National Association of Independent Review Organizations (NAIRO)

Periodically, I like to mention acronyms that may be unfamiliar to most physicians.

Are you familiar with NAIRO?

The National Association of Independent Review Organizations (NAIRO) was formed by the majority of URAC-accredited independent review organizations (IRO). The need for uniform regulations from state to state and a uniform application process is what brought NAIRO together. The primary objective of NAIRO is to simplify the regulated independent review organization application process and independent medical peer review requirements among the states.

NAIRO is dedicated to protecting the integrity of the independent medical peer review processes. Utilizing the expertise of hundreds of board-certified clinicians throughout the country, NAIRO members embrace an evidence-based approach to independent medical peer review, in order to resolve coverage disputes between enrollees and their health plans.

Job Post: Physicians to perform IME's and CE's

The following is a Job Post:

Physicians to perform IME's and CE's
TSOM - Multiple locations, GA

I am looking for a physician to join a group performing Consultative Exams for Social Security in Georgia. We provide all administrative needs including scheduling, transcription, assisting, and billing. Pay for the day's work is guaranteed regardless of turnout and is paid promptly regardless of time of collection. Of course there is no call and no weekend work. We are currently in need of a physician part-time working with our group 1 to 4 days a month to start. Physicians working for us have various background and training including General Practice, IM, FP, pain mgt., surgery, orthopedics, neurosurgery, cardiology, occ. med, and physical medicine.

Contact: bgube@aol.com

Working From Home Part I – Chart Review

Author: Heather Fork, MD, CPCC

I’m hearing from more physicians who want to work part-time from home. The reasons vary: more time with the kids, a less stressful environment, greater job flexibility and some extra income.

With advances in communication technology and the availability of digitalized information, the opportunities to work from home are increasing in many professions, including healthcare.
While the electronic medical record may be challenging for a variety of reasons, it is providing more options for physicians to work in the comfort of their own home. Two areas that are a natural fit for this type of work are doing Chart Reviews and Telemedicine.

Today, I will be discussing Chart Reviews, and in Part II, I will cover Telemedicine. Chart Reviews, also called Independent Reviews, provide a third-party evaluation on a matter relating to patient care.

Complimentary Webinar: Multi-national Retrospective Chart Review Studies

Complimentary Webinar: Multi-national Retrospective Chart Review Studies
June 28, 2011 12:00 pm - 1:00 pm EDT

Multi-national, retrospective chart review studies offer a means to gather real-world clinical and health economic data not typically available from medical claims or other databases. These studies can result in tailored, comprehensive, repositories of patient level data that can be used to characterize real-world patients, evaluate clinical and safety outcomes, document patterns of usual care, and estimate treatment costs. Data can be used to support burden of illness evaluations and other pricing and reimbursement related research initiatives.

BHM physician advisors

BHM physician advisors are a network of board-certified physicians with diverse specialties and over 40 years of combined experience. Whether a complex or standard case, our network of physician advisors can meet your needs. The services provided go beyond initial review, and encompass the complete review process from beginning to end. Our physician advisors will bring their expertise to your organization by employing an evidence based approach in analyzing all peer to peer clinical review cases. We will take this experience and use it to help the members of your organization shape ongoing treatment goals.

Services include

• Initial review
• Both standard and expedited reviews
• Concurrent reviews
• Appeal process
• Both standard and expedited appeals
• Medical record review
• Clinical treatment shaping and consultation
• UM Medical Necessity Review
• Physician Advisor Consultation

American Medical Forensic Specialists

Here's some information about an organization called the AMFS:

American Medical Forensic Specialists (AMFS) is America's premier medical expert witness and medical legal consulting company. We have been a trusted partner with the legal community for more than 20 years providing experts to both plaintiff and defense counsel for personal injury, medical malpractice and other medical-legal matters. Our superior method of retaining the most qualified experts has enabled us to provide board-certified experts in active practice in over 15,000 malpractice and personal injury cases.

Benefits of joining the AMFS network:

* Earn supplemental income without disrupting your practice
* Keep informed of issues affecting your specialty and the medical community
* Accept or decline casework at your discretion and according to your schedule
* Outsource all non-billable administrative tasks and ensure payment for services rendered
* 20 years and 15,000 cases of medical-legal experience and expertise
* Receive complex case facts and briefings from a doctor (AMFS Medical Director)

Learn how you can become an AMFS expert here. (panel of experts limited to actively practicing, board-certified physicians who are willing to testify in support of their unbiased opinion)

Medical Expert Witness Directories

This is not meant to be an exhaustive list, but here are some Expert Witness Directories that list medical, nursing, and other health care professional consultants who are willing to serve as expert witnesses in medicolegal cases.

http://www.jurispro.com/
http://www.seakexperts.com/
http://www.experts.com/
https://www.naclncdirectory.org
http://www.expertwitness.com/
http://www.almexperts.com/ExpertWitness/
http://www.hgexperts.com/
http://expertpages.com/
http://www.roundtablegroup.com/about/

I plan to update this list periodically, so bookmark this page (or this website) and check back frequently.

File Review Consulting Assignments

Here's information about the SEAK National Directory of Medical File Review Consultants:

The deadline to place your listing in the SEAK, Inc. National Directory of Medical File Review Consultants, is Thursday, September 30th, 2010.

File reviews can be done from home, are low stress, do not require any patient contact or travel, almost never results in having to testify and generally pays $100-$200/hour or more.

File review consulting work is varied and includes: utilization reviews, peer reviews, chart reviews, second opinions, underwriting reports, disability opinions and pre-authorizations.

