Governance, Mission, Growth

MGMA Study: Salary Increases Not Keeping Pace with Inflation
Patient Web Site Takes the Pain Out of Health Forms
Survey Says EMRs Lessen Malpractice Risk
SNM Revises Guidelines for Nuc Med Technologists

MGMA Study: Salary Increases Not Keeping Pace with Inflation

by Cat Vasko

“The Physician Compensation and Production Survey: 2007 Report Based on 2006 Data” from the Medical Group Management Association (MGMA), Englewood, Colo, is out, and the verdict is yet again mixed. While most specialties posted a salary increase, it was rarely commensurate with inflation. And, explains MGMA’s vice president of practice management resources, Dave Gans, productivity is increasing at a rate similar to the rate at which income is going up. In short, specialists are treading water, paddling ever harder just to keep their heads above water.

“Radiologists earn a very good salary,” said Gans. “They’re among the most highly compensated professions in the United States. And they work for it.”

Gans explained that, according to the MGMA’s survey—which collates responses from more than 50,000 providers—radiologists put in an average of 41 to 42 medical service hours per week. “Radiology tends to be similar to the surgical specialties in terms of clinical hours,” said Gans. “When you add the administrative meetings and other work, you have a very full workweek.”

Though productivity is always on the rise, compensation isn’t escalating accordingly. “What we see in radiology is that gains in compensation are identical to the increase in work,” said Gans. “Radiologists are working harder to stay in the same place. Their work has gone up slightly more than their compensation over the past 5 years.” Diagnostic radiologists are the same as the other specialists in that they experience the same problems of restrained reimbursement.

Sure, we all know reimbursement is a problem. But, as Gans pointed out, it is more nefarious than it sounds. “Medicare has realigned some of its payment rates to increase the payment for office visits,” he said. “Radiologists do very few office visits, so they may see some changes.”

And the office visit problem is only the first in a litany of issues. “Radiology is a very IT-heavy specialty, and because it’s a higher user of technologies, it tends to have very expensive equipment, which means you have very high fixed costs and need high patient volume to break even,” Gans said. “If you manage and operate your own imaging center, how do you attract patients so you can get a return on investment? How do you keep your equipment state of the art? You have to fund replacement, which means you have to fund for the future.”

He does not, however, suggest that the solution lies in ratcheting productivity up to the next level. “My personal belief is that you can work only so many hours,” he noted. “And that’s what radiologists say: how can they work any harder? The changes in productivity are due to technology, the use of MRI and CT has a higher charge than plain film, but then there’s the added cost and complexity of managing those technologies.”

What radiologists need is not to work harder, but rather to manage their practices better, said Gans. “Radiologists in private practice need better management expertise, whether it’s for marketing, equipment purchase and management, or the general complexity of health care,” he said.

Patient Web Site Takes the Pain Out of Health Forms

by Marianne Matthews

A new web site offers patients privacy, convenience, and plenty of time to complete and submit important health care forms before they even enter your office. is an Internet service that allows an unlimited number of patients to fill out their HIPAA forms, personal and insurance information, and medical histories online—in their own homes —before coming to your facility for their appointment.

Free of charge to patients, the web site calls itself “hi-tech, professional, and a practice builder.” For busy imaging centers, the web site is one way to streamline administrative services and free up staff. Practices can link the forms directly from their web site or can use the Submit

PatientForms service even without having their own web site.

Industry research shows that health care consumers are responding to web-driven initiatives. More and more, consumers are relying on the Internet to obtain information and communicate with their health care professionals. In fact, industry research suggests that eight in 10 Internet users have searched for health information online.

For patients, the new web site offers ease of use, privacy and organization. In addition to completing and submitting the forms online, patients can print a copy before they submit, which organizes their own records. Once they are submitted, the practice receives an e-mail notification that the patient has registered. Your staff is directed to a password-protected account and has the ability to view, print out a hard copy, or download the completed forms in PDF or JPEG format into your facility’s computer system or electronic patient folder.

SubmitPatientForms is available to health care practices for a monthly fee of $18.95. If you sign up for a quarterly or annual membership, there is a 10% and 20% discount, respectively.

Many practices have spent years developing and designing business, health, and medical history forms that reflect the nature of their facility. SubmitPatientForms recognizes that every practice has its own type and sequence of questions, so physicians and staff can receive the necessary information that will help diagnose, treat, protect, and safeguard the health of its patients. With this in mind, SubmitPatientForms has developed new software that replicates your own custom forms and exclusively enables your patients to utilize these same forms online. For facilities that prefer this approach, there is a one-time fee of $249 to take advantage of the custom software.

