How to Measure Practice Productivity Using RVUs

How to Measure Practice Productivity Using RVUs

RVUs are a useful gauge of doctors' productivity, but practices also should look at such aspects as each practitioner's caseload and reimbursements.

FSGS: Talking Points for the Practicing Nephrologist

Distinguishing primary from secondary focal segmental glomerulosclerosis is crucial because the treatment approaches and therapeutic goals differ.

Big Data, Transparency and Accountability

Big Data, Transparency and Accountability

We crave clinical and scientific data, yet we grieve the performance-based data increasingly directed toward us.

How Practice Managers Can Build Market Share

How Practice Managers Can Build Market Share

Growing a practice is a matter of knowing your market and reaching out to referral sources and patients.

The Need for a Kidney Research Prize: Interview with Sharon Moe, MD

The Need for a Kidney Research Prize: Interview with Sharon Moe, MD

Dr. Moe spoke about the importance of nephrology research and how a prize competition can facilitate the process.

The Challenge of Dialysis at the End of Life

The Challenge of Dialysis at the End of Life

Dialysis is not necessarily in the patient's best interest, clinicians and ethicists say.

"Doc, Did You Check My Cholesterol?"

"Doc, Did You Check My Cholesterol?"

Many patients still insist that I need to check and manage their cholesterol.

How to Rehabilitate Your Practice

How to Rehabilitate Your Practice

As we move to a more comprehensive model, it makes sense to diminish the separation between the clinical and administrative sides of practice.

Ultrasonic Propulsion of Kidney Stones: Interview with Jonathan Harper, MD

Ultrasonic Propulsion of Kidney Stones: Interview with Jonathan Harper, MD

Jonathan Harper, MD, of the UW School of Medicine in Seattle, explains his "Rolling Stones" concept as a feasible office procedure.

Kidney Function Assessment: The Need for a Confirmatory Test

Confirmation of creatinine-based eGFR should be performed in select circumstances using, where appropriate, either measured GFR or cystatin C.

Medicare Payments Exposed

Medicare Payments Exposed

For the first time, the federal CMS has made public a database showing what it pays out to individual physicians.

J. Francois Eid, MD: Benefits of the Coloplast Titan

Coloplast has been involved in the manufacturing of inflatable penile prosthesis since 1973.

How to Buy Technology for Your Medical Practice

How to Buy Technology for Your Medical Practice

Out-of-pocket is one option, but it may make better business sense to lease equipment or borrow money to pay for it.

Renal Stenting and the CORAL Study: Interview with Lance Dworkin, MD

Renal Stenting and the CORAL Study: Interview with Lance Dworkin, MD

CORAL study chair Lance Dworkin, MD, discusses the controversial finding with Renal & Urology News.

Nutrition Advice Challenged — Again

Nutrition Advice Challenged — Again

Human beings are unique in the animal kingdom when it comes to nutrition.

Omega-3s and Prostate Cancer: What to Advise Patients

Omega-3s and Prostate Cancer: What to Advise Patients

Some researchers are not convinced that high blood levels of omega-3 fatty acids are associated with an increased PCa risk.

The Pluses and Minuses of Concierge Medicine

The Pluses and Minuses of Concierge Medicine

Nephrologists and urologists can spend more time providing quality care for patients, but establishing referral sources may be a challenge.

Sidestepping Sepsis via TP Biopsy: Interview with Jeremy Grummet, MBBS

Sidestepping Sepsis via TP Biopsy: Interview with Jeremy Grummet, MBBS

Rising readmission rates of subsequent sepsis have given urologic surgeon Jeremy Grummet, MBBS, MS, FRACS, pause.

Personalized Medicine in 2014

Personalized Medicine in 2014

The term "personalized medicine" remains an overused promise to apply specific treatment plans.

How to Establish an In-House Clinic

How to Establish an In-House Clinic

In-house clinics can be a cost-efficient way to provide high-quality healthcare, without having to make a large investment.

Immunosuppression-Free Transplant: Interview with Suzanne Ildstad, MD

Immunosuppression-Free Transplant: Interview with Suzanne Ildstad, MD

Immunologic mismatch may no longer be a barrier between living kidney donors and recipients.

