November 2013

NOVEMBER 2013

A PUBLICATION OF PNNwww.PhysiciansNewsNetwork.com

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R E P O R T I N G O N T H E E C O N O M I C S O F H E A L T H C A R E D E L I V E R Y

T h e O f f i c i a l P u b l i c a T i O n O f T h e l O s a n g e l e s c O u n T y M e d i c a l a s s O c i a T i O n

2013 LA Healthcare Awards HEALTHCARE CHAMPION OF THE YEARPatrick Soon-Shiong, MD personnel • time management • Hipaa ComplianCe

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NOVEMBER 2013 | w w w. p h ys i c i a n s n e w s n e t wo r k .com 1

Volume 144 Issue 11

Physician Magazine (ISSN 1533-9254) is published monthly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Volume 143, No. 04 Copyright ©2012 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. Advertising rates and information sent upon request.

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10 2nd annual la HealTHcaRe awaRdS

Patrick Soon-Shiong, MD, and others were honored at the annual Healthcare Awards, which celebrate leadership, inno-vation, education, and community service in Los Angeles County while raising funds for the Patient Care Foundation’s Medical Student Scholarship Program.

dePaRTMenTs 6 fROnT Office | PRacTice ManageMenTTips, hints, advice and resources

8 Balance | lifeSTYle & wellneSSNews, studies, tips and opportunities to help physicians maintain a balanced lifestyle

12 Pnn | newS in ReViewThe latest headlines impacting the economics of healthcare delivery in Southern California

14 SPecial SecTiOn | HOlidaY TRaVel

fROM yOuR assOciaTiOn

4 PReSidenT’S leTTeR | MaRSHall MORgan, Md

26 ceO’s leTTeR | ROckY delgadillO

27 lacMa newS | aSSOciaTiOn HaPPeningS

18

feaTuRe18 BeST PRacTiceS

With the wider imple-mentation of health reform just weeks away, Physician Magazine provides a compre-hensive overview of key best practices including, person-nel, efficiency, time manage-ment, and HIPAA-compliance.

SPecial: Holiday Travel

Section 14

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SubScriptionSMembers of the Los Angeles County Medical Association: Physician Magazine is a benefit of your membership. Additional copies and back issues: $3 each. Nonmember subscriptions: $39 per year. Single copies: $5. To order or renew a subscription, make your check payable to Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. To inform us of a delivery problem, call 213-683-9900. Acceptance of advertising in Physician Magazine in no way constitutes approval or endorsement by LACMA Services Inc. The Los Angeles County Medical Association reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of Physician Magazine, LACMA Services Inc. or the Los Angeles County Medical Association. Physician Magazine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. PM is not responsible for unsolicited manuscripts.

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The Los Angeles County Medi-

cal Association is a profes-

sional association representing

physicians from every medical

specialty and practice setting

as well as medical students,

interns and residents. For more

than 100 years, LACMA has

been at the forefront of cur-

rent medicine, ensuring that its

members are represented in the

areas of public policy, govern-

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relations. Through its advocacy

efforts in both Los Angeles

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your physician leaders and staff

strive toward a common goal–

that you might spend more time

treating your patients and less

time worrying about the chal-

lenges of managing a practice.

LACMA’s Board of Directors consists of a group of 30 dedicated physicians who are working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, Executive Assistant, at [email protected] or 213-226-0304.

It’s Open Enrollment time for the Los Angeles County Medical Association sponsored Group Dental program. This plan is designed to help you, your family and your

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4 p h ys i c i a n m aG a Z i n e | NOVEMBER 2013

THe liVeS Of large organizations are punctuated by annual meetings, which serve both practical and cer-emonial ends.

The CMA House of Delegates (HOD) convened on October 11-13 at Disneyland for a decision-making meeting where CMA policy was deter-mined by your elected representatives.

Here are some practical matters considered by the HOD that I believe are im-portant.

CMA has recognized that its governance structure is unwieldy, insufficiently agile, and much too expensive. The report of a Governance Tech-nical Advisory Committee recommended changes that include shortening the House of Delegates, decreasing the size of the Board of Trustees, and adopting a year-round decision-making process in which Reference Committees will function year-round. Most of the delegates consider this to be a necessary and positive development, which is still in process.

Spurred on by the need to protect MICRA against the im-pending attack by the trial law-yers, delegates contributed a total of $180,000 to CalPAC, a

record high for the HOD.A resolution that targeted the UC Medical

Schools’ exemption from the Corporate Bar was soundly defeated. The vote was so lopsided that it clearly reflects CMA’s commitment to the medical schools and reaffirms CMA’s mission to represent doctors in all modes of practice and serve as an umbrella organization dedicated to empowering physicians and promoting public health.

Two policy actions (among a hundred others)

by the House directed CMA:

- To sponsor legislation to require insurers to reimburse physicians for telephonic and elec-tronic patient management

- To support elimination of the “outpatient ob-servation status” because it places an undue financial burden on patients

Also, more in the ceremonial realm, new offi-cers were elected, past presidents were honored, the Nye Award (for advancing physician well-be-ing) and the Meissner Award (for exemplifying the virtues of a rural practitioner) were bestowed on outstanding doctors whose accomplishments and dedication to patient care made me, for one, very proud of our profession.

Closer to home, the 2nd Annual Healthcare Awards Program, presented by the LACMA-affiliat-ed Patient Care Foundation of Los Angeles County, was held on October 17 at the California Club in Los Angeles. This meeting appears to be almost entirely ceremonial; it provides well-deserved recognition to persons and institutions that have made extraordinary contributions to medicine and to healthcare in general. Not incidentally, it also raises the profile and recognition of LACMA among community leaders and physicians.

However, it also has an important “practical” function: the money raised by sponsors of the program support the Foundation’s Medical Stu-dent Scholarship Program. As of this writing the accounting is not complete, but we anticipate the Foundation will receive tens of thousands of dol-lars from the event.

Details of the Awards Program, with photo-graphs of participants and information about the awards and the recipients, can be found elsewhere in the magazine. I urge you to “read all about it.”

Marshall Morgan, MD, is a professor and chief of emergency medicine at the Ronald Reagan UCLA Medical Center and director of the emergency medicine cen-ter at the David Geffen School of Medicine at UCLA. He is the 142nd president of the Los Angeles County Medical Association.

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Many factors differentiate the needs and wants of the newly insured from those currently receiving care, and their choice of care providers will reflect these differences.

Who are the newly insured? According to a brief prepared by a Kaiser Commission study [footnote], 60% of the uninsured population is comprised of childless adults, and of these, 41% are under 35 years of age. Patients under 35 have much different expecta-tions and doctor loyalty than those in older age brack-ets—for example, they are much more likely to switch doctors and hospitals—but under-35 consumers have additional requirements.

