At this year’s ASA Practice Management Meeting in Las Vegas, there was a recurring theme of understanding disruption, embracing change and “Defining the Future.”
With over 1,000 anesthesiologists, residents, practice managers, coders and business leaders, the conference is an excellent opportunity to network, learn about the business side of anesthesiology and develop strategies to run a successful practice.
Work is Fun When You’re Doing Good
With provider burnout in health care becoming an all-too-common problem, Wayne M. Sotile, PhD, an expert in life coaching, physician resilience and work-life balance, gave the keynote lecture, titled “The Key to Resilient Medical Organizations.” He introduced his comments with a quote from Sigmund Freud: “Life is about love and work.” He then asked the audience, “Are you happy? And who are you to the ones you love and work with?”
The pace of change in health care can be dramatic. Sotile said, “Work is fun when you’re doing good work.” Unfortunately, a fear of burnout leads to work ambivalence, which reduces engagement. This causes lower-quality care and a reduced sense of fulfillment. The resulting negative feelings can carry over from work to home, affecting one’s personal life.
As a life coach, Sotile teaches people a set of skills that enables them to get through difficult times. Resilient attitudes include realistic optimism, incorporation, meaning and “wonderment.” He defined wonderment as seeing the familiar in unfamiliar ways. He also teaches physicians to manage their ambivalence by answering these questions:
- Does your work match your values?
- Can you do it to the best of your abilities?
- Do you enjoy working with the people you work with and serve?
- Do your family members and close friends admire you for what you do?
In a recent video, Eugene R. Viscusi, M.D., new president of American Society of Regional Anesthesia, professor of anesthesiology at Sidney Kimmel Medical College of Thomas Jefferson University and the director of Acute Pain Management at Jefferson Health, discussed physician wellness and how to prevent burnout. He states, “Changes in the past 10 years have brought on feelings of being disenfranchised, left out of the decision making.” Mainly because over 80% of medical care was delivered in physician-owned private practice and it is now under 30%.
To avoid, or overcome, this “loss of control” feeling, he says physicians need to empower, or re-invigorate, themselves through continued education, gaining insight and understanding in practice management and taking ownership in advancing your career.
Changes in Healthcare
In 2017, the health care sector became the largest source of jobs (exceeding retail) and continued to grow, adding 318,000 jobs in 2018. One of the changes needed to thrive in today’s health care environment is to provide value… what value can you add as an anesthesia specialist? Change is an opportunity to innovate, and increasingly, health care innovation is being powered by artificial intelligence (AI).
Regulatory changes affecting the practice of anesthesia include the “Patient over Paperwork Initiative,” which is designed to reduce the administrative burden on physicians and the “Meaningful Measures” initiative, which promotes alignment of measures across the health care spectrum and focuses on outcome measures.
The Centers for Medicare & Medicaid Services (CMS) has proposed changes to Evaluation and Management (E/M) codes that will affect office and outpatient services and the Quality Payment Program (QPP) has added a “low covered services” (less than 200) exclusion to the exclusionary criteria, exempting more providers from the QPP.
New in 2019 is the ability for facility-based providers to use a hospital’s Value-Based Purchasing score for the quality and cost categories of the Merit-Based Incentive Payment System (MIPS). No action is required on your part; CMS will determine your score automatically and compare it with your MIPS score. Facility-based providers are defined as those who provide 75% of their services at inpatient hospitals, on-campus outpatient hospitals (as identified by a Place of Service code), or an emergency room. The ASA recommends continuing to report MIPS quality data this year until you determine your facility scores. In addition, you are still required to report Improvement Activities and participate in the Promoting Interoperability category (if eligible).
Building Leadership Skills
Providers are under pressure to cut costs and improve results. Health care is a business, and anesthesiologists need a sound business case for what they do. Hospital leaders sometimes struggle in aligning their mission with the business side to achieve it. This is an area where an anesthesia medical group can make a big difference.
In an effort to develop the next generation of physician leaders, the ASA has created the Executive Physician Leadership Program, designed in partnership with the Northwestern University Kellogg School of Management. Successful completion of this curriculum will advance leadership and health care strategy skills while earning continuing medical education credits and a certificate of completion.
Moving forward, it is important for anesthesia specialists to understand the changing landscape in health care, whether you are an experienced anesthesiologist or a new resident beginning your career.
Practice Management 2019: Defining the Future. anesthesiologynews.com
Physician Burnout in Anesthesiology and the Case for More Practice Control. anesthesiologynews.com