Problems With Obtaining Certification From the ABIM? Recommendations For Physicians

Facing Possible Discipline or Sanction? Obtain Legal Counsel Early.

If you are a physician who receives a letter regarding improprieties or possible disciplinary action from the ABIM regarding your certification, it is important that you obtain legal representation at the very outset. Any statement you make to the ABIM, written or oral, can be used against you as an admission.

Tips for The Physician.

The following are some tips which may help prevent mistakes that can compromise a defense in such matters:

1. Retain the services of an experienced healthcare attorney who is familiar with such matters, immediately. The American Health Lawyers Association or your state bar association are good sources. Ask for a referral of a health lawyer who represents physicians.

2. Avoid e-mailing or discussing your situation on any listservs or blogs. You do not know how many places such communications may wind up, and your complete identity will be easily determinable. The specialty boards and other certifying bodies routinely monitor these.

3. Be completely candid with your attorney and reveal all facts, documents and prior communications that have occurred. Your attorney cannot effectively represent you otherwise.

4. Do not let any deadlines go by without requesting, in writing, via a verifiable method (not e-mail) that you have requested a review, hearing, appeal or other due process rights. “Verifiable” means sent by a method that can be tracked and receipt of which is documented (e.g., U.S. express mail with a return receipt requested, Federal Express, etc.).

5. Make sure any correspondence, documents, requests for hearings, requests for appeals, etc., are actually received (not mailed) by the ABIM by the date given. Keep documents proving this and follow-up.

6. If there is documented proof that you have actually been involved in a compromise of the examination, sometimes it will be advisable to admit this to the committee, produce any mitigating factors, apologize and propose a less harsh sanction. (Note: this will be contrary to what most defense attorneys would ordinarily recommend.) In the face of convincing evidence that you breached the rules, this may be the most reasonable and least damaging course to pursue.

7. Review any employment contracts, independent contractor agreements, provider agreements with third-party payers and medical staff bylaws (for hospitals at which you have privilege) with your attorney to determine if you are required to report this event.

8. Advise your employer (or prospective employer) of the situation and offer to do whatever is required to help alleviate any problems this causes to your employer.

9. See if your employer (or prospective employer) would be amenable to negotiating an amendment to the terms of your employment, including different duties, more supervisory, administrative or managerial duties, lower salary, etc., if necessary. Also consider requesting a postponement of starting date, leave of absence, sabbatical or other alternatives to full-time employment.

10. Explore charitable work and community service opportunities, such as service in community health clinics, volunteering in free/charity clinics and hospices, volunteering for overseas medical organizations such as Physicians without Borders, service in medically under served areas, and similar opportunities. This might also serve as a basis to convince ABIM to reduce the period for retaking the exam or becoming certified.

11. Every individual, case and situation is unique. You should consult with your attorney on every issue and follow his or her advice.
Tips for the Employer or Prospective Employer.

Here are some recommendations for the employer or prospective employer of a physician who has received notice from ABIM that he or she will not be certified:

1. Consult your healthcare attorney regarding the matter immediately.

2. If your contract with the physician requires him or her to be board certified (as almost any well-written contract will require) and it does not appear he or she will be able to meet this requirement, this will most likely be grounds to terminate or void the contract.

3. Attempt to obtain complete information from the physician on what his or her exact circumstances are and whether or not he or she is likely to become certified in the near future.

4. The easiest and least expensive resolution may be to terminate the physician’s contract, if the contract provides for this. The more complex and more expensive resolution may be to negotiate an amendment to the physician’s contract and to try to find alternative duties for the physician.

5. If it looks like you will be terminating or voiding the contract, start looking for a replacement physician right away. (The law requires you to mitigate your damages.)

6. If you have a medical group, use group numbers to bill third-party payers, and the physician is a member of your group or is a participating physician on the panel of the payer, review your provider contracts to determine if you must report this or take action to avoid having the payers’ patients treated by the physician.

