Lycopene: Good for prostate health

There is some decent evidence that suggests that diets rich in lycopene can protect against prostate cancer. Lycopene is found in tomatoes.

Coverage?

What is coverage? The answer is that it varies. To a surgeon in the OR it means having an assistant. To an attending at a teaching hospital, it means having residents take care of their patient in-house. To a private practice doctor, it means having someone take care of patients when you are away.
If you take ER call, coverage is very important. Coverage in this case enables you to take vacation once in a while.
If you are in a group, coverage tends to not be an issue, unless of course you are doing the majority of covering for your partners as they vacation. This can lead to bad feelings.
As a solo doctor, coverage is vital, yet in many ways easier to come by than when part of a group. In many areas, ER call is valuable, so it is easy to give away. This means as a solo doc you can get away when you want.
Technology has made coverage less vital as well. With cell phones and EHRs, mundane tasks like rx refills and lab checking are non issues. With several minutes a day at a netbook, you can keep up to date and avoid the dread of the first day back mile high chart build up.
Yeh, life is good.

How to Attest For Meaningful Use

I just attested, successfully, for 2012 EHR meaningful use.  I can tell you that this has been no small feat.  I started the process in January 2011 and was it took me almost 20 months to get it right.  And I am a savvy EHR user.  Attesting for MU dollars is a process.  First you must register, then you must report for a 90 day period, then you attest.  Oh yeh I forgot, first you use select a qualified EHR & learn how to use it in a meaningful way.

CMS, the Center for Medicare Services, has lots of documentation on there website regarding MU, attestation, EHR selection, etc.  Click here, https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms/32_Attestation.asp to be taken to the site.  I know you will find tons of information on the site, just not a bit of it helpful.  I don't know who developed the content for the site, but either they were oblivious to the needs of the people who use it or intentionally made the site confusing to make especially difficult to start and complete the MU process.

The real link, the one you need to get the $$$ is here: https://ehrincentives.cms.gov/hitech/login.action
I just don't think CMS wants you to know it.

Here is how to do it, step by step:

• Register for MU at the link above
• you must have a NPPES password to do this.  If you do not, you must get one.  If you cannot, you are SOL.
• Answer the questions asked
• Find your EHR number (ask vendor or search on the EHR incentive site.
• Complete MU reporting process
• Return to link, complete questions, hit submit.

Sounds easy.  Is not.

Good luck.

Commodity vs Superstar?

If you were a hospital or clinic administrator, and you were charged with hiring a new doctor, would you want a competent but no-named doctor or a superstar?

The no-name, of course.  He/she costs less and can be replaced easily with less disruption to the organization at large.

Of course it you are the doctor, your goal is to become the superstar because you cost more and can't be replaced so easily without disruption to the organization.

The administration, if they are smart, will have policies in place that in effect make it difficult to become a superstar.

Of course, in this era of social media, this can be problematic for administration.

Interesting eh?

Write book. Why?

Do you have information you want to give to the world? Do you want to write a book? Here's an easier way:
recorded what you know on video. Then convert it to a DVD and get it out there. Way more more reach.
Easier, faster, cheaper, better.

A great use for MMS

Here is a cool use of technology. I had a patient who needed to understand how to use an injectable medication. He was unable to come into the office for a demonstration in person. So I video recorded me showing him how to draw the medication into a syringe using the vidoe function on my iPhone. Then I MMSed the video to him. Technology; wonderful.

A vasectomy consult with Dr Richard A Schoor MD FACS

I had this video made for my vasectomy patients.

http://www.youtube.com/watch?v=Q6DlGNeQEZ4&feature=youtube_gdata_player

Richard A Schoor MD FACS
www.schoorurology.com

Spousal consent prior to a vasectomy?

