Building business acumen

5 things every DO can do to better understand the business of medicine

A DO who literally wrote the book on the business of medicine shares advice for those looking to learn more about it.

To say you learn a great deal in medical school, residency and fellowships is an understatement. After years of hard work studying and training, doctors are often very well-prepared to care for patients. Whether most are well-prepared to understand the business side of patient care, however, is generally another story.

Britton Jewell, DO, MHA, wants to help change that.

While he’s now entrenched in the business of medicine as Associate Medical Director of Clinical Services at Desert Oasis Healthcare in Palm Springs, California, when he was a resident, he quickly realized there had been a significant blind spot in his medical education.

“I started to ask my attending physicians questions on why we had to document things a certain way, why we were worried about certain quality metrics, length of stay and different things that the hospitalists wanted to do,” Dr. Jewell said. “It was the first time I ever started learning about all the different players in the health care system.”

During his first job post-residency as a hospitalist, he met Christopher A. Clyne, MD, a cardiologist who also had an interest in helping doctors better understand the business of medicine. Together, they co-wrote Field Guide to the Business of Medicine: Resource for Health Care Professionals, which was published by Wolters Kluwer last year.

The book is meant to give to doctors at all stages of their careers insight into a side of medicine they often have to seek out to understand on their own, Dr. Jewell says. He hopes it can fill a missing piece in standard medical education, and that hopefully it will someday become a part of some schools’ curricula.

Additionally, given how much COVID-19 has impacted every aspect of the industry, Dr. Jewell says it is more important than ever for physicians to understand medical business operations.

Without giving too much away from his book, Dr. Jewell shares some quick tips below for what DOs can do to learn more about the business side of medicine.

1. Get involved by joining a committee in your hospital. 

As a clinician trying to make the jump, hospital committees are the first place to start to see what the other stakeholders are involved, what decisions are being made and why. I’m chair of the quality committee at my hospital.

So either become a member of one of the committees or even chair a committee, but keep in mind that due to COVID-19, some committees may have had to postpone their meetings or hold them virtually, which may make it more difficult for new physicians to become involved.

However, a lot of hospitals have developed COVID-19-focused committees or task forces, which have brought more opportunities for physicians to get involved. Overall, the pandemic has brought an increased demand for physician involvement.

2. Make connections and don’t be afraid to ask questions.

Speak to the chairs of your hospital’s quality committee or utilization review committee, or speak to your hospital administration. Usually you could speak to a chief medical officer, and a lot of organizations employ a physician adviser who would be a good go-to person to bridge the gap between the clinical and the business sides.

Ask about the different parts of Medicare, who the different insurers and stakeholders are, how are they paid, how doctors and hospitals are paid, and the correct way to document. Those are all good jumping-off points.

3. Consider an advanced degree and/or a certificate.

In the future, I think it’ll almost be required for a physician to have an advanced degree. I went back to school to get my MHA (master’s of health administration) after one year as a hospitalist, as well as Health Care Quality and Management Board Certification.

I wanted to stay in the health care realm rather than get an MBA. All of our case studies were health care focused, and on multiple organizations within health care, as opposed to other sectors of the economy.

4. Brush up on coding and billing procedures.

Documentation integrity, coding and billing are directly linked to the diagnoses that physicians are making at the bedside. And a lot of physicians don’t realize it.

It’s important for a physician to document effectively, not only from a clinical perspective, but also for the insurers that may be looking at their notes for coding and billing purposes, and also so that a physician can get paid fairly. It’s important to be aware of the payment models and how you’re going to be reimbursed.

During COVID-19, billing and coding procedures have been changing rapidly. You can keep up with all of these changes on the AOA’s excellent COVID-19 resources page. I also encourage physicians to visit their state medical board websites for additional information and resources.

5. Educate yourself.

It’s good for physicians to understand how an insurance plan works, how a hospital system runs and how it reimburses providers, how the hospitals are paid by the insurers, and the basics of clinical documentation integrity.

Our book provides an overview of all these things. Medscape’s Business of Medicine section is a great resource for current news related to the business of medicine. The American Association for Physician Leadership website is a great organization to join for continuing education on leadership and the business of medicine.

In our book, we discuss how the health care system is moving away from fee-for-service medicine toward more of a value-based care approach, which is focused on improving the quality of care while keeping costs the same or hopefully lowering costs. It’s a broad stroke of where the industry is as a whole.

Related reading:

95% of DOs in private practice experienced a drop in practice revenue during the pandemic

JAMA survey study shows physicians more resilient than most, but still have high rates of burnout

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