Survey Says EMRs Lessen Malpractice Risk

by Nikos Valance

The Medical Records Institute (MRI) has issued the results of a joint survey with Professional Risk Associates (PRA) regarding the relationship of electronic medical records (EMRs) to malpractice risk.

The joint survey sought information regarding the adoption of EMRs in physician practices and the impact of EMR usage on patient safety and malpractice risk. Respondents from 115 practices in 27 specialties representing 36 states completed the Internet-based survey, which was conducted from March 21 to June 30, 2007.

Of the 62% of respondents with EMR systems, more than two thirds have stand-alone systems (not part of a regional or hospital system) and have had the systems for more than a year. A physician was identified as the “Power User” by almost half of the practices with an EMR system, and nearly two thirds indicated their providers fully use the system. Approximately a quarter of those who have EMR systems complained the system does not have the functions they need, and a similar percentage stated they did not receive adequate training.

Nearly 20% of respondents stated their malpractice insurer offers a discount for having an EMR system, and close to half (45%) believe EMRs will make them less vulnerable to malpractice cases. Among the almost one fifth who have had a malpractice case in which documentation was based on the EMR, over half (55%) said the EMR was helpful.

“This is an important first survey on the current status of EMRs and their impact on malpractice risk,” said C. Peter Waegemann, CEO, Medical Records Institute. “It shows the need to address EMR system usage, training, and legality.”

“These survey results are a great tool for medical malpractice insurance carriers to begin researching the impact of EMR functions on malpractice claims,” advised Bob Meadows, executive vice president, Professional Risk Associates. “We are excited to be in the forefront of this initiative and intend to continue working with our physicians and carriers to help reduce medical errors that lead to malpractice litigation and to encourage our carriers to develop discounting programs for physicians who properly use EMR technology.”

MRI serves as an international forum for sharing knowledge, experience, and solutions with the health care community at large, but especially with health care practitioners, as well as professionals in health information technology (HIT) and health information management (HIM).

PRA is an independent insurance agency that focuses on professional liability for health care providers and is leading an initiative that seeks to improve the efficiency of medical practices and reduce medical errors that lead to malpractice litigation through the use of EMRs.

SNM Revises Guidelines for Nuc Med Technologists

by C. Vasko

David Gilmore

The Technologist Section of the Society of Nuclear Medicine (SNM), Reston, Va, recently issued a revision of the “Scope of Practice for the Nuclear Medicine Technologist 2007.” The revised set of guidelines focuses primarily on public protection and acknowledgement of the evolving nature of technology and science, defining a technologist’s procedures, actions, and processes in nuclear medicine and molecular imaging.

“Scope of practice is a fluid concept,” said SNMTS President David Gilmore, program director for the school of nuclear medicine technology, Beth Israel Deaconess Medical Center, Boston. “It changes as knowledge and technology advance and medical imaging evolves. The dynamic work of nuclear medicine technologists has expanded into the rapidly emerging—potentially revolutionizing—field of molecular imaging.”

The “scope of practice” now includes performing CT scans and administering contrast, as well as in vitro testing and transmission imaging. There are parameters for patient care, quality control, diagnostic procedures, radiopharmaceuticals, radionuclide therapy, and radiation safety.

“Nuclear medicine technologists must possess the knowledge, skill, and ability to perform their duties,” said Gilmore. “Our scope of practice recognizes changes in medicine and technology and promotes better consumer care and competent providers.”

The document will receive regular review for consistency with current knowledge and practice, and will aid states in defining licensure and clinics in approving job descriptions.

Cindi Luckett-Gilbert

“Our scope of practice is a generic description of the practice of nuclear medicine technology and includes information about the profession and its current and future status,” said Cindi Luckett-Gilbert, chair of the SNMTS special task force to revise the scope of practice and supervisor of PET/CT imaging for Presbyterian Hospital, Charlotte, NC. “It includes parameters to define the profession, such as federal and state regulations, institutional regulations, and professional standards.”

The scope of practice was last updated in 2001; there are now more than 21,000 certified nuclear medicine technologists in the country, and the field continues to grow. The new scope of practice is not intended to modify or alter existing tort law; it is instead an outline of nuclear medicine technologist skills and responsibilities. All tasks within the scope are subject to federal, state, and institutional regulations.

“The biggest change to the scope of practice was to include performing CT scans and administering contrast,” said Luckett-Gilbert. “Since many of the state-of-the-art nuclear medicine cameras—as well as the PET scanners—have CT scanners attached to them, performing CT scans becomes one of the nuclear medicine technologist’s tasks.”

The updated scope of practice is available on the SNM web site; it was also published in the September issue of the Journal of Nuclear Medicine Technology.