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MMA members: If you have an idea for an article you’d like to post on Digital Rounds, contact Dan Hauser. We reserve the right to edit blog content for space and accuracy. Thanks.


Four transfers and 23 minutes later (Part 3)

Editor’s Note: On March 17 and then again on April 20, Immediate Past President Cindy Firkins Smith, MD, detailed her and her patient’s frustrations with the current medication prior authorization process. Here’s an update.  

It’s nearly July and summer is full-blown. Life barrels ahead full steam. Not so, my patient’s prior authorization (PA) nightmare.

When I first wrote about my Ciciatricial Pemphigoid patient March 17 he had recently been denied his mycophenolate mofetil (MMF) and I was struggling through the confusing and frustrating process we call prior authorization. I haven't read Dante’s Inferno but having seen descriptions of his Circles of Hell I was sitting in the Fifth Circle: Anger.

For the entire article, click here.

 

Tuesday, June 23, 2015/Author: Cindy Firkins Smith, M.D./Number of views (369)/Comments (0)/
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3 Financial Tips for Young Physicians

Guest bloggers: Joel Greenwald, MD, CFP® and Mai S. Yang, CFP®

Residents, fellows and physicians early in practice have unique financial challenges. The good news is that if they make a few good decisions early on, they can significantly improve their chances of long-term financial success. Here are a few financial planning tips for young physicians.

1.    No one likes to think about bad things that might happen, like death or disability, but insurance protection is the foundation of any young physician’s financial plan.  

For the entire article, click here

 

Tuesday, June 16, 2015/Author: Author Guest/Number of views (467)/Comments (0)/

Four transfers and 23 minutes later (Part 2)

Editor’s Note: On March 17, Immediate Past President Cindy Firkins Smith, MD, detailed her and her patient’s frustrations with the current medication prior authorization process. Here’s an update. 

Since I last wrote, my patient’s (and therefore my) Mycophenolate Mofetil (MMF) prior authorization (PA) woes continue. Since then…

For the entire article, click here.

Monday, April 20, 2015/Author: Author Guest/Number of views (708)/Comments (0)/

Four transfers and 23 minutes later…

Prior authorization makes health care a daily battle, not a team sport

By Cindy Firkins Smith, MD    

I recently attended the MMA’s Day at the Capitol and had the opportunity to hear the specifics on the MMA’s endeavor to “Fix PA Now.” Sen. Melisa Franzen explained to attendees how her bill (SF 934) will make prior authorization (PA) a process that is less burdensome to medical professionals and fairer to patients. This discussion couldn’t have been timelier for me because I happened to be in the middle of an onerous and potentially dangerous PA battle.

For the past three years, I have been caring for a patient with Cicatricial Pemphigoid. This autoimmune bullous disease results in blisters and erosions on mucous membranes. In my patient’s case, multiple areas were involved - most debilitating to him were the involvement of his conjunctiva and oral mucosa. When I first saw him he already had conjunctival scarring and tethering between the conjunctiva and cornea, resulting in restricted range of motion of his eyes. He also had double vision.  Continued blisters and erosions put him at risk for blindness. He couldn’t eat without tearing erosions in his mouth, causing him tremendous pain. We discussed his situation and chose the medications we felt were best for his disease and safest for him, and ultimately gained control of his disease with a combination of Mycophenolate Mofetil (MMF), Dapsone and topical corticosteroids. He did beautifully… until he changed insurance.

For the entire article, click here.

 

Tuesday, March 17, 2015/Author: Cindy Firkins Smith, M.D./Number of views (767)/Comments (0)/

Another Prior Authorization Headache

By Matthew Kruse, MD

One morning this month, I braced myself for the inevitable onslaught of hold music and recorded assurances that my call is valued as I began a medication prior authorization for one of my patients. I must admit, I was not surprised once I finally got through to an operator to learn I had been given the phone number for the wrong department. The operator gave me the correct number and wished me a nice day. The hold music greeted me like a familiar, yet awkward acquaintance. Eventually, operator number two apologized that I’d again been given the wrong number.

Long story short(er), I reached the correct department after the fifth number.  I felt like Theseus, navigating a labyrinth of call centers and help desks. In all, I spent 68 minutes on the phone to continue a medication that has provided my patient years of stability. These were 68 minutes that I was unable to use for patient care, education, or even self-care.

For the entire article, click here

Thursday, February 05, 2015/Author: Author Guest/Number of views (962)/Comments (0)/
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