Canadian Medicine

MDs vs. NB conflict at at end?
New Brunswick and its doctors have reached an agreement in principle on how to deal with the raise that was offered by the government and then rescinded when it became apparent that the recession would cause revenues to fall short of where they were predicted to be. The medical association's announcement, however, did not make clear whether the new agreement in principle would reinstate the raises or would grant the government some of its cuts. [CMA News] Read more about the dispute on Canadian Medicine.

Extra H1N1-flu pay for doctors?
Physicians in several provinces -- Alberta , Saskatchewan , and others as well -- are asking governments to pay them extra for treating H1N1 flu patients. The BC Medical Association is asking for a new fee for fielding phone calls from patients concerned they may have the flu. Manitoba and PEI are reportedly not considering any new payments for the H1N1 pandemic. Nova Scotia's physicians are working on a plan with the provincial government to insure them against potential income losses as a result of the pandemic.

Docs do drugs to stay awake
Ever wonder how doctors manage to stay awake and alert enough on emergency-department night shifts to be able to respond at a moment's notice and be ready to make life-or-death decisions? Toronto emergency physician Brian Goldman, the host of CBC Radio's White Coat, Black Art confesses to using a drug called modafinil to keep himself alert, just as other doctors do. "Frankly, my colleagues have been far too silent about how difficult they find it to stay awake and alert," he wrote recently. "In being silent, they may have given you the erroneous impression that the problem is being taken care of, and that it's nothing you need to worry about." Listen to an MP3 of the September 12 episode or listen to Dr Goldman's discussion with a colleague about their drug use .

MORE NEWS FROM ACROSS CANADA AND BEYOND
Quebec will provide H1N1 flu vaccines free to residents but may cancel its regular flu shots this year in favour of delivering H1N1 flu shots.

New guidelines from the Canadian Paediatric Society recommend doctors adopt watchful waiting more frequently than jumping right to antibiotics when it comes to kids' ear infections. [Full guidelines available free online from the journal ]

Nova Scotia's Apology Act comes into effect on the first of October. [Read the new law: ]

Newfoundland doctor Brenda Penney has threatened to leave Lewisporte, NL, if provincial health minister Paul Oram follows through on his plans to move laboratory services out of the town.

The recently elected NDP government of Nova Scotia hired the controversial MD -- the man declared a mass casualty alert at his Halifax hospital last year when wait times got unmanageably long, in a move that embarrassed the now-deposed Progressive Conservative government -- to improve the province's emergency departments.

Dr Eric Hoskins, a co-founder of War Child Canada along with his wife Dr Samantha Nutt, a former federal Liberal candidate, and a former government policy adviser, won a seat in the Ontario Legislative Assembly running as a Liberal. []

A fascinating interview with a German military MD who worked in Afghanistan. (Don't worry: it's not in German.)

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If you've somehow managed to avoid hearing the news about what's been going on lately with the US effort to reform the country's health-insurance and healthcare systems, an impassioned by Rolling Stone's Matt Taibbi provides a good look at the progressive perspective on recent events.

We might look back on this summer someday and think of it as the moment when our government lost us for good. It was that bad. [...]

All that's left of health care reform is a collection of piece-of-shit, weakling proposals that are preposterously expensive and contain almost nothing meaningful — and that set of proposals, meanwhile, is being negotiated down even further by the endlessly negating Group of Six. It is a fight to the finish now between Really Bad and Even Worse. And it's virtually guaranteed to sour the public on reform efforts for years to come. [...]

It's a joke, the whole thing, a parody of Solomonic governance. By the time all the various bills are combined, health care will be a baby not split in half but in fourths and eighths and fractions of eighths.

It's really worth taking the time to . And keep in mind that Mr Taibbi's article came out a few weeks ago, before Senator Max Baucus's Group of Six decided to altogether eliminate the public option from its .

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Forget trying to scale back your overhead — focus on your income

A south-central Ontario group practice did some reorganizing and realized they had an 800-square-foot surplus of office space. They’d already committed to a mortgage on the building, and finding a new doctor to join their group was proving difficult. What to do?

The answer, provided by Practice Solutions consultant Jim Sweeney, was to rent out the surplus office space to other health professionals — in this case, a team of physiotherapists. “This was a win-win opportunity,” says Sweeney, a 37-year veteran of practice management consulting. The group practice got rid of the drag on their finances, while the physiotherapists got access to an office that was already set up for patients.

Renting out extra office space (or even your own office space during hours it goes unused) to ancillary medical services providers or to other doctors, is one of the most effective ways to maximize your practice’s revenue, says Sweeney.

For most physicians, expenses are already as low as they can reasonably go. Unless your staffers are earning outrageous salaries or your waiting room is so lavish that patients just come in to relax, you probably don’t have much fat to trim. That’s why if you want to offset your overhead you’ll have to look at maximizing your revenue, either via new sources (like renting out unused office space) or through existing channels. The most fruitful thing you can do with your existing revenue stream, says Sweeney, is to optimize your billing.

Read the rest of this Practice Management article, which appears in the September issue of Parkhurst Exchange magazine, online .

Photo: Shutterstock