PCP Issues and Answers

On November 7, 2012, an elite panel met at the U.T. Dallas Center for Values in Medicine, Science, and Technology to discuss “The Value of Primary Care Medicine”.   The meeting was chaired by nationally known pediatrician Dr. Bob Kramer, who founded the Cystic Fibrosis Foundation Research and Development Council in addition to his many other contributions to pediatrics.  Internal Medicine was represented by Steven L. Leach, M.D. who holds the Irene Wadel and Robert Atha Professorship of Internal Medicine at U.T. Southwestern.  Richard Young, M.D. is director of the Family Medicine residency at John Peter Smith Hospital in Fort Worth, the largest Family Medicine residency in the nation.  Chris Gregory, from his perspective as a wealth manager for physicians, spoke about the financial pressures being exerted on PCPs.  The panel was rounded out by a businessman who is recognized nationally for his many successes in organizing physicians, our own Harris W. Miers, Jr. of PDA and the Flagship Physician Network.

The most news worthy take-away from the discussion was the presentation of Dr. Richard Young.  As a member of the CMS Innovation Advisory Program, he has developed a new payment methodology for primary care physicians.  His proposal has a well-developed mechanism to more fairly compensate PCPs for the time they invest in patient care.  There are codes for telephone conversations with patients, which can eliminate the need to schedule an office visit to qualify for payment.  There are codes for addressing multiple issues during a single office visit and even codes for completion of paperwork.  In short, Dr. Young’s system corrects many of the misguided incentives that are built into today’s coding structure, incentives that force PCPs to race through the day like a gerbil on an exercise wheel.  Flagship management has reviewed Dr. Young’s work, and we hope to integrate it into the Flagship payment structure to further our goal of high quality, cost-effective healthcare.  The review of this effort by CMS is feedback that we all await.

From this writer’s third party viewpoint as a physician specialist observing the discussion, two emotions were most prominent.  First was a sense of renewed hopefulness that there are indeed solutions to the problems we face.    Second was a sense of pride that our organization, the Flagship Physician Network, is in the forefront of development and innovation as we move to confront these problems.  Answers do exist, and our speed is limited only by available energy and the funding available to us.

Providing the Resources to Compete

Our mission is to assist our practitioners in making more money, avoiding bureaucracy, and accomplishing this without more time at work. This strategy clearly works, as we have doubled our physician representation and have a pipeline of new revenue generation opportunities for 2013.  PDA has been re-invented over the past three years.  The independent physician can succeed in the “new normal” with creative strategies, high quality performance, and the best of customer/patient service.  To that purpose, the “Company Store” is open for business.  Each product or service is vetted by the PDA Medical Director, Chief Medical Officer and Chairman and receives an in-depth financial review.  The best products and services are no better than the management that presents and implements them. The Company Store has attracted a tremendous medical marketer to assist you.  Please welcome David Varnell to the fray.

David, president of DFV Ventures One, Inc., has agreed to coordinate all PDA ancillary services for our members.  He graduated with a BS degree from West Point.  Captain Varnell proudly served in the US Army as an Airborne Ranger.  Upon discharge, he began his career in medical sales.  He was one of the top 10 sales representatives for Davol and Bard EMS and was one of their national sales trainers.  After 10 years he left Davol and Bard to become the Executive VP of Medmax, a manufacturer of electronic stethoscopes where he enjoyed a three year tenure.  After he coordinated the sale of Medmax, he started Southern Mobile X-ray and EKG which became the 2^nd largest portable x-ray service in Texas, covering North Texas, East Texas, and the Houston area.  After selling Southern Mobile, he started DFV Ventures One, Inc., the first company in Texas to provide mobile DEXA bone density services to rural hospitals.  This service eventually evolved into an ancillary service for physicians in the North Texas area.

Mr. Varnell has continued to expand his ancillary business model and now is working exclusively with PDA to provide a business model to generate a strong revenue stream for PDA members.  Dave shares our strength and commitment to the Flagship brand.  When Dave visits your office, please take a moment to meet him and to discuss how to grow your bottom line.

This week we welcome two new members to the PDA family as a new feature of our blog:

Gerardo Losoya, M.D.       Family Medicine   972-271-3330              1901 E. Northwest Hwy, Garland

Michael Benavides, D.O.   Family Medicine   972-682-5757             1350 N. Buckner, Dallas

The Big Picture

Medicare was created by the Social Security Act of 1965.  There was a great hue and cry from physicians who thought socialized medicine had arrived.  Ronald Reagan said, “If you don’t stop Medicare…one of these days you and I are going to spend our sunset years telling our children’s children what it once was like when men were free.”

But physicians’ incomes were trending upward.  We were all forced to admit that Medicare was the best thing that ever happened to us.  Medicare ushered in the “Golden Years of Medicine”.

That lasted for a while, and then the dire predictions began to come true.  DRGs and RBRVS were introduced to start the racheting down of reimbursements.  They were so successful that the federal government was soon able to enforce patient care at cost and then even below cost. 

In 2003, the government broadened its intrusion.  The Federal Trade Commission (FTC) began to intervene in the practice of medicine.  While teachers, police, fire fighters and airline pilots have long held the ability to collectively bargain, the FTC moved to declare physician organizations guilty of restraining trade.  And, that was the origin of the infamous “messenger model” presentation of managed care contract offerings.  

In more recent years, the FTC has continued to encroach on local and state medical boards.  Medical boards in Alabama, Florida, Georgia, Kentucky, Louisiana, Missouri, Maine, North Carolina, and Tennessee are under review.  Most licensing boards have limited budgets and are easily intimidated by the FTC.  The threat of personal liability for triple damages to medical board members can be overwhelming.

And then, along comes ObamaCare.  In the 1960s doctors, hospitals and the entire healthcare system were told, “If you don’t fix the medical system, politicians will fix it for you.”  It’s happening!

The handwriting is on the wall.  It’s the eleventh hour.  It’s now or never.

You can give up, or you can start making a difference.  Step 1 is to VOTE!  Step 2 is to get on board with the Flagship Network regardless of who wins the election.  Every successful movement has to start somewhere, and the Flagship plan can be “A LOCAL SOLUTION FOR THE NATIONAL PROBLEM”. 

But first, you must VOTE!