Guidelines and the Older Patient with CKD

Guidelines and the Older Patient with CKD

Geriatric patients with CKD are at high risk for morbidity and mortality from the potential side effects of treatments.

Controversies in Blood Pressure: Management in Hemodialysis

Controversies in Blood Pressure: Management in Hemodialysis

A majority of patients on HD have hypertension, and CVD is the leading cause of death in these patients.

Nephrologists Woefully Underpaid in U.S vs. Canada

Nephrologists Woefully Underpaid in U.S vs. Canada

This higher level of dialysis care in Canada is partly owed to substantially higher reimbursement fees for nephrologists.

PCA3: What Is Its Role in Prostate Cancer Screening?

Although several biomarkers show promise, PCA3 has garnered substantial attention following FDA approval and its role in the diagnosis of PCa will grow.

B12 Supplements Ease Inflammation in CKD

B12 Supplements Ease Inflammation in CKD

Elevated levels of Hcy are associated with increased levels of cardiovascular inflammation.

How to Cut Down on No-Show Patients

How to Cut Down on No-Show Patients

Medical office staff need to understand which patients often miss their appointments and why.

Non-Medical Treatments for Kidney Stones: What Nephrologists Need to Know

Non-Medical Treatments for Kidney Stones: What Nephrologists Need to Know

The surgical treatment of urolithiasis has undergone a marked evolution over the past 30 years.

PCa Control Similar with RT, Radical Surgery: Interview with Frank Critz, MD

PCa Control Similar with RT, Radical Surgery: Interview with Frank Critz, MD

Some may find it surprising that Dr. Critz generally considers RP to be the go-to treatment for localized disease.

Why Not A Federal Medical License?

Why Not A Federal Medical License?

When we move from one state to another, typically we must obtain a driver's license from the state to which we are relocating.

How to Evaluate Cost to Improve Care, Retain Patients

Sensitivity to the price of medications, for example, may improve patient adherence to pharmacotherapy.

New Albumin Self-Testing Platform: Interview with Aydogan Ozcan, PhD

New Albumin Self-Testing Platform: Interview with Aydogan Ozcan, PhD

A digital sensing platform could allow patients with chronic kidney ailments or diabetes to test their own urine albumin levels.

Placing Very Elderly Patients on RRT

Placing Very Elderly Patients on RRT

As a venue for presenting important research on kidney disease to the world, Kidney Week never disappoints.

New Ablative Techniques in Urologic Oncology

Innovative approaches offer the potential for effective treatments to limited target 
areas with improved side effect profiles.

Six Technological Advances That Will Change Practice

Clinicians will use neurostimulation, mobile apps, portable dialysis, artificial kidneys, and remote monitoring in innovative ways.

A Hematuria Risk Index: Interview with Ronald Loo, MD

A Hematuria Risk Index: Interview with Ronald Loo, MD

Urologist Ronald K. Loo, MD, of Southern California Permanente Medical Group and colleagues created and validated a Hematuria Risk Index.

Adequate Vitamin D Important for Immunologic Regulation

Adequate Vitamin D Important for Immunologic Regulation

Vitamin D is often recognized for its impact on bone metabolism, but it is also an important regulator of immune function.

Medical Research and the Federal Shutdown

Medical Research and the Federal Shutdown

After the end of 16-day federal shutdown in October, media headlines touted the financial impact on America and the cost of restarting the government.

Bladder Cancer in the Elderly: Balancing Disease and Surgical Risk

Elderly patients face greater perioperative risks and postoperative mortality, so careful selection of surgical candidates is imperative.

How to Increase Revenue, Stability in a Practice

Physicians need to know such particulars as what they pay per square foot for office space and the cost per minute of patient care.

What You Don't Know About Hyponatremia: Interview with Juan Carlos Ayus, MD

What You Don't Know About Hyponatremia: Interview with Juan Carlos Ayus, MD

Hyponatremia authority Dr. Juan Carlos Ayus receives calls all the time from fellow nephrologists who have questions.

High Fat, Low Carb Diet Beneficial for CKD Patients

High Fat, Low Carb Diet Beneficial for CKD Patients

For years, dietary recommendations have focused on reducing saturated fat and its potential sources.

