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In answer to the many requests The Riner Group has received for training in leadership and strategy, The Leadership and Strategy College was developed. The information below highlights some of the focus provided. Customized programs are available to meet your organization’s needs.
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We would suggest that patient access increased from April 2000 to April 2002, according to a new report by the Government Accountability Office (GAO). The GAO looked at data samples in the Medicare Part B fee-for-service program in 99 geographic areas, both urban and rural, for the month of April 2000, 2001 and 2002. The analysis focused on the percentage of beneficiaries who received services and the number of services provided to beneficiaries who were treated, including the number of office visits.
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Patients and physicians differ on their views concerning liability law suits. However, both patients and physicians feel that there are too many suits being brought against doctors and that the amounts being paid is in excess of that which might be appropriate. The survey included 1,396 adults conducted from November 4-28, 2004.
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| The graph below indicates a significant increase in the median compensation for cardiologists according to the nationwide survey of MGMA (Medical Group Management Association). While there is no single reason for the increases, two key factors have had a significant impact: an increase in the wRVU productivity by cardiologists and an increase in access to ancillary service revenue. 
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A recent survey by Modern Healthcare and PricewaterhouseCoopers showed that the number one priority for the senior executives was the electronic medical record. Respondents to the survey stated that they were earmarking approximately 2.5% of their operating budgets to IT, compared with 2.2% in 2004 and 2.3% in 2003. Six in ten participants said their organizations are now committing 10-40% of their capital budgets to IT, up from 5% and 10% a year ago. Although inpatient clinical IT was still listed as the biggest priority for developing an integrated delivery network, the ambulatory side of the hospital’s operation became a priority for IT investment for the first time. Pursuing clinical quality also was listed as a high objective for investment in information technology. There is without question a move to clinical improvement rather than worker productivity as a rationale for endorsing investments in information technology.
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A recent study by Manhattan Research LLC estimates that 423,000 physicians went online for continuing medical education in 2004. These findings were based on information gathered through a telephone survey of 1,201 practicing physicians. As the cost of attending meetings increases as well as the cost for time away from the office, this would appear to be a trend that will continue to grow.
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It is estimated that the United States will need to train more physicians each year to meet growing medical needs of an aging, demanding population. It usually takes about 10 years to train a physician, and based on those numbers it is predicted that there will be a shortage of 85,000 to 200,000 doctors in 2020 unless changes are taken. It should be noted that previous attempts at calculating manpower needs have been off target. The nation now has about 800,000 active physicians, up from 500,000 twenty years ago. The United States drastically expanded the number of physicians being trained in the 1960s and 1970s, creating two new physicians for every one that retired, according to the Health Policy of the Medical College of Wisconsin. However the production of new physicians has changed little since 1985. Today, new physicians roughly equal the number of physicians retiring.
The Association of American Medical Colleges (AAMC) has recommended that U.S. medical schools increase enrollment 15% by 2015 to head off the impending physician shortage. A 15% increase in enrollment at all 125 credited medical colleges would yield an additional 2,500 new physicians per year. The AAMC recently created a Center for Workforce Study to survey and monitor physicians workforce issues at U.S. medical schools. Currently there are approximately 67,466 students enrolled in medical schools. 
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Even physicians accustomed to utilizing technology are still overwhelmingly relying on paper when it comes to recording their billing charges. According to a recent survey of 102 physicians who use and are familiar with healthcare IT systems, only slightly more than one in five were using an electronic charge system, while more than three out of four still use a paper-based super bill. The cost of moving to electronic claims processing and adoption of technology continues to be an impediment for many physician practices in adopting these types of technologies.
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A recent report entitled “U.S. Health Spending Projections for 2004-2014” concluded that healthcare spending will outpace economic growth in the United States and account for almost 19% of the country’s gross domestic product by 2014.
According to the CMS’ projections, the rate of hospital spending growth increased 7% in 2004 from 6.5% in 2003. Nursing home spending growth increased 4.2% in 2004 from 4% in 2003. Home health spending growth increased to 13% in 2004 from 9.5% in 2003. The report notes that the United States is expected to spend the equivalent of $11,046 per person annually on healthcare in 2014 compared with $6,040 spent per person in 2004. Critics of the report have stated the report is extremely one sided and presents a doom and gloom approach toward healthcare spending. Some are saying it does not take into account the benefits of increased healthcare spending including lower mortality rates, fewer hospital stays, drops in disability among the elderly, and life expectancies. Nonetheless, everyone in the healthcare field understands the implications and importance of appropriate attention to the finances of modern healthcare delivery. 
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It should be noted that there is a significant trend occurring among older retired individuals. Many are rethinking retirement. The creation of social security in 1935 in the Great Society programs of the 1960s – Medicare for health coverage and the Older Americans Act for community services – provided older Americans with a base of financial security. However, many baby boomers are shunning the golden years notion of retirement, and surveys by AARP and other organizations are finding that up to 80% of boomers plan to do some sort of paid work in their 70s. The data below shows that people past retirement age make up a rapidly growing share of American population. However, lately fewer of them are leaving employment behind at 65 or even 70.
We foresee a trend that redesigns clinical practice to allow older physicians to contribute significantly to clinical practice and meet some of the projected shortfalls in physician supply. Our organization is assisting many of our clients with these types of design programs. 
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The following question was posted on the Riner Group Website for the month of February 2005. “Who earns a higher average annual income – internists and family practitioners or dentists?”
On average, general dentists in 2000, the most recent year for which comparative data are available, earned $166,460 compared with $164,100 for general internal medicine doctors, $145,700 for psychiatrists, $144,700 for family practice physicians and $137,800 for pediatricians. Those figures are in sharp contrast to 1988 when the average general dentist made $78,000, 2/3 the level of the average internal medicine physician and behind every other type of physician. From 1988 to 2000, dentists’ incomes more than doubled, while the average physicians’ income grew 42%. The rate of inflation during the same period was 46%. When you take into account the hours worked – dentists work on average 40 hours a week according to the American Dental Association while the American Medical Association says physicians generally work 50-55 hours per week – the discrepancy becomes even greater. Multiple factors are at play, not the least of which is the influence of insurance payment mechanisms and the ability of the various practices to offer cash-based services. However, it should be noted that financial constraints are a significant factor contributing to a decrease in applications for certain segments of the population looking at medicine as a career choice. TO VIEW OUR NEW POLL QUESTION, VISIT US ON THE WEB: www.rinergroup.com 
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| With over twenty-five years of clinical and business experience, we have
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over the past 20 years. The average tuition and fees at public medical schools during the 2003-2004 academic year amounted to $16,153 and the corresponding figure for private schools was $32,588. Adding $20,000 to $25,000 for living expenses, books and equipment brings the estimated cost of four years of attendance to about $140,000 for public schools and $225,000 for private schools (Association of American Medical Colleges, 3/23/04). The average debt carried by 1984 graduates was $22,000 for public school and $26,500 for private school. By 2004, the debt had increased to $105,000 for public school and $140,000 for private school and only about 20% of medical students graduated with no debt (Association of American Medical Colleges, 2003). To find out more about The Riner Group,
please visit our website
or contact
us directly via confidential voicemail or fax.
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5811 Pelican Bay Blvd, Suite. 210 |
Naples, FL 34108 |
314.727.7098 |
1.800.965.8485
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Copyright - The Riner Group, 2010 |
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