ValueMany of these first-time purchasers will be spend-

ing what they see as a significant percentage of their income on insurance. Consequently, they’ll insist on value for their money and will seek out doctors and hospitals that appear to provide it. It will be important for physicians and hospitals to create marketing mate-rials that heavily emphasize their expertise and use of the most cutting-edge and effective techniques while at the same time complementing these services and cre-

dentials with a human touch, such as telephoning the patient after procedures or offering a prompt response to their emails and texts.

easy access & locationA large number of the newly insured will be work-

ing two or more jobs or will be freelancing, implying a more unpredictable workday. Therefore, the ease of making appointments will be vitally important, and the ability to book online will be expected. Many of these consumers will not end their day at the traditional 5 or 6 o’clock, so providing extended office hours, espe-cially later at night, and offering to text them if a delay is imminent will be helpful in establishing loyalty.

expectation of Web & social Media presenceHaving grown up using and relying on social me-

dia for almost every type of decision making, the new-ly insured will put greater emphasis on information gained via Facebook and blogs than more established patients. Having a positive, strong and active Facebook presence can make a significant difference.

Websites will have a major influence on the pa-tient’s decision making process. The look and tone of the site: warm, empathetic and bursting with real-life success stories, friendly blog posts written in a con-versational style, videos of the doctors explaining their roles and telling stories will win out over cold clinical language and confusing medical terms.

office enVironMentNot being used to medical environments, the

newly insured will respond to waiting rooms , hospi-tals and clinics that create an office atmosphere that feels familiar and comfortable. Amenities such as free mineral water, wi-fi and coffee bars will definitely be appealing and distract from long wait times.

In conclusion, using these insights to create a tar-geted marketing plan will inevitably allow a medical provider to stand out from their competitors and to eas-ily interest a fresh new market.

Raquel Baldelomar, is founder and managing director of Quaintise, www.Quaintise.com

Marketing to the Newly InsuredBy RAqUEL BALdELOMAR

ManY dOcTORS and medical institutions have yet to create marketing plans that specifically tar-

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consumers will respond positively to strategies that were successful with previous patients.

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To master this unstated curriculum, medical stu-dents have historically developed an emotional armor shielding them from feeling too much and disguising any depth of emotion experienced. By graduation from medical school, physicians have gained experience with death and dying patients. While studies show that they’re far less apprehensive about communicat-ing with dying patients and their families than first-year students, their degree of empathy has dropped.

detachMent in practice: hoW physician eMpathy affects patient care

While a certain amount of emotional detachment is necessary, how much is too much? Studies con-ducted over the past 20 years suggest the emotional detachment that physicians work so hard to develop isn’t helping patient outcomes:• Numerous studies suggest that patientswho per-

ceive their doctors as emotionally distant when giving a cancer diagnosis are less apt to adhere to their treatment plans and seek subsequent care.

• Ina three-yearstudyof891diabeticpatients,pa-tients whose physicians had high scores on the em-pathy scale were significantly more likely to have good control of hemoglobin A1c (56%) than pa-tients of physicians with low empathy scores (40%).

• Ina2010study,whenpatientsperceivedtheircli-nicians as empathetic, the severity, duration and objective measures of the common cold signifi-cantly changed.

What about the health and well-being of the physi-cian? Are caring and empathetic doctors at a higher risk for burnout and “compassion overload”? The re-search suggests not:• Inarecentstudyofpalliativeandhospice-carecli-

nicians, frequent exposure to death and dying was largely a positive experience that added meaning to their lives.

• Ina2009study,participationinamindfulcommu-nication program was associated with short-term and sustained improvements in well-being and at-titudes associated with patient-centered care.

• A1995studyfoundthatoncologistswhoexpressedan inability to communicate with patients had greater stress and more symptoms of burnout.

experiencing grief & loss: it’s not all sadnessIn many instances, it’s not only the intensity of the

emotions that upsets a physician, it’s also the nature of those emotions.

In addition to sadness over the loss of a patient, most doctors feel a wide mix of emotions, including anger and guilt. It’s not unusual for them to lose con-fidence, blame the patient, worry that they did some-thing wrong, or worry about getting blamed for some-thing they couldn’t have prevented.

Though those reactions are commonplace, it’s also quite normal for physicians to think they’re “the only ones” that ever experienced them. Physicians are typi-cally somewhat competitive with their colleagues and concerned about appearing less than competent. It’s not unusual for them to isolate and suffer in silence.

Here are ways that physicians can deal more con-structively with their emotions—and regain the empa-thy they might have lost:• Accept that it’s normal—and healthy—to have

these feelings, and take time to examine them.• Talk about them, perhaps with a physician peer

coach or colleague who understands the pressures faced by physicians today—and the mix of anxiety, concern, self-doubt, justifiable/unreasonable irrita-tions and grief involved in dealing with critically ill patients and their families.

• Understandthatothersonthecareteamareprob-ably experiencing similar emotions. Having your organization conduct sessions such as Schwartz Center Rounds can provide a way for colleagues to share experiences, thoughts and feelings.

Liz Ferron, MSW, LICSW, Senior Consultant and Manager of Clinical Services, Physician Wellness Services

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Coping with Grief and LossLiz FERRON

dealing wiTH deaTH and dying—it’s among the most stressful experiences most humans en-

counter, but the first lesson taught in medical school is not to care too much. Emotionalism is

viewed as unprofessional and thought to interfere with patient care.

Physicians often underestimate the toll that death and

dying takes on their emotional health and well-being.

Just because you “don’t have time”

to think about your emotions doesn’t mean you aren’t

experiencing them.

1 0 p h ys i c i a n m aG a Z i n e | NOVEMBER 2013

On OcTOBeR 17, Patrick Soon-Shiong, MD,

joined last year’s Healthcare Champion of the

Year awardee, Los Angeles County Supervi-

sor Mark Ridley-Thomas, in the new Health-

care Hall of Fame. Dr. Soon-Shiong, chairman

of the Chan Soon-Shiong Family Foundation,

leading medical researcher and scientific in-

ventor as well as prominent philanthropist,

was named by the Los Angeles County Medi-

cal Association (LACMA) and the Patient

Care Foundation the recipient of the annual

Healthcare Awards, which celebrate leader-

ship, innovation, education, and community

service in Los Angeles County.


LACMA’s second annual Healthcare Awards dinner pro-vided the opportunity to recognize outstanding physicians in the community while raising funds for the Patient Care Foundation’s Medical Student Scholarship Program, which gives students from underserved areas the funds to fulfill their dream of going to medical school.

Troy Elander, MD, president of the Patient Care Founda-tion of Los Angeles County, said the event is a “win-win.” “There are a lot of worthy people, but it’s wonderful to recognize these people who have done such significant things,” Dr. Elander told PNN. “They are so inspiring, and in the process of recognizing these great achievements, we are also raising funds for medical school scholarships.”

Dr. Elander describes this year’s Healthcare Champion, Dr. Patrick Soon-Shiong, as a wonderful selection.

Dr. Soon-Shiong is the chairman of the Chan Soon-Shiong Family Foundation and a leading medical research-er, scientific inventor and philanthropist.

