The Exchange

Commentary and Observations from
the Medical Front Lines

Latest Practice Management/Career Articles on PCE's The Exchange

Honest and Confident Patient-Provider Relationships

Honest and Confident Patient-Provider Relationships

Continuing Adelaide's case example from post 1 and post 2.

Two months later, Adelaide is back in your primary care office for a routine visit. She has been compliant with all her medications and her heart failure with reduced ejection fraction (HFr... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Hope Tempered With Reality

Hope Tempered With Reality

"We don't want to lose hope or let Mom think we don't believe she'll get better." For palliative care providers like myself, this is a common sentim... Continue Reading

Filed under: Miscellaneous, Practice Management/Career

Why Palliative Care?

Why Palliative Care?

Palliative and serious illness care can be thought of as a "newer" specialty in medicine. The specialty is still proving its worth to many providers—especi... Continue Reading

Filed under: Practice Management/Career

Toxic Culture and Driving Meaningful Change

Toxic Culture and Driving Meaningful Change

I have recently taken an increased interest in podcasts. One of my favorites is Brené Brown's Dare to Lead series. In an April 2022 episode, Brown... Continue Reading

Filed under: Miscellaneous, Practice Management/Career

Engaging and Empowering Team Members

Engaging and Empowering Team Members

As healthcare professionals, we are lifelong learners. I like to think of our endless pursuit of knowledge extending even beyond the healthcare space—a... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Nurses Make a Difference – Happy Nurses Week

Nurses Make a Difference – Happy Nurses Week

May represents Nurses Month, with Nurses Week held annually from May 6 through May 12; the theme for 2022 is "Nurses Make a Difference." At its sta... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Potential Nursing Shortage Is a Major Workforce Concern

Potential Nursing Shortage Is a Major Workforce Concern

According to a national survey of more than 6000 acute and critical care nurses that was conducted by the American Association of Critical-Care Nurses (AACN)... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Cultivating Trust as a Healthcare Leader—Part II

Cultivating Trust as a Healthcare Leader—Part II

What do trust and trustworthiness really mean? How can we really establish ourselves as trustworthy leaders in healthcare for our colleagues and patients? Wh... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Cultivating Trust as a Healthcare Leader—Part I

Cultivating Trust as a Healthcare Leader—Part I

Many clinician leaders who I have met over the years have emerged from 1 of 3 groups: Planned: Leadership was their planned/expected career p... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Tips on the Insurance Peer-to-Peer Process in Patient Care

Tips on the Insurance Peer-to-Peer Process in Patient Care

Medical care has evolved significantly since I started practicing almost 18 years ago: From paper charts to electronic records, and from local pharmacies to... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

Barriers in Healthcare: A Focus on Language

Barriers in Healthcare: A Focus on Language

We live in a society filled with a diverse set of cultures and languages. The US especially has been known to have one of the largest immigrant populations.... Continue Reading

Filed under: Miscellaneous, Practice Management/Career

Hospital Rounding Update: How COVID Affects Patients Without COVID-19, Excerpt From A 9-hour Cardiology Shift

Hospital Rounding Update: How COVID Affects Patients Without COVID-19, Excerpt From A 9-hour Cardiology Shift

My day started with learning that heart surgeries were on hold for 3 patients because there were no ICU beds for recovery; another patient could not get tran... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

What Will Happen in 2022? Concerning Trends for Healthcare

What Will Happen in 2022? Concerning Trends for Healthcare

The past year has seen a tremendous shift in workforce issues that profoundly impact healthcare. Since the beginning of the pandemic, 1 in 5 people in health... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Rheumatology and Telemedicine: Here to Stay or Passing Pandemic Fad?

Rheumatology and Telemedicine: Here to Stay or Passing Pandemic Fad?

