Ivy Clinicians

The 2024 Medicare Physician Fee Schedule (MPFS) changes are reshaping reimbursements, with a focus on rebalancing compensation toward cognitive services. Many physicians are deeply concerned that the government’s payment structure has led to worsening physician underpayment across specialties. CMS payments to physicians are not adjusted for inflation, steadily eroding the value of reimbursements. Meanwhile, the costs to run a practice are increasing. Add in sizeable med school debt that carries high interest rates, and physicians feel truly squeezed. Brief overview of the MPFS 2024 changes: - CMS has increased RVUs for cognitive evaluation and management (E&M) services to address historical undervaluation, aiming to better compensate cognitive care.  - A 3.4% reduction in the conversion factor is planned to offset higher E&M payments, impacting specialties differently. - Emergency medicine faces a projected 1% decrease in Medicare reimbursements, contrasting with potential gains for primary care. CMS has announced further cuts for 2025. How much more government cutting can physicians take? Read the full article here: https://lnkd.in/dfeehaMd

The Emergency Nurses Association Lantern Awards recently announced the 2024 recipients, with this year being the largest number of ER’s nominated in the last 14 years. 94 emergency departments across the United States received the award after submitting applications sharing stories “highlighting their commitment to care and the initiatives to improve nursing staff’s well-being.” A few of the notable achievements this year include these 5 hospitals who have received the award multiple times: Boston Children's Hospital (five-time awardee) Penn Medicine, University of Pennsylvania Health System (four-time awardee) Children's Hospital Los Angeles (CHLA) (three-time awardee) Nemours Children’s Hospital Florida (three-time awardee) TriHealth Bethesda Butler (three-time awardee). Additionally, the Southwestern Vermont Medical Center Emergency Department became the first Vermont ED to receive the Lantern Award. Congrats to all the recipients! Check out the full list on ENA’s website here: https://lnkd.in/gAqiuabs 

How do you add some levity to your life as an emergency medicine physician? For Dr. Alex Arroyo at Maimonides Medical Center in Brooklyn, he has a few tricks up his sleeve including: - Wearing costumes (including Boba Fett from Star Wars) to connect with young patients as the director of pediatric emergency medicine - Practices jujitsu up to 10 times a week as a stress outlet - Balances administrative duties with hands-on patient care - Maintains a playful family life, including themed costumes for Comic Con "I generate a lot of joy by strangling people who I consider my friends. It's an amazing outlet for the horrors of the world I see on a daily basis." - Dr. Arroyo on his jujitsu practice What do you think - are you going to start wearing a Boba Fett costume at work? Read the full article here: https://lnkd.in/enVGUKNm 

A controversial tactic to alleviate physician shortages is gaining traction after the new Tennessee law that went into effect on July 1st. It involves International Medical Graduates (IMGs) - doctors who earned their medical degrees outside the US and Canada. Here's what you need to know: - Tennessee law enables easier licensure for IMGs - TN law went into effect July 1, 2024 - Similar measures considered in Florida, Virginia, Alabama, and Colorado Tennessee Requirements Under New Law: - USMLE Steps 1 and 2, ECFMG certification - 3-year international residency/practice - 2-year provisional period IMGs compose 25% of the US physician workforce and in 2023, US and non-US IMGs represented 40.5% of all residency applicants. Yet the current IMG match rate is only about 60%. From the article: There are many other challenges IMGs must face, including cultural differences, difficulty in adapting to the healthcare system, communication barriers, emotional distress, racial discrimination, and financial constraints. Authors writing in The New England Journal of Medicine offer a perspective on this unique initiative. To practice in the US, IMGs must complete a US residency program—even if they have residency experience or have practiced medicine elsewhere (except from Canada). In their perspective piece, the authors state, “While the mandated US-based residency training intends to standardize training quality, it presumes that IMGs received substandard training overseas and causes duplicative clinical training with unclear benefit to their skills and competencies.” Moreover, hospitals often don't cover H-1B visa costs. Many IMGs opt for the J-1 medical trainee visa, with some utilizing the Conrad 30 waiver, which permits them to switch to an H-1B visa by committing to work in health professional shortage areas (HPSAs). These hurdles may limit IMGs' skill utilization and cause some to drop out of training. What do you think? Could this help with physician shortages? How do you think the impact will be in rural locations? Read the full article on MDLinx here: https://lnkd.in/ePuWrMw4 