Tips for Interviewing Doctors – Using Authentic Videos to Strengthen the Doctor-Patient Relationship

Our recent experience producing video interviews for a wide range of professional service providers shows, first of all, that authentic marketing is the key. It is important to recognize that authentic video marketing is significantly different (and more effective) than traditional, commercial video advertising — especially when interviewing doctors, nurses and healthcare specialists. This essentially means editing out any segments that appear to be overly staged, contrived, practiced, unnatural and exaggerated. Similarly, it makes no sense to add background music, special effects, extensive voice-over narration and animations that distract from the authenticity and reality of the interview.

Keep in mind that the primary objective, in most cases, is to capture sincere and understandable answers to top-of-mind questions that a patient might want to ask of his or her doctor and other healthcare service providers. After all, these are the professionals entrusted with making decisions about a person’s future health, medical procedures and treatments, recovery, medical bills and general well-being! The next objective is then to get the message out so it is actually seen and heard by the “target audience” – the current and future patients visiting the hospital, medical center or doctor’s office. Current patients need assurances that they’re getting the best possible medical care; prospective patients may be asking some of the same questions as they evaluate the alternatives. In both cases the interview video needs to be sufficiently interesting, relevant and entertaining to keep the viewer’s attention.

Getting the targeted viewers (or “eyeballs”) is the topic of a separate article in this series that covers search engine optimization (“SEO”) and other relevant video marketing strategies for health care professionals. An important prerequisite, however, is ensuring that the video content is appropriate and effective.

Here’s a short preparation checklist to ensure effective video interviews:

  • pick a working title and subtitle
  • write a preliminary description
  • identify the target audience and relevant keywords
  • prepare relevant and interesting questions based on the interview objectives
  • outline and discuss the most appropriate answers and calls-to-action.

Following the shoot, the video material must be edited and reduced to produce the final product:

  • combine multiple audio and video channels into a single project
  • delete unusable segments and pauses; add transitions
  • finalize the title with an engaging subtitle
  • finalize a short description
  • finalize the keywords
  • choose a thumbnail image to spark curiosity
  • review and score the questions and responses based on how well they meet the interview objectives
  • split into multiple videos if appropriate; restructure and re-sequence as necessary
  • record voice-over questions and narrative as appropriate
  • add the credit trailer, copyright/watermark and call-to-action links
  • publish as appropriate on websites, YouTube, Facebook, LinkedIn, CCTV and other media
  • add search engine optimization and other elements of an effective video marketing strategy.

Specifically for medical professionals (primary care physicians, specialists, surgeons, psychologists, chiropractors, nurses, you name it), we have highlighted six aspects that need special attention to ensure that video interviews achieve their maximum potential:

Reputation – Relevant professional recognitions, special awards and achievements should be highlighted through one or more leading questions since it is important for the patient to understand that the interviewed medical professional is the best of the best. Educational background information and hospitals where residency requirements were completed may also be relevant to emphasize exceptional professional qualifications.

Trust – Building personal trust is perhaps the most subjective and most significant factor that influences whether a prospective patient “likes” the doctor. In addition to projecting a friendly and caring demeanor through facial expressions, appearance and word choice, it is also important to convey messages such as working closely with patients to determine the best way to help them and listening carefully to help patients make the right health care decisions.

Professional Preferences – A video interview obviously provides a public platform for a doctor to express his or her personal opinions, preferences and philosophies about quality of life and healthcare issues. The objective would typically be to establish the basis for an authentic and sincere discussion in addition to attracting patients who agree and share the same beliefs and convictions. For example, a doctor may wish to talk about his areas of specialization and preferences concerning prescriptions, lab tests, referrals, disease treatment, wellness, prevention, new treatments, new medicines, etc. Lead questions can then be formulated to give the doctor the opportunity to include this information in his answers.