“He’s done so many things not only in the field of medi-cine, but also as a philanthropist,” Dr. Elander said.

His new company, NantOmics, aims to change the way cancer is attacked. In 2007, Dr. Soon-Shiong also founded NantHealth, which uses a supercomputer-based system and network that analyzes genetic data. The goal is to share the genomic data among sequencing centers, medical re-search hubs and hospitals to advance cancer research.

The event also featured the winner of a scholarship pro-gram who has dreamed of going to medical school. Thanks to the foundation, her undergraduate and medical degree programsatBrownUniversityarefullyfunded.

“The foundation doesn’t only give money, but they treat students like family and offer them emotional support,” Dr. Elander noted.

Other Honorees at the Event Include (pictured above in order, left to right):cHRiSTOPHeR cRiSeRa, Md, and kOdi azaRi, Md, co-directorsofUCLAOperation Mend, were honored with the Innovation Award for Commu-nity Service. Operation Mend provides returning military personnel with severe facial and other medical injuries access to the nation’s top plas-tic and reconstructive surgeons and comprehensive medical and mental health support for the wounded and their families.

eRic SaViTSkY, Md,UCLAEmergencyMedicineCenter,washonoredwiththe Hospital Physician Leadership Award for his outstanding service to the community and patients.

PaTRick SOOn-SHiOng, Md, Healthcare Champion of the Year awardee,

RicHaRd zaPanTa, Md, Eastside Orthopedic Medical Associates received this year’s Independent Physician Leadership Award for his contributions to professional groups and health communities and service to patients.

weSTSide faMilY HealTH cenTeR (represented by Ms. Debra Farmer, President/CEO) a leader in women’s and family health, received the In-novation Award for Facilities for delivering quality patient care, improv-ing the health of its patients and promoting a healthier community.

caRMen PuliafiTO, Md, Office of the Dean, Keck School of Medicine, USC, was honored with the Innovation Award for Technology for his contributions to academic medicine and diagnosing and treating reti-nal disease.

MaTTHew lin, Md, founder of Pacific Orthopedic Medical Group and president of Central Health Plan and AHMC International Cancer Cen-ter received the Innovation Award for Public Education. His leadership in education initiatives and international and local relief efforts has a profound impact in his community.

ROckY delgadillO, CEO LACMA


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A SERVICE OF The LOS ANGeLeS COuNTy MediCAL ASSOCiATiONPNN | LOCAL • TIMELY • RELEVANT

reporting on the econoMics of healthcare deliVery

read full stories and subscribe to the pnn eneWs bulletins at WWW.physiciansneWsnetWork.coM

Decision inFavor of micra huge Victory for Lacma

In a published opinion, the 2nd District Court of Appeal recently upheld the con-stitutionality of

California’s Medical Injury Compensation Reform Act (MICRA), which marks a huge victory for LACMA and other groups trying to preserve the landmark law.

In Rashidi v. Dr. Moser, the jury awarded the plaintiff $125,000 in economic damages and $1,325,000 in non-economic damages.

The new LACMA advocacy campaign to defeat California’s trial lawyers’ threat to go to the ballot box and repeal MICRA continues to win supporters.

LACMA’s District 9 president, William Averill, MD, told PNN last week that the Torrance Memo-rial Medical Executive Committee approved an immediate allocation of $100,000 toward the cam-paign and plans to provide additional funding.

St. Vincent Medical Center, Facey Medical Group and Providence Holy Cross each donated $5,000 as of Oct. 14, 2013.

policies set on important issues at cma house of Delegates

The California Medical Association’s (CMA) an-nual House of Delegates convened in Anaheim on October 11-13. LACMA delegates along with physicians from across the state debated and set policy on important healthcare issues including vaccinations, the Affordable Care Act, health infor-mation technology and public health.

During the three-day meeting, the 500 del-egates addressed nearly 90 resolutions on these and other key issues that affect the practice of medicine.

La county physicians Buck trend to Leave private practice

Two LA County private practitioners say they have no plans to enter into hospital employment, contrary to the trend of the fleeting solo practice.

Drs. Lisa Thomsen of Glendora and Dr. Emil

Avanes of Glendale rank among several private practitioners who, according to the 2012 Physician Benchmark Survey published by the American Medical Association (AMA), run opposite to media reports and experts forecasting the shrinking solo practice and a consolidation trend.

Lacma Follows Up town hall meeting with Letters to health plans

With the implementation of Covered Califor-nia gaining traction, LACMA continues its efforts to help its physician members navigate the un-knowns and represent doctors’ concerns.

“We have a direct connection to Covered Cali-fornia representatives and the health plans that attended the Sept. 17 town hall meeting, and we are doing our best to represent physicians and the concerns of our doctors and facilitate a response,” said Rosario Ortega, LACMA’s membership out-reach representative.

another Big affiliation to Bridge academia and primary care

UC Irvine Health and MemorialCare Health System are en-tering into an affilia-tion agreement to be-

gin a new collaboration with a partnership to open new primary care health centers in Los Angeles and Orange Counties.

According to the joint announcement made by the two health systems, this is the only health-care partnership in Orange and Southern Los An-geles counties that includes the entire continuum of care. Services range from an academic medical center, teaching and research hospitals, a chil-dren’s hospital and community hospitals to scores of physician practices, outpatient centers, imaging facilities, ambulatory surgery centers, urgent care, a health plan and retail health.

city of hope and providence partner to expand oncology services in La county

Los Angeles-based City of Hope and Providence Health & Services, Southern California, announced their intent to affiliate in order to expand access to

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oncology services within the Southern California communities served by Providence. The two orga-nizations signed a letter of intent last week.

This may be an indication of an accelerating trend of academic medical centers forming part-nerships with healthcare organizations that have a strong primary care emphasis. Only last week PNN reported on an affiliation of MemorialCare with UCI Medical Center, which had a similar goal.

change in sponsorship of saint John’s center

Providence Health & Services Southern Califor-nia announced recently it signed an agreement with SCL Health Systems (SCL-HS) to assume sponsorship of Saint John’s Health Cen-ter in Santa Monica.

The deal is pending approval from the Archbish-op of Los Angeles, Vatican officials and the Attorney General of California in the next three months. If the agreement is approved, Providence is expected to assume sponsorship and management of Saint John’s at year-end or the first quarter of 2014.

concierge Groups Looking to add sites in Los angeles

Personalcare Physicians, which manages con-cierge medical groups and was recently ranked among Orange County’s fastest-growing private companies, is rapidly expanding with plans to make its way into Los Angeles.

“We plan to open at least two practices with a maximum of four a year in the next four years,” said Troy Medley, CEO and co-founder of Personalcare. This November, the company will open a site in Aliso Viejo. A fifth site is planned in Newport Beach next summer, then San Diego in 2014 and Los An-geles in 2015.

aca will Bring major changes to addiction care in La county

With the Affordable Care Act’s recognition of drug addiction and alcoholism as chronic diseases that must be covered by health insurance plans, healthcare systems and providers in Los Angeles County and elsewhere anticipate major changes in addiction care.

