Off the Chart: A Business of Medicine Podcast

Medical Economics Assistant Editor Austin Littrell and Jay W. Lee, MD. MPH, FAAFP, board member at the AAFP and medical director at Integrated Health Partners of Southern California, discuss how to overcome vaccine hesitancy in patients.

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Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction to Vaccine Discussion (00:00:00)
The podcast introduces the topic of vaccine hesitancy among patients.

Overview of CDC Recommendations (00:01:03)
Dr. Lee discusses the latest CDC recommendations on COVID-19 and pneumococcal vaccines.

Importance of Encouraging Vaccinations (00:03:19)
Dr. Lee emphasizes the need for physicians to promote vaccinations during the respiratory season.

Changing Approaches Post-COVID (00:06:02)
The conversation highlights how vaccine discussions have evolved due to misinformation since the pandemic.

Building Rapport with Patients (00:08:33)
Strategies for physicians to address vaccine hesitancy through establishing trust and open dialogue.

The Role of Family Practices (00:10:55)
Dr. Lee explains the importance of family practices in providing vaccines and maintaining patient relationships.

Encouraging Usual Source of Care (00:12:35)
The significance of having a consistent healthcare provider for better patient outcomes is discussed.

Medical Economics Managing Editor Todd Shryock and attorney Emma Schuering, of the Polsinelli law firm discuss non-compete agreements in health care.

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Editor's note: Episode timestamps and transcript produced using AI tools.


Introduction to Non-Compete Agreements (00:00:14) Introduction to the episode and the guests discussing non-compete agreements in healthcare.

Current Legal Landscape (00:01:06) Emma Schuering explains the ongoing uncertainty about non-compete agreements following the FTC's rule and legal challenges.

Elements of Non-Compete Agreements (00:03:19) Discussion of the typical components of non-compete agreements, including restrictions on employment and geographic limitations.

Public Policy Considerations (00:04:26) Emma highlights the strong public policy against restricting physicians from treating patients of their choice.

State Law Variations (00:05:38) Overview of how enforceability of non-compete agreements varies by state, including buyout clauses.

Alternatives to Non-Competes (00:08:36) Exploration of legal mechanisms that protect practices without limiting physicians' employment opportunities.

Risks of Hiring Physicians with Non-Competes (00:13:25) Discussion on the potential liability for practices hiring physicians with existing non-compete agreements.

Consequences of Termination (00:15:36) Explanation of the legal complications that arise if a physician is fired due to a non-compete issue.

Enforcement of Non-Solicitation Agreements (00:17:41) Details on the process and recourse for practices when a former employee violates a non-solicitation agreement.

Implementing Non-Compete Agreements (00:22:44) Advice for practice owners on assessing the need for non-compete agreements and understanding applicable laws.

The Future of Non-Compete Agreements (00:26:17) Discussion on the trend of banning non-compete agreements and preparing for a world without them.

Planning for Change (00:27:39) Importance of proactive planning for healthcare practices regarding non-compete agreements and future regulations.

Closing Remarks (00:28:13) Concluding thoughts and gratitude from the host and guest, emphasizing the conversation's significance.

Subscription Information (00:28:34) Encouragement to subscribe to the podcast and the Medical Economics newsletter for more insights.

Medical Economics presents the Physician’s Guide to Running for Office.  This is a companion piece to the wonderful print feature by Medical Economics Editor Richard Payerchin. This episode has been pulled from the hours of interviews he performed with Physicians serving in government at the local, state, and federal level.

Physician politicians: Why doctors choose to serve -- and how you can too by Richard Payerchin

Cast list (in order of appearance)

Name: Jasmeet Bains, M.D.
City, State: Delano, California
Specialty: Family medicine, addiction medicine
Elected Office: Assemblymember, California State Assembly
Medical school: American University of Antigua

Name: Ken Moore, M.D.
City, State: Franklin, Tennessee
Specialty: Orthopedic surgery
Elected Office: Mayor, Franklin Tennessee
Medical school: University of Tennessee College of Medicine

Name: Elizabeth Steiner, M.D.
City, State: Portland, Oregon
Specialty: Family medicine
Elected Office: Senator, Oregon Senate, and running for Oregon state treasurer
Medical school: University of Massachusetts Medical School

Name: Alice Mann, M.D., M.P.H.
City, State: Edina, Minnesota
Specialty: Emergency medicine
Elected Office: Senator, Minnesota Senate
Medical school: Meharry Medical College, Johns Hopkins University

Name: Ami Bera, M.D.
City, State: Sacramento County, California
Specialty: Internal medicine
Elected Office: Congressman, U.S. House of Representatives
Medical school: University of California, Irvine

