DISCLOSURERS LEARNING OBJECTIVES 1/16/2015. No Monkey Business! 5 Year Perspective on a Business of Medicine Curriculum for Ob/Gyn Residency

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1 No Monkey Business! 5 Year Perspective on a Business of Medicine Curriculum for Ob/Gyn Residency Holly R. Khachadoorian-Elia, MD, MBA Samantha J. Pulliam, MD Lori R. Berkowitz, MD Vincent Department of Obstetrics and Gynecology Massachusetts General Hospital Boston, MA DISCLOSURERS We do not have any financial relationships to disclose LEARNING OBJECTIVES Following this presentation the participant will: 1) Be familiar with the educational topics that are included in the CREOG Education Committee s published curriculum The Business of Medicine Teaching Manual (formerly the APGO Business of Medicine Modules) based on the ACOG publication The Business of Medicine An Essential Guide for Obstetrician-Gynecologists. 2) Learn about how our program performed a needs assessment and incorporated some of these topics into our residency curriculum amid many competing educational demands. 3) Work in groups with colleagues to identify further educational opportunities and ideas for educational materials given the ever-changing business environment of medicine; including meaningful use obligations, electronic health records, productivity-based and patient satisfaction related compensation, and the upcoming implementation of ICD-10 for coding. 1

Following this presentation the participant will: 1) Be familiar with the educational topics that are included in the CREOG Education Committee s published curriculum The Business of Medicine

2 BACKGROUND Various aspects of the Business of Medicine are weaved seamlessly into our daily lives as clinician educators. Residents, however, have little exposure to many of these topics until they approach graduation. They are then instantly expected to know and understand the inner workings of licensure, board certification, credentialing, malpractice, other insurance, as well as practice operations and management. As resident educators, we aim to empower our learners with meaningful educational topics to introduce them to the real world before they experience it personally. MOTIVATION We hope this Breakout Session will serve as a way to share our experience and learn from others about how they have incorporated these very important topics into their curricula Business of Medicine Topics GO 2

They are then instantly expected to know and understand the inner workings of licensure, board certification, credentialing, malpractice, other insurance, as well as practice operations and

3 BUSINESS OF MEDICINE TEACHING MANUAL Developed via APGO & CREOG Education Committee in 2008 Educational Tool that consists of 12 Units Each Unit is complete with slides, didactic component, bibliography, evaluation tools & a teachers guide Departments/CREOG/CREOG-Search/BUSINESS- OF-MEDICINE-TEACHING-MANUAL BUSINESS OF MEDICINE TOPICS 1) Planning for Practice 2) Finding a Position 3) Selecting and Using Professional Advisors 4) Contract Terms & Issues 5) Licensing & Credentialing 6) Insurance BUSINESS OF MEDICINE TOPICS 7) Personal Skills 8) Practice Operations 9) Practice Finances 10) Law & Regulations 11) Personal & Professional Growth 12) Personal Finance 3

org/about-acog/acog- Departments/CREOG/CREOG-Search/BUSINESS- OF-MEDICINE-TEACHING-MANUAL BUSINESS OF MEDICINE TOPICS 1) Planning for Practice 2) Finding a Position 3)

4 EXAMPLE: Planning for Practice Subject: Introduction to the Business of Medicine 1. Topic- Timelines & Practice Types 2. Content- This session will discuss the variety of practice types available and the timeline residents can use to guide them as they make practice decisions. 3. Goals: Aims/Outcomes- The resident will be able to identify an ideal practice type given his or her own personal preferences. 4. Objectives- The resident will be able to articulate a realistic timeline for his or her job search The resident will articulate several types of practice options available The resident will list the benefits and limitations of group practice, solo practice, academic practice, public sector positions, locum tenens, and nonclinical positions. EXAMPLE: Planning for Practice 5. Materials and Aids- Power Point presentation 6. Procedures/Methods- A. Introduction- Review Power Point with residents B. Development- 1. Panel discussion with MD in private practice, HMO, academic practice, other. 2. What does each type of physician like about his/her practice? 3. What do they dislike? 4. What do they wish they knew when they were looking for a practice? 5. Other questions from residents C. Practice- Residents work in pairs to identify what they would and would not like about various practice types. D. Independent Practice- N/A EXAMPLE: Planning for Practice E. Accommodations (Differentiated Instruction)- Power point available on-line for residents who are unavailable to attend session. F. Checking for understanding- 1. Resident pairs report back to group about perceived benefits/limitations of each practice type. 2. Group discussion (ideally with the MDs on the original panel present) about perceptions of various practice types. G. Closure- Facilitator to thank each panel member and emphasize that many different practice types can lead to a fulfilling career and the need to be introspective as you make a career choice. 7. Evaluation- Each resident pair completed a worksheet with at least three benefits and limitations of group practice, solo practice, academic practice, public sector positions, locum tenens, and non-clinical positions. 4