The biggest change is that 40 million people could enter substance abuse treatment, which opens a huge market for addiction care, according to news reports.


Can you cook? Let’s assume your answer is “yes,” then why do you go to a restaurant, paying a premium for food that could be made at home?

Dining out is easier than cooking at home, isn’t it? Is the chef the expert at preparing what you’d like to experience...making it all come out at the same time, as you hoped it would? Do you become a steady cus-tomer if it’s just what you wanted? Isn’t it the total ex-perience? Having someone wait on you, describe the dishes, and clean up afterwards are all integral parts.

Would you frequent this restaurant if they didn’t “cater” to your likes and dislikes or if you felt they were not delivering value for the money paid? What if the wait staff knew that the Blue Plate Special was really not good but sold it to you anyway, they didn’t seem to appreciate your business?

Now, let’s talk about shopping. Specifically, let’s talk about the very special times in a woman’s life when she’s shopping for an important occasion, her prom dress, her wedding gown. Does she go it alone? Well, usually not. She will most often ask a close friend whose taste she appreciates, her sister or her mother to go with her to give her advice as to whether or not it’s perfect for her.

Are you getting the drift? We can save you enor-mous time.

1. We will make sure that all the components of your business trip or vacation come out “together.” It’s way beyond airlines and hotels; it’s passports, visas, insurance, inoculations, transfers, parking, restau-rant and spa reservations, tickets to events, metro passes, tour guides, and so, so much more.

2. We will strive to make you a client for life. We will not sell you just anything; we will search to find what’s the perfect “fit” for you.

3. We will advise when we believe something is bet-ter than what you may have chosen or agree when we think you’ve found what’s best!

hasn’t the internet put all agencies out of business?

In a word, no. What most people don’t realize is that when they go online to search for travel options, they are nearly always going on a travel agent’s web-site. It may be an individual sitting in their bedroom in Florida with a super website or a mega travel agency using any number of business aliases. But, unless you are on the official website of the cruise line, hotel, or airline, you’re looking at a travel agency’s website. Ex-pedia, Travelocity and others are travel agencies that have chosen to distribute their product over the Inter-net. And, what did they do when their business model started to fail? They put in call centers for the human touch, and their business has improved.

Sixty-eight percent of all airline travel is still booked by travel agents. Business people, who are the “road warriors” of lore, overwhelmingly use travel agents, as they recognize the value we bring to the travel reserva-tion, purchasing process and on-the-road support.

What we have found in the current economy is that travelers are looking for security, trust, relationships, and value. They simply don’t want to gamble with ei-ther their time or money.

Please do what we do—research on the web, do some looking around, but before purchasing that trav-el experience, visit our website for ideas; www.Wil-lettTravel.com and then call us for the personal atten-tion you deserve.

doesn’t it cost More to go through a traVel agent?

Sometimes, yes, but, usually, no. If you’re the trav-eler who strives for the cheapest price above all else,

Why Should I Use a Travel Agent?TAMA TAyLOR hOLVE

OH, cOMe On and aSk .. .You won’t hurt our feelings! We’ve heard all the questions before and

truly appreciate the opportunity to answer! Uh...why should I use a travel agent? There are many

reasons why clients use our services and for holiday, as well as business and vacation travel, yet, there

are times when even we feel it’s not necessary and we’ll let you know when that is the case!

Sixty-eight percent of all airline travel

is still booked by travel agents. Business people,

who are the “road warriors” of lore, overwhelmingly

use travel agents, as they recognize

the value we bring to the travel reser-vation, purchasing

process and on-the-road support.

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if you’re feeling stressed just thinking about traveling during this holiday season, you’re not alone. here are six simple tips to ease your travel pain:

1. Do Your Research - If you’re driving to visit family this holiday season, giving yourself an extra day to travel or taking the less scenic route could make for a more pleasant drive. When flying, make sure to check air-line restrictions early, arrive way ahead of time and avoid checking in luggage whenever possible.

2. Travel Outside Peak Days - With Wednesday before Thanksgiving being the biggest travel day of the year, a better option may be leaving on Thanksgiving Day or a few days ahead of schedule to avoid record traffic and travel.

3. Plan for the Unexpected - If you have only an hour before connecting to your next flight, you may want to consider booking another flight. Leaving extra time before and between flights to deal with security, long lines, flight delays due to extreme weather, and other unexpected events is especially critical dur-ing the holiday travel time.

4. Travel Early or Late in the Day - Flight statistics show planes traveling earlier in the day have a better on-time performance. And if your flight is cancelled, you have the option of taking a flight later that same day, which eases the stress of traveling as well.

5. Don’t Abandon Healthy Habits - ‘Tis also the season for overindulging and letting go of healthy habits like your exercise regimen. Realizing that bad habits will only add to your stress level, let alone your waistline, follow these easy tips before going to your next holiday party:

• Bring a healthy dish to the party.• When consuming alcohol, drink one glass of water after consuming alcohol to stay

hydrated and avoid overindulging• Make it a point to exercise before going to a party• Stay away from the dessert tray • Avoid second helpings

6. Stick to an Exercise Routine - This is the time of year when many people abandon their exercise routine. Don’t let this happen to you. Hiring a personal trainer, working out with the entire family by going for walks or hikes together or playing outside, and going for walks after your big holiday dinners as a family will not only de-stress you, but bring the entire family together.

Follow these easy tips and you’re guaranteed to have a happier, healthier holiday. happy holidays!

then you’re probably not going to appreciate what we do.On the other hand, if you’re the traveler who wants

the best price for the experience that fits you perfectly, then you are the client who would appreciate our ser-vice and the emphasis we place on value. (You can return the cheap sweater that you realize you don’t like; the time you spent on a vacation, or business trip can’t be returned.)

Our buying power is enhanced by our membership in Signature Travel Network, the leading Travel Agen-cy Cooperative in North America. With sales of over $5 billion and 320 offices, we are proactive in offer-ing discounts and added value amenities that are in-comparable. Proudly, we are a Four Seasons Preferred Partner; you will receive much better rates and inclu-sions through us than if you were to book their hotels directly.

For our Travel Management Fee, travel details are an-ticipated and you are accorded our attention from long before the initial deposit is made, during your journey, and until after your return.

Many prefer to travel independently, and our exper-tise in designing customized itineraries offer flexibility, ease, security and value.

What’s the difference betWeen a traVel agent & consultant?

The title “travel agent” was very accurate when for decades you could purchase airline tickets, rail travel, and steamship passages only from agents directly li-censed by these entities. Through the years, the role of the agent has grown into that of a consultant. Although “agent” is still widely used, we actually work on behalf of our clients, not the travel suppliers.