In March 2020, the world changed for many of us. For those of us in healthcare, we found ourselves with new lives and new ways of trying to treat our patient... Continue Reading

Filed under: Practice Management/Career, Rheumatology

The Value of Advanced Practice Providers Performing Office Cystoscopy

The Value of Advanced Practice Providers Performing Office Cystoscopy

As the advanced practice provider (APP) community continues to grow and various areas are identified where they can make a difference in patient care, patien... Continue Reading

Filed under: Practice Management/Career, Urology

Focus on the Task

Focus on the Task

Effective leaders, in any space, have the ability to successfully modulate their emotions as part of self-regulation. This allows for the selective filtering... Continue Reading

Filed under: Miscellaneous, Practice Management/Career

Advanced Practice Clinicians in Rheumatology, Part 1

Advanced Practice Clinicians in Rheumatology, Part 1

I have been practicing as an NP in rheumatology for 7 years and I love it. I got lucky, really: A recruiter reached out to a fellow student who was not inter... Continue Reading

Filed under: NPs & PAs, Practice Management/Career, Rheumatology

Innovation in a Post-Pandemic World: What We Have Taught Ourselves

Innovation in a Post-Pandemic World: What We Have Taught Ourselves

So much has changed since January of this year. By now, most states are working to get back to some sense of normalcy while hospitals and healthcare systems... Continue Reading

Filed under: Health Policy and Trends, Miscellaneous, Practice Management/Career

The PA Profession Wants to Change Its Name

The PA Profession Wants to Change Its Name

In May 2021, on a vote of 198 for and 68 against, the American Academy of Physician Assistants (AAPA) House of Delegates (HOD) passed a resolution to change... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Leveraging Telehealth to Improve Access to Healthcare

Leveraging Telehealth to Improve Access to Healthcare

While strides have been made in the overall expansion of (and reimbursement coverage for) telehealth services during the COVID-19 pandemic, there continue to... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

Wellness-Centered Leadership – Why it Matters

Wellness-Centered Leadership – Why it Matters

A paper recently published by Shanafelt et al titled: "Wellness-Centered Leadership: Equipping Health Care Leaders to Cultivate Physician Well-Being and Prof... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Nurses Week 2021: May 6 - May 12

Nurses Week 2021: May 6 - May 12

I can't believe a year has gone by since I wrote about the 2020 Nurses Week theme. This year, the American Nurses Association (ANA) joined with the World Hea... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

New in April: Open Notes Law Goes Into Effect

New in April: Open Notes Law Goes Into Effect

The 21st Century Cures Act, passed by Congress in 2016, has gone into effect in April 2021. This gives patients the right to immediate electronic access to t... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

The Power of Presence

The Power of Presence

For the greater part of a decade, I was fortunate to work with, and be mentored by, an incredible physician leader. When you think about attributes of a grea... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

The Art of Listening

The Art of Listening

One of my favorite songs is "The Sounds of Silence" by Paul Simon and Art Garfunkel. Although my interpretation of this song may vary from the artists' inten... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

New E/M Coding Definitions for 2021

New E/M Coding Definitions for 2021

The American Medical Association's Current Procedural Terminology 2021 codebook updates the existing guidelines developed in 1995 and 1997. For new patients,... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

Health Assessment During COVID-19: The New Normal

Health Assessment During COVID-19: The New Normal

This year has changed how we teach health assessment or provide objective structured clinical examinations (OSCE) to our students. Now, everyone has gone to... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

The Future of the Affordable Care Act

The Future of the Affordable Care Act

We've been hearing a lot about the Affordable Care Act (ACA) and whether the Supreme Court will overturn the law or parts of the law. The Kaiser Family Found... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

Prostate Cancer and Shared Decision-Making

Prostate Cancer and Shared Decision-Making

All men are at risk for prostate cancer and one out of nine will develop the disease; age and family history influence the chance of a man developing prostat... Continue Reading

Filed under: Oncology/Hematology, Practice Management/Career, Urology

COVID-19 Expands PA/NP Autonomy…and Scope of Practice for Other Professions, Too

COVID-19 Expands PA/NP Autonomy…and Scope of Practice for Other Professions, Too

The COVID-19 pandemic has been but one justification for expanding PA and NP autonomy in some states. In New York, Governor Andrew Cuomo's Execu... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