Name: Michael C. Burgess, M.D.
City, State: Cooke County, Texas
Specialty: Obstetrics/gynecology
Elected Office: Congressman, U.S. House of Representatives
Medical school: University of Texas Medical School

Name: Kim Schrier, M.D.
City, State: Sammamish, Washington
Specialty: Pediatrics
Elected Office: Congresswoman, U.S. House of Representatives
Medical school: University of California, Davis, School of Medicine

Name: Bill Hauter, M.D.
City, State: Morton, Illinois
Specialty: Emergency medicine, anesthesiology
Elected Office: Representative, Illinois House of Representatives
Medical school: Indiana University

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 COCKTAIL by Mythical Audio - stock.adobe.com
 
 Editor's note: Episode timestamps and transcript produced using AI tools.
Introduction to the Episode (00:00:00)
Discussion on the impact of policy decisions made by those without medical experience on healthcare practices.

Challenges in Politics (00:01:11)
Dr. Jasmeet Bains shares her hesitations about entering politics and the significant commitment required.

Dr. Ken Moore's Quick Decision (00:02:10)
Dr. Ken Moore explains his spontaneous decision to run for office in Tennessee.

Dr. Elizabeth Steiner's Advocacy (00:02:51)
Dr. Steiner discusses her advocacy work and the realization of the need for a physician's voice in legislation.

Dr. Alice Mann's Motivation (00:04:50)
Dr. Mann shares her concern for patients and her journey back into politics after initially stepping away.

Dr. Ami Bera's Political Entry (00:06:51)
Dr. Bera describes his motivation to run for office during the Affordable Care Act discussions.

Dr. Michael Burgess's Influential Moment (00:07:31)
Dr. Burgess reflects on how 9/11 influenced his decision to run for office.

Fundraising Challenges (00:08:06)
Dr. Kim Schrier discusses her discomfort with fundraising and the necessity of it in campaigning.

Campaigning and Community Engagement (00:10:11)
Dr. Steiner emphasizes the importance of community interaction during her campaign.

Negative Campaigning Experiences (00:11:12)
Dr. Bill Hauter recounts facing negative attacks from his own party during the primary election.

Dr. Mann's Insight on Political Messaging (00:14:10)
Dr. Mann shares her experiences with misleading attack ads during her campaign.

Reflections on Losing Elections (00:16:34)
Dr. Bera discusses his initial loss in 2010 and the valuable experiences gained from it.

Trust in Election Results (00:17:42)
Dr. Schrier expresses caution regarding election numbers but acknowledges the trust constituents place in her.

Day-to-Day Life in Congress (00:18:58)
Dr. Bera describes the demanding schedule of a U.S. House representative.

Legislative Routine in Oregon (00:20:50)
Dr. Steiner outlines her busy schedule during legislative sessions and the importance of relationship building.

Full-Time Commitment in Politics (00:22:43)
Dr. Mann explains her view of her legislative role as a full-time job alongside her medical practice.

Balancing Family and Politics (00:24:02)
Dr. Mann discusses how she incorporates her family into her political activities and campaign efforts.

Balancing Politics and Practice (00:24:44)
Dr. Bains shares her experience managing time between being a legislator and medical director.

The Need for Physician Advocacy (00:25:53)
Discussion on the importance of physician voices in state politics despite time constraints.

The Dual Role of Physicians (00:26:59)
Physicians must prioritize advocacy while managing their demanding medical careers.

Diversity in Political Perspectives (00:28:51)
Dr. Burgess highlights the lack of uniformity among physician politicians in Congress.

Bipartisan Collaboration (00:29:53)
Dr. Schreier emphasizes the importance of physician camaraderie across party lines for effective governance.

Pressure and Freedom in Politics (00:31:05)
Dr. Horton discusses the freedom of being a citizen legislator without career politician pressures.

Advice for Aspiring Legislators (00:33:07)
Dr. Steiner advises on the patience and tenacity required for legislative roles.

Understanding Your Motivations (00:33:26)
Reflecting on the importance of knowing why one wants to run for office.

The Interconnection of Medicine and Politics (00:33:51)
Dr. Mann stresses the necessity for physicians to engage in political processes affecting healthcare.

Closing Remarks (00:35:01)
Host Keith Reynolds concludes the episode, thanking contributors and encouraging political engagement.

Medical Economics Editorial Director Chris Mazzolini and Dr. Eve Cunningham, chief of virtual health and digital care at Providence and founder of MedPearl, discuss challenges with patient management and workflow.

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Editor's note: Episode timestamps and transcript produced using AI tools.
Access Challenges in Healthcare (00:00:00)
Discussion on the growing access challenges in healthcare if not addressed.

