Wake Forest University, which runs a medical school, wants to build an eight-OR facility, adding seven rooms to its total inventory and relocating one existing room to the new center.

The facility would also include two teaching rooms to simulate operating and robotic surgery techniques for medical students.

Read the Business Journal Serving the Greater Triad Area’s report on Wake Forest University Baptist Medical Center.

Wake Forest Medical Center in North Carolina Proposes 8-OR ASC

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2. Don’t live in a bubble. Great leaders listen to their people, obtaining a variety of perspectives from a variety of sources. This helps them distill their own decision-making. They ask employees what they think and probe them on the pros and cons of a proposal. This not only shows employees that they are valued but also gets the leader closer to the best solution.

3. Cherish and respect employees. Leaders function as enablers, helping employees perform their jobs to the nth degree. A leader can only get work done through other people. Employees who get respect will produce at their highest capacity and make the leader look good. Make sure people have the tools to do their jobs — and the freedom to make mistakes!

4. Choose a clear mission. Leaders make sure the mission of their organization is plainly articulated and followed day in and day out. A mission statement can sound nice and look really good, but it has to be more than a bunch of words. It should be the very heart and soul of what the organization is about. It should inspire and direct.

5. Demonstrate integrity. Successful leaders recognize that the way they behave reflects the principles and ethics of the organization. Integrity and ethics are essential for any leader. A leader cannot just be “one of the boys.” Leaders need to stand above the rest and show the way.

6. Be transparent. Great leaders don’t believe in secrecy or closed-door meetings. They must conduct themselves with transparency and openness so that rumors don’t start and employees don’t feel shut out. Leaders who are frank rather than evasive — even about difficult issues — will be able to win employees’ trust.

7. Embrace responsibility. Outstanding leaders come in all shapes and sizes, from a variety of backgrounds, but what really sets them apart is their enjoyment in taking on responsibility and willingness to make tough decisions when necessary. Leaders don’t waffle or equivocate. They make sure their decisions are fair-minded and balanced.

8. Share credit. Leaders know the value of giving credit to others, even as they step forward immediately to take the blame for losses, so that their people are protected and valued. “A leader is best when people barely know he exists,” the Chinese philosopher Lao Tzu said. “When his work is done, his aim fulfilled, they will say, ‘We did it ourselves.’ ”

9. Leadership isn’t for everyone. Not all that many people want to take the hard hits that leaders have to absorb, regardless of whether they run a hospital, a clinic or a restaurant. A study of graduate students several years ago showed that well over 60 percent did not want the responsibility of being a leader. While there are many talented people, only a select few will embrace a leadership role.

10. Have courage. Leadership requires courage. Leaders have to go beyond just taking care of their own careers. They need to engage in calculated risks that will secure the future of the whole organization. This is especially important in these trying times, when healthcare is faces so many enormous challenges.

Chuck Lauer ( chuckspeaking@aol.com ) was publisher of Modern Healthcare for more than 25 years. He is now an author, public speaker and career coach who is in demand for his motivational messages to top companies nationwide.

Chuck Lauer: 10 Points on Leadership

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Ms. Coakley’s office based the findings on a year-long study of the Massachusetts market, finding that about 10 hospitals enjoy reimbursements 10-100 percent higher, for similar work, than reimbursements for the other 55 hospitals in the state.

The office’s report says the 10 favored hospitals had brand-name recognition or few competitors in their markets, but it did not name any provider or insurer, saying its aim was to identify systemic problems and not blame individual organizations.

Based on its findings, the report recommended against establishing global payments covering a patient’s entire medical care for an illness, an approach recommended by a state commission.

The study concluded that higher healthcare costs are basically caused by rising prices, not increased demand for new services. One major insurer reported provider price increases accounted for 80 percent of the growth of medical expenses from 2006-2009.

The report called on the state to:

• Discourage or prohibit contract provisions that perpetuate market disparities;
• Increase transparency and standardization in payment and quality;
• Reform payments to account for market distortions; and
• Encourage development of a “value-based” healthcare market.

Read the Massachusetts Attorney General’s release on health insurance reimbursements.

Massachusetts Report Finds Hospitals’ Negotiating Clout With Insurers Drives Up Costs

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Federal prosecutors allege that William S. Burke diverted to a personal bank account charitable contributions from the hospital’s “Dare to Care” fundraising program and medical-supply rebates to the cardiovascular center from 2007-2009.

Hospital employees reported the alleged theft to federal law enforcement officials and Burke left South Shore in Oct. 2009, after more than four years of service.

Read the Enterprise News’ report on South Shore Hospital.

Former Hospital Executive Charged With Stealing From Donations

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Dr. Baumann’s promotional statements about Dysport, which were made to two magazines and NBC’s “Today Show,” were reportedly made in 2006, prior to the drug’s FDA approval. The statements were therefore in violation of the FDA’s regulations on pre-approval promotion, the agency said in its letter.

Dr. Baumann was involved as a researcher in Phase III trials of Dysport, also known as Reloxin, at the time she made the promotional statements, the FDA stated.

Dr. Baumann’s statements about Dysport included claims that its effects “last a month longer than Botox (onabotulinumtoxinA, Allergan, Irvine, Calif.),” the FDA letter cited. The FDA approved Dysport for treating forehead wrinkles and frown lines last spring. Ipsen granted distribution rights for the drug’s cosmetic use to Medicis (Scottsdale, Ariz).