How COVID-19 is Impacting the PA and NP Professions

How COVID-19 is Impacting the PA and NP Professions

Have you or one of your colleagues had an impactful change to your career or current job because of COVID-19? Apparently, it is happening to more than we kno... Continue Reading

Filed under: Practice Management/Career

<em>JAMA Internal Medicine</em> Retracts Well-Publicized Paper

JAMA Internal Medicine Retracts Well-Publicized Paper

In what was then considered a very significant finding, JAMA Internal Medicine published an article in 2018 entitled "Association Betwe... Continue Reading

Filed under: Practice Management/Career

Telehealth Visits During the COVID-19 Pandemic: What are the Benefits?

Telehealth Visits During the COVID-19 Pandemic: What are the Benefits?

Never before has there been such a frenzy of media exposure about an infectious disease as there has been surrounding COVID-19. We are faced with constant up... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

Game Changer: Telehealth for NPs and PAs in the Age of COVID-19

Game Changer: Telehealth for NPs and PAs in the Age of COVID-19

Having worked as a nurse practitioner for almost 30 years, I have seen so much change and evolution in health care, from practice standards to system changes... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

Connecting with our Patients: What Matters Most

Connecting with our Patients: What Matters Most

We all have busy clinical days, but it is still important to make a personal connection with our patients. I think it is fair to say that one of the main rea... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Millennials and Healthcare

Millennials and Healthcare

Millennials, also known as Generation Y, are those born between 1981 and 1996. They currently comprise one-fourth of all Americans and seem to look at health... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

Should We Accommodate Discriminatory Requests from Patients?

Should We Accommodate Discriminatory Requests from Patients?

As medical providers, we took an oath to provide the same quality of care to all our patients regardless of their race, gender, religion, sexual orientation,... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

Mistakes in the Ambulatory Care Setting

Mistakes in the Ambulatory Care Setting

A report published in late October entitled "Deep Dive: Safe Ambulatory Care, Strategies for Patient Safety and Risk Reduction" Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career, Public Health

Do Physician Assistants and Nurse Practitioners Know What They Bill?

Do Physician Assistants and Nurse Practitioners Know What They Bill?

As a practicing clinician, do you know what you bill for? Do you know how much is asked for in the bills that are sent to your patients? The truth of the mat... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

November is Diabetes Awareness Month

November is Diabetes Awareness Month

Along with the colder weather and the promise of holiday season, November brings us the opportunity to raise awareness about diabetes. Both type 1 and type 2... Continue Reading

Filed under: Cardiometabolic, NPs & PAs, Practice Management/Career, Preventive Medicine, Public Health

Women in Oncology

Women in Oncology

As a nurse practitioner, I practice in a predominantly female profession. However, I have seen a wave of symposia at recent major conferences that focus on w... Continue Reading

Filed under: Health Policy and Trends, Oncology/Hematology, Practice Management/Career

Telehealth Policy Update—A National Resource for Advanced Practice Providers

Telehealth Policy Update—A National Resource for Advanced Practice Providers

Telehealth is a method of enhancing delivery of health services, including diagnosis and monitoring of acute and chronic conditions, counseling, therapy, and... Continue Reading

Filed under: Practice Management/Career

Advanced Practice Providers and Liability Risk

Advanced Practice Providers and Liability Risk

It is a misconception that advanced practice providers (APPs) can’t get sued because any errors are a physician’s responsibility. PAs and NPs can and do... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

How Much Revenue Do You—and Your Practice—Generate for Your Hospital?

How Much Revenue Do You—and Your Practice—Generate for Your Hospital?

Merritt Hawkins, a large search firm specializing in physicians and advanced practice providers (APPs), has published their periodic survey report detailing... Continue Reading

Filed under: Practice Management/Career

Leading the Charge Toward Maintenance of Certification Changes

Leading the Charge Toward Maintenance of Certification Changes

The rationale and justification behind certification examinations has always been explained to me as it must be guaranteed to patients that anyone practicing... Continue Reading

Filed under: Practice Management/Career

Development Widget