The Future of Dialysis in the U.S.

The Future of Dialysis in the U.S.

Over the past 10 years the annual ESRD incidence rate per million U.S. population has remained stagnant or even shown sporadic downward trends.

Dietary Interventions for Treating Progressive Chronic Kidney Disease

The type and amount of ingested protein affects clinical outcomes such as protein-energy wasting, kidney function and even survival.

How to Make Your Private Practice Thrive

Cultivate good referral relationships and prove to payers that you provide high-quality, cost-effective care.

An Update on New Therapies for mCRPC: Interview with Oliver Sartor, MD

An Update on New Therapies for mCRPC: Interview with Oliver Sartor, MD

Radium-223 was approved in May 2013 for the treatment of mCRPC with symptomatic bone metastases and no visceral disease.

OAB: Current and Emerging Therapies for Optimal Individualized Treatment

Keeping abreast of the most current treatments for idiopathic OAB can lead to improved outcomes and quality of life.

Curbing Fructose Intake May Decrease Elevated Uric Acid

Curbing Fructose Intake May Decrease Elevated Uric Acid

Elevated uric acid levels are associated with increased risks for hypertension, gout, and renal impairment.

Genetic Risk and PCa Treatment: A New Era Dawning

Genetic Risk and PCa Treatment: A New Era Dawning

For men at risk of developing prostate cancer (PCa), prophylactic prostatectomy seems almost irrational for several reasons

How Nurse Practitioners Can Improve a Practice

These mid-level healthcare providers make it possible to increase caseload and free up doctors so they can focus on higher-cost services.

New Noninvasive Gold Standard for PCa Diagnosis: Interview With Vikram Dogra, MD

New Noninvasive Gold Standard for PCa Diagnosis: Interview With Vikram Dogra, MD

A nascent technology combines laser optics and ultrasound to distinguish between benign and malignant prostate tissue.

Specialist to Primary Care Coordination Essential

Specialists must work with primary care doctors and other healthcare providers to ensure cost-effective delivery of medical services.

Mediterranean Diet Improves Health of CKD Patients

Mediterranean Diet Improves Health of CKD Patients

The Mediterranean diet is getting more attention because of its long-term benefits in terms of overall mortality and CVD risk.

Another Nutritional Warning: Omega-3s

Another Nutritional Warning: Omega-3s

Once again, a study offers evidence that one of the keys to good nutrition is avoiding excess.

Active Surveillance of Renal Masses: Interview with Paul Crispen, MD

Active Surveillance of Renal Masses: Interview with Paul Crispen, MD

Dr. Crispen highlights the advantages and challenges of active surveillance for small renal masses.

Fish Oil, Omega-3 Improves Blood Lipid Parameters in CKD

Fish Oil, Omega-3 Improves Blood Lipid Parameters in CKD

The benefits of omega-3 (n-3) fatty acids in renal populations were last discussed in this column in 2007.

Self-Cannibalizing for Peritoneal Dialysis Growth?

Self-Cannibalizing for Peritoneal Dialysis Growth?

In the nephrology community, there have been heightened discussions and apparent enthusiasm about the revival of PD as the prototype for home dialysis.

Update on the Medical Management of Kidney Stones

The first step in prevention is adequate and quantitative counseling regarding fluid intake, which is effective and inexpensive.

Four Financial Solvency Tips for Physicians

Four Financial Solvency Tips for Physicians

Live like a medical resident for a while and save a minimum of 15% of your income throughout your career, financial planners advise.

Botox for Urinary Incontinence: Interview with David Sussman, DO

Botox for Urinary Incontinence: Interview with David Sussman, DO

David O. Sussman, DO, has been ready to educate urology colleagues on the appropriate use of Botox.

Let's End the Small Renal Mass Dilemma

Let's End the Small Renal Mass Dilemma

The vow never to treat SRMs may seem hard to believe and self-defeating.

Zinc Protects Against Inflammation, Malnutrition, and Oxidative Damage

Zinc Protects Against Inflammation, Malnutrition, and Oxidative Damage

Zinc supplementation has been shown to decrease levels of plasma aluminum and reactive oxygen species in dialysis patients.

