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● Roundup: Practice Management

AMA releases new study of physician practice arrangements

Private practice medicine remains strong despite increase in hospital employment.

CHICAGO — The American Medical As- sociation (AMA) recently released new data on physician practice arrangements showing that private practice medicine remains strong despite an increase in hospital employment. This is the fi rst nationally representative study of physician practice arrangements in fi ve years. “To paraphrase Mark Twain, the reports of the death of private practice medicine have been greatly exaggerated,” says AMA President Ardis Dee Hoven, M.D. “This new data shows that while there has been an increase in hospital employment, more than half of physicians (53.2 percent) were self-employed in 2012, and 60 percent worked in practices wholly owned by physicians. Needed innovation in payment and delivery reform must recognize the wide range of practice types and sizes that exist today so all physicians can participate in the move to a more patient-centered system that rewards high-quality care and reduces costs.”

While this new study shows 60 percent of phy- sicians in physician-owned practices, there has been a trend toward more hospital employment during the last fi ve years. In 2012, 29 percent of physicians worked either directly for a hospital (5.6 percent) or for a practice that was at least partially owned by a hospital (23.4 percent). A 2007-2008 AMA survey did not distinguish be- tween direct hospital employment and employ- ment in a hospital-owned practice, but found that 16.3 percent of physicians worked in one of the two settings. Other important fi ndings include: • The percentage of physicians who were practice owners in 2012 decreased 8 percentage points from 2007/2008.

• Eighteen percent of physicians were in solo practice, down 6 percentage points over fi ve years.

• Single specialty practice was the most common practice type in 2012, account- ing for 45.5 percent of physicians. This study is part of the AMA's Policy Research Perspective (PRP) series, which is available on- line at news/2013/2013-09-17-new-study-physician-

10 October 2013

physical activity. T is approach creates a platform of trust and communication between the provider and patient, and this ongoing trust provides opportunities for providers to broaden the communication to areas beyond self-care. Further, online lifestyle programs complement other

wellness activities, such as challenges, incentives and health reimbursement accounts (HRAs), by providing a deeper, longer-term and more engaging connection beyond what other wellness services off er. T ese lifestyle-management programs also supplement chronic disease initiatives, pro- viding the complementary lifestyle support to their focus on medical issues. In conclusion, online lifestyle interventions provide value

to group practices and hospitals in promoting improved self-care, engaging patients beyond the providers’ walls, pro- viding a relationship platform for further communication, complementing wellness activities and extending chronic condition-management services.

Mike Magrath, Gemalto

Closing an open door in healthcare IT security EHRs are a helpful way for medical professionals to keep track of patient records, but the information in these records can be easily compromised. In fact, the FBI estimates healthcare fraud costs the country $80 billion each year. Today’s exam rooms are equipped with PCs that require

the provider to log into the patient’s EHR. But what hap- pens if the provider is called away from the room or forgets to log out before fi nishing with a patient? T e patient’s records are now easily available to the next person who enters the room. One example of how technology may fi nd a way to pre-

vent this in the very near future is with a form of endpoint access control. Using near-fi eld communications (NFC), hospitals can link a provider’s EHR login to their immediate location. If they log into a patient’s fi le, but must step out of the room, they are immediately logged out. Similar types of innovative secure access are already be- ing used in the United States to increase the integrity of health data. In 2011, Seattle Children’s moved to secure token technology for remote access of EHRs using multi- factor authentication, an additional layer in secure access authentication to the network. As more healthcare professionals tackle the burgeoning

threat of patient identity fraud, NFC and multi-factor au- thentication are solutions that merit a closer look.


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