Monday, May 05, 2014
Friday, May 02, 2014
Thursday, June 20, 2013
MGMA: Physician Compensation Increasingly Based on Quality Measures
MGMA: Physician Compensation Increasingly Based on Quality Measures
John Commins is a senior editor with HealthLeaders Media.
MGMA: Physician Compensation Increasingly Based on Quality Measures
John Commins, for Health Leaders Media , June 14, 2013
Primary care physicians have 3% of their total compensation based on quality measures, but doctors will increasingly be tied to these metrics as reimbursement aligns more closely with quality and cost measures, Medical Group Management Association data suggests.
Quality measures are emerging as components in physicians' compensation, a trend is expected to grow as value-based reimbursements gradually supplant fee-for-service, volume-based models, a new survey from the Medical Group Management Association shows.
The Physician Compensation and Production Survey: 2013 Report Based on 2012 Data examined data on more than 60,100 physicians, and found that primary care physicians and specialists reported that 3% and 2%, respectively, of their total compensation was based on quality measures.
Although the percentages are small, MGMA's Todd Evenson says physician compensation will increasingly be tied to these metrics as reimbursement aligns more closely with quality and cost measures.
"Really what we are seeing is the very front end for many organizations as they start to address under the Affordable Care Act and the commercial environment value based reimbursement. Ultimately those components of quality and satisfaction will become an ever-emerging component of reimbursement," says Evenson, MGMA's director of data solutions."
Actually, Evenson says the survey is low-balling the extent of quality measures in compensation packages for some healthcare organizations.
"Clearly there are some groups that are much more dynamic in the way they have been able to apply that. It's not uncommon in the industry and in many of the large organizations or health systems for that number to be somewhat higher. I have talked to many colleagues in the industry and figures anywhere from 10% to 30% aren't that uncommon for those larger institutions," Evenson says.
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"As we look toward large healthcare institutions, the likelihood that they have decoupled compensation from collections is very high. And as a function of that in order to promote the behaviors around quality and satisfaction that they would like to see they want to incentivize their physicians in the appropriate ways to compensate them for those behaviors or activities. But overall, when we are looking at smaller organizations or medium-sized organizations then it is much more likely that there is that direct linkage."
Evenson says it's not necessarily a bad idea for some healthcare organizations to wait and watch before launching a quality component in their compensation packages.
 Physician/Specialists Compensation, 2008-2012 (PDF) |
"You don't want to be on the cutting edge. You want to be just behind the cutting edge as it relates to how you change your compensation strategies," he says. "It wouldn't be very effective if you were being paid 90% fee-for-service and paid 50% on quality to your teams of providers. The math wouldn't work in your favor."
Physician Compensation
The report also reaffirmed that median compensation for physicians fluctuated by specialty. Primary care physicians reported $216,462 in median compensation in 2012, and specialists reported $388,199 in median compensation. Evenson says the considerable gap in compensation could prove difficult to overcome, even with a concerted push to get more medical school students to take up primary care.
"The last data I had a chance to look at as I looked towards family practitioners just coming out of residency was something like 40% had over $200,000 in debt. And when we see that coupled with the median compensation for a family practitioner this year was right around that $205,000, it ends up being where there is definitely a constraint that is worth noting," Evenson says.
"We and others in the health industry understand the importance of this. The demand for primary care physicians is going to continue to increase but we have seen that kind of differential between primary care and specialty care compensation. We've even seen a number of advocacy efforts from a number of organizations (to improve primary care compensation) and that continues to evolve, but unfortunately it has remained at a static pace as a ratio of one related to the other. We did see some narrowing of that gap over the last few years, but I have seen that stagnate."
Evenson says the report verifies that healthcare organizations are moving toward an increasing reliance on physicians' assistants and nurse practitioners to make up for the shortage of primary care physicians. As a result, these highly specialized nurses are enjoying significant compensation hikes.
Over the past five years nurse practitioners' compensation has increased, on average about 13.4%, to the median of $92,717 in 2012. For physicians' assistances in the surgical suite that compensation increased by 9.6% over five years to a median of $112,689. For physicians' assistants in the primary care setting the compensation increased 10.4%, with a media of $96,834 in 2012, MGMA reported.
"When we look at their compensation this really underscores how the environment and the healthcare system is leveraging providers to the maximum of their license," Evenson says. "It shows how teams and organizations are dealing with that primary care shortage. They are looking towards the nurse practitioner and their role in the organization. Even if you're in a gastroenterology practice they are leaving the scope work to the physicians and the follow up visits to the practitioners. They are leveraging them to try to meet that demand."
John Commins is a senior editor with HealthLeaders Media.