Managing Bone Loss Associated with Androgen Deprivation Therapy

While bone loss and reduction in bone mineral density are well known consequences of ADT, the main concern is increased risk of osteoporotic fractures.

Using Data to Improve Your Practice

Using Data to Improve Your Practice

Strategies to maintain a competitive and healthy practice include getting patients involved in their own care and learning about sources of patient referrals and income.

Membranous Nephropathy: Interview with Daniel Cattran, MD

Membranous Nephropathy: Interview with Daniel Cattran, MD

The MENTOR study is poised to change first-line-treatment recommendations for idiopathic membranous nephropathy.

Hemoglobin Levels Fall, Transfusions On the Rise

Hemoglobin Levels Fall, Transfusions On the Rise

Two studies presented at the recent NKF Spring Clinical Meetings provide more evidence of a trend toward decreasing use of ESAs and decreasing hemoglobin levels.

Ghrelin Offers Good Outcome Measures in CKD

Ghrelin Offers Good Outcome Measures in CKD

Ghrelin is metabolized by the kidney; thus serum levels are elevated in chronic kidney disease populations.

Medical and Surgical Management of Bladder Outlet Obstruction

Treatment of LUTS secondary to BPH has evolved from surgical therapy to medical monotherapy, and now combination therapy.

Common HIPAA Compliance Oversights

Common HIPAA Compliance Oversights

Compliance gurus bet there are at least a few things physicians are not doing to comply with HIPAA.

Study Could Extend Survival Benefit of Provenge: Interview with Samir Khleif, MD

Study Could Extend Survival Benefit of Provenge: Interview with Samir Khleif, MD

Provenge is a breatkthrough treatment option for men with asymptomatic or minimally symptomatic metastatic, hormone-resistant PCa.

BMI is More Reliable than Leptin Levels in Dialysis Patients

BMI is More Reliable than Leptin Levels in Dialysis Patients

Questions have been raised as to whether leptin has an impact on malnutrition in this population.

Reflections on the EAU Annual Congress

Reflections on the EAU Annual Congress

Having just returned from the always-stimulating European Association of Urology annual congress, I'd like to share a few impressions.

Adrenal Masses: Often Incidental, Not Always Insignificant

Given the frequency with which these lesions are found, urologists and nephrologists should be familiar with their evaluation.

Group Visits Pay Off for Patients and Doctors

Group Visits Pay Off for Patients and Doctors

Studies have shown that group therapy can be at least as effective as individual treatment.

In Search of Kidney-Saving Treatments for FSGS: Interview with Fernando Fervenza, MD

In Search of Kidney-Saving Treatments for FSGS: Interview with Fernando Fervenza, MD

The scar tissue that forms on sections of some glomeruli in FSGS will lead to kidney failure if left untreated.

Uric Acid and the Kidney - Is There a Role for Urate Lowering?

Uric Acid and the Kidney - Is There a Role for Urate Lowering?

Many but not all cohort studies examining the relationship between hyperuricemia and CKD outcomes suggest they may be intertwined.

When Deciding Dietary Restrictions, Assess Uric Acid Levels

When Deciding Dietary Restrictions, Assess Uric Acid Levels

Foods that may increase gout flare risk are also dietary factors that may promote further kidney decline in individuals with CKD stages 3-5.

Why Not 24/7 Dialysis Urgent Care?

Why Not 24/7 Dialysis Urgent Care?

Almost half a million Americans depend on chronic dialysis therapy to survive.

Thyroid Functional Disease in Dialysis Patients

Emerging data suggest that thyroid hormone deficiency may be associated with 
greater cardiovascular morbidity and mortality in this population.

Glomerular Diseases: Updates on Pathogenesis and Treatment

Glomerular Diseases: Updates on Pathogenesis and Treatment

A number of new diagnostic and therapeutic tools have emerged in the field of glomerular diseases.

The Pros and Cons of Vitamin D Supplementation

In both nutritional and activated forms, vitamin D may have side effects that are as yet under-appreciated.

Working with ACOs, Medical Home Neighborhoods

A major consideration is the new relationship specialists will have with primary care providers.

