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APRIL | MAY 2019 UTAHStill the Greatest Profession.PHYSICIAN Making HIPAA Second-Nature Page 18 HOUSTON, WE HAVE A YES, NOW IS A GOOD 2019 LEGISLATIVE REVOLUTION TIME TO DISCUSS YOUR SESSION REPORT PAGE 4 ESTATE PLAN PAGE 10 www.utahmed.org PAGE 8 Trust the specialists. Helping physicians reach their financial goals since 1993. Entrust your financial goals to an organization dedicated to physicians. At UMAFS, we understand the unique circumstances of school loans, insurance needs, career changes, family and retirement goals. Take your financial needs to the specialists. Call us for a no-cost financial analysis today. CALL 801-747-0800 OR VISIT ONLINE AT UMAFS.ORG UTAHStill the Greatest Profession.PHYSICIAN Editorial Board Wallace Akerley, III, MD FEATURES Brian J. Moench, MD Karen M. Radley, MD 2 CEO's Message Daniel R. Faber, MD By Michelle S. Mcomber, MBA, CAE Carissa S. Monroy, MD 4 UMA Leadership Development: Houston, We Have Staff a Revolution Michelle S. McOmber, MBA, CAE By Rodney A. Pollary, MD, FAAP Chief Executive Officer Mark Fotheringham V.P. of Communications 8 Yes, Now Is A Good Time To Discuss Your Estate Plan By Gregg D. Stephenson, Ray Quinney & Nebeker Editorial Office Utah Medical Association 10 2019 Legislative Session Report 310 East 4500 South, Suite 500 By Mark Brinton, JD – UMA General Counsel and Director of Government Affairs and Michelle S. Mcomber, MBA, CAE – UMA CEO Salt Lake City, Utah 84107-4250 Phone: (801) 747-3500 Fax: (801) 747-3501 18 Making HIPAA Second-Nature By Sara Vandermolen, Utah Health Information Network E-mail: [email protected] Advertising Information 20 The Small & Medium-Sized Practice's Guide to HIPAA Mark Fotheringham (801) 747-3500 x234 Originally Published By Docbookmd, A UMA Member Benefit Partner ©2019 UTAH PHYSICIAN | The newsLINK Group, LLC. All rights reserved. The information contained in this publication is intended to provide general information 24 Utah Health Status Update for review, consideration and education. The contents do not constitute legal advice and should not be relied on as such. If you need legal advice or assistance, it is strongly recommended that you contact an attorney as 26 The Value of Expertise to your circumstances. The statements and opinions By Ryan M. Bladen MBA, CFP®, Vice President, Financial Advisor, UMA Financial Services expressed in this publication are those of the individual authors and do not necessarily represent the views of the The Utah Medical Association, its board of directors, or the publisher. Likewise, the appearance of advertise- ments within this publication does not constitute an en- dorsement or recommendation of any product or service advertised. UTAH PHYSICIAN is a collective work and as such some articles are submitted by authors that are independent of the Utah Medical Association. While the Utah Medical Association encourages a first print policy, in cases where this is not possible, every effort has been made to comply with any known reprint guidelines or re- strictions. Content may not be reproduced or reprinted without prior written permission. For further information, please contact the publisher at: 855.747.4003. DEPARTMENTS CME Calendar 27 CME Spotlight 27 CEO’S MESSAGE MICHELLE S. MCOMBER, MBA, CAE Physicians Under Attack ODAY, PHYSICIANS AND HEALTHCARE in general Trusted Professionals’ once again ranks nurses as number 1 (84% are under constant scrutiny and attack by the legislature ranking very high/high), physicians as number 2 (67% ranking and others. I am concerned about what is happening in the very high/high), and pharmacists are number 3 (66% ranking Tlegislature and how people view physicians, particularly in the past very high/high), just barely lower than physicians. On the flip few years. How people feel about physicians affects what happens side for very low rankings, nurses are again number 1 for the in the legislature. It affects where healthcare is going, and the role fewest low rankings (only 2% ranking low/very low, pharma- physicians will play in that healthcare. Physicians are the high- cists are number 2 (5% ranking low/very low), accountants are profile providers who are often blamed for all healthcare problems number 3 (7% ranking low/very low) and physicians are num- including the cost of healthcare and patient unhappiness with their ber 4 (8% ranking low/very low). Other surveys or polls rank healthcare experience. physicians even lower for trust and honesty, below firefighters, teachers and others. In my many years of legislative sessions, I have never seen such animosity and direct attacks on healthcare or physicians as I have during the session that just ended. The scrutiny and Why are physicians losing ground? There are many reasons desire to change and control all healthcare started in full force that are espoused by experts including: 1) patients questioning about 2008. Since that time, without fail and ever