FDA issues warning letter to researcher about promoting Ipsens Dysport

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The Senate recently passed pay-as-you-go legislation requiring Congress to offset new spending or tax cuts with corresponding spending cuts or tax increases, and the House passed a similar bill last year and is expected to take up a new version next week, The Hill reported. The Senate bill includes an exemption from pay-as-you-go for the physician payment fix. Specifically, it would allow Congress to spend up to $82 billion for physician payments without having to find offsetting savings or revenue sources. This amount would be enough to lock in fees at their current rates for five years.

The American Medical Association and other physician groups — joined by AARP — have been lobbying for a more expensive overhaul to the Medicare physician payment system, known as the sustainable growth rate formula, or SGR. Passing a permanent fix could cost $200 billion, according to a Feb. 2 report in Politico. Finding such a solution tops the AMA’s healthcare reform agenda.

Read The Hill’s report on physician fee cuts.

Five-Year Fix for Medicare Doctor Pay Cuts in Works

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It is clear to me that when a physician is hired to do research, the output of this research should belong to the hospital, and the hospital should acknowledge his/her contribution by giving away part of the benefits obtained from it. In this case, the new idea would probably have been unthinkable outside the premises of the hospital, without its infrastructure and assets, so it makes sense.

But what happens if an employee has an idea, let’s say, related to his/her field of experience but not necessarily linked to research? Let’s take this example, if an OR Nurse perceives a need and thinks about a solution to this need while in the operating room, let’s say a new medical device, should the idea belong to the hospital? Well, yes, the idea came to them because they were working at the hospital, but can the hospital claim any ownership over it?

Who is the owner of the idea, then? It may seem a futile discussion, but to me it represents the most important barrier to innovation in our healthcare systems, so it is far from trivial. Sometimes employees don’t engage in innovation because they perceive the ownership issue as unfair. If we want to foster innovation in healthcare, this question needs to have a clear answer. At the end of the day, it all goes down to how the hospital sees healthcare professionals: Do employees work for the hospital, or do they work at the hospital?

Are hospitals really willing to encourage innovation and intrapreneurship inside their premises? Are hospitals willing to create a culture of reward for those entrepreneurs? There is a lot to be gained here: if the hospital succeeds in fostering innovation, it can create a great environment to attract talent, lead, and generate economic value and social impact.

People do respond to incentives. That’s something I learned very early when dealing with innovators and entrepreneurs. Innovation should not trigger a war between the healthcare facility and the employee. It should always be a win-win scenario where both parties can create a lot of value if they cooperate. So, in my opinion this is not about claiming ownership, but about both parties acknowledging how far can they go and how better they will be if they work together, and share the ownership. That’s the answer that makes sense to me.

Intrapreneurship

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Currently, optometrists in West Virginia can perform eye exams and prescribe glasses and contact lens. They are prohibited from performing surgery, giving injections or ordering lab tests, according to the report.

If the bills pass, optometrists would be allowed to perform surgery involving lasers and scalpels and to give injections around the eyes. The bills would also expand the state’s Board of Optometry authority, which could expand optometrists’ ability to prescribe medications.

Ophthalmologists say that approval of such a bill could pose a patient-safety risk, as only ophthalmologists have the medical training to understand how certain drugs interact, according to the report. Additionally, ophthalmologists worry that some optometrists have only had weekend training in certain procedures that require more in-depth study.

Optometrists say that the bills would expand coverage to patients in rural areas, who currently have to drive hours to see an ophthalmologist.

Florida recently proposed a similar law that would allow optometrists to prescribe certain eye medications in oral form, which has been met with similar opposition.

Read the Gazette’s report on optometrists’ scope of practice.

W.Va. Optometrists Next to Request Removal of Practice Limits

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Under Paterson’s bill, PBMs would be required to disclose the actual use of drugs by the health plan’s participants, any conflict of interest that the PBM might have with the health plan, any increase in the net price to the health plan for a covered drug and the reason for the increase, and all contracts entered into by the PBM with a network pharmacy or pharmaceutical manufacturer. The bill would also notify patients and disclose any relevant clinical and financial information to prescribers before a PBM could switch a patient to a more expensive drug, the governor said in the press release.

Gov. Paterson proposes bill to require disclosure from PBM

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In a recent study, published in the Journal of Cellular Physiology, researchers focused on the 16INK4A due to its suspected role in retinoblastoma progression and its link to familial cancer predisposition.

In the study, Marco G. Paggi, M.D., Ph.D., and colleagues assessed blood samples taken from 29 patients and their parents. They found low to moderate 16INK4A protein expression in five of 11 (45%) retinoblastoma tumor specimens. They also found reduced p16INK4a RNA expression in blood in 16 of 29 (55%) retinoblastoma patients compared to normal controls. This reduction was associated with the depletion of the p16INK4a gene, the researchers said in the release.

The researchers also found reduced expression in at least one parent among nine of the 16 (56%) patients with reduced p16INK4a RNA expression. This suggests a heritable susceptibility to retinoblastoma, the researchers said.

Gene expression may be linked to retinoblastoma progression

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