Entrepreneurs are resourceful, decisive, motivated, and forward-thinking being skilled at solving problems and making critical decisions when the occasion arises.

According to the Society of Physician Entrepreneurs, i.e., SOPE, an entrepreneur is someone in the ‘pursuit of opportunity with scarce, uncontrolled resources’. According to them, all entrepreneurs have a goal, i.e., using innovation to gain an end goal. Considering that physicians could be regarded as small to medium-sized business owners, they are also social entrepreneurs, intrapreneurs, and, finally, technopreneurs due to their constant use of new technologies. Because of the vast role fulfilled by doctors, many use their education to benefit the healthcare field.

How Doctors Can Use Their Training

Doctors can use their extensive yet intensive training outside a clinic situation in several ways. We will look at a few of these.

In Healthcare Technology

Doctors, due to their direct involvement in taking care of patients, make a good choice as startup leaders when […]

Dealing with a worker’s compensation claim is a challenging process in many cases. To make things a little easier, we will look at the role played by a third-party administrator (TPA), an independent review organization (IRO), and an independent medical exam (IME) when dealing with such a claim.

The Third-Party Administrator

A TPA refers to an independent organization that handles and processes all medical insurance claims. This they need to do following a set of drawn up laws. Very often, when an insurance company finds themselves unable to expedite a claim, they will work with a TPA to do so. Although the TPA may handle the claim, the paying of the claim is in the hands of the insurance company or self-insured employer.

How The Third-Party Administrator And Independent Review Organization Collaborate

When you, as an employee, submit a workers’ compensation claim, you would usually have to undergo an insurance medical examination. This examination […]

  The healthcare industry makes use of different peer review types. Examples of these include:

• Peer reviews of journals to ensure any scientific paper is scrutinized by an expert peer in their field.
• To ensure a doctor’s skills and performance are of a high standard.
• The review of medical records helps determine whether a claim is covered or not.

In all instances, these reviews are undertaken by a healthcare expert in the same area of expertise as determined by a specific medical claim.

An example of this is where, if a claim were the result of a test or procedure carried out by a heart specialist, someone of equal standing would review that particular case. This is known as a specialist-to specialist review.

What Happens During a Peer Review?

Each peer review, undertaken by a medical professional of equal or higher standing, looks at both the patient and his clinical condition. The physician undertaking […]

When dealing with workers’ compensation claims, a medical review company helps ensure that a worker receives both the appropriate and necessary medical care that allows them to go back to work.

Defining An Independent Medical Review Company

An independent medical review company is also called either an independent review organization or a peer review company. An independent review company does medical assessments. They are objective in their conclusions and work independently from any medical insurance company. Usually, you would request an independent medical review after exhausting an appeal process via your medical insurance provider.

Challenges Posed By A Workers’ Compensation Claim

Most of the challenges faced by those involving workers’ compensation claims are the same. Amongst these challenges you may find the following:

1. An increase in the complexity of submitted claims
2. An increase in healthcare and medication costs
3. The health and lifestyle of an employee, i.e., diabetes, joint pain, obesity, etc.
4. Changes in laws […]
   

Many physicians are experts in their areas of practice, but the medical field is vast, and there’s no way for one doctor to be an expert in everything. It is impossible to keep up with each advancement for every condition or treatment option. That is why physicians and health care facilities use the peer review process: To rely on one another to determine individual areas for improvement and maintain an overall high quality of care. Peer review enables physicians to learn and be confident in their observations and decisions. From a patient’s point of view, peer review ensures everyone receives the best medical care possible.

Utilizing Physician Peer Review

Peer review is used by hospitals and other health care facilities in a variety of ways. Some hospitals are required to use peer reviews for existing doctors to maintain their privileges, and for new […]

As an external peer reviewer, you can earn extra income by applying your expertise outside your day-to-day practice. Our physician reviewers cite a number of additional benefits of being a peer reviewer, including:

•  Clinical and intellectual stimulation: Applying current, evidence-based medicine to case reviews is interesting and professionally satisfying.
•  Self-improvement and awareness: Reviewing cases helps physicians improve their own clinical care and documentation.
•  An opportunity to make a difference: Serving as an objective external case reviewer offers a way to improve care provided by others and give back to the medical community.