Vasectomy Complications

Count your jewels

A jeweler, on the way home from a business trip runs into a merchant friend of his. The merchant has some diamonds he needs to sell to the jeweler. The jeweler, having just made a purchase, does not have much money remaining. But the merchant is really offering a good deal. So the jeweler looks through his wallet and decides that he can make the purchase, but he'll have to travel home coach, when he is accustomed to first class, luxurious travel.
On the way home, the jeweler sees another friend. The friend asks the jeweler why he is in coach and not first class. Has the jeweler fallen on hard times?
The jeweler responds that when he feels cramped and uncomfortable, and when his back and legs hurt, and when he is hungry, he gets his bag of jewels and counts them, and he feels better.
When is the last time you counted yours?

Richard A Schoor MD FACS
www.schoorurology.com

Make a business plan

Even if your practice is up and running it is probably worth while to look at your business plan. If you are just now planning to start a new practice, having a business plan is essential.
A formal business plan contains many parts. You can get a template free from the US Governments Small Business website. It is a great and free resource. The business plan is your chance to plan for as much contingencies as possible before you spend the money. Brainstorm all the what if's. List them all. Then add up how much money worst case will cost.
Then compute the upside--the most you can make with the business.
Is your business still worth the risk?

Behave!

If you work in the same community I'm which you live, you better behave. You never know that the person you are mouthing off to may have been a future client or patient or customer.
These things happen.

Who is your best worker?

Miguel was beloved. He was an icon. Over his tenure, he became an institution at my temple.
But Miguel was really a slacker. Raul, his underling. was the gem. When Miguel left. Raul rose to the occasion and has out shined his former boss in all respects.
Are you honoring your true gem?

Richard A Schoor MD FACS
www.schoorurology.com

Semen analysis: what is normal?

The WHO recently re-analyzed "normal" values for semen analysis. Without boring you with statistics, I think that the results can be summarized as follows:

More is better.

Let me elaborate.
10 million sperm is better than 5 million sperm and 20 million is better than 10 million. To go further, 50 million beats 30 million while 100 million beats 50 million. In other words, the probability that a couple will conceive within a year increases as sperm counts increase. Same with motility and morphology.

Do what is my job? My job as a male infertility specialist is to help you produce more and better quality sperm.

Order Sets

Order sets go by several names but essentially they encompass all the pertinent diagnostic and treatment options indicated for any given disease process. Any EHR worth its price will come hardwired with datasets and will also allow you to customize your own. Datasets should ideally come from evidence based medicine and your society's best practice guidelines.
Does your EHR have them?

The IU.

Patient Satisfaction Surveys

Collecting data on how your practice performs in customer service is important. But there is a right way to get the data and many wring ways.
Wrong way: leave surveys in the office and hope people complete them

Wrong way: embed survey in website and hope people complete them

Wrong way: mail patients surveys and hope they complete them

Right way: ?

The problem with all surveys is wether or not the information is useful and accurate and unbiased. Doing surveys the wrong way will get you inaccurate biased and useless data.

Do it right or not at all.

Richard A Schoor MD FACS
www.schoorurology.com

EHR Slow Down

Do EHRs slow down physicians? Yes and no. EHRs force docs to be more complete, more thorough. If that slows you down then perhaps you needed to slow down. Ultimately though, as the doctor masters the templates and the flow of the EHR, he or she can actually speed up yet remain thorough.
A win win.

Richard A Schoor MD FACS
www.schoorurology.com

Live close to work. Work close to life.

One day you may be tempted to get a job or take call at a hospital greater than 30 minutes from your house. If at all possible, don't do it.

You may make some more money but you'll miss life.

Richard A Schoor MD FACS
www.schoorurology.com

Remember this when things are slow

When the phone keeps ringing
When patients keep showing up
When you have to see yet another
When you have to return another call
When you have to sign off another lab
When. . .

Richard A Schoor MD FACS
www.schoorurology.com

What is your plan?

Now is the time to start planning for next year. How are you going to:

Increase revenue
Decrease overhead
Get more new patients
Decrease risk
Decrease staff turnover

Now is time to plan.

Richard A Schoor MD FACS
www.schoorurology.com