Goals – Patients are always interested in hearing what the personal motivation was to study to become a doctor, the personal and professional goals and milestones achieved so far, and future goals. For example, what is the personal motivation behind involvement in specific research or working with patients with specific medical conditions?

Nursing Staff and Office Staff – Where possible, it is often valuable to include the nursing or office staff in the video interview to show that they are friendly, helpful and eager to answer practical questions about office hours, the average waiting time, returning calls promptly, emailing, telephone consultations and after-hours care.

Colleague & Patient Testimonials – Since medical professionals often rely heavily on referrals to attract new patients, it may be valuable to include one or more colleague referrals and testimonial clips as part of an interview video. Healthcare success stories with before-and-after images are useful, provided that HIPAA privacy rules are followed and any necessary consent forms are signed. Including approved interview videos on websites and social networking sites (Facebook pages, YouTube channels, LinkedIn, etc.) facilitates sharing and word-of-mouth recommendations.

OK – so now you’ve recorded a great interview with optimal content and need to get it “published” where your target audience will see it on your website, YouTube channel, CCTV and elsewhere. Tip: if you still need help with recording and editing your video interviews, then you may want to consider outsourcing and employing the services of a video marketing specialist (local or remote) together with Google Hangouts, GoToWebinar or a similar videoconferencing platform. Videoconference interviewing, when done properly, can be used to produce high-quality results from multiple locations at a significantly lower cost… optionally using an iPhone, iPad or smartphone with a high-definition (HD) camera. Read the other articles in this series to learn more about videoconference interviewing, publishing your interview videos and using social media to achieve results.

11 Tips For Traveling With ME/CFS or FM

Traveling long distances with ME/CFS or FM – most of us avoid it at all costs! It’s just too much for our bodies to handle!

I had the very same opinion because I was (and still am) largely housebound due to Post Viral Fatigue Syndrome (also known as ME/CFS). But as a result, I had forfeited seeing my beloved family (who live abroad) for four long years. So recently, I decided to ‘bite the bullet’ and go. Post Viral Fatigue Syndrome or not.

I had a lovely time there, but the voyage there and back raised quite a few issues for me as a sufferer of Post Viral Fatigue Syndrome.

When it comes to ME/CFS no one sufferer has the same experience as the next. For a start, you may suffer from this condition less or more severely than I do. You probably also experience a different mix of symptoms. But there are a few things you can bear in mind if you do plan on making a long trip:

1) Rest adequately beforehand.

This might mean not exerting yourself mentally or physically for a number of days or even weeks beforehand – easier said than done, I know. But bear in mind that resting is a BIG priority PRE-trip.

2) Plan your trip.

Leave LOTS of time in-between train, bus or plane times so that you don’t have to rush. **Over-estimate** the amount of time it will take you. That way, if you get there early you can just sit and rest instead of rushing and stressing, which will only make you feel more weak and ill.

3) Get help.

If you’re making a long trip then it’s advisable that you ask someone (like a relative or friend) to accompany you there and back. Ideally this would be someone who understands your condition and how it affects you. If you have trouble walking (or if this wears you out too much usually) then consider asking someone from the train or plane company to meet you with a wheelchair. Most large commercial companies seem to offer this service, but you usually have to tell them in advance. You might also consider using a walking stick. Anything to help you get there in one piece, right?

4) Don’t rush.

Pack slowly. Don’t leave it until the last minute! I had an open suitcase in my bedroom in which I put things as I thought of them. I also made a check list for the morning of the trip, so that I didn’t forget the things that I needed to pack after using them that morning (like toothbrush, toothpaste, tablets etc).

5) Pack light!

If you’re going on a short trip, then maybe you can get away with not packing any luggage at all?

—– SIDE NOTE —–
If you’re traveling to a different time zone, consider taking some ear plugs and a light-blocking sleep mask with you, just in case you need to sleep during the day.
—– SIDE NOTE —–

6) Don’t forget to pack your medicines, vitamins, and supplements!

