Not so many years ago, anybody who’d been through medical school would associate the abbreviation PT with patient, physical therapy, maybe even patellar tondonopathy. The abbreviation for part time, so familiar to the rest of the working world, was as foreign to physicians as Vedic Sanskrit. Not so anymore. The classified sections of medical magazines are full of help-wanted ads offering physicians the option of part-time hours, along with other once unheard of perks such as “No nights. No call. No holidays. No weekends.”
For that flexibility, physicians can thank their younger colleagues, who are demanding and getting a better quality of life.
“The difference in the mentality of this generation is that they want a better balance between personal and professional life,” said Stephen Klasko, MD, dean of the University of South Florida College of Medicine. “That’s especially true among young physicians who are sons of doctors. They understand the toll of immersing yourself in work 100 hours a week.”
The 2007 Retention Survey from the American Medical Group Association (AMGA) and Cejka Search, a St. Louis-based physician recruiter, shows just how fast the image of a physician’s workweek is changing. The 2005 survey revealed 13 percent of physicians worked part time. By 2007, the rate reached to 19 percent.
“I’m afraid the number will jump up,” said W. Wheeler Jones, Jr., regional vice president for Cejka Search. “For Generation X, Generation Y and Millennials, lifestyle is more important.
“They want to be employed. They do not want to start a practice. They want to work 40 hours a week or less.”

* For the complete story, call our Circulation Department at 800-327-3736 ext. 127

Gov. Charlie Crist spent nearly two months selling his “historic” piece of health-care legislation to lawmakers. Now his administration has a much more daunting task: Selling it to the health-care providers, insurance companies and HMOs who are needed to make the plan a reality.
On the final day of the 2008 session, legislators passed Crist’s Cover Florida plan. Now Crist’s administration has one month to draft its plan to have providers and carriers compete against each other to sell stripped down benefit plans to 3.8 million uninsured residents.
Crist -- who identified increasing health-care access as his top priority for the 2008 session -- said he wants the Cover Florida health-care coverage to be effective no later than January 1.
“This is historic legislation. Never before in Florida has there been this kind of effort,” Crist said immediately after the legislature approved the bill. “I am more grateful than I could ever possibly be as a result of what has happened here in Tallahassee, Florida today.”
While the legislation OKs a number of different ways at whittling away at Florida’s growing uninsured population, all eyes remain on Crist’s Cover Florida plan. The governor has said the coverage would cost about $150 a month for the more generous product that includes emergency department care and inpatient hospitalization. The more stripped down plans would be about $100 a month, he said.

* For the complete story, call our Circulation Department at 800-327-3736 ext. 127

Q: As far as a physician is concerned, what’s the difference between health-law and other attorneys, in terms of what I need to know about services that are -- or are not -- provided?
A: In 1996, after I became certified by the Florida Bar as a health-law specialist, I proudly presented my card to my doctor. He looked at it, scratched his head, and said “so what do you do with this, sue doctors?” Well no, I explained, medical malpractice is considered a sub-specialty of tort law, not health law. Although health lawyers are familiar with the legal issues, they usually do not litigate malpractice cases.
Next, I proudly advised my lawyer friends that I had become a board-certified health lawyer, and they responded: “health law, health law…so what is that, anyway?” The Florida Bar says that health lawyers “deal with legal issues involving federal, state, or local laws, rules, and regulations and health care provider issues, regulation of providers, legal issues regarding relationships between and among providers, legal issues regarding relationships between providers and payors, and legal issues regarding the delivery of health care services.” I read this definition to my wife. Her face went blank.
The field has only come to be recognized as a discrete specialty in the last 25 years or so and has grown in importance as the health-care sector has gobbled up more and more of the national gross domestic product.

* For the complete story, call our Circulation Department at 800-327-3736 ext. 127

In recent years, Florida has positioned itself to become one of this country’s leaders in biotechnology. As part of this endeavor, the state has pursued ventures related to personalized medicine, a relatively new field in its own right.
For example, cancer centers at the University of Florida and the H. Lee Moffitt Cancer Center & Research Institute have engaged in relevant research and development. Moffitt has spent $20 million dollars on a project called “Total Cancer Care,” with the aim of building a database of information from 50,000 patients, and providing individualized treatment options. In this field, Moffitt has partnered with Merck & Co. and Genzyme Corp., as well as universities such as Duke University.
In personalized medicine, one applies information about a person’s unique genetic makeup, environment and lifestyle to select strategies for detection, treatment or prevention of diseases. Personalized medicine optimizes effectiveness and minimizes toxic side effects in a particular patient. The field frequently takes advantage of diagnostic kits, tools and molecular screening methods for genetic biomarkers, which have been the focus of hundreds of patent filings worldwide.

