Top Docs Radio

Telemedicine Today’s technology, particularly internet, communications, and mobile platforms, is empowering disruption in the traditional healthcare delivery model. Telemedicine is an emerging trend that shows no sign of slowing and my guests on this episode focus on this platform for delivering high quality care. In some ways, mobile technology is bringing us full circle.  The […]

Telemedicine

Today’s technology, particularly internet, communications, and mobile platforms, is empowering disruption in the traditional healthcare delivery model. Telemedicine is an emerging trend that shows no sign of slowing and my guests on this episode focus on this platform for delivering high quality care.

In some ways, mobile technology is bringing us full circle.  The “House Call” is back and being seen by a physician and/or other health professional in our home or other location outside of a doctor’s office, urgent care, or ER will likely be as common as it was decades ago, if not even more so.

Telemedicine is taking advantage of these technology capabilities to put patients together with healthcare professionals virtually and in some cases, through a combination of someone sitting with the patient facilitating an exam while another provider is connected to the interaction via video/telephony.

TeleHealth Solutions is a consultancy that works with healthcare organizations and practices seeking to add telemedicine to their delivery model.  The company is able to evaluate the client’s goals and determine (hopefully prior to any expenditures on equipment/platforms) the best platform for achieving those objectives.

In some cases they may even advise the client to hold off on adding such a platform, depending on what they were expecting it to do, avoiding large costs for something that will ultimately not be used.  Turner Smith explained how there are often unseen pitfalls around launching such a delivery model, so working with experts such as himself and his team can insure desired patient outcomes are achieved while making financial investments in the right technology/service.

Glenn Pearson spent nearly 20 years leading the Georgia Hospital Association.  As such, he’s well-versed in the in’s and out’s of how hospitals do business, make decisions regarding technologies they will deploy (or NOT deploy), and factors that can make what seems to be a great idea for a solution that will ultimately fail to be adopted.

He’s leveraging that experience at Pearson Health Tech Insights, providing consulting services for  tech companies who are developing (or plan to develop) technology solutions that will serve the hospital/health system space.  He and his team can help the tech developer potentially pivot their solution if needed, or in some cases do some redesign before going to market.  In this way, just as Turner’s firm helps tech buyers purchase wisely, Glenn’s company helps the developer have greater probability of success in getting their technology adopted.

I met Tanya Mack a couple of years ago on her show Doctors Roundtable here on Business Radio X.  She is now leading a company called, Women’s Telehealth, a virtual physician practice comprised of maternal-fetal specialists and high-risk pregnancy OB’s.

These healthcare experts are able to link up with a hospital or group’s existing telehealth technology to provide the medical expertise needed by moms in high-risk pregnancies.  With value to both urban and rural areas, Women’s Telehealth is allowing organizations that do not have high-risk OB specialists on staff, to be able to handle many of these patient needs, allowing the organization to simultaneously meet a patient need, while keeping them in their delivery system rather than losing them to a competing hospital.

Special Guests:

Tanya Mack, President, Women’s Telehealth    

Dr. John Johnson of WellCare of Georgia talks diabetes WellCare of Georgia and Diabetes Dr. John Johnson is the Senior Medical Director at WellCare Health Plans, Inc. – which is one of the Medicaid CMOs in Georgia. His areas of responsibility include utilization review, care management, quality improvement and clinical outcomes.  Dr. Johnson graduated from the University […]

Dr. John Johnson of WellCare of Georgia talks diabetes

WellCare of Georgia and Diabetes

Dr. John Johnson is the Senior Medical Director at WellCare Health Plans, Inc. – which is one of the Medicaid CMOs in Georgia. His areas of responsibility include utilization review, care management, quality improvement and clinical outcomes.  Dr. Johnson graduated from the University of Medicine and Dentistry of New Jersey in Rutgers. He completed his residency at Emory University Hospital. Dr. Johnson is Board Certified in internal medicine.

He also has an MBA from Emory University’s Goizueta School of Business. Dr. Johnson owned and operated a practice in Douglasville that cares for patients with acute and chronic medical conditions for more than 13 years. Before joining WellCare in 2014, Dr. Johnson was the medical director for Blue Cross Blue Shield of Georgia. While there, he oversaw utilization review and case management for more than 600,000 State Health Benefit Plan patients.  Dr. Johnson is a member of MAG, the AMA, and the American College of Physicians.  He is a also colonel in the U.S. Army Reserves Medical Corps.

Diabetes is becoming more common in the United States. It afflicts more than 29 million Americans, including more than one million Georgians. One quarter of the people who are affected by it aren’t aware that they have the disease. An additional 86 million people have pre-diabetes, which means that their blood glucose (sugar) is higher than normal but not high enough to be classified as diabetic. Estimates project that as many as one in three American adults will have diabetes by 2050.