increasingly, a doctor’s honesty or ethics of a diagnosis; 2) patients blaming we have discovered and fought to stop or change bill proposals physicians for a diagnosis or not believing a physician because that seek to control and legislate every aspect of healthcare, par- they have diagnosed themselves; 3) third-party interference in ticularly what physicians can and can’t do via parameters that the physician/patient relationship – dictating decisions or care others seek to put on physicians through legislation. Instead of such as what procedures or even medications can be given; 4) looking to rein in mid-level and other types of providers (includ- administrative burdens placed on physicians which require them ing fringe providers) and keep appropriate parameters around to spend more time on administrative tasks and less time with them, I have seen an increasing number of bills which allow patients; 5) media focus on a few bad actors that give all physi- expansion for every healthcare provider (whether legitimate or cians a bad name; 6) physicians not giving patients everything not) while putting more constraints on physicians. they want; 7) patients blaming a physician when they have a bad experience or outcome during care (long wait times, rude Physicians in the past, and even today, are still near the top providers – medical assistants, others; 8) curt or abrupt commu- of the list of those whom individuals trust most and rank highly nication between a physician and a patient; 9) blaming physicians for honesty and ethical standards. However, over the past few for rising healthcare costs; and 10) blaming physicians for public years, physicians have been bypassed by nurses and, depending health epidemics – opioid crisis, not doing enough to help those on the survey, by other professionals. Gallup’s 2019 list of ‘Most who may be suicidal when they may have seen those individuals 2 www.utahmed.org recently, etc. These are just some of the reasons there has been a decline in public trust in physicians even though most of these reasons have nothing to do with the integrity of or ability of a physician to give good care. Most physicians strive to do what is right for their patients under new Unfortunately, all these reasons also bring more scrutiny to physicians and healthcare and an attempt to control both. With and increasingly difficult practice the rise in healthcare costs and since healthcare takes such a large portion of state and national budgets, legislators increasingly environments and that should focus on physicians and healthcare and on how they interact. Some of this scrutiny has helped bring about good changes to be recognized. healthcare, but much of it just brings forth legislation that some- one thinks is a good idea without thought of the consequences. Or legislation proposed because someone else has asked for it whether it is good policy or not. Physicians are being attacked from all sides and the decreas- For example, while transparency in healthcare is a good idea, ing trust by patients does not help. Some of those patients are transparency that does nothing but increase costs is not some- legislators, or they approach legislators, and then a bill is opened thing that should be passed. This year we had four transparency that will affect the ability of a physician to practice without more bills, all asking physicians (and hospitals) to provide different restrictions or requirements. information to patients to place “transparency” in the system. We support transparency, but it should be meaningful. Some of While many of the requirements placed on physicians are the requests were reasonable and made sense and were possible, the reason for the lack of trust or loss of trust in physicians, I others were completely unreasonable and impossible and would believe we need to work on the public image of physicians in cost the healthcare system more money without providing any Utah. We need to fight back against this attack on physicians. benefit to patients. One bill would have required a physician to I believe in physicians, in who they are and what they are, and tell a patient exactly how much they would have to pay for care their importance to healthcare. Most physicians strive to do what before the care and not allow the physician to charge something is right for their patients under new and increasingly difficult different even if the care ended up being different from that used practice environments and that should be recognized. Physi- to calculate the original estimate. It would have required the cians should not be under attack and blamed for all healthcare physician to see the patient. The bill was completely unreason- woes. We need to make sure that we let legislators, the media, able, even impossible in certain cases, and would have increased and others know what physicians do and how much they con- costs because a physician would have to give the highest possible tribute to the good of healthcare.