To place your listing, please sign up online at http://filereviewconsultants.com/signup

A one-year listing is only $395 and we offer a full 100% money back guarantee with your listing. If you are not satisfied with the number and quality of file review assignments that you receive or for any other reason, you have until August 1, 2011 to request and receive a full refund of your standard listing fee.

Review charts as a physician expert witness (legal medicine)

Many physicians have found that they can review medical charts and earn supplemental income as a physician expert witness. Some people think that they may need to testify in court, but this does not happen very frequently. We all know that many cases get settled outside of court. If you'd like to be a medical consultant for attorneys, then you should pursue a career in the field of legal medicine. 

One way to get started in the field of legal medicine is to add your name to an Expert Witness Directory. For example, SEAK has an Expert Witness Directory and they offer a 100% Money Back Guarantee. Here's what they say:

If at any time within 8-months after the publication of the first Directory in which you appear you are not completely satisfied, you may request and receive a full refund of your standard listing fee.

Let's take a look at what it means to be a physician expert witness. Here's what the American Academy of Family Physicians (AAFP) has to say about being a physician expert witness:

1. The physician expert witness must have a current, unrestricted license to practice The physician expert witness should be fully trained in the medical specialty or area of practice about which he or she is testifying.
2. The physician expert witness must have current clinical experience in the medical specialty or area of practice about which he or she is testifying and during the two-year period immediately preceding the occurrence which led to the lawsuit, such person must have been actively engaged in clinical practice in the medical specialty or area of medicine about which he or she is testifying.
3. At least one physician expert witness for the plaintiff and one physician expert for the defendant should be in the same clinical specialty as the defendant physician. (1989) (2009 COD)

Interested in legal medicine? You may want to learn about the American College of Legal Medicine (ACLM)

The Mission of the American College of Legal Medicine is to “promote the continued professional advancement of its members, as well as non-member physicians, and other interested professionals, through education, research, publications, and interdisciplinary and collaborative exchanges of information. The educational meetings are designed to improve the professional performance of the participants and focus primarily on research, methodologies, techniques, and issues and advances in the field of legal medicine. The education activities encourage interdisciplinary exchanges of ideas and information and thereby facilitate enhanced service to society in the healing arts and legal professions.”

Becoming an Entrepreneur When You Can’t Find a Job

AARP has some great articles on jobs and careers. I doubt that any of these articles are focused on the physician community, but the concepts and principles behind them are sound advice.

For instance, there's an article on AARP titled, "Hire Yourself: Becoming an Entrepreneur When You Can’t Find a Job"

There are many physicians who are over 50 and they are seeking to transition to a non-clinical career. I've spoken to many of these individuals in 2009 and I anticipate speaking to more of them in 2010. The difference between physicians and business executives is that physicians tend to under-estimate the power of social networking. They also focus too much on formal training and education as opposed to work experience and skills that may be self-taught. I'm obviously generalizing here, but much of this is due to the way that physicians are educated and trained. During medical school and residency, we don't rely on robust networking skills to succeed and advance in our careers. Instead, it's generally about self-related accomplishments such as grades, test scores, publications, research, etc.

So, if you're looking for a job and you can't seem to find one, are you ready to become an entrepreneur? Do you know what it will take to create a company and generate enough revenue for you to maintain your quality of life? I think it's a great idea to start a business, but you have to know where to begin. Some of the easiest places to start include the following:

• Writing. You can begin a freelance medical writing career and establish a business very quickly if you have strong writing skills and if you know how to begin.
  
• Internet. There are many web-based businesses that include different elements of health care resources, services, and products. It's very easy to create a website and to leverage that for your business.
  
• Consulting. Physicians tend to be good at consulting. After all, they have spent their careers solving problems.
  
• Medical Chart Review. Many physicians are establishing their own business as medical reviewers. They may review medical charts for a variety of clients.
• Teaching and Tutoring. There are many college and medical students who could benefit from some teaching and tutoring. Whether it's MCAT prep, USMLE step 1, or some other standardized exam, students are seeking help.

So, are you ready to be an entrepreneur? It may start by being an independent contractor and then forming your own business as your volume of business increases.

Non-clinical opportunities for supplemental income

Some physicians spend many hours "moonlighting" to generate supplemental income for the household. There was a time when I did a fair bit of moonlighting myself. Many physicians are looking for creative, non-clinical ways to earn supplemental income. Here are some examples of ways you can generate some income in your spare time.

• Medical writing. You can find some freelance/contract projects that have fixed durations (example: 3 months). You may also find some part-time writing projects that don't require extensive work experience as a formal medical writer.
  
• Consulting. Some start-up companies are looking for physician consultants to provide some medical direction and guidance as they develop their business strategy. Other companies may need physicians to offer advice about clinical workflow issues, decision-making processes, health care administrative issues, etc.
  
• Medical chart reviews. There are a growing number of companies that are paying physicians to review charts. Some chart reviews may be for medicolegal purposes. Other reviews may deal with claims and reimbursement. The world of "administrative medicine" is expanding quickly.
• Tutoring and teaching. There are many opportunities to help college and medical students with test prep (MCAT, USMLE Step 1, etc.). Some students need some personalized attention, especially if they struggle with a learning disorder, ADHD, etc.
  
• Blogging. Yes, blogging can generate supplemental income if you're creative and persistent.

You may also stumble upon some market research surveys that pay for your time (for instance, you'll see quite a few of these on Sermo). You may also choose to sell things on eBay, explore the world of real estate, or develop an online business where you're selling some type of product. If you've got an entrepreneurial spirit and you have some creative juices flowing in your head, then I'm sure you'll find many different ways to generate some supplemental income.