market law of supply and demand. The regulated healthcare environment in the United States fails to increase prices (i.e., reimbursement rates) as demand outstrips supply. Healthcare practitioners must find alternative methods in order to continue providing excellent patient care while at the same time maintaining an economically viable practice. Practice consolidation with the assistance of private equity healthcare investment is an extremely attractive solution to this imbalance.
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Nalliah RP. Dentistry Should Adopt Strategies from Large Hospital Networks. J Mich Dent Assoc 2016; 98:69-90. [PMID: 27029187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Villarreal C. COMMON PHOBIAS SURROUNDING PRACTICE OWNERSHIP, and Why You Shouldn't Let Them Hold You Back. Tex Dent J 2016; 133:44-46. [PMID: 27008842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Reif C. More tips for promoting health equity. Minn Med 2016; 99:5. [PMID: 26897884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hiltunen NS. The Changing Nature of Dental Practice and Retirement. J Mass Dent Soc 2016; 65:24. [PMID: 27400553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Gallego G, Chedid R, Dew A, Bulkeley K, Lincoln M, Bundy A, Brentnall J, Veitch C. Private Practice Disability Therapy Workforce in Rural New South Wales, Australia. J Allied Health 2016; 45:225-229. [PMID: 27585620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/13/2015] [Indexed: 06/06/2023]
Abstract
Despite an increasing demand for therapy services, there is a shortage of therapists in rural areas. We describe the existing private therapy workforce in rural western New South Wales (NSW), Australia. A cross-sectional design study, using an online survey, was conducted with occupational and physiotherapists, speech pathologists, and psychologists working in private practice in western NSW. Forty-one private therapists completed the survey. The average years of qualification was 19; 51% worked part-time. Two-thirds (68%) indicated they had adequate access to professional development opportunities. Sixty-four percent reported intending to stay in their job for 12 months. Most (95%) reported high levels of job satisfaction. Respondents had worked in western NSW for a median of 17 yrs. Sixty-eight percent described opportunities for social interaction as very good. Sixty-six percent grew up in rural areas. All respondents agreed that they loved the rural lifestyle. The results portray an experienced, stable, flexible, and highly satisfied professional group. With the current changes in policies within the disability sector, it is important to maximise these features of private therapy in order to contribute to the rural workforce and increase access to the range of supports available for people with disability.
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Affiliation(s)
- Gisselle Gallego
- Faculty of Health Sciences, The University of Sydney, Cumberland Campus, PO Box 175 East St., Lidcombe, NSW 1825, Australia. Tel +61421429472.
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Bendix J. FIGHTING BACK. PART 2. The Quest for Independence. Stake your claim to medical practice freedom. Med Econ 2015; 92:22-3, 25, 27 passim. [PMID: 26540782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Bendix J. FIGHTING BACK. PART 1. Overcome the challenges of independent practice. Med Econ 2015; 92:22-28. [PMID: 26427171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Gray M, Mukkamala B, Kulkarni N, Edison M, Jacobs J. Perspectives in Independent Practice. Mich Med 2015; 114:10-15. [PMID: 26369001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Fleming B. Remaining Independent: How Doctors in Private Practice are Adapting in the Changing Environment. Mich Med 2015; 114:16-17. [PMID: 26369002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Benbassat J. Provision of Private Care by Doctors Employed in Public Health Institutions: Ethical Considerations and Implications for Clinical Training. Isr Med Assoc J 2015; 17:335-338. [PMID: 26233989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper summarizes the difficulties that may emerge when the same care-provider attends to private and public patients within the same or different clinical settings. First, I argue that blurring the boundaries between public and private care may start a slippery slope leading to "black" under-the-table payments for preferential patient care. Second, I question whether public hospitals that allow their doctors to attend to private patients provide an appropriate learning environment for medical students and residents. Finally, I propose a way to both maintain the advantages of private care and avoid its negative consequences: complete separation between the public and the private health care systems.
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Harrington K. Read the Fine Print. Tex Med 2015; 111:57-61. [PMID: 26047521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Physicians in private practice must negotiate contracts with vendors for various services. Many contracts often come with fine print that's worth taking some time to examine.
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Nithman RW. Business Entity Selection: Why It Matters to Healthcare Practitioners. Part II--Corporations, Limited Liability Companies, and Professional Entities. J Med Pract Manage 2015; 30:377-380. [PMID: 26182701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvantages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with organizational mission or vision statements, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.
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Raffoul M, Petterson S, Moore M, Bazemore A, Peterson L. Smaller Practices Are Less Likely to Report PCMH Certification. Am Fam Physician 2015; 91:440. [PMID: 25884741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Green J. Going solo as a nurse-managed practice. MGMA Connex 2015; 15:21-23. [PMID: 26591803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Abstract
OBJECTIVE This proof of concept study aimed to determine whether a pharmacist-managed medication therapy management (MTM) program in a private endocrinologist physician's practice reduced healthcare services utilization and related costs 6 months after patients' discharge from an institution with a transition of care service. METHODS Patients were included in the study if they were English-speaking, ages >18 years, had type 1 or 2 diabetes, and had a recent transition of care experience (inpatient hospital stay or emergency department/urgent care/paramedic or other acute care visit). The study had a non-randomized design where intervention patients, enrolled July 1, 2012-September 30, 2013, were administered MTM at four visits over 6 months and were compared to historical control patients with available electronic medical records from August 8, 2008 to March 15, 2012. The primary study end-point was the rate of 30-day hospital readmissions, as related to the reason for the index admission. Secondary end-points included the cumulative rate of all-cause hospitalizations, emergency department, paramedic and urgent care visits at 30, 60, 90, and 180 days post-discharge as well as imputed total costs, including prescription medication costs, at 180 days. Propensity score weights were constructed to balance covariate characteristics between the intervention and control groups. Weighted multivariate negative binomial and generalized linear regressions were used to model cumulative utilization rates and log-transformed costs, respectively. RESULTS The intervention (n = 28) and control (n = 73) groups had 0% hospital readmissions at 30 days post-discharge. In propensity score weighted multivariate analyses, cumulative utilization rate was not different between the two groups (IRR = 1.61, p = 0.72 at 180 days) while costs in the intervention group were lower but not statistically different (cost ratio = 0.65, p = 0.13 at 180 days). CONCLUSIONS Further studies should investigate whether the integration of pharmacists in transition of care models could reduce readmission and healthcare utilization rates post-discharge.