Goals: Aims/Outcomes- The resident will be able to identify an ideal practice type given his or her own personal preferences. 4.

5 OUR EXPERIENCE 5-year experience with our Business of Medicine Curriculum in the BWH/MGH Integrated Obstetrics and Gynecology Residency Program. In the Fall of 2008 we devised an on-line needs assessment questionnaire based on the ACOG publication The Business of Medicine An Essential Guide for Obstetrician-Gynecologists and the APGO Business of Medicine Modules to perform a needs assessment which was distributed to all residents in our program. NEEDS ASSESSMENT 76% of residents responded to our initial survey (N=31). 79% of those responding believed that a Business of Medicine Curriculum would be a helpful addition to their resident education. The majority of residents (91%) reported either absent or limited prior education regarding this topic. Using a 5 point Likert scale (with 5 being MOST important & 1 being the LEAST), residents rated the most important topics Career Advisors/Mentors (4.85) Finding a Job/Fellowship (4.78) Insurance & Malpractice (4.62) Licensure & Credentialing (4.44) Planning for Practice (4.37) 5

of Medicine Modules to perform a needs assessment which was distributed to all residents in our program. NEEDS ASSESSMENT 76% of residents responded to our initial survey (N=31).

6 EDUCATIONAL INITIATIVE Starting in 2009, the 3 rd Year Residents were informed via of the Business of Medicine educational initiative Review the five PowerPoint Modules Complete each associated 5 question multiplechoice quiz ensuring completion of the modules Complete a short Post-Curricular Survey to provide feedback on the curriculum. OUR EVALUATION TOOL Survey Monkey Quiz 5 Questions PDFs of Answers saved to Dropbox & shared when Residents informed us that they had completed the Quizzes 6

completion of the modules Complete a short Post-Curricular Survey to provide feedback on the curriculum.

7 COMPLETION & FEEDBACK 48% of the 3 rd Year Residents completed the curriculum during the 5 year time line Of those completing the curriculum: 62% completed the post-curricular feedback questionnaire 94% felt that The Business Of Medicine Curriculum was a helpful addition to their Resident Education The most highly rated modules in the Curriculum were The Boards, Licensing & Credentialing (4.38) and Malpractice & Other Insurance (4.25) As for the topics not currently included, Employment Contracts (4.44), Laws & Regulations (4) and Personal Finance (3.94) were the most highly desired additional topics to consider adding to the Curriculum. KNOWLEDGE GROWTH Pre-Curricular & Post-Curricular Surveys asked residents how knowledgeable they felt with regard to the subjects Knowledge reportedly increased on all topics included in the curriculum Interestingly of the topics NOT included three ultimately ranked the same, but four also trended upward with increased knowledge. 7

38) and Malpractice & Other Insurance (4.25) As for the topics not currently included, Employment Contracts (4.44), Laws & Regulations (4) and Personal Finance (3.

8 SUMMARY OF OUR EXPERIENCE We simplified the Curriculum based on a Needs Assessment Time Constraints limited the delivery of this Curriculum to PowerPoint & Online Quiz format Only 48% of the Residents invited to complete the curriculum did so & only 62% of them completed the Post-Curricular Feedback Survey This highlights the struggle that exists with the competing demands on our Residents today BEST PRACTICES HOW DO YOU EFFICIENTLY & EFFECTIVELY DELIVER THIS CURRICULUM TO YOUR RESIDENTS? FUTURE DIRECTIONS IF APGO/CREOG WERE TO READDRESS THIS SUBJECT WHAT ELSE SHOULD BE INCLUDED IN THE CURRICULUM & HOW SHOULD IT BE DELIVERED? 8

highlights the struggle that exists with the competing demands on our Residents today BEST PRACTICES HOW DO YOU EFