Green Tea Health Benefits Blog

Maryland physicians have invited the state to look closely at their wallets.

After years of lobbying by MedChi, the Maryland State Medical Society, a committee of health care experts, physicians, and representatives from the state and the insurance industry are meeting as members of Gov. Martin O'Malley's Task Force on Health Care Access and Reimbursement.

The task force is due to issue an interim report Dec. 1 to the governor and state legislators, and a list of final recommendations by June 30, 2008. Among the items the task force will consider:

• Potential legislative changes to reimbursement regulations.
• Clarifying or making legislative changes to the authority of the attorney general and insurance commissioner to regulate reimbursement rates and business practices of health plans.
• Recommendations as to whether to link reimbursement to quality measures.
• Recommendations as to whether companies should be allowed to require physicians to participate in all plans owned by a single company -- otherwise known as all-products clauses. (The AMA has policy against these clauses.)

The task force is scheduled to meet monthly.

A study done by the Maryland Health Care Commission in 2004 found that Maryland physicians' reimbursements were in the lowest quartile of the nation.

Physicians are leaving the state, and will continue to do so, seeking better pay, said Martin Wasserman, MD, executive director of MedChi, and a member of the task force.

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Bloomberg reports that obesity and smoking add $100 billion annually to health care costs in the US.  The obesity rate in the US is 33% compared to 17% in Europe.  “Health policy makers can't rein in medical costs in the U.S. unless they reverse obesity trends, said lead researcher Kenneth Thorpe, an Emory professor of health policy.”

Obesity threatens to reverse the years of gains in improved health and life expectancy that the US has been enjoying over the last several decades.  It also threatens the solvency of the health care system.  The huge difference in obesity rates between the US and Europe are a ready refutation of the theory that individuals can’t control their weight, or that it is genetically determined. 

Many life coaches perceive physicians as a booming market for their services. The reverse also is true -- many physicians perceive the life-coaching business as a booming market for their services.

Type "life coaching, physicians" into an Internet search engine and you will be inundated with listings of helpful souls who want to get physicians "unstuck from ruts" related to business, finances, stress, anger, relationship troubles or any combination thereof. Some of those potential helpers are physicians who have stopped practicing medicine and started coaching, or whose practices offer life coaching as part of the services.

For some physicians, adding coaching to their practices isn't a big leap. "Many folks have gone into the life-coaching piece because it's easier to market," said Gabriela Cora, MD, a Miami psychiatrist. "It's an easier sell, and unfortunately the stigma of heaving a mental health label is still out there, so it makes it a lot easier for a person to say I have a coach, rather than I have a therapist."

Dr. Cora operates a life-coaching business focused for executives. She also is on an American Psychiatric Assn. business relations committee whose tasks include examining life coaching and the psychiatric practice. The APA, as with organized medicine as a whole, as yet has no policy specifically on the subject.

So for physicians seeking life coaching, or seeking to offer life coaching, the landscape is wide open -- albeit potentially confusing, as there are, literally, no rules for this job.

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While retail-based health clinics generally rely on nurse practitioners and physician assistants to see patients, another model is emerging that staffs entirely with physicians.

Despite the increase in overhead, that new model works, say clinic operators, because of its expanded scope and greater marketing potential. And some big names and deep pockets are jumping behind the concept.

One of the model's early adopters is Jacksonville, Fla.-based Solantic, which recently expanded its stand-alone clinic chain to include clinics located inside Wal-Mart stores.

Solantic's chief medical officer, Nathan Newman, MD, said because physicians are present, Solantic can offer x-ray services and suturing. It's also a good marketing strategy to say each patient will be treated by a board-certified physician, he said.

Solantic is also gaining attention because of one of the names behind it. Richard Scott, who founded Solantic in 2002, gained notoriety for taking two struggling Texas hospitals and creating, through mergers and acquisitions, the Columbia/HCA Healthcare Corp., which became the largest for-profit hospital chain in the world.

However, a massive Medicare fraud investigation cost Scott his job as Columbia/HCA's CEO and president. Scott was never charged with wrongdoing, though other executives were, and HCA -- which dropped the Columbia name -- agreed to pay $1.7 billion in civil penalties and damages to settle the case, without admitting wrongdoing. In 2003, upon the finalization of the settlement, the Justice Dept. called it the largest Medicare fraud settlement ever.

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Two months after a legal dispute threatened to stall development of a large-employer consortium-based personal health record system, the project was resurrected with a new vendor and two new members.

Dossia, a nonprofit consortium of large employers created to provide PHRs for their employees, dependents and retirees, announced last month that AT&T and Sanofi-Aventis have joined as founding members. The two companies join Wal-Mart, Intel Corp., Pitney Bowes, Applied Material, Cardinal Health and BP America. The combined work force the group represents is now more than 5 million.

The consortium also announced it has contracted with Children's Hospital Boston to create the technology behind the PHR.

The news comes after legal disputes with Dossia's former vendor, Portland, Ore.-based Omnimedix Institute, surfaced in July.

Omnimedix was the target of a preemptive restraining order filed by Dossia in late June after Omnimedix reportedly threatened to file suit against Dossia for what it said were missed payments. Dossia said funding wasn't an issue.

An Oregon circuit court judge approved a restraining order in July that required any suits filed by Omnimedix be sealed, and prevented the company from discussing the ongoing dispute. Neither Dossia nor Omnimedix would comment on the case.

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