Monday, May 27, 2013
2011-2020: United Nations Decade on Biodiversity
United Nations Decade on Biodiversity
The United Nations General Assembly declared 2011-2020 the United Nations Decade on Biodiversity (Resolution 65/161). The UN Decade on Biodiversity serves to support and promote implementation of the objectives of the Strategic Plan for Biodiversity and the Aichi Biodiversity Targets, with the goal of significantly reducing biodiversity loss.
The United Nations General Assembly declared 2011-2020 the United Nations Decade on Biodiversity (Resolution 65/161). The UN Decade on Biodiversity serves to support and promote implementation of the objectives of the Strategic Plan for Biodiversity and the Aichi Biodiversity Targets, with the goal of significantly reducing biodiversity loss.
Tuesday, March 12, 2013
Maynard's Texas Vegan Buffet
Maynard's Texas Vegan Buffet
Let's have a contest (no cash prizes - just "posted popularity") to
ENVISION a full vegan restaurant concept
(start-to-finish imagination):
I'll start!
Dietitian-developed vegan buffet complete with calorie counts, sign up for birthday parties and anniversaries, celebrations of going vegan, etc. Everyone dressed in colorful uniforms made of vegetable-patterned or fruit-patterned cloth, different vegetables celebrated each day, with free recipes tweeted out (or in RSS feeds) to those who sign up online or in the vegan buffet centers; big parties for vegetarian days, such as GAMO (Great American Meatout), World Vegetarian Day, National Heart Month, International Vegan Day, Gandhi's birthday, Feast Day of St. Francis, etc.
Concept: Overeating - if you dare, but we strongly advise against it, for the following reasons: 1, 2, 3, 4. We CAN make eating right amounts of vegan food VERY satisfying by integrating culinary arts with dietetic and nutritional science and skill. We educate and nurture our clients - in person and electronically. Value-Added venue that is affordable (on both sides) and sustainable.
ENVISION a full vegan restaurant concept
(start-to-finish imagination):
I'll start!
Maynard's Texas Vegan Buffet:
Get all you can and can all you get
"WHAT ARE YOU GOING TO EAT AS A VEGAN?"
DRIVE IN TO MAYNARD'S VEGAN BUFFET AND FIND OUT!
Dietitian-developed vegan buffet complete with calorie counts, sign up for birthday parties and anniversaries, celebrations of going vegan, etc. Everyone dressed in colorful uniforms made of vegetable-patterned or fruit-patterned cloth, different vegetables celebrated each day, with free recipes tweeted out (or in RSS feeds) to those who sign up online or in the vegan buffet centers; big parties for vegetarian days, such as GAMO (Great American Meatout), World Vegetarian Day, National Heart Month, International Vegan Day, Gandhi's birthday, Feast Day of St. Francis, etc.
Concept: Overeating - if you dare, but we strongly advise against it, for the following reasons: 1, 2, 3, 4. We CAN make eating right amounts of vegan food VERY satisfying by integrating culinary arts with dietetic and nutritional science and skill. We educate and nurture our clients - in person and electronically. Value-Added venue that is affordable (on both sides) and sustainable.
Thursday, October 04, 2012
How to DO Animal Rights! Free Online eBOOK
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Animal Rights Motto
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| Free Use Animal Rights Paintings, Prints, Posters |
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 Your completely freeonline-book to action animal rights. |
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| Buy the book version ofHow to Do Animal Rights. |
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This web site, How to Do Animal Rights, is your completely free online-book about how to do animal rights as a practical and legal activity. Find out what animal rights (and welfare) are and be an activist!
You are welcome to copy the text of this online guide for your non-profit use to promote animal rights. You may also buy the printed paperback version or the ebook version of this web site. We live in a human-made animal holocaust and mass extinction about which most people give no thought. So let's defend life and promote a humane society. Pursue animal rights as a meaningful and legitimate successful activity! The greatest threat to people is ignorance. The greatest threat to animals is ignorant people.  |  |
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Chapter 1
Introduction
Introduction
- 1. The Broad Setting
- the big problem.
2. Mass Extinction
- we live in the Sixth Extinction.
3. Animal Holocaust
- we live in an enduring and worsening animal holocaust.
4. World Scientists' Warning to Humanity
- scientists attempt to alert the world to the impending catastrophe.
Chapter 2
Philosophy: Key Topics
Philosophy: Key Topics
- 1. Animal Rights
- know what animal rights are.
2. Equal Consideration
- are animal and human moral interests equally important?
3. Animal Ethics
- rationally defend your animal rights activism.
4. Consequentialism
- the morality of your action depends only on its consequences.
