Letters
What about solo docs?
To the Editor:
Family Practice Management seems oriented more toward large groups and clinics, further marginalizing the dinosaur solos.
Peter J. Gates, MD
Ledyard, Conn.
Editor's response:
I'm sorry you have that impression of FPM, because we are trying to serve family physicians in virtually all practice models. The range of settings in which family physicians practice is so broad, and the journal is so slender, that it does present a challenge to have something for everyone. Still, most of each issue, from "Coding and Documentation" to "Balancing Act," should be useful to any practicing family physician.
Two elements in this issue in particular may interest those in solo practice:
- "A Model for Successful Rural Practice," page 41, describes how a rural community and its physicians found creative solutions to the problems of rural health care.
- "Practice Diary," page 57, offers real-life, frontline lessons from Sanford J. Brown, MD, a solo family physician.
On the other hand ...
To the Editor:
Every month, I eagerly await your publication! It's a great source of management information for us solo docs. Keep up the good work!
Shafik Ahmad, MD
Dayton, Ohio
Victim of disintegration
To the Editor:
I have just become a victim of "disintegration," and as I re-establish my family practice in the area, I will once again start taking hospital call and admitting patients -- something I'd been able to stay away from for the past 15 years.
Thank you for helping me with both of these issues by providing the standardized admit orders [November/December 1999, page 30] as well as the recent articles on disintegration ["Disintegration: How Employed Doctors Are Landing on Their Feet," November/December 1999, page 36, and "Is Disintegration the Answer?" February 2000, page 25].
Edgar B. Powers, MD
Stone Mountain, Ga.
Important code for FPs
To the Editor:
The article "CPT Changes for 2000" [January 2000, page 15] missed a very important new CPT code: 99173, "Screening test of visual acuity, quantitative, bilateral."
According to CPT, to use this code, the screening test "must employ graduated visual acuity stimuli that allow a quantitative estimate of visual acuity (e.g., Snellen chart). Other identifiable services unrelated to this screening test provided at the same time may be reported separately (e.g., preventive medicine services). When acuity is measured as part of a general ophthalmological service or of an E/M service of the eye, it is a diagnostic examination and not a screening test."
This is a very important CPT code, especially for family physicians doing children's vision screening. A simple vision screening test can find common eye problems such as amblyopia, suppression and strabismus that can impede a child's development and performance if uncorrected.
Christy J. Bendersky
Chicago
Stark and rural offices
To the Editor:
In your September 1999 issue, an Ask FPM question addressed Stark regulations and a potential relationship between two physicians with ultrasound equipment ["Stark Regulations," page 58].
In this question, the author said he had a rural office. My understanding of the Stark regulations in the Federal Register (Jan. 9, 1998) is that if the parties are located outside of a Metropolitan Statistical Area they are exempt from Stark. Has something changed since then, or am I incorrect?
Paul Ullom-Minnich, MD, MPH
Moundridge, Kan.
Response:
There is a rural exception in the Stark law and regulations. Specifically, section 1877(d)(2) of the Social Security Act provides that designated health services furnished by an entity in a rural area are not considered to be an ownership or investment interest otherwise prohibited under Stark if substantially all of the designated health services furnished by the entity are to individuals residing in a rural area.
Section 1886(d)(2)(D) of the Social Security Act defines the term "rural area" as any area outside a Metropolitan Statistical Area (as defined by the U.S. Office of Management and Budget). Thus, your understanding of the exception is generally correct.
It should be noted that there are other exceptions beyond the group practice exception mentioned in FPM and the rural exception mentioned above.
Kent J. Moore
Manager, Health Care Financing
and
Delivery Systems
AAFP
Leawood, Kan.
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We want to hear from you. Letters is an open forum for our readers. Write to Letters Editor, Family Practice Management, 11400 Tomahawk Creek Parkway, Leawood, KS 66211-6272. If you prefer, fax your letter to 913-906-6080. You may also contact FPM by e-mail at fpmedit@aafp.org. Include your address, daytime phone number and fax number, if any. Letters may be edited for length and style. All letters sent to the editors of FPM are presumed to be intended for publication unless otherwise specified in the text of the letter. Submission of a letter constitutes transfer of the copyright to the AAFP. |
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