A travel consultant’s career is dependent upon build-ing trust with clients, developing knowledge of what the client values, and counseling on the absolute best way to spend precious vacation dollars, and their even more precious time. A company or website that is not looking at being your “travel agent for life” may sell you any-thing—regardless of whether it’s right for you. We won’t.Tama Taylor Holve, CTC, CTIE, WILLETT TRAVEL, 818-762-0676 ext 234 * 818-763-7806-fax, www.WillettTravel.com

avoiding travel stressMARiON WEBB

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By Mario

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With the

rollout of

Covered Cali-

fornia under way

and the wider implemen-

tation of health reform being

merely weeks away, efficiency,

quality and optimal healthcare deliv-

ery are more critical than ever for physi-

cian practices. This article provides a com-

prehensive overview on making the best hiring

decisions, identifying tools to run a more efficient

and effective practice, optimizing your time manage-

ment and finding ways to increase your revenue stream. It

also offers practical steps to become HIPAA-compliant as

well as how to use mobile health to your advantage.


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every Practice is different, but each

requires basic re s o u rc e s

to ensure t h a t

a l l claims

are sub-mitted accu-

rately to insur-ance companies

the first time around, which cuts the delays

in accounts receivable and can increase practice viability.

In today’s world, physicians can get many resources for

practice management for free, but that doesn’t

mean they should. Often, buying a superior product will

improve accuracy and productiv-ity, because they are easier to un-

derstand and easier to use. Therefore, you want to consider the following three

items before making your purchase:

• Will it help you improve accuracy?• Will it help you become more efficient?

• Will it help you minimize compliance risk while im-proving your bottom line?

coding and Billing resourcesEvery practice must have the most-up-to-date coding and

billing tools to make sure every dollar is collected without claim-ing non-billable services.

The typical practice purchases include the Physicians’ Cur-rent Procedural Terminology, International Classification of Dis-ease (ICD-10), Healthcare Common Procedure Coding System, The National Correct Coding Initiative and the Resource-Based Relative Value Scales.

Additional resources include Practice Management, which provides physicians outside managerial advice, and Compli-ance, which satisfies state and federal requirements of the Office of Inspector General (OIG).

Adopting an OIG compliance plan is voluntary, but it shows a good faith effort to comply with standards set by public and pri-vate payers. An OIG fraud and abuse compliance plan has the fol-lowing six elements:

• Standards of Conduct• Training and Education• Appointment of a Compliance Officer• Open Lines of Communication• Monitoring • Enforcement

Other compliance areas to consider are OSHA (Occupational Safety and Health Administration), which sets and enforces stan-dards for employees and patient safety, and HIPAA (Health Insur-ance Portability and Accountability Act), which sets standards for transactions between providers and payers, patient privacy, and security for electronic data.

When it comes to maintaining reimbursement and compli-ance, your greatest resource is your staff.

Professional certifications and credentials and the education and training that come with them can help ensure that your staff is competent, productive and up-to-date on the complex rules and regulations, which will be pivotal during this time of change.

The following organizations offer certification programs for practice staff, often for free:

• The Medical Group Management Association (www.mgma.com) offers certification for physician office managers through the American College of Medical Practice Executives (ACMPE).

• Practice Management Institute (www.pmimd.com) offers cer-tifications for medical office managers, medical coders, and medical insurance specialists.

• DecisionHealth offers certification and education for spe-cialty practice coders through its Board of Medical Specialty Coding (www.medicalspecialtycoding.com).

• The American Academy of Procedural Coders (www.aapc.com) offers various medical coding certification exams for physician practices and the outpatient facility environment, and specialty certification.

consultantsA consultant can serve as a physician’s physician diagnosing

and curing practice ailments. Look for consultants with practical experience, have a good

understanding of your expectations and long-term goals, and who can help you with your revenue cycle management, regula-tory compliance and operational efficiency.

The best way to find a consultant is via a referral, but you can also check with your state, county or specialty society or profes-sional organizations such as LACMA, who have vetted referral sources for you and may be able to provide discounts.

medical associations While it has always been critical for doctors to become mem-

bers of their local and state medical associations, the current health environment with its uncertainties and challenges de-mands it.

Together, physicians can get their voices heard by lawmak-ers, for-profit health industry members, government regulators and others trying to interfere with their ability to care for their patients.

LACMA and other associations are partners working every day to develop and maintain a physician-led, patient-centered health environment. Association members also get valuable dis-counts on resources.

rESourcES for prActicE SuccESS


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Whether it comes to seeking a new receptionist, biller or office man-

ager, making the right hiring de-cision is key to any successful

physician practice. The right individuals

should not only pos-sess the needed

skills, knowl-edge and ex-

perience, but also have a posi-

tive attitude and work well with other employ-

ees and management.Here are some of the key

considerations for hiring the best person for the job.

Job DescriptionA well-written job description lays the

foundation for improved performance manage-ment of employees.

A good job description should define all tasks and responsibilities of the position and follow these guidelines:

• Be precise in the descriptions.• Include only pertinent information.• Define salary, hourly range for the position .• List all required skills (Microsoft Word, Excel, etc.).• Explain work relationships and boundaries.• Describe the tools and equipment used at the job.

recruitmentOnce a job creation is developed and the em-

ployment needs are identified, your search begins. Experts recommend narrowing down applicants to three people, taking into account their experience, salary expectations, skills and most important the proper chemistry to work well with your team.

A good way to weed out candidates and save time in reading resumes is to grade them with letters A, B and C.

Ideally, you’re looking for candidates who are committed and want to grow with your practice. How-ever, remember that some candidates may have valid reasons for gaps in employment, such as wanting to stay home to raise children or caring for a loved one.

Once you find a good candidate, schedule a phone interview first. This is particularly important for hiring a receptionist. You want your receptionist to have a friendly voice and sound professional.

interviewIf you find a good fit, schedule your first face-to-

face interview. Experts recommend that you come prepared

by writing a list of standard questions that you ask all candidates and take notes. Ask only job-related questions and try not to ask closed-ended questions. Good questions to ask are the following:

• Tell me about yourself.• What are your short-term and long-term goals?• What are your strengths and weaknesses?• How would you describe your current supervisor

and co-workers?• What is it about this job that interests you?

Be aware that questions related to race, national origin, gender, age, sexual orientation, marital status, children, religion, residency, physical and mental con-dition or disabilities, and foreign languages spoken at home are illegal.

checking referencesSimilarly, when checking references, you want to

avoid the following common pitfalls:

• Employers may be sued for defamation of charac-ter if found giving inaccurate or false information. For this reason many employers will now only verify only basic information, such as title held and dates of employment.

• References are often mere opinions. • You may end up screening out an excellent candi-

date because of personality conflicts or disagree-ments with a previous employer.

trainingTraining new employees is absolutely necessary,

no matter how much experience the person brings to the table. You want to ensure that the new staff mem-ber clearly understands the responsibilities of the new job, gets a chance to review the office policies and procedures manual with the office manager and signs and dates it, and that all necessary paperwork has been completed at this time.

Keep in mind that everyone learns at his or her own pace.