In addition to its detrimental health effects, the American Diabetes Association reports that the U.S. spends $174 billion a year to treat the disease.  The primary risk factors for diabetes include being overweight; sedentary; over the age of 45; and having a family history of diabetes. African Americans, Hispanics/Latinos, Native Americans, Asian Americans, and Pacific Islanders are at an increased risk for developing the disease.

Diabetes is the nation’s seventh-leading cause of death. It is also a leading cause of kidney failure, non-traumatic lower-limb amputations, new cases of blindness, heart disease, and stroke. A significant number of Georgians who are struggling with diabetes, particularly those in low-income and medically underserved populations, do not fully understand how to manage diabetes on a day-to-day basis.

WellCare is working to address the needs the diabetic population by collaborating with patients, providers, family members, and the community using a variety of mechanisms, including value-based care, telemedicine, field-based case management, the patient-centered medical home, and advocacy.

Special Guests:

Dr. John Johnson, MD, Senior Medical Director, WellCare of Georgia  

* Doctor of Medicine, University of Medicine and Dentistry of New Jersey

* Board Certified, Internal Medicine

* MBA, Goizueta Business School, Emory University

* Colonel, US Army

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia     

* JD Law, Loyola School of Law

* Board of Directors,

Dr. Mark Beaty and Dr. Manny Rodriguez I was joined in studio by facial plastic surgeon, Dr. Mark Beaty, and I spoke with infectious disease physician, Dr. Manny Rodriguez about the Zika virus. Dr. Mark Beaty specializes in elective aesthetic facial procedures to improve or reconstruct facial blemishes and flaws.  Today we know there is […]

Dr. Mark Beaty

Dr. Manny Rodriguez

Dr. Mark Beaty and Dr. Manny Rodriguez

I was joined in studio by facial plastic surgeon, Dr. Mark Beaty, and I spoke with infectious disease physician, Dr. Manny Rodriguez about the Zika virus.

Dr. Mark Beaty specializes in elective aesthetic facial procedures to improve or reconstruct facial blemishes and flaws.  Today we know there is more than simple vanity as reasons to consider improving the look of one’s face, particularly when you are a business professional.

Dr. Beaty shared information about recent studies that looked at individuals who underwent aesthetic procedures to address issues such as symmetry with regard to their earning over time.  The study showed that business professionals in sales/leadership positions earned significantly more over time than counterparts who did not correct such issues.

We talked about some of the various ways Dr. Beaty is able to improve facial beauty, including some of the basic surgical procedures he performs, such as lifts and tucks, reconstruction of the nose, etc.  He draws upon years of experience and refinement of his technique to offer what he calls, ProLIFT, allowing optimal aesthetic result with less recovery time.

He also discussed a number of innovative non-surgical procedures he is able to offer that hasten return to work with short recovery, minimal bruising or external thermal wounds.  His CoolSculpting program creates the best value for non-surgical fat reduction through the use of a special device that is able to kill adipose cells, while protecting other tissues in the trouble spot.

He also explained the new Profound skin tightening procedure for non-surgical improvement of loose, saggy skin.  Dr. Beaty is pleased to now have an office located in Midtown Atlanta to increase convenience for his in-town patients.

We’ve heard much about the Zika virus in the news lately, as several persons in the US have been found to be carrying the disease upon returning to the US (typically from Brazil).  The virus has caused alarm due to the fact that it has recently been attributed as the cause for microcephaly in infants delivered to mothers who were infected during pregnancy.

Infectious disease physician, Dr. Manny Rodriguez took time to sit down and share some information about the virus for our listeners.  In many ways, the zika viral infection is relatively benign, according to Dr. Rodriguez, with only a small number of persons exhibiting symptoms that alert them to the fact that they were exposed to the virus.

We talked about the symptoms that are most commonly seen when symptoms manifest, how the infection is diagnosed, what to expect should one become infected, along with some useful information on how to avoid the infection to begin with.

As we approach the Olympic games that will be held in Brazil, I’m sure we will continue to focus on this issue.  I’m pleased to share some information straight from the expert for our listeners!

Special Guests:

Dr. Mark Beaty of Beaty Facial Plastic Surgery  

         

Project DAN and Georgia’s 911 Medical Amnesty Law We continued our series with Medical Association of Georgia this week, talking about Project DAN and Georgia’s 911 Medical Amnesty Law.  Dallas Gay and Dr. Shonali Saha were my guests. MAG Foundation ‘Think About It’ campaign Community Chair Dallas Gay and Shonali Saha, M.D. – an adolescent medicine […]

Dr. Shonali Saha, CW Hall, Dallas Gay

Project DAN and Georgia’s 911 Medical Amnesty Law

We continued our series with Medical Association of Georgia this week, talking about Project DAN and Georgia’s 911 Medical Amnesty Law.  Dallas Gay and Dr. Shonali Saha were my guests.

