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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 (295)/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 (350)/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 (410)/Comments (0)/

Approaching Retirement? 3 Financial Planning Tips Physicians Must Consider

Guest blogger: Joel Greenwald, MD, CFP®

Some physicians, who have planned accordingly, have a smooth transition into a retirement filled with meaningful work, time with family and friends, travel and relaxation.

For others, the thought of retirement is daunting, fraught with worries they may not have saved enough. To avoid this angst, physicians should consider earlier what they want their post-medicine life to look like. If you calculate your projected spending accurately and invest your financial assets appropriately, you, too, can transition into your Golden Years with less worry.

As you approach the last few working years as a practicing physician, consider three financial planning tips that may help you secure a comfortable retirement savings level and may help ensure your ideal retirement.

For the entire article, click here

Monday, December 01, 2014/Author: Author Guest/Number of views (694)/Comments (0)/

A measure too far

When is it too much? What burden is too great for a clinic or health system to absorb when implementing new or changing measures?  

These questions come to mind when considering the clinical algorithm Minnesota Community Measurement (MNCM) recently created to determine whether a patient meets criteria for statin therapy. Once the algorithm is completed, the results can be used as part of the Optimal Diabetes and Optimal Vascular measures to replace the former cholesterol guidelines.

While the algorithm’s criteria are thoughtful and clinically sound, they are also burdensome. The programming, training and auditing required to implement the change is extensive. This is compounded by the fact that data collection is supposed to begin Jan. 1, 2015.  

For entire article, click here

Tuesday, November 11, 2014/Author: Barb Daiker/Number of views (634)/Comments (0)/
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