MDNews - Minnesota

With an estimated third of U.S. adults having low health literacy — for example, having difficulty following medical instructions, reading prescriptions or understanding what a medical provider says to them — will a continual data stream on a smartphone or tablet be truly empowering, merely confusing or completely inaccessible? Some researchers suggest that "the predominantly paternalistic communication style of the medical community" — exactly what Dr. Topol decries — hinders people's understanding of their own health and contributes to healthcare illiteracy. Access to devices may be 2014's real barrier to the digital democratization of health care. According to the Pew Research Center, two-thirds of Americans did not own a tablet in 2013. About 44 percent of Americans did not own a smartphone. Medical Technology: Miniature Miracles Patients are not the only ones using space-saving medical technology in 2014. Physicians and researchers are finding that when it comes to innovation, less may be more. + Physicians working with the U.S. Air Force have created a mobile endoscope using an iPhone 4S, an Endockscope coupling system and a cystoscope. Cost: $154. + A handheld melanoma scanner, MelaFind, uses technology developed for missile navigation to help physicians decide whether to biopsy suspicious moles. The finder relies on a matching algorithm and a library of 10,000 images for comparison. + Scientists at Florida International University destroyed an ovarian tumor in 24 hours by combining chemotherapy agent Taxol with nanoparticles. Using a magnetic field, the researchers drew on differences in electronic properties between cancerous and noncancerous cell membranes to direct the nano-enhanced chemotherapy directly into cancer cells. Result: Tumor cells died; healthy cells lived. + For pathologists, IBM has developed a glass-and-silicon "slide" that can apply dozens of chemical reagents to tissue sections as small as 50 micrometers in width, reducing the need for multiple biopsies and exploratory surgeries. + Sometimes, less is less. Patients find the idea of email consultations with their primary care providers attractive — but resist the idea of paying for digital visits. University of Michigan researchers found that 77 percent of parents polled would seek out email consultations for their children, but 48 percent thought such advice should be free. Physician Employment: En Vogue, but Read the Fine Print Physicians continue to seek employment rather than open their own businesses — about 25 percent of specialty physicians and 40 percent of primary care physicians work for hospitals. Financial considerations, such as reimbursement cuts and climbing expenses, often drive the decision when physicians sell practices to hospitals or healthcare organizations. The physician wants a guaranteed income, and the hospital promises a salary. A s t hese tra nsactions proliferate, think carefully before following a trend, says Carey Kalmowitz, Esq., founding shareholder, The Hea lth Law Partners. "Ever y physician, when considering what is best for him or her or the group, will have particular circumstances that will drive his or her decision," Kalmowitz says. "No one can say in the abstract whether it makes sense or is injudicious to consider employment or alignment." Rather, physicians should consider the particular deal being offered them in light of their needs and values, as well as their desired career trajectory. When examining a potential alignment or employment contract, Kalmowitz looks for these strengths: + Maximum autonomy in conducting one's practice, including retaining chosen staff and location + Employment and income security for several years after the transaction + Incentive compensation based on work performed rather than a percentage of earnings, to account for declining reimbursements "Consider whether under your particular circumstances a relationship with a system makes sense," Kalmowitz says. "It's critical to determine [based] on a physician's own circumstances and what is offered to him or her at this junction whether this is the right move to make." What will 2014 bring to your practice? Join the discussion at www.mdnews.com. ■ MDNEWS.COM ■ MD NEWS Twin Cities | 13

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