December 2018, Volume XXXIII, No 9

Physician unionization

A path worth considering

“Hospital administrators easily manipulated physicians, treating them as if they were hired hands. Insurance companies were dealing with them as if they were employees. Government programs … controlled key aspects of doctors’ work, told them how much they would be paid, and what procedures they would be paid for.”

—Sanford A. Marcus, MD, founding physician of the Union of American Physicians and Dentists (AFL-CIO)

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December 2018, Volume XXXIII, No 9

interview

Challenges and rewards of independent practice

Keith A. Oelschlager, MD, Entira Family Clinics

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Capsules

Brief reviews the top news

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Medicus

Physician appointments and recognitions

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cover story One

Physician unionization, A path worth considering

By Mick Hannafin

“Hospital administrators easily manipulated physicians, treating them as if they were hired hands. Insurance companies were dealing with them as if they were employees. Government programs … controlled key aspects of doctors’ work, told them how much they would be paid, and what procedures they would be paid for.” —Sanford A. Marcus, MD, founding physician of the Union of American Physicians and Dentists (AFL-CIO)

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cover story two

A practice built on principle, Taking a stand

By Jeanne Mrozek, MD

After 35 years of service, 12,775 overnight shifts, and countless life-changing encounters with families and patients at our Children’s Hospital Minneapolis location, Minnesota Neonatal Physicians is moving into the North and West Metro. It would be lying to say this change isn’t difficult and emotional. The relationships we’ve built with medical staff and families of medically fragile newborns are deep and, we hope, lasting.

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Administration

Regaining the voice of our profession, A clinic’s journey to unionize

By Emily Onello, MD, and Louise Curnow, PA-C

Union organizing was not at the forefront of our thoughts when we were having workplace difficulties with management. Like most professionals, we tried to address issues of concern with management—issues such as patient visit time and productivity. These weren’t necessarily new issues—our previous CEO of many years had brought up proposed changes to address the ever-increasing drive to increase productivity.

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Special Focus: rural Health

Supporting unpaid caregivers in rural Minnesota, What physicians should know

By Carrie Henning-Smith, PhD, MPH, MSW; and Megan Lahr, MPH

According to the AARP, the vast majority of all long-term care is provided by unpaid friends and family members, who provide an estimated nearly $500 billion worth of care annually. At the last count, more than 40 million Americans are providing unpaid care to a loved one.

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Special Focus: rural Health

Rural Health Innovations, An integrative behavioral health program

By Kami Norland, MA, ATR

Living with a mental illness in rural Minnesota is more challenging than one might anticipate. Lack of local behavioral health providers, limited access to tele-psychiatry and inpatient psychiatric beds, and new or unknown community awareness of support services, all contribute toward a health system that fails for many patients with mental illness. However, there are some critical access hospitals across Minnesota that are engaging their communities to address these challenges and provide whole-person care through the integration of behavioral health.

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Special Focus: rural Health

Stroke and telehealth, Improving access and outcomes

By Muhammad Fareed K. Suri, MBBS

ccess to specialty care in rural areas is often limited by distance and accessibility. Rural Minnesotans and specialty providers are well aware of this challenge. Residing in or visiting the remote areas of Minnesota can mean long drives to medical facilities and, in certain cases, additional time needed for emergency medical transportation, evaluation, and initial treatment, resulting in vastly varying outcomes.

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Electronic Health Records

Leveraging your information resources, Put your data to work

By Sara Richter, MS, and Samantha Carlson, MPH

Over the past decade, the transition to electronic health records (EHRs) has increased the amount of health data at our fingertips. At the same time, the pressure to improve access to care and patient outcomes is steadily increasing. Fortunately, advances in technology now allow providers to more easily leverage the data in the EHR to make improvements in care, recognize trends in their patient population, improve clinical processes, and publish and disseminate research.

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advertorial

Meals for Healing, Second Harvest Heartland’s FOODRx program tackles food insecurity and chronic illness, paving the way for better outcomes and lower costs

By Mo Perry and Quinton Skinner

Ralph and Lisa, a married couple in St. Cloud, Minnesota, have a range of challenging health diagnoses between them, including type 1 diabetes, type 2 diabetes, and congestive heart failure. They also struggle with food insecurity, with Lisa’s health conditions making it difficult for her to work.

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Special Focus: rural Health