5. Deontology
- the morality of your action depends only on doing your duty.
6. Virtue Ethics
- the morality of your action depends only on your character.
7. Comparing Philosophies
- comparing animal rights with ethics, welfare & conservation.
8. Deep Ecology
- contrasts with animal rights and gives it perspective.
Chapter 3
Campaigning: Methods for Animal Rights
Campaigning: Methods for Animal Rights
- 1. Campaigning
- change society for the better.
2. Civil Disobedience
- campaign by civil disobedience to right injustice.
3. Direct Action
- a stronger form of civil disobedience.
4. Action Planning
- take care that your activities are successful.
5. Lobbying
- sway the prominent and influential.
6. Picketing
- protest your target visibly and publicly.
7. Starting a Group
- find and organise your troops.
8. Leafleting
- reach out to influence people.
9. News Media
- use and handle the news media.
10. Internet
- communicate globally with the widest reach.
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Chapter 4
Activities for Animal Rights
Activities for Animal Rights
- 1. Teacher
- a most effective way of opening minds to ideas.
2. Animal Lawyer
- practice law to advance animals and their allies.
3. Undercover Investigator
- amass the evidence that animal advocates fire at abusers.
4. Video Activist
- seize people's attention by bringing home vivid reality.
5. Animal Preacher
- expound The Word for animals.
6. Animal Rescuer
- liberate abused animals.
7. Investigative Reporter
- probe questionable activities hidden from the public.
8. Media Watcher
- sway the shapers of public opinion.
9. Street Theatre Actor
- perform and entertain for animal rights on the streets.
10. Blogger
- use your creative writing skills for animals.
11. Philosopher
- philosophers do it by reasoning.
12. Flyer
- look down on your opponents to see what they are up to.
13. Personal Activist
- includes the single most effective thing you can do for animals.
14. Author - Playwright
- write short stories, novels and plays of the animal rights genre.
15. Animal Friendly Traveller
- prepare yourself for travel abroad.
16 Politician
- start your own animal political party.
17. Prisoner Supporter
- succour animal rights prisoners.
18. Public & School Speaker
- orate on behalf of animals.
19. Aerial Snooper
- reconnoitre and photograph by remote control.
20. Scientific Investigator
- plan, scrutinise, analyse and report.
21. Solo Information Worker
- display info and eye-catching knowledge.
22. Voluntary Worker Abroad
- jump into far-off cultures for animal rights.
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Chapter 5
The Law & Animal Rights
The Law & Animal Rights
- 1. Terrorism
- a few people wielding disproportionate pressure - but are they just?
2. Violence or Nonviolence?
- can we licence violence?
3. The Law - US & Britain
- what might you be up against?
4. Police Arrest
- prepare by knowing what to expect.
Chapter 6
Animal Statistics
Animal Statistics
- 1.Summary
- some of the billions people kill annually.
2.Meat Statistics
- how much meat do people eat?
3. Chicken Statistics
- how many chickens do people keep & kill?
4. Pig / Hog Statistics
- people kill 23 million pigs a week.
5. Sheep & Goat Statistics
- how many sheep & goats do people keep & kill?
6. Beef Cattle Statistics
- how many cattle do people keep & kill?
7. Fish Statistics
- how much fish do people farm and catch from the sea?
8. Fur Animal Statistics
- the fur trade kills endless millions and threatens species.
9. Numbers of Animals in Biomedical Research
- how many animals do people experiment on in laboratories?
10. Human Overpopulation
- the more people the more animal abuse.
Chapter 7
More Philosophy
More Philosophy
- 1. Anthropocentrism
- everything is secondary to human needs.
2. Anthropomorphism
- humanising animals.
3. Environmentalism
- how to interact with living and inanimate nature?
4. Golden Rule
- a simple moral test that guides our behaviour.
5. Intrinsic Value
- do animals have value in themselves?
6. Is Ought Fallacy
- facts (is) are one thing whereas value judgements (ought) is another.
7. Painism
- is it morally wrong to cause severe pain to reduce a lesser pain?
8. Subject of a Life
- an animal is a subject of a life and a singular individual.
9. Moral Daggers: egoism, emotivism, subjectivism
- are moral judgements merely emotional flows?
10. Utilitarianism
- the greatest good to the greatest number - but minorities watch out.
11. Absolutism
- a standard by which you can judge everything.
12. Contractarianism
- why some people are against animal rights.
13. Legalism
- does the law always say what is morally right?
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Chapter 8
Animal-Human Issues (Some of Them)
Animal-Human Issues (Some of Them)
- 1. Bearskin Hats
- the British army makes hats of bears.
