The Ides of March (and NPAC!) Is Upon Us

The ides of March is upon us…don’t I know it!???? However, in this instance, it’s also something to look forward to because March 15th?puts us at just about a month before the?2023 National Physician Advisor Conference (NPAC)?starts at the?Loews Portofino Bay Hotel?in Orlando, Florida.

It’s funny…back when I was preparing to graduate from my pediatric residency and failed to be accepted into a Pediatric Emergency Medicine fellowship (that was my originally intended career path – thank goodness it did not come to fruition!??EM would not have been a good match for me, no pun intended), a mentor of mine suggested I apply for “some new position called a pediatric hospitalist.”??While adult #hospitalists had been around for a couple of decades, there was still a very strong culture of children remaining under the care of their primary #pediatricians – the doctors who many times had followed the patient since just after birth – even when the kiddo was hospitalized.??But, as more and more community hospitals established Neonatal and Pediatric Intensive Care Units into their service lines and pediatric patients with complex acute and chronic conditions no longer required transfer to a tertiary center in a large metropolitan area, the role grew.??

A decade later, I found myself entering yet another newish and burgeoning field – that of #physicianadvisors involved in hospital #casemanagement/ #utilizationmanagement and clinical documentation integrity.??Like many of you, immersion into the work involved not many understanding what specifically was supposed to be accomplished.??Was something like, “we were told by a consultant that we needed to have a physician in this position,” one of your first introductions to the role???If so, you’re not alone.

Most physicians don’t get into #medicine for the business aspect, they are looking to heal.??Raise your hand if you remember your training as a #physician or nurse involving how you should never, EVER take finances or insurance coverage into account when assessing and treating a patient.??I know I do.??Which is why it was such a wake-up call when as a practicing peds hospitalist, I learned the H&H (hemoglobin and hematocrit) test I was ordering to monitor anemia in some of my patients was three times more expensive to run than a CBC (complete blood count).??My initial thinking was spot-on – all I needed to know was what the hemoglobin and hematocrit were, I didn’t need information about platelet count, white blood cell count, etc.??It made sense to think a test that checked only two values would be more cost-efficient than the one which checked a dozen.??But, for reasons I am not completely sure about, it most certainly was not.

Similarly, who remembers when they discovered the out-of-pocket cost to the patient for a “Medrol dose pack” was more than if you took the time to write out the same dosing schedule for methylprednisolone???(Mind you, perhaps it’s different now, but this was the case back in the early 2000s.)??These are the same kind of “aha moments” physician advisors illustrate to their administration and providers every day.

“You mean, we DON’T get paid for every test and imaging study we perform during the hospital stay?”??

“The case manager can just fix the status to whatever is right the next morning, can’t they???If it’s eventually correct, who cares?”

“There’s no more reimbursement for this planned surgical case if they stay overnight versus going home the same day from PACU?”

While the importance of the #physicianadvisor within #hospitals and #healthsystems continues to grow and happily, I see more light shed on this topic in journals, webinars, chapter and national conferences every week, there remains a sense of isolation most in our field experience on some level.??What does it mean to be a #doctor who doesn’t perform their role clinically???How can we say we positively impact the provision of #healthcare of hundreds if not thousands of patients a day without touching a single one???When success involves ensuring #compliance or pro-actively saving a hospital from millions of dollars of lost revenue, how can that be translated into an ROI?

This is why you should come to #NPAC2023 next month.??If you have been on the fence about registering for the American College of Physician Advisors (ACPA) ' conference, now’s the time to jump off.??Join us.??Join your tribe.??Learn from the best, and evolve as a mentor for those who are just starting on the path.??Together, let’s witness the upward trajectory of our field.