The nursing profession is facing a critical retention crisis that directly impacts emergency care. Key points from recent research shared in a Medscape article: • Over 262,000 RNs graduate yearly, but 33% quit within 2 years • Current RN shortage: 78,610 • Projected exodus: 900,000 nurses (1/5 of US RNs) plan to leave by 2027 Major factors driving nurse turnover: • Burnout • Stressful work environments • Poor staffing ratios • Lack of leadership • Low pay and benefits • Patient-to-nurse ratios in ER/ICU often 4:1 (double the recommended) • 80% of nurses experienced workplace violence in the past year "Workplace violence has climbed tremendously. Nurses are afraid for their safety." - Robin Geiger, DNP, MSN, APRN, FNP-BC, NEA-BC Proposed solutions: 1. Legislation: SAVE Act & the Nurse Overtime and Patient Safety Act. The Safety from Violence for Healthcare Employees (SAVE) Act was introduced in the US House of Representatives in 2024 to mandate federal protections for healthcare workers who are victims of violence and intimidation in the workplace. Geiger calls it "a good starting point," adding, "We're all advocating and working together to get the SAVE Act and other HR bills either initiated or passed."  2. Mentorship & training programs 3. Improved work conditions 4. Resources for self-care  "We know what needs to be done. Let's stop this." - Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, ANA President Have you seen this in your ER? What strategies do you think are or aren’t working? Read the full article here: https://lnkd.in/gD2ZGNmH 

A recent study in JAMA Network Open provides valuable insights into unprofessional behaviors among physicians, with specific findings for emergency medicine. Here are some key takeaways: Key Findings: 1. Overall, 9.1% of 35,120 physicians received at least one coworker report of unprofessional behavior. 2. Emergency medicine physicians were less likely to receive reports compared to surgeons and proceduralists, but more likely than non-surgeon non-proceduralists. 3. 10.9% of emergency physicians received at least one report. 4. Only 0.7% of emergency physicians showed a pattern of repeated reports. 5. Most common reports across all specialties involved communication and professional responsibility. "Understanding more about the distribution and patterns of unprofessional behaviors in health care that interfere with individual and team performance can support coworker well-being and the ability to deliver safe high-quality care." "The structure of teams in emergency medicine and the interaction of emergency medicine physicians with multiple professions and specialties introduces unique stresses on team function in that setting." How does this research resonate with your experiences in the ED? What steps can we take to enhance professionalism in our high-stress environment? Full study here: https://lnkd.in/eXXDCCpX #EmergencyMedicine #ProfessionalDevelopment #PatientSafety #TeamDynamics

"A World of Hurt: How Medical Malpractice Fails Everyone" is an insightful, heartfelt, and expertly produced exploration of the problems with - and possible solutions for - the US medical malpractice system. A learning point, from Richard C. Boothman, the legendary malpractice defense attorney who developed the Michigan Model - a systematic, principled approach that proactively treats injured patients honestly, fairly, and transparently while prioritizing rapid clinical improvement: "Research has shown very clearly that the top three reasons patients sue are first, just a simple search for answers; factual information about what happened. Secondly, they have a very powerful sense that what happened to them not happen to someone else. There is a sense of responsibility that they are actually thinking about others. And thirdly, there is a yearning for some sense of accountability." https://lnkd.in/dET7ydzv Gita Pensa, M.D., Megan Ranney, Viknesh K., Katie DeRoche American College of Emergency Physicians American Academy of Emergency Medicine (AAEM) Society of Emergency Medicine Physician Assistants (SEMPA) American Academy of Emergency Nurse Practitioners (AAENP) Emergency Medicine Residents' Association (EMRA)

Medscape: PAs “enjoyed a good year on the salary front.” “The total compensation, on average, jumped by around 6% for US PAs last year. The biggest single component of that compensation is base pay, which rose by about 7%. Those hikes came on the heels of 4% and 3% bumps, respectively, in the prior year.” “PAs have taken matters into their own hands. They are more mindful about their approach now when they take a job, and that makes them happier in their job,” Blake Moser, CEO of MedicalRecruiting.com explains. “New graduates are turning down jobs that are on the lower end of the pay scale, knowing there is another [offer] waiting around the corner. See the full breakdown on Medscape here: https://lnkd.in/eMA2iBCW

Medscape has created a list of the 10 best and 5 worst states for a physician to practice in based on the following criteria: physician compensation, cost of living, malpractice premiums, health of state’s residents, and physician burnout levels. The top 5: 1. Wisconsin 2. Minnesota 3. North Dakota 4. Hawaii 5. Ohio The bottom 5:  1. West Virginia 2. Alabama 3. Arkansas 4. Florida 5. Georgia Find Medscape’s full breakdown here: https://lnkd.in/dxDXnhib And if you want to check out how your facility ranks, based on reviews provided by actual emergency physicians, head over to ivyclinicians.io!

🏥 "Emergency physicians and the communities they serve are geographically divergent. Most emergency physicians live in urban areas, while a higher proportion of emergency department patients live in rural regions. Per Christopher Bennett, MD, the author of a large emergency medicine workforce study, “Demand for emergency care in rural areas will remain high while emergency physician shortages in these communities continues to pose significant challenges for health systems and patients.” 🔍 Learn more about the state of rural healthcare and emergency medicine as a whole in Ivy Clinicians' thorough analysis of staffing data for physicians, PAs, and nurse practitioners. Their "State of the US Emergency Medicine Employer Market - March 2024" offers an excellent window into the many shifts and challenges unfolding in the field today. 👀 Visit: https://lnkd.in/gFRVNiUf #ivyclinicians #emergencymedicine #EM #emergencydepartment #physicianshortage #AdvancedPracticeProvider #APP #healthcare #healthcarestaffing