But it’s always a good idea to praise your employ-ees for a job well done. Consider giving bonuses to show your appreciation to ensure that the goals are attainable and clearly communicated.

A great team that works well together can do won-ders for improving your practice and growing your business, both of which will be ever more essential in this changing health environment.

HirinG quALifiED pErSonnEL

NOVEMBER 2013 | w w w. p h ys i c i a n s n e w s n e t wo r k .com 2 1

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During this time of change, when doctors are expected to do more with less, time management and cost control are pivotal.

The best way to learn whether your practice is running as efficiently and effectively as possible, it’s crucial to review how your day-to-day work is performed and then develop an action plan to optimize tasks.

Looking at your practice with the eyes of your patient

The first step in doing so is to take a close look at where your practice is succeeding and where it needs improvement. To do this requires you to put yourself into the shoes of a patient undergoing registration and check-in.

Therefore, you want to experience what it’s like to be a patient in your own practice. Experts recommend the following five steps for assessing your practice:

1. Find and review your documentation you have for check-in and registration procedures and make a list of all forms.

2. After you have reviewed the documentation, you can begin interviewing your staff by having them walk you through the process. You want to take notes to see if your staff is knowledgeable, iden-tify bottlenecks and inefficiencies, create an up-dated job description (if needed) and create new training tools and education to bring your staff up-to-date and give your staff the opportunity to provide comments and feedback.

3. Next, watch your staff conduct patient registration and check-in twice a week for several weeks dur-ing peak hours, which will give you a very good idea about shortcomings and how your practice is doing. However, don’t make suggestions just yet—just listen and observe.

4. Have different staff engage in role-playing during peak hours several times during the month and take notes. Honestly assess your waiting room to see if it’s truly clean, friendly and well functioning in all aspects, then observe the people in the wait-ing room and take note of remarks.

5. Once you’ve completed all the steps, deficien-cies will become apparent and you can take steps. Outline recommendations, determine the cost to make changes, meet with your staff to discuss recommendations and fine-tune the process and monitor progress over time.

identify and eliminate VariancesVariance in the ways tasks are performed can

contribute significantly to breakdowns in processes, which can create inefficiencies.

Here are five recommenda-tions to eliminate variances, in-

crease practice productivity and re-duce work.

1. Define Roles: Successful businesses main-tain manuals that clearly define employee roles

and provide step-by-step instructions on how to complete tasks.

2. Front-End Processing: Reduce inaccuracies by veri-fying all patient information at the time of schedul-ing and verify the information again at check-in.

3. Appointment Scheduling and Check-In: Ensure that your appointment calendar is optimized and that your staff is trained in learning online tools.

4. Collecting: Collecting co-pays, coinsurance, de-ductibles, and past due balances from the patient at time of service is often the most overlooked task in a physician’s practice. Remember that co-pays alone can represent as much as 20% of a physician’s income.

5. Manage Call Volume: Instituting better processes will be increasingly important for successful prac-tice. Putting patients on hold for long periods of time or not responding in a timely manner will turn patients off and prompt them to go elsewhere.

unDer health reform , small practices will face more scrutiny regarding HIPAA poli-cies, documentation and procedures.

new rules—what it means for your practice

While March 26 marked the effective date for the 563-page “omnibus” privacy and security rule, most aspects of the rule be-came effective on Sept. 23.

In case you missed it: Doctors who had a HIPAA-compliant business associate agreement in place before the new rule’s Jan. 25 2013 official publica-tion date in the Federal Register, and whose contract didn’t need to be renewed between March 26 and Sept. 23, have a one-year grace period; those who didn’t have a contract in place prior to Jan. 25, 2013, needed to get a contract compliant with the new rule in place by Sept. 23.

Another big change involved the policies and technologies needed to comply with a patient con-sent management provision.

Under the ARRA, a patient who pays out of pocket for treatment can ask a provider not to share a record of that treatment with the patient’s health insurance plan, and a provider must comply with that request, which means staff need to be made aware and trained to never pass on that information.

HipAAcoMpLiAncE

tiME MAnAGEMEnt


hipaa enforcementHIPAA enforcement is real. Data from the Office of

Civil Rights (OCR) show that complaints and investi-gations are on the rise. HIPAA complaints have risen since 2003 by 117%, according to the experts. Most complaints come from disgruntled employees.

For this reason, it’s key for physicians to review their current policies and procedures and upgrade them if needed.

Federal law does not create what is known as a private cause of action under HIPAA, which means private individuals cannot sue for a privacy or security violation citing HIPAA regulation.

Only the federal government can enforce HIPAA and take covered entities to court for violations.

However, some states have allowed private par-ties to bring actions seeking remedies for violations of HIPAA.

how can you Lower your risk?The best defense against HIPAA-related action is

not to have a privacy or security violation occur. Here are five tips to help lower your risk, including

medical identify theft:

1. Periodically review your HIPAA privacy and security compliance efforts.

2. Ensure that all staff members are up-to-date on training.

3. Ensure that your business associates have a written agreement in place.

4. To protect medical information, contact your vendor to see who has access to which information online.

5. If an employee is terminated, make sure all health re-cords are protected immediately upon termination.

compliance review and investigationPhysicians should be aware that in the case of a

complaint or investigation, HIPAA requires coopera-tion from covered entities, including allowing investi-gators access to facilities, records and other informa-tion at any time and without any notice.

With the government likely focusing on more au-dits as an educational tool, doctors are well served to stay prepared. To learn more about the HIPAA audit program, visit http://bit.ly/HIPAA-Program.

Understanding your revenue streamIn today’s environment of decreasing reimburse-

ment, consumer-directed healthcare and increasing complexity around payer-specific payment rules and medical policies, it’s ever more critical for solo practi-tioners and small practice owners to understand and manage their revenue streams.

To prevent shortfalls, you want to proactively

monitor incoming pay, in particular your accounts receivable (AR) by measuring your days in accounts receivable (DAR) by payer, service and provider and managing self-pay.

MEASURING DAR: The first step in understanding your revenue is to look at how long it takes for you to receive pay for services you provided.

Here are five ways to analyze your payer DAR:

1. To understand where outstanding revenue sits by payers, run a standard AR aging report. This will give you a snapshot of your AR by payer and how long it takes each payer to correctly pay a claim.

2. Run the aging report to show outstanding AR by payer. If the total amount in the over-60-days cate-gory does not reflect the same percentage as your overall charge volume with that payer, you need to examine the payer more closely.

3. Report by service/CPT code tells you how long it takes to receive pay for each service you perform and allows you to identify trends that have a nega-tive impact on your AR.

4. Report by rendering provider helps you to iden-tify providers that have a higher outstanding AR amount relative to their peers with a given payer.

5. Use the information in renegotiating contracts or in trying to improve payment times, which in turn will help you run a more efficient billing system.

MANAGING SELF-PAY: Analyzing your self-pay will become increasingly important, as much of the cost of co-payment, coinsurance, deductibles and out-of-pocket expenses are increasingly being shouldered by patients. This, in turn, could make it more difficult to collect pay.