MAG Foundation ‘Think About It’ campaign Community Chair Dallas Gay and Shonali Saha, M.D. – an adolescent medicine and addiction medicine physician with the Georgia Behavioral Health Professionals practice in Smyrna – discussed naloxone and the state’s ‘9-1-1 Medical Amnesty Law’ on the ‘Top Docs Radio’ program on the Business Radio-X Network at 12:00 p.m., Tuesday, March 8.

Naloxone is an effective, non-addictive prescription medication that reverses the effects of opioid drug overdoses. Under Georgia’s 9-1-1 Medical Amnesty Law, naloxone can be delivered on an intranasal or intramuscular basis. Physicians in Georgia can prescribe naloxone via a standing order to a person who is at risk of experiencing an opioid overdose. And at their discretion, physicians can prescribe naloxone to pain management clinics, first responders, harm reduction organizations, or family members or friends or other people who are in a position to assist a patient who is at risk of experiencing an opioid overdose.

The 9-1-1 Medical Amnesty Law provides limited immunity for individuals who possess certain drugs and drug paraphernalia when they experience a drug overdose and are in need of medical care, for people who seek medical care for a person who is experiencing a drug overdose, and for certain underage drinking offenses for minors who seek medical care during an alcohol overdose.

Special Guests:

Dallas Gay, Co-Chair, “Think About It” Campaign

 

 

* Board Member, Northeast Georgia Medical Center

* MBA, Georgia State University

* Member, Drug Free Coalition of Hall County

* Former President, Protein Products, Inc

* Former President, American Proteins, Inc.

Dr. Shonali Saha, MD, Georgia Behavioral Health Professionals    

 

* Doctor of Medicine, Mount Sinai School of Medicine New York University

* Residency, Cambridge Health Alliance

* Fellowship, Adolescent and Addiction Medicine, Johns Hopkins School of Medicine

* Attending Physician, Ridgeview Institute

Health Care Fraud and False Claims I hosted 2 False Claims Act legal experts on this week’s MAG edition of Top Docs Radio.  You’re going to want to check out what they have to say, as it could mean the difference between practicing medicine or not, in the end. Scott Grubman is a partner with […]

Scott Grubman, CW Hall, and James Marcus talk healthcare fraud.

Health Care Fraud and False Claims

I hosted 2 False Claims Act legal experts on this week’s MAG edition of Top Docs Radio.  You’re going to want to check out what they have to say, as it could mean the difference between practicing medicine or not, in the end.

Scott Grubman is a partner with the law firm of Chilivis Cochran Larkins & Bever in Atlanta. He represents health care providers of all types and sizes with government investigations and audits, False Claims Act, and other complex litigation and various regulatory and compliance matters.  Prior to joining private practice, Scott served as a trial attorney with the U.S. Department of Justice in Washington, D.C., and as an assistant U.S. attorney in Savannah – where he served on a district health care fraud taskforce.  Scott also serves as an adjunct professor at Georgia State University’s College of Law, where he teaches a course in health care fraud and abuse.

Jason Marcus is among a select group of lawyers who devote their practice to qui tam and related retaliation claims under federal and state False Claims Acts. He has practiced FCA law exclusively since 2008, and he formed the firm of Bracker & Marcus in January of 2015 with partner Julie Bracker, who is dedicated to representing whistleblowers nationwide. Jason is a 2006 graduate of the University of Georgia School of Law, a former clerk to the honorable Magistrate Judge G.R. Smith of the Southern District of Georgia, and a member of Taxpayers Against Fraud Education Fund and the Georgia affiliate of the National Employment Lawyers Association.

Health care is one of the fastest growing and most heavily-regulated industries in the United States.  Given that government payers (Medicare, Medicaid, etc.) finance a significant portion of the system, regulators and law enforcement have dedicated tremendous resources to rooting out and punishing fraud and abuse in health care.  In fiscal year 2015 alone, the federal government recovered nearly $2 billion in settlements and judgments from health care providers under the federal False Claims Act, which does not include recoveries through audits and other administrative avenues.

Moreover, not only are the actions of healthcare providers constantly scrutinized by federal and state auditors

and law enforcement, but also by competitors, commercial insurance companies, private whistle blowers, and the public. Big hospitals and health care entities with “deep pockets” have historically carried the bulk of the liability in government enforcement actions.  But beginning in 2015, the federal government announced a new policy which focuses on holding individuals – particularly individual health care providers – responsible and liable for unlawful conduct. A lot of the laws governing health care fraud and abuse do not require a specific intent to defraud or even actual knowledge of the unlawful nature of the conduct. In fact, one of the major laws governing health care fraud and abuse (the physician self-referral law or “Stark law”) requires no culpable mindset whatsoever.  Accordingly, it is crucial for health care professionals of all types to be aware of the various statutory and regulatory schemes that govern health care billing and to act accordingly.

MORE INFO SOON!

Special Guests:

Scott Grubman

Jason Marcus