Ask an Expert

By Joel Schlessinger, MD

Q How is the economic downturn affecting the medical side of practice?

The same sorts of concerns that have emerged in the cosmetic arena have happened in the medical arena as well, but in reverse. What we are seeing is that those who have great insurance still come in, but the self-pay patients for acne and other minor medical concerns are "spacing out" visits or no-showing on a more regular basis. This probably is reasonable to expect in a down economy, but it is important to offer these patients appointments and follow up to ask them if they wish to reschedule. Many are rescheduling when asked to do so, as they recognize the importance of these appointments and may need a week or two extra to put aside the money for these visits.

Additionally, we are now sending out confirmation cards a week out rather than three days earlier in order to let our patients get their finances arranged or reschedule at their convenience. We used to only send confirmation cards to Monday appointment patients, but we are now sending them to all our patients. We have always called our patients with reminders, and we continue to do so.
– JS

QWhat are you doing about advertising for this year?
I plan our advertising for the upcoming year during the preceding fall. Over the last few months, I found there are many deals to be had for ads, such as radio and print, if you are aggressive. If you plan accordingly, these outlets are very concerned and will allow a discount over previous years if asked. But you have to ask!
– JS

Practical Pearls in This Issue
The single most effective way to improve a PA's productivity is to assign a medical assistant or nurse to work exclusively with the PA. Some PAs (myself among them) have two MAs assigned to them, while the most prolific may have three. Some practices hesitate to assign an MA or nurse to the PA because they immediately identify a practice expense without recognizing the bottom-line benefit.

A lack of proper documentation is the single most challenging issue that arises during terminations. Documentation serves as "backup" in the event of a wrongful termination claim, where a disgruntled former employee fights a termination, claiming there is no substantiation behind the firing. Document everything related to job performance, including dates, times, witnesses, and events.

Afrin (Schering-Plough HealthCare Products), the popular nasal spray, contains oxymetazoline hydrochloride, which is a vasoconstrictor. When the product is applied topically to the skin, it provides rapid improvement in erythema associated with rosacea. Patients should use this intervention only as a "rescue" and avoid daily application.

Findings from the recent study would seem to suggest that roughly one in four melanoma cells is capable of promoting tumor growth or metastasis. Those are good odds for cancer but unfavorable ones for patients. Although cancer stem cells do not seem to represent an important therapeutic target in melanoma, researchers will continue their quest for appropriate targets and related therapies.

When it comes to financing the early stages of your practice, you may not need to be as well-backed as you think. However, it's essential that you take the time to find the right candidate(s) for a practice consultant and/or accountant. It was also key for us to observe and query other practices and owners. Making the wise investment is the most important part of starting the process, and you can make that first step by teaming the people with whom your sensibilities are aligned.

When using topical agents for the management of PIH, proper application—and thus patient education—is crucial. Patients should apply or "dab" medication sparingly to hyperpigmented lesions then use the fingertips to gently spread the medication out over the entire face.

Prior to electronic submission or printing HCFA claims, a pre-billing worksheet should be printed and reviewed for claim errors that will result in a denied claim. Once all claims for a given day have been transmitted, review the EMC confirmation report to ensure that all were received successfully. If rejected, immediately correct and re-send any claims that did not transmit successfully.

The most frequent reason a claim is denied as the patient cannot be identified as insured is that either the patient's name or the Medicare number has been entered incorrectly. Employees entering patient data must understand the importance of entering the name exactly as it is on the Medicare card. The patient may be Patti Smith to her friends, but if her Medicare is in the name of Bertha P Smith, she is Bertha P Smith in your computer.


Contact Info

For advertising rates and opportunities:
Rick Ehrlich
Group Publisher
(609) 922-0337

About Practical Dermatology

Practical Dermatology is the monthly publication that provides coverage of medical care, cosmetic advancements, and practice management for clinicians in the field. With straight-forward, how-to advice from experts in various fields, we strive to enhance quality of care and improve the daily operation of dermatology practices.