In reviewing your self-AR, you want to analyze the amount represented by self-pay and determine which payers contribute the most to your self-pay business.Here are five tips for managing self-pay in your office:

1. Determine which payers contribute the most to self-pay and which tools they make available to as-sist you and help you estimate patient responsibil-ity. Sometimes it’s easier to issue a patient a refund than to chase the dollar.

2. Create a well-documented office policy and set clear expectations with your staff and patients.

3. You want to collect full pay at time of service with the account being automatically flagged in your practice management system when balances are due.

4. If your practice offers payment plans, you want to collect partial pay before providing new services

5. Verify coverage of each patient and clearly define your collection policy.These techniques are key for staying in the black

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and will greatly reduce your administrative hassles.With millions of newly insured accessing health-

care services in 2014, experts predict that hospitals, health systems, payer organizations and physicians will be faced with major disruptions, including front-end and back-end business operations, information systems and clinical services.

among the greatest challenges for providers and payers will be the ability to keep business transforma-tion models moving forward.

The requirements for ad-dressing healthcare de-livery to the sickest population with chronic diseases will become an even greater concern for orga-nizations hardest hit with practitio-ner skill-level deficiencies.

To prepare for these business trans-formation challenges, every component of the healthcare universe will turn to mobile health, or mHealth, capabilities.

Already, glucometers have been ship-ping en masse since the 1990s, but pro-viders have found these devices to be less than perfect. Problems include loss of key data, false patient submissions and non-prescribed episodic use.

Health experts predict that mobile de-vices with the following characteristics will become increasingly important:

• Those that support health information exchange across the care continuum and care delivery enterprise, robustly supporting organization-to-organiza-tion patient information exchange

• Devices that are patient-centric with ac-tive patient engagement

• Devices that meet and can adapt to es-tablished mHealth standards

• Technologies that enable broad con-nectivity and interchange of data

Experts predict that technologies with end-to-end capability will experience the most rapid demand and growth.

These technologies will allow for secure, shared information and can be accessed from many different locations. Patients will be able to use these technologies at their con-venience through new service models that

will not only improve quality of care, but also cost less.There are a number of provider organizations that

have pilot programs under way. For instance, the Veterans Administration Medical

Center has been the leader in this space with 35,000 connected health devices deployed to date that are

actively managing and improving patient care for veterans.

Meanwhile, private and public companies are also developing products they hope

will ultimately improve population health, disease management and

personalized medicine.

Whether it’s hiring new staff or trying to find the

right electronic health system and other tools to

optimize your business, imple-menting some of these strategies

above will set you on the path to im-proving operational efficiencies, reim-

bursement, collections and growing your business to success.

MobiLE HEALtH

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in the Day -to-day operations of a professional practice, physicians focus on providing care to their patients, and with the man-dates of the Affordable Care Act, that focus is expanding to managing the continuum of care for a patient, in essence moving from a quantitative methodol-ogy to a qualitative one.

One of the physician’s tools is to apply best practices to the ongoing care for their patients. At its simplest, a best prac-tice is a method or technique that has consis-tently shown results superior to those achieved with other means and is used as a benchmark.

A series of best practices is used to create systems that allow care to be delivered effectively and efficiently while meeting the overall goal to provide quality of care to patients.

Just as the theory behind best practices can improve delivery of care, best practices can also improve the busi-ness aspects of the professional practice.

Together, best practices for treatment as well as for business results can have a tremendous impact on the bot-tom line of the business, and in turn increase its value.

To understand how these can impact value, a brief background on how value is determined when looking at a professional practice is necessary.

Most professionals are familiar with the idea of multi-ples. In short, multiples are simply an expression of market value of an asset relative to a key statistic that is assumed to relate to the value. That statistic, whether it is gross rev-enues, net income, EBITDA or some other measure, must bear a logical relationship to the market value observed.

The problem with multiples when valuing professional practices is that they no longer express value with any sort of accuracy that is worthwhile in today’s complex and vola-tile marketplace.

In order to appropriately determine the value of a pro-fessional practice, each practice must go through a rigor-ous analysis that considers three different methodologies: the market approach, the cost approach and the income approach.

The market approach focuses on a comparison of the business enterprise being valued to similar businesses that have actually been sold or have marketable shares of stock traded on an active market. If actual sales transactions of stock or equity interest have recently been valued at arm’s length, the prior transaction should also be considered in a determination of value based on the market approach.

In the context of professional practices, sales transac-tions of comparable business enterprises usually do not occur in a public market, but in private transactions. In-formation about transactions can frequently be obtained from trade associations, brokers, or other databases. How-ever, those databases rarely contain sufficient information to infer a conclusion of value. Often this methodology is

relegated to a rule of thumb when looking at privately held, profes-

sional practices.Under the cost approach,

value of a professional practice is based on the net aggregated fair

market value of the under-lying net assets (assets less

liabilities) of the business entity. This approach consists of restating

the balance sheet of the enterprise by substituting the fair market value of its tan-

gible and intangible assets and liabilities for the corresponding book values of such assets

and liabilities. Since intangible assets are frequently not reflected on the historical balance sheets prepared

on a cost basis, a methodology must be employed to esti-mate the fair market value of intangible assets.

This method often does not reflect the value of a suc-cessful going concern, as it does not take into account the synergistic value of the assets operating in conjunction.

The income approach measures the value of an asset as the present value of the future economic benefits to be derived from the asset. When applied to business owner-ship interests, value indications are developed by either capitalizing historical normalized earnings, or by discount-ing to present value of expected cash flows or projected earnings.

When valuing professional practices, the discounted cash flow method is most commonly utilized to address the uncertain nature of reimbursement and rapid changes in the healthcare industry.

If the methodology utilized is to discount to present value future cash flow, or future earnings, the future in-come stream is discounted using a discount rate.

The discount rate is determined by reference to the current market risk-free rate for the use of capital, plus a premium for the risk associated with the particular type of business or enterprise, plus an additional factor for the risk associated with the particular business, and an additional factor that represents the expected growth rate over time.

It is in the realm of the discount rate that the impact of best practices in place can have a dramatic impact.

At the heart of the discount rate is the concept of risk. The implementation, monitoring and adjustment of

best practices, creates a system of efficiency and stability, and stability decreases risk.

In an environment where decreasing reimbursement is a constant concern, the likelihood of a professional prac-tice being able to make significant positive changes on its bottom line in the short-term is unlikely. The best way to positively impact the enterprise value of your practice is to take control of both the care you provide as well as the efficiency with which your business runs by implementing a system-wide use of best practices.Jerome French, CPA, CVA, is the head of the Healthcare Division for Mann Urrutia Nelson, CPAs..

bESt prActicES AnD tHEir iMpAct

on EntErpriSE VALuE JEROME FRENCh

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ceo’s letter

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HaPPY THankSgiVing. Enjoy the holiday with your family and friends. This fall season, LACMA will be ever more vigilant in following the many new developments affect-

ing all physicians and the patients they serve in Los Angeles County.The rollout of California’s Health Exchange on October 1 was mired in problems: computer issues,

long wait times, misinformation and other glitches that prompted Covered California to shut down its online enrollment system twice. These challenges only reinforce the great need for all doctors to stand united behind LACMA and advocate on behalf of their patients.