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Affiliation(s)
- Fadia T Shaya
- a a University of Maryland School of Pharmacy , Baltimore , MD , USA
- b b University of Maryland School of Medicine , Baltimore , MD , USA
| | - Viktor V Chirikov
- a a University of Maryland School of Pharmacy , Baltimore , MD , USA
| | | | - Roxanne W Zaghab
- a a University of Maryland School of Pharmacy , Baltimore , MD , USA
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DeSteno CV, Donofrio B. NYU's Dental Faculty Practice: Private Practice Opportunities for Faculty, Care Options for Patients, and a Mini Residency for DDS Students. J Am Coll Dent 2015; 82:17-20. [PMID: 26455047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The New York-University College of Dentistry's Dental Faculty Practice operates two clinics in Manhattan, staffed by specialists from multiple disciplines who hold teaching positions at the college. These facilities service several populations, ranging from students to patients with very complex dental conditions. The practices are managed by the school with a view to financial stability while allowing faculty members to focus on their advanced professional skills.
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Ciano C, Lepelletier D. Colleague Connection. J N J Dent Assoc 2015; 86:20-21. [PMID: 26495675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hertz KT. Top 3 strategies to survive--and thrive--as a private practice. MGMA Connex 2015; 15:52-53. [PMID: 26647526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hanucharurnkul S, Leucha Y, Chutungkorn P, Chantraprasert S, Athaseri S, Noonill N. Cost-effectiveness of primary care services provided by nurses' private clinics in Thailand. Contemp Nurse 2014; 13:259-70. [PMID: 16116782 DOI: 10.5172/conu.13.2-3.259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this descriptive study was to determine the cost-effectiveness of primary care provided at nurses' private clinics in Thailand. The sample consisted of 63 nurses' private clinics and 3518 clients. These clinics were selected by multi-stage random sampling. An observation sheet and three questionnaires were used to collect the data. The data indicated that Nurses' private clinics can provide services for about 90% of the clients' problem at the primary care level at about a 50% lower cost than physicians' services. Thus, nurses' private clinics' services should be included in the reimbursement criteria of the national health care system. For nurses who run their own clinics, the Thailand Nursing Council should require additional training and certification in primary medical care. Nurses' private clinics should extend to home care service for people in the nearby area.
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Abstract
Currently there is considerable debate on the role and function of nurses in Australia and internationally. This debate stems from developments within the nursing profession itself from political and economic issues in health platforms, due to restructuring of the health care system, consumer expectations of health care and nurses' expectations of a career. This paper provides the opportunity to reflect on the development of the role of the private practice (independent nurse) and where that role is situated in the nursing profession. This forms the basis for discussion of the development of specialty practice at an advanced level in Australia and to demonstrate its relationship with the nurse practitioner movement in Australia.
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Eastern J. Maintaining adequate third-party compensation. Cutis 2014; 94:269-270. [PMID: 25566566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Wright GP, Ecker AM, Hobbs DJ, Wilkes AW, Hagelberg RS, Rodriguez CH, Scholten DJ. Old dogs and new tricks: length of stay for appendicitis improves with an acute care surgery program and transition from private surgical practice to multispecialty group practice. Am Surg 2014; 80:1250-1255. [PMID: 25513925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Acute care surgery (ACS) programs have emerged mainly at academic medical centers to provide timely care for emergency general surgery and trauma patients. We hypothesized that the development of an ACS program in a multispecialty group practice would improve outcomes for patients with acute appendicitis. A retrospective analysis of patients with acute appendicitis was performed in two time periods: 18 months of private practice and the following 12 months with ACS coverage. Length of stay was the primary outcome measure. A total of 871 patients were studied (526 private practice, 345 ACS). The ACS group had a greater proportion of laparoscopic appendectomies (P < 0.001) and more transitions in care between surgeons (P < 0.001). Length of stay was shorter in the ACS group (1.6 ± 1.5 [mean ± standard deviation] vs 1.9 ± 2.4 days, P = 0.01) and a greater proportion of surgeries were performed during the daytime (44.9 vs 36.6%, P = 0.02). Multivariate analysis demonstrated length of stay was related to appendicitis grade (P < 0.001), American Society of Anesthesiologists class (P < 0.001), symptom duration (P = 0.001), and laparoscopic approach (P < 0.001). The initial transition from private practice to ACS resulted in decreased length of stay with no increase in morbidity related to transitions of surgical care in patients with appendicitis.
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Affiliation(s)
- G Paul Wright
- GRMEP/Michigan State University General Surgery Residency, Grand Rapids, Michigan, USA
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Eastern J. The discount dilemma. Cutis 2014; 94:219-220. [PMID: 25474448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Schnack D. [How a small practice chain is formed]. MMW Fortschr Med 2014; 156:10-11. [PMID: 25417451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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