Introduction to the Podcast (00:00:18)
Keith Reynolds introduces the podcast and its focus on healthcare challenges.

Guest Introduction (00:00:50)
Dr. Eve Cunningham is welcomed to discuss patient management and workflow challenges.

Challenges in Patient Management (00:01:23)
Dr. Cunningham outlines the complexities of patient management and referral decisions for primary care physicians.

Overwhelming Medical Knowledge (00:01:27)
Discussion on the rapid increase of medical knowledge and its impact on clinicians.

Referral Dysfunction Issues (00:02:31)
Exploration of common referral dysfunctions and the need for optimized transitions.

Examples of Referral Issues (00:03:41)
Real-life examples illustrating the frequent misdirection in patient referrals.

Access to Care and Burnout (00:04:48)
Highlighting the shortage of doctors and its effect on access to care and clinician burnout.

Introduction to MedPearl (00:06:19)
Overview of MedPearl as a solution to the challenges faced by doctors.

Genesis of MedPearl (00:06:38)
Dr. Cunningham shares the story behind the development of MedPearl.

Communication Gaps in Healthcare (00:07:13)
Discussion on the knowledge-sharing gap between primary care and specialists.

Need for Clinician-Centric Technology (00:08:13)
Emphasis on creating technology that supports primary care clinicians effectively.

Med Pearl's Features (00:09:31)
Description of MedPearl's capabilities and how it aids clinicians at the point of care.

Case Study in NEJM Catalyst (00:11:35)
Discussion on a case study highlighting the impact of MedPearl in clinical settings.

Pilot Program Results (00:12:45)
Review of pilot results demonstrating Med Pearl's effectiveness in referrals and patient care.

Scaling MedPearl (00:13:58)
Description of MedPearl's scaling process and its growing user base.

Improving Referral Value (00:15:10)
Discussion on enhancing referral quality and outcomes through MedPearl.

Burnout and Clinician Efficiency (00:15:10)
Exploration of how MedPearl addresses clinician burnout and improves efficiency.

Importance of Clinician Involvement (00:17:02)
Discussion on why clinician input is essential in developing effective healthcare solutions.

Future Plans for Med Pearl (00:19:40)
Dr. Cunningham shares upcoming implementations and goals for MedPearl.

Medical Economics Managing Editor Todd Shryock sits down with Roger Kapoor, MD, author of "Work Happy" to discuss the scourge of burnout.

Music Credits: Burned Out by Stefan Kartenberg - stock.adobe.com
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COCKTAIL by Mythical Audio - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction to Stress (00:00:00)
Discussion on the nature of stress, highlighting that not all stress is detrimental.

Podcast Overview (00:00:14)
Keith Reynolds introduces the podcast and its focus on physician burnout.

Defining Burnout (00:01:29)
Kapoor explains burnout as a syndrome recognized by WHO, emphasizing its chronic nature.

Workplace Causes of Burnout (00:02:28)
Exploration of workplace factors contributing to burnout, such as administrative tasks and lack of control.

Lifestyle Choices and Burnout (00:03:41)
The impact of personal lifestyle choices on burnout, including sleep deprivation and work-life balance.

Differentiating Burnout from Stress (00:04:38)
Key signs of burnout versus normal work stress, including emotional exhaustion and depersonalization.

The Nature of Stress (00:06:22)
Discussion on how stress can be both beneficial and harmful, depending on its management.

Job Satisfaction and Change (00:07:57)
Kapoor discusses the importance of aligning career with personal purpose and the concept of ikigai.

Understanding Ikigai (00:08:59)
Introduction to ikigai, a Japanese concept for finding one's life purpose through self-reflection.

Example of Ikigai in Action (00:10:07)
Story of Joe Addis, illustrating how passion and purpose can lead to success.

The Importance of Nurturing Skills (00:11:14)
Metaphor of apple picking to emphasize the need to nurture personal skills and competencies.

Finding True Purpose (00:12:19)
Encouragement to explore personal passions and competencies to discover true purpose.

Mindset Around Job Change (00:16:10)
Discussion on the emotional struggle of leaving a job and the importance of prioritizing well-being.

Steps to Combat Burnout (00:18:58)
Practical advice for physicians experiencing burnout, including self-reflection and job satisfaction.

Prioritizing Sleep (00:22:07)
Emphasis on the critical role of sleep in preventing burnout and maintaining well-being.

Understanding Emotions and the Brain (00:24:31)
Overview of brain layers and their role in processing emotions, relevant to managing burnout.

