Noteworthy: What's Your Signature Worth?; Primary-care Makeover


Luring physicians with unusual incentives; telemedicine crosses state lines; primary-care practice makeover; and more.

Luring Docs with Unusual Incentives

Forget higher salaries, fancy homes, and signing bonuses. A tiny hospital in southwest Kansas is trying a different route to attract physicians. Candidates are offered eight weeks off for missionary work overseas. The tactic has already lured at least one physician to the medical center, Ashland Health Clinic, according to NPR.

Telemedicine Crosses State Lines

When it comes to practicing medicine remotely via telemedicine, the regular rules may not apply. A Utah senator hopes to promote telemedicine by introducing a bill this spring that would eliminate the requirement that physicians apply for separate medical licenses in each state where they practice, according to Government Health IT.

What's Your Signature Worth?

In 2011, 88 percent of hospital-recruited physicians were paid an average bonus of more than $20,000 to sign their employment contracts. That's according to The Medicus Firm, a national physician search firm, which compiled physician placement data from 103 healthcare systems ranging from rural community hospitals to large national healthcare systems.

Interaction Improvements

How can you improve your exam-room interactions with patients? Here are 10 easy tips, courtesy of Practice Notes blogger George Taylor, president of Beyond Feedback, a firm that advises practices on patient experiences:

1. Minimize interruptions.
2. Ask open-ended questions.
3. Stand or sit at the patient's eye level.
4. Face the patient directly and maintain eye contact.
5. Always speak in the first person.
6. Describe clinical issues in nonclinical language.
7. Use analogies to explain complex issues.
8. Explain each step of the exam.
9. Note when and how patients will hear about test results.
10. Encourage patients to call with questions.

Fun Distraction

Need a timeout from work but want to keep your brain moving? Visit The site provides physicians with an opportunity to answer health questions posed by nonphysicians. If users like a physician's answer, they "thank" it; if other physicians like an answer, they "agree" with it. As physicians accumulate responses, they receive virtual prizes, like the "Doogie Howser Award" and the "Dr. Healthcliff Huxtable Award." Site organizers told the New York Times they've signed up more than 9,000 physicians and are seeing an average of 100 or more visitors each day. The site requires only that physician users are licensed in the U.S.

Home-birth Boom

The number of U.S. home births increased 29 percent between 2004 and 2009, according to the CDC. That could raise concerns among organizations like the American Congress of Obstetricians and Gynecologists and the AMA, which say the safest place to give birth is at a hospital or birthing center, according to Kaiser Health News.

Primary-care Makeover

The Washington Post recently laid out two predictions for how primary care will change as the country addresses the looming doc shortage. In one scenario, the "traditional" primary-care work force would be bolstered by increased reimbursements, more residency openings, and additional scholarships to medical students. The other scenario would establish a "different" type of primary-care work force. Requirements for foreign doctors to practice in the U.S. would ease, and other medical professionals - like nurse practitioners - would take on more responsibilities. Which scenario is most likely to occur? According to The Post, "a looming shortage of 30,000 primary-care physicians by 2015 leaves space to bump up the numbers of traditional and nontraditional providers."

Overweight Omissions

Physicians who are overweight or obese are far less likely than their thinner counterparts to discuss weight-related issues with obese patients. That's according to a nationwide survey of 500 physicians conducted by Johns Hopkins Bloomberg School of Public Health. The survey, published in the journal Obesity, also found that overweight physicians are less confident discussing diet and exercise with patients.

Medicinal Microchip

We've all heard of implanting GPS microchips in family pets, but what about implanting medicinal microchips in humans? That could soon be a very real possibility. Encouraging results of a human clinical trial with an implantable, wirelessly controlled and programmable microchip-based drug delivery device was recently published in Science Translational Medicine. MicroCHIPS, the company that created the device, hopes it will improve management of chronic diseases like osteoporosis, cardiovascular diseases, multiple sclerosis, and cancer. It plans to file for regulatory approval of the device in 2014, according to PhysBizTech.


"Strong professional relationships are as vital to patient treatment as medication, because patients can sense when there's an undercurrent of tension. And that's the last thing a sick person needs."
Sue Jacques, consultant

"Disgruntled is probably just too soft of a term for this. It's really devastating to try to run an office in this environment."
Robert Wah, MD, speaking to NPR about Congress' decision to implement a temporary Medicare "doc pay fix."


20 The percentage increase in the number of American medical students matching into primary-care residencies between 2009 and 2011.
Source: Association of American Medical Colleges

This article originally appeared in the April 2012 issue of Physicians Practice.


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