2. Bushmeat
- over five million tonnes of animals from West Africa alone.
3. Chickens - Broilers
- cheap mass-production of chickens for the supermarkets.
4. Chickens - Egg-laying Hens
- five billion egg-laying hens.
5. Climate Change
- the greatest burden on our moral behaviour.
6. Foxhunting with Hounds
- honourable sports do not harm other beings.
7. Fur Brushes & Bows
- do not forget the forgotten fur (and bows).
8. Fur Farming
- the fur trade is money and slaughter.
9. Fur Marketing
- pelts pass through many international stages before getting to women.
10. Fur Morality
- fur-wearers are the ultimate key to the fur trade's existence.
11. Fur Species & Sales Value
- animals the fur trade wastes.
12. Fur Trapping
- devastated native peoples and eradicated animal populations.
13. Factory Farming
- one of the primary issues in animal rights.
14. Goldfish Bowls
- making life multi-problemed for ornamental fish.
15. Human Superiority
- we cannot judge animals solely by human values.
16. Mutilation of Farm Animals
- trying to fit animals to farms, not farms to animals.
17. Religious Tradition
- styles of religious thought clash with animals.
18. Zoophilia
- something the animal rights debate does not discuss.
19. Zoos
- what are zoos for?
Chapter 9
Science
Science
- 1. Altruism
- why do you help others?
2. Behaviourism
- it seriously retarded research on animal minds.
3. Brain: milestones of understanding
- the main medium of thoughts, feelings and behaviour in animals.
4. Clever Hans the Counting Horse
- a lesson about attributing to animals characteristics they do not possess.
5. Consciousness
- how do we know other species are conscious?
6. Mirror Test of Animal Consciousness
- giving animals a mirror to see if they are self-aware.
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Chapter 10
Ideas
Ideas
- 1. Animal Rights Motto
- a forceful motto for your animal rights work.
2. Expanding the Circle
- extending our moral circle outwards from humanity.
3. Cat Traffic Training
- do not let the motorist nobble your cat.
4. Dog Training
- communicate effectively with your dog with these effective tips..
5. The Five Freedoms
- ideals of welfare more honoured in the breach.
6. Great Apes
- bestowing rights on great apes.
7. Han means He or She
- avoid repeating 'he or she' all the time.
8. It - Stop Calling Animals It
- calling animals 'it' degrades them into the class of things.
9. Number Fallacy
- because there are lots of them it is all right to kill them?
10. Invertebrate Harmony
- we should try to live in harmony with all creatures.
11. Posters, Paintings, Cartoons & Prints
- use these graphics freely.
12. Predation
- predators cannot make moral choices and predation is vital for life.
13. Soul
- do humans have souls while animals do not?
14. Think Like an Animal
- thoughts need not be based on language.
15. Euphemisms
- beware the hidden euphemism.
16. Universal Declaration on Animals
- the hope is to recognise animals as sentient beings.
17. Universal Declaration on Animal Welfare
- draft of the Universal Declaration on Animal Welfare.
18. Vegetarianism
- making a start is a declaration example.
19. Vermin
- ecological rivals are competitors not scum.
20. Wolf Ethics
- do not lose a major battle to live with animal life.
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Chapter 11
Personalities
Personalities
- 1. Aquinas, Thomas
- God made animals for man and it is not a sin to kill them.
2. Aristotle
- animals cannot reason so we can use them without consideration.
3. Bentham, Jeremy
- the question is not can animals reason but can they suffer?
4. Copernicus, Nicolaus
- humanity does not occupy a privileged position in the cosmos.
5. Darwin & Natural Selection
- explained how humans are animals that evolved from animals.
6. Descartes
- propounded that animals are automata, a view adopted by science.
7. John Lawrence
- on of the earliest modern writers on animal rights.
8. Richard Martin
- he fought for laws and duelled for animals.
9. Henry Salt
- the first animal rights book.
10. Steven Best
- we are in a battlefield not at a bargaining table.
11. Andrew Linzey
- the face of Christianity embracing animals.
12. The McLibel Two
- laid bare the nasty deeds of quick food business.
13. Ingrid Newkirk
- a wheel needs all its spokes to make it go round.
14. Jill Phipps
- a hero whose actions will inspire.
15. Henry Spira
- the most effective activist of the modern animal rights movement.
16. Philosophers Three
- activism comes in words as well as deeds.
Chapter 12
Sundry Animal Rights Stuff
Sundry Animal Rights Stuff
- Posters, Paintings, Cartoons & Prints
- use these freely for your non-profit animal rights work.
Glossary
- glossary of animal rights and related terms on this web site.
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