Understanding Emotions and Burnout (00:27:11)
Discusses how emotions influence responses and the importance of pausing before reacting to avoid burnout.

Cumulative Negative Emotions (00:28:26)
Explores how unresolved emotions can build up, leading to cynicism and burnout.

The Power of Journaling (00:28:26)
Recommends keeping a daily journal to process emotions and allow rational thought to catch up.

Proactive Leadership to Prevent Burnout (00:30:14)
Highlights the need for leaders to recognize burnout signs in their staff and take proactive measures.

Stockholm Syndrome Analogy (00:31:08)
Compares employee burnout to Stockholm syndrome, emphasizing the difficulty in recognizing toxic environments.

Recognizing Team Efforts (00:32:19)
Stresses the importance of acknowledging team contributions to boost morale and prevent burnout.

Avoiding Micromanagement (00:32:19)
Discusses how micromanagement can drain energy and creativity from employees.

Constructive Feedback (00:32:19)
Emphasizes the need for clear, constructive feedback to reduce anxiety and burnout among teams.

Realistic Expectations (00:32:19)
Warns against setting unrealistic goals, advocating for achievable objectives to foster long-term success.

Hiring and Firing Practices (00:33:39)
Advises on hiring practices focused on insight and decisively addressing underperformance to maintain a healthy environment.

Burnout Awareness in Leadership (00:34:55)
Notes that if leaders feel burned out, their employees are likely experiencing it even more.

Book Overview (00:35:11)
Kapoor discusses his book "Working Happy," born from experiences during the COVID-19 pandemic.

Patient Care Online Editor Sydney Jennings and Dr. Steven P. Furr, Former President of the American Academy of Family Physicians sit down to discuss immunizations.

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Editor's note: Episode timestamps and transcript produced using AI tools.


Introduction to Immunizations (00:00:05)
Overview of the podcast and introduction of speakers discussing immunizations in primary care.

Decline in Vaccination Coverage (00:00:32)
Discussion on the decrease in vaccination rates among kindergarten students and its implications.

Impact of COVID-19 on Well-Child Visits (00:00:54)
How COVID-19 disrupted routine well-child visits affecting vaccination rates.

Measles Cases and Vaccination (00:01:33)
Increase in measles cases linked to unvaccinated individuals and the importance of herd immunity.

Vaccine Hesitancy Post-COVID (00:03:15)
Concerns about ongoing vaccine hesitancy and misinformation stemming from the COVID-19 pandemic.

Addressing Vaccine Confusion (00:03:30)
Need for clear communication from primary care providers regarding vaccination updates and schedules.

Encouraging Vaccination During Visits (00:04:44)
Strategies for clinicians to suggest vaccinations during patient visits to improve uptake.

Adult Vaccination Recommendations (00:05:52)
Changes in adult vaccination recommendations as respiratory virus season approaches.

Challenges with Medicare Vaccine Coverage (00:07:27)
Issues with Medicare coverage affecting access to certain vaccines for patients.

Advocacy for Vaccine Coverage (00:09:09)
Discussion on the need for advocacy to improve vaccine coverage under Medicare Part B.

Medical Economics Editorial Director Chris Mazzolini sits down with Bob White, president of The Doctors Company to discuss trends in malpractice litigation and what recent verdicts mean for the industry at large.

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COCKTAIL by Mythical Audio - stock.adobe.com


Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction to the Episode (00:00:21) Overview of the podcast and introduction of the speakers discussing malpractice caps.

Definition of Damage Caps (00:01:10) Bob White explains what medical malpractice damage caps are and why they are significant for physicians.

Inflation and Damage Caps (00:02:23) Discussion on whether damage caps are linked to inflation and how they can change over time.

Recent Changes in Colorado (00:03:37) Overview of recent developments in Colorado regarding malpractice caps and their implications.

Current Cap in California (00:05:40) Details about the current cap in California and how it has changed over time.

Colorado's Legislative Changes (00:07:32) Comparison of Colorado's recent legislation on malpractice caps to California's changes.

Arguments for Increasing Caps (00:08:18) Discussion on the plaintiffs' bar's rationale for advocating higher damage caps.

State Variations in Caps (00:09:49) Insight into how different states have varying laws regarding malpractice caps and potential trends.

Impact of High Verdicts (00:13:00) Examination of the increase in large verdicts and its effect on the malpractice landscape.

Consequences of Rising Caps (00:14:38) Exploration of the effects on insurance companies and physicians when damage caps rise.

Settlement Pressures (00:15:03) Discussion on how rising caps influence the decision-making process for settling lawsuits.

Historical Context of Verdicts (00:17:48) Comparison of significant verdict amounts over the years and the implications for the medical profession.