* For the complete story, call our Circulation Department at 800-327-3736 ext. 127

Q: I am a cardiologist in private practice that works part time performing interpretations for an Independent Diagnostic Testing Facility (IDTF). From time to time, I do refer patients to the diagnostic center and I end up performing the interpretation. Thereafter, the IDTF bills Medicare globally for the service. I have just been informed by the diagnostic center that they can no longer bill global for services that I interpreted on my own patients. That doesn’t make any sense, can you confirm this policy?

Cardiologist,
Miami
A: The new Medicare Local Coverage Determination (LCD) policy for IDTFs went into effect February 29, 2008. In the new LCD policy, it states that when the technical component of a test is performed by the IDTF and the interpreting practitioner is the practitioner who ordered the test, the IDTF cannot bill for the interpretation. The interpreting practitioner must bill the interpretation since the IDTF cannot bill when the interpreting physician is the referring physician.

* For the complete story, call our Circulation Department at 800-327-3736 ext. 127

Not long after Holy Cross Hospital completed its purchase of North Ridge Medical Center, John C. Johnson, president and CEO of the Fort Lauderdale Hospital, announced its intent to shut down operations at the former Tenet Healthcare Corp. facility to the dismay of some physicians and staff.
“The decision to close is because it is a significantly underutilized facility,” Johnson said. “The price we paid, $20 million, is what the land, equipment and residual value of the building is worth. We didn’t pay anything for the business.”
Johnson declined to reveal Holy Cross’s plans for the building, except to say that it would be used not demolished. Holy Cross owns the medical office building adjacent to North Ridge.
Tenet spokesman Steven Campanini said in an email request to questions that Tenet sold “North Ridge, because it no longer fits strategically in Tenet’s portfolio due to increased competition and micro market dynamics.”
North Ridge stopped admitting patients on April 2. Patrick Taylor, MD, chief operating officer and chief medical director at Holy Cross, expected the hospital would continue caring for those patients in house until they are ready for discharge and would not need to transfer any patients. In the interest of safety, Holy Cross has placed an intensivist at North Ridge. Elective surgeries and outpatient procedures were transferred to Holy Cross, which is about one mile away.

* For the complete story, call our Circulation Department at 800-327-3736 ext. 127

A Florida appeals court recently issued an opinion affirming a jury verdict awarding more than $1.5 million to a Miami pathology group. While the decision specifically concerned whether a Florida HMO must compensate the pathology group for the professional component of clinical pathology services, the court’s opinion more broadly establishes that medical providers can successfully sue HMOs operating in Florida to enforce the statutory provisions governing HMOs, including those concerning reimbursement.
In 1999, Florida’s largest health insurer, Blue Cross and Blue Shield of Florida (BC/BS), unilaterally changed the reimbursement policies of its HMO, Health Options, Inc (Health Options). BC/BS decided that, in order to save an estimated $4.1 million per year (according to its own internal documents), it would change its long-standing practices and no longer pay hospital-based pathologists for their professional clinical laboratory services. BC/BS’s stated rationale was that it was already paying the hospitals for such services.
In 2005, Palmetto Pathology Services, a hospital-based provider that was not contracted with Health Options, brought suit against Health Options in Miami-Dade County to enforce the laws governing HMO reimbursement. Palmetto Pathology specifically sought to recover its full-billed charges on all unpaid claims submitted to and denied by Health Options for professional clinical pathology services rendered to Health Options’ subscribers at two Miami-area hospitals.
Nearly two years later, in April 2007, Palmetto Pathology prevailed at trial and was awarded its total billed charges plus interest. Health Options thereafter appealed to the Florida appellate court and the appellate court, on April 16, 2008, upheld the trial court’s decision. The appellate court explained, in a well-reasoned 16-page opinion, that medical providers in Florida may bring lawsuits against HMOs to enforce the statutory and administrative regulations governing HMOs, including those relating to compensation.

* For the complete story, call our Circulation Department at 800-327-3736 ext. 127