Don’t make the mistake of not packing enough. Count out how many tablets you’ll need just to make sure.

7) Warn the people you’re going to be staying with about your needs.

This may be your family, friends or the hotel manager. Let them know about your sleeping habits and your dietary needs. Is there anything you *can’t* eat or drink? Caffeine or dairy, for example? Should they get some special food or drink in like say, soya milk?

8) Bring a book on ME/CFS with you just in case the people you stay with are interested in your condition.

If you have ME/CFS then I really recommend Lynn Michell’s book ‘Shattered’, because it really explains what it’s like to live with the condition. AND it packs a punch – just in case you face any skepticism while you’re there! No need to start explaining yourself – just hand them the book. 😉

———- SIDE NOTE ———-

To read a complete review about Lynn Michell’s book, visit:

http://www.sleepydust.net/CHRONIC-FATIGUE-SYNDROME-AND-TREATMENT-book-LM-shattered.html

———- SIDE NOTE ———-

9) Sensory overload.

When you suffer from ME/CFS, visual and aural stimuli can be too overwhelming for your brain to process adequately. This is especially true when you’re traveling…

… the noise of the train, bus or plane, the chatting people, the fast moving countryside outside, the throng of other travelers…

All of this can play havoc with your brain and can end up making you feel even *more* exhausted, and your brain even *more* foggy!

There’s not much you can do about this. But say you’re on a train for example – if the fast moving countryside is making you feel dizzy, then try to avoid looking out the window. Close your eyes if you have to, or wear a sleep mask. If you find that you’re getting dizzy and tired when you’re in a busy corridor full of commuters in the subway for example, stop and face the wall for a few seconds to regroup and regain your clarity and balance.

10) Wear some magnetic insoles.

I had made it a point to see my Nutritionist/ Kinesiologist before I left for my trip abroad. She tested me with all the supplements I took daily, and found that the ‘Pure Synergy’ superfood powder really raised my vital force (see point 11 below).

But perhaps even more astounding was the magnetic insoles she gave me – they raised my vital force so much that at first, it literally felt like I was standing on a power pod! I could even feel a subtle tingling sensation in my legs!

I wore my magnetic insoles on the trip and I have to say that I *did* feel more energized! It’s a very subtle feeling and after an hour or so of using them the tingling went away. You may or may not have the same sensations when you first try them – depending on how severe your ME/CFS is and how susceptible you are to external forces. But they’re well worth a try. I now make it a point to wear my magnetic insoles whenever I have to venture outside and now that I know how much they help me, I most certainly wouldn’t be without them.

———- SIDE NOTE ———-

You can check out my full review of wearing magnetic insoles here:

http://www.sleepydust.net/ME-CFS.html#magnetic

———- SIDE NOTE ———-

11) Perhaps most importantly, pack some nourishing food and supplements specifically for your voyage.

It’s important to eat small amounts regularly especially when you travel. It’s not a good idea to eat sugary foods or anything containing caffeine (including coffee, tea, sweets or chocolate) because although that may pep you up for the first few minutes, they are likely to make you feel a lot worse in the long term.

I took a few of Dr Gillian McKeith’s ‘Living Food Energy Bars’ with me – I always keep a spare one in my handbag for emergencies anyway. Nuts are also a great idea when you’re traveling (if you’re not allergic to them that is).

I also took some of that amazing ‘Pure Synergy’ superfood powder, and mixed it in with some cooled herbal tea in a small bottle. No sugar. No caffeine.

It was my energy pep-up drink – and I swigged it all the way back on my voyage. It did the trick.

———- SIDE NOTE ———-

You can read my in-depth review of Pure Synergy here:

http://www.sleepydust.net/ME-CFS.html#pure

———- SIDE NOTE ———-

So there you go – eleven things that will help to make any long trip less stressful and exhausting. Bon voyage!

Copyright, Claire Williams, 2003-2005. All Rights Reserved.

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