Public Perception and Caps (00:19:50) Discussion on societal attitudes towards caps and their impact on the medical field.

Advice for Physicians (00:21:09) Bob White shares best practices for physicians to protect themselves from malpractice claims.

Building Patient Rapport (00:23:37) Discusses the importance of patient-provider relationships for legal protection against lawsuits.

Transactional Healthcare Concerns (00:23:55) Explores the shift towards transactional healthcare and its impact on physician-patient relationships.

Retail Medicine Issues (00:24:44) Addresses the challenges of retail medicine in building rapport between patients and healthcare providers.

Physicians' Motivation (00:25:46) Highlights physicians' desire for strong relationships with patients as a primary reason for entering medicine.

Insurance Choices for Doctors (00:26:10) Discusses the importance of understanding insurance options and the advocacy role of insurance companies.

Advocacy in Malpractice Insurance (00:27:12) Emphasizes the need for insurers to advocate for doctors and engage in legislative matters.

Medical Economics Managing Editor Todd Shryock sits down with Scott Dewey, chief managed care officer at PayrHealth about the best strategies for payer negotiations.

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Introduction to Negotiations (00:00:12)
Overview of the podcast and introduction of the speakers discussing payer negotiations.


Starting Preparation for Negotiations (00:01:03)
Importance of having a strategy and understanding leverage before entering negotiations.

Timing for Preparation (00:04:04)
Advice on how far in advance physicians should prepare for payer negotiations.

Contract Length Considerations (00:05:11)
Discussion on the pros and cons of long-term versus short-term contracts.

Negotiating Power of Smaller Practices (00:06:47)
Insights on how smaller practices can find leverage against larger payer organizations.

Dealing with Non-Negotiable Contracts (00:08:54)
Advice for practices facing contracts labeled as "not negotiable."

Prior Authorizations in Contracts (00:09:53)
Strategies for negotiating limitations around prior authorization requirements.

Unilateral Amendments in Contracts (00:12:31)
Discussion on the commonality of unilateral contract amendments by payers.

Common Contract Mistakes (00:14:11)
Overview of frequent mistakes made by physicians in contract agreements.

Value-Based Care Contracts (00:16:34)
Differences between value-based care contracts and traditional fee-for-service agreements.

Final Contract Considerations (00:19:48)
Importance of getting all agreements in writing and understanding contract updates.

Conclusion (00:21:43)
Wrap-up of the discussion and thanks to the guest for sharing insights.

A special preview of what to expect at this year's Tri-State Healthcare Leaders Conference featuring interviews with three of the presenters. 
Jennifer Wiggins, CEO of Aegis Malpractice Solutions, will take part in a roundtable discussion on the malpractice landscape on Sept. 19.
Ashkan Nikou, head of security at Bluegrass Orthopaedic, will present a session on using verbal judo to persuade on Sept. 19.
Stephen A. Dickens, vice president at SVMIC, will present a session entitled "Steps for Success in Strategic Planning & Leading Change" on Sept. 19.

Sign up for the conference here.

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Introduction to the Conference (00:00:00) Keith Reynolds introduces the special bulletin and previews the 2024 Tri-State Healthcare Leaders Conference.

Jennifer Wiggins on Networking (00:00:53) Jennifer Wiggins expresses excitement for the conference and networking opportunities among healthcare administrators.

Roundtable Discussion on Malpractice (00:01:38) Wiggins discusses her roundtable on the malpractice landscape, highlighting current trends and important changes.

Ashkan Nikou's Perspectives (00:02:24) Ashkan Nikou looks forward to hearing diverse perspectives from practices across Indiana, Ohio, and Kentucky.

Verbal Judo Presentation (00:02:37) Nikou shares details about his session on using verbal judo to persuade attendees on September 19th.

Stephen Dickens on Networking (00:03:08) Stephen Dickens shares his eagerness to network and learn new approaches at the conference.

Strategic Planning Session (00:03:43) Dickens presents his session titled "Steps for Success in Strategic Planning and Leading Change" on September 19th.

Closing Remarks (00:04:48) Reynolds concludes the bulletin, emphasizing the importance of this year's conference and encourages subscriptions.

Medical Economics Editorial Director Chris Mazzolini joins the show for a special bulletin detailing some of the top results of the Medical Economics 95th Physician Report.

The 95th Physician Report (free registration required):
https://www.medicaleconomics.com/view/2024-physician-report-exclusive-data-on-physician-salaries-practice-finances-and-more

Medical Economics Practice Academy Live, Sept 12, at 2pm Eastern. Register here:
https://cvent.me/AOoxQ8

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