Lunch with Sermo's Dr. Daniel Palestrant here at #HIMSS10

I had the pleasure of having lunch with Dr. Daniel Palestrant (Founder and CEO of Sermo) today here at HIMSS10. We had a great discussions today and we talked about physician adoption of EHRs, the use of social media, the evolution of Sermo, our families, and many other interesting health IT topics. Given that the vast majority of physicians are not early adopters of technology, what has made Sermo so successful as an online physician community? It was a really fun discussion given my personal interests in social media and health information technology.

Yesterday, athenahealth and Sermo released data about "Enabling Physicians to Leverage Technology to Improve Patient Care." What do physicians really think about ARRA and HITECH? What are their opinions regarding EHRs and "meaningful use"? Are physician opinions polarized, or are they in unison on these topics? Let's wait to see what type of data athenahealth and Sermo release over the next several weeks.

Daniel shared some great insights about the practical needs of physicians as they relate to practice management, billing, clinical workflow, reimbursement, EHR usability, and more. Through Daniel, I also met Adam Sharp, MD, Chief Medical Officer of Sermo and Jonathan Bush, athenahealth's Chairman and CEO. Thanks again for your time today Daniel. It was a real pleasure to connect and I look forward to chatting again in the future.

Special thanks to HP for sponsoring me to attend and blog here at HIMSS10.

Dr. Nancy: Should doctors be on salary? Survey results are in!

Should doctors be on salary? Today, MSNBC featured survey results from a Sermo posting about physicians being on salary. The data got presented on the Dr. Nancy Show, hosted by Dr. Nancy Snyderman. Also appearing on the show was Sermo Founder, Dr. Daniel Palestrant who debuted the Sermo survey results on the issue of healthcare reform and physician salaries and Dr. William F. Streck, President and CEO of Bassett Healthcare.

Visit msnbc.com for Breaking News, World News, and News about the Economy

Should all physicians be on salary?

This is the Sermo "poll du jour." Former governor of Vermont and DNC Chairman, Howard Dean closed the recent debate with Dr. Daniel Palestrant on CNBC by saying: “All physicians should be on salary.” If you are a physician, do you agree?

• What impact will making physicians salaried employees have on patient care?
• What action would you most likely take in the event that the Federal Government attempts to make all physicians salaried employees?
• Would you accept more federal involvement in your healthcare practice, on behalf of your patients care?
• Would this involvement improve overall efficiency in your practice? For you? For your patients?
• What if doctors are forced to negotiate payment rates with the US Secretary of Health and Human Services?

So far, we have over 700 responses on this Sermo poll. Let's see what gets published in a few weeks. If you missed the CNBC debate on TV, you can catch it here: CNBC debate between Gov Dean and Sermo

CNBC debate between Gov Dean and Sermo

Here's the video (embedded in this blog post) of the CNBC debate between Gov Dean and Sermo physicians:

CNBC Debate To Feature Sermo Physicians

CNBC debate between Governor Howard Dean, MD and Daniel Palestrant, MD who will present the Sermo physician community's perspective on the healthcare reform debate.

Monday, July 27, 10:30 am ET, 9:30 am CT

As part of its day long coverage on healthcare reform, CNBC has asked the Sermo community to weigh-in on a number of healthcare reform issues. Daniel Palestrant, MD will participate in a debate with Governor Howard Dean, MD. Governor Dean has been a vocal supporter of the current healthcare bill (HR 3200), and has emphasized its endorsement by the AMA. CNBC has asked several questions to the physician community. During the debate, Daniel Palestrant will deliver the results of this survey as well as the previous survey that Sermo physicians have used to voice our perspectives on healthcare reform. Over 10,000 physicians responded to the last poll in less than one week, stating that they did not support the AMA's endorsement.

Why physicians will always lose the reimbursement game

Got another e-mail from Sermo's founder Daniel Palestrant, MD. This one was titled, "Why physicians will always lose the reimbursement game." If you're interested in seeing the contents of this letter, then you'll have to get on Sermo (which is currently only available for U.S. physicians).

If you've been following the news, you know that the House Democrats recently unveiled a massive health care reform plan. According to CNN, "House Democrats unveiled their revised version of health care reform Tuesday, offering a proposal that includes a government-funded health insurance option, requires both individuals and employers to participate, and taxes the wealthy to help cover costs... Democratic House leaders said the measure, titled "America's Affordable Health Choices Act," met the requirements set by President Obama for health care reform by lowering costs to consumers and businesses, letting people keep their current plan if desired, and preventing denial of coverage due to pre-existing medical conditions."

Specific provisions of the bill include:

-- A Health Insurance Exchange providing individuals and small business with choices for coverage, including a government-funded public option.

-- No more coverage exclusion for pre-existing conditions.

-- Affordability credits for low- and moderate-income individuals and families, available to those with incomes up to 400 percent of the federal poverty level, or $43,000 for individuals and $88,000 for a family of four.

-- Limits on annual out-of-pocket spending.

-- Expanded Medicaid coverage to individuals and families with incomes at or below 133 percent of the federal poverty level.

-- Required participation by individuals, with a penalty of 2.5 percent of adjusted gross income for non-compliance.

-- Requirement that businesses with payrolls exceeding $250,000 provide their employees with health coverage or contribute up to 8 percent of their payroll on their behalf.

-- A series of measures intended to reduce costs of Medicaid, Medicare and other existing systems.

So how will these changes impact physician reimbursement? If we're trying to cut costs in healthcare, then it seems only logical that we'll be cutting some costs in physician reimbursement (although this may impact certain specialties more than others). Will physicians choose to transition into non-clinical areas and leave clinical medicine? Read the CNN article here.

Sermo's founder Dr. Daniel Palestrant on video

Here's a video of Dr. Daniel Palestrant, Founder and CEO of Sermo (which is currently at war with the AMA). Sorry, but the video isn't about the battle with the AMA. Instead, it's about how Humantific has helped Sermo and I thought it was interesting, so I wanted to share it.

Things are getting ugly between Sermo and the AMA

Wow, things are starting to get quite nasty here. The marriage has turned into an ugly divorce. When Sermo announced its partnership with the AMA, I was optimistic. However, they have had an ugly split recently and they're now at war.

I just got an e-mail from Sermo's founder Dr. Daniel Palestrant. The subject line reads: "From the Founder: CPT - Why physicians always get screwed, thanks AMA"

He highlights the results of a recent survey that included over 4,000 US physicians and it generated over 700 comments on Sermo. The results are quite striking:

• 75% of physicians surveyed are not members of the AMA.
• 89% of physicians claim, "The AMA does not speak for me."
• 91% of physicians surveyed do not believe the AMA accurately reflects their opinion as physicians.

Now, the focus on Sermo is shifting towards Current Procedure Terminology (CPT) coding. Here's some background on CPT codes:

For most physicians, Current Procedure Terminology or CPT codes have become a defining aspect of how we must practice medicine. They have become the "currency" of healthcare, mandating all manner of payments to physicians from the most complex surgical procedures to routine office visits. In the process, the CPT coding system has turned into an incredibly complex system of codes, modifiers, and exceptions. Add to that the RVU formulas, and it is no wonder that most physicians are drowning in paperwork.

So, now it's time to consider some questions related to CPT codes:

• Who publishes these CPT codes?
  
• Is it right that the AMA makes more money from selling licensing for CPT codes than it does from membership dues?
  
• Should our government continue to support the AMA’s monopoly on CPT codes?
• Who should manage CPT codes?

If you're a U.S. physician, have you joined Sermo? Are you a member of the AMA?