With 700,000 newly insured patients expected to sign up via the exchange in Los Angeles County alone—the equivalent of all of San Francisco County’s population coming online as newly insured—and not enough physicians to take care of these patients, doctors in Los Angeles are rightly concerned and anxious.

To draw a comparison, imagine handing 700,000 Los Angeles County residents who have never owned a car before the keys to a new car. Then put them on the road.

Meanwhile, we do not add any new freeways, improve our streets, install new traf-fic lights or add safety traffic officers. It simply does not make sense.

But this is the new reality. At this point, we remain hopeful that the country’s largest state-run health insur-

ance exchange will eventually move in a more positive direction. We will keep a watchful eye on new developments.

LACMA and the Patient Care Foundation are doing their part in a small way to solve the physician shortage in Los Angeles County. Last month the LA Healthcare Awards reached a new milestone, raising over $100,000 to help support medi-cal school student scholarships. We honored Dr. Patrick Soon-Shiong as the 2013 Healthcare Champion of the Year.

We continue to keep a pulse on other critical issues of the day. While the delay of the dual-eligible demonstration project, or Cal Medi-Connect—

with its earliest implementation now being slated for April 2014—marks a victory for LACMA and its newly created taskforce, challenges remain.

We will voice our concerns and seek details regarding the planned implementa-tion of the demonstration project in Los Angeles County specifically during a meeting with Jane Ogle, deputy director at the California Department of Health Care Services, this month. We are hopeful that she will listen to the doctors regarding the many challenges this presents to our underserved patients.

Many doctors have indicated that they would leave the profession if the demonstration project becomes a reality. Disruption of care is a serious concern for all doctors but more importantly for their patients.

This fall, we will continue to reach out to large physician groups to stand with LACMA. Whether you are in a small practice or large group, all physicians in Los Angeles County need to

unite to add to our strength and to fight for the patients they serve.Once again, Happy Thanksgiving and remember to give thanks for the many blessings physicians

contribute to our lives.

Rocky Delgadillo

Rocky DelgadilloChief Executive Officer


LAC

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MICRA PROTECTIONmiCra saVes la CoUntY pHYsiCians an aVerage oF $87,000 annUallY - Trial lawyers have begun their assault on MICRA, a statute enacted by the California Legislature in 1975 intended to lower medical malpractice li-ability insurance premiums for healthcare providers by decreasing their potential tort liability. If they are successful, malpractice insurance rates will quadruple. your membership ensures our victory against the self-serving trial lawyers trying to generate more in legal fees.

PRACTICE MANAGEMENT SERVICESlaCma anD Cma staFF memBers HelpeD memBer pHYsiCians reCoUp oVer $7 million in UnpaiD/UnDerpaiD Claims sinCe 2010 - How much could you be saving? Receive access to free Reimbursement Assistance, Jury Duty Assistance, Medical-Legal Resources, and E.H.R./H.I.T. support for your practice.

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IN 2013, LACMA ALSO- Challenged the State’s Dual Eligible Demonstration Project and

was victorious in delaying its implementation - Filed major lawsuits against Aetna and Healthnet for abusive busi-

ness practices against physicians and patients - Launched its first-ever dedicated resource center for solo and

small group practice physicians and surgery centers

OUR WORK IS NOT DONE.Only through your continued support will LACMA and CMA be able to

serve members first and foremost through our advocacy efforts and ser-vices that will help serve patients and improve your bottom line.

RENEW TODAY!By now, all LACMA and CMA Members have received their 2014 dues statements. Dues are due by December 31, 2014. Please be sure to renew your membership to ensure continuation of your benefits.

DUES CAN bE RENEWED CONVENIENTLY ONLINE AT WWW.LACMANET.ORG

tHank YoU For sUpporting YoUr proFession anD YoUr patients BY sUpporting organiZeD meDiCine!


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As heard on KFI

lOOking TO dRaw blOOd?

If you’re talking to LACMA physician, Paul Wallace, MD, this could open up a discussion that could knock you on your feet—literally.

On Oct. 19, Dr. Wallace became the first physician ever to be inducted into the California Boxing Hall of Fame. His name now ranks among such boxing legends as George Foreman, Harold Lederman, An-dre Ward, Abel Fernandez, Joey Giambra and Loui Loy.

Dr. Wallace was appointed as a California Ringside Physician in 1989.He is now the Chief Ringside Physician of the California State Athletic Commis-

sion, chairman of its Medical Advisory Committee and the chairman of the World Boxing Council of the Medical Advisory Board, and lectures for the IBF and WBO.

He is the founder and current board member of the Association of Ringside Physicians and the California Association of Professional Ringside Physicians.

Along with being co-chair of the WBC Medical Congress 1 and 2—the most comprehensive medical meetings in boxing history—Chief Ringside Physician, Dr. Wallace also served as the Technical Medical Advisor for seasons 1 and 2 of the reality TV series “The Contender.”

Dr.WallaceisaretiredveteranoftheU.S.Army(NationalGuardandReserve)specializing in military trauma and wound ballistics.

He ranks as his most influential fight Chavez vs. Taylor 1 and most controversial fight Vitali Klitschko vs. Lennox Lewis.

Dr. Wallace was inducted into the California Boxing Hall of Fame 2013 on Oct. 19 at the Sportsmen’s Lodge in Studio City. LACMA congratulates Dr. Wallace on his honor and all of his achievements in the boxing world.

By now, all LACMA and CMA Members have received their 2014 dues statements.

DuES ARE DuE by DEcEMbER 31, 2013. Please be sure to renew your membership to ensure continuation of your benefits.

Dues CAn Be reneweD ConvenientLy onLine At

WWW.LACMANET.ORGthank you for supporting your profession and your patients by supporting organized medicine!

attention lacma/cma members

RENEW TODAY


to pLace a cLassiFieD aD Visit www.physiciansnewsnetwork.com OR CONTACT DARI PEBDANI AT [email protected] OR 858-231-1231.

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PhysiciaNs News Network iNtroduces

REpORTIng On ThE TEChnOlOgY Of hEAlThCARE DElIvERY


20%

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By

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| BES

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Staffing costs are inching upward toward an all-time high of nearly 30% for primary care physi-cians

Co-pays alone can represent as much as 20% of a physician’s in-come.

StaffingCosts

30%

By The NumBers

Collecting: Collecting co-pays, coinsurance, deductibles, and past due balances from the pa-tient at time of service is often the most overlooked task in a physician’s practice.

HIPAA complaints have risen since 2003 by 117%, according to the experts. Most complaints come from disgruntled employees.

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November 2013

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