New Center for All-Around Prostate Cancer Treatment: Interview with Ashutosh Tewari, MB

New Center for All-Around Prostate Cancer Treatment: Interview with Ashutosh Tewari, MB

Ringing in the new year was especially exciting this time around for Ashutosh K. Tewari, MB, BS, head of the new Center for Prostate Cancer at New York-Presbyterian.

Managing Dyslipidemia in CKD can Decrease Risk of Cardiovascular Events

Managing Dyslipidemia in CKD can Decrease Risk of Cardiovascular Events

Dyslipidemia often is a concern in patients with CKD because mortality in this population typically is the result of cardiovascular complications.

Transplants Candidates: How Much Does Size Matter?

Transplants Candidates: How Much Does Size Matter?

Obese individuals often are rejected as renal transplant candidates in large part because of their increased risk for surgical complications and adverse outcomes.

Physicians: Managers of Risk

Physicians: Managers of Risk

Physicians are more often defined by their ability to diagnose, treat, and research a disease than their willingness to manage its spectrum of risk.

Pre-treatment Percutaneous Biopsy of Small Renal Masses

Urologists typically treat a renal cortical mass without biopsy, but this should be re-evaluated in the era of the incidental small renal cortical neoplasm.

Pay-For-Performance: A Changing Payment Paradigm

Pay-For-Performance: A Changing Payment Paradigm

Fee-for-service will be a mainstay of reimbursement, but insurers may increasingly move toward a pay-for-performance model.

Serious AKI On the Rise: Interview with Chi-yuan Hsu, MD, and Raymond Hsu, MD

Serious AKI On the Rise: Interview with Chi-yuan Hsu, MD, and Raymond Hsu, MD

The incidence of AKI requiring dialysis is now higher than the incidence of ESRD requiring dialysis or transplant.

The Rise of the Coffee Shop Doctor

The Rise of the Coffee Shop Doctor

How often have you met for business in a Starbucks, Coffee Bean, or any other coffee shop?

Increased Intake of Fruits, Vegetables Lowers Dietary Acid Load

Increased Intake of Fruits, Vegetables Lowers Dietary Acid Load

Age and physical activity have profound effects on the accrual and retention of lean body tissues, but a range of nutritional factors can influence this process.

The Association Between Kidney Failure and Renal Cell Carcinoma

Scientific speculation suggests that uremic toxins, viral mediators, and immune ­inhibition could play a role in malignant transformation.

How to Combat Burnout

How to Combat Burnout

Doctors have to figure out how to work smarter, not harder.

Implantable Artificial Kidney Could Help Tens of Thousands: Interview with Shuvo Roy, PhD

Implantable Artificial Kidney Could Help Tens of Thousands: Interview with Shuvo Roy, PhD

A promising hybrid device that works from the inside to provide renal functions beyond dialysis 24 hours a day, seven days a week, has the potential to change a lot of lives.

Transplant Program Biorepository Poised to Promote Research

The Cleveland Clinic has initiated the collection and storage of biospecimens from kidney and pancreas transplant recipients.

Low Testosterone Increases Risk of Mortality, Anemia, Reduced ESA Response

Low Testosterone Increases Risk of Mortality, Anemia, Reduced ESA Response

Testosterone deficiency is common in many patients with CKD, but the treatment of this deficiency and associated side effects have not always received much attention.

Highlights of Kidney Week 2012

Highlights of Kidney Week 2012

Kidney Week 2012, held in San Diego, is now history and as usual I like to reflect on the world's biggest and most prestigious meeting for kidney specialists.

Current Controversies Surrounding PSA Screening

It is hoped that selective screening, selective biopsy, and selective therapy will 
further decrease the morbidity associated with screening.

Running an Efficient Practice: Tips for Reducing Chaos and Disorganization

Running an Efficient Practice: Tips for Reducing Chaos and Disorganization

Technology can help, but increasing productivity is often a low-tech process requiring just a little bit of dedicated time and energy.

A Way to Reduce Discard Rates of Kidneys with Capsular Damage

More than 100,000 patients are on the kidney transplant waiting list and the increasing number of patients without living donor options underscore why it is important to decrease the discard rate of deceased donor kidneys available for transplantation.

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