据圣地亚哥报道——医学管理国际协会2008年度会议于10月19日至22日在圣地亚哥召开。此次会议的大部分讨论都聚焦于如何在经济衰退面前保持医生的执业依然有利可图。

芝加哥Allscripts-Misys医疗保健系统的首席执行官Glen Tullman在与“医疗保健金融新闻”的一次采访中说，“我认为目前的问题是医生如何以更少的成本来实施最大的影响。”

Tullman表示，已放宽的斯塔克法规能够及时为医生诊所补贴电子医疗记录，即使在经济困难时期也是如此。

Tullman说，“我仍然相信医院将会投资医生诊所的急救系统，因为虽然考虑到当前的经济因素，他们不大可能进行资金较多的项目，但是相较于较低的投资，信息技术可以提供较高的回报。”同时，他还指出，已放宽的斯塔克法规可以帮助较为困难的医生诊所保持“独立”。

McKesson医生执业解决方案系统的资深副总裁兼总经理David Henriksen同意经济危机严重冲击了医生执业，并表示本行业应当担忧大型医院与“小型诊所的生命力”。

Henriksen说，“小型办公室的提供商应当更具创意以减少损失。医生们在财政方面很可能会继续受到打压，因此新的管理层与国会将必须强调侵权行为改革与未保险问题。但是，我仍然认为在接下来的十年内，大约70%的医生社区并不会做出任何改变。”

Greenway医疗技术公司的行销与政府事务部门副总裁Justin Barnes表示，众多医生诊所所面临的一大问题就是他们运作的方式与其他商业不同。

Barnes说，“诊所仅能获得他们帐单的一半。”

“在2010财政年度，我们将会遭遇前所未有的医疗保险比率缩减。诊所的资金不再是唾手可得，他们需要更加节省，主要的方式就是利用信息技术。

科罗拉多州木湖市洛基山胃肠病学协会首席执行官Craig Bakken表示，医生诊所所面临的另一大问题是付费者与患者之间日渐增加的医疗保健成本转换。

Bakken说，“患者的自我支付责任量发生了巨大转变。它为诊所处理集资创造了一种批发改革。前向支付将得到更多强调，而患者对此的反映并不好。很多医生也不愿意将前向支付的压力置于患者身上。”

Economy's impact on physicians the talk of MGMA

By Richard Pizzi, Contributing Editor

2008年10月23日

SAN DIEGO - The 2008 Annual Conference of the Medical Group Management Association met here on Oct. 19-22, and much of the talk centered on how to keep physician practices profitable in the face of economic recession.

"I think the issue is how do physicians spend less but get the most impact," said Glen Tullman, CEO of Chicago-based AllscriptsMisys Healthcare, in an interview with Healthcare Finance News.

Tullman said the relaxed federal Stark regulations could prompt hospitals to subsidize electronic health records for physician practice, even in tough economic times.

"I still believe hospitals will invest in ambulatory systems for physician practices, because although they're unlikely to engage in large capital projects – given the economy – information technology offers a high return for a relatively low investment," Tullman said, noting that the relaxed Stark regulations could help struggling physician practices remain "independent."

David Henriksen, senior vice president and general manager of McKesson Physician Practice Solutions, agreed that the financial crisis had hit practices hard, and said the industry needed to be concerned about the "vitality of the small practice" as well as the large.

"Providers in small offices will need to do some creative things so as not to lose money." Henriksen said. "Physicians will likely continue to get squeezed from the financial side, so the new administration and Congress will have to address tort reform and the problem of the uninsured. But I still think that in about 10 years, approximately 70 percent of the physician community will look exactly like it does today."

A major problem for many physician practices is that they do not operate like other businesses, said Justin Barnes, vice president of marketing and government affairs at Greenway Medical Technologies.

"Practices get only about half of what they bill," Barnes said.

"And in fiscal year 2010 we'll be looking at an even greater Medicare rate cut than we've seen in the past. Practices can't continue to leave money on the table. They'll have to get better at collections, primarily by using information technology."

Craig Bakken, CEO of Rocky Mountain Gastroenterology Associates in Lakewood, Colo., said another major issue facing physician practices is the increasing shift of healthcare costs from payers to patients.

"There has been a massive shift in the amount of self-pay responsibility for patients," Bakken said. "It's creating a wholesale revolution in the way practices handle collections. There's going to be greater emphasis on up-front payments, and patients do not react well to that. A lot of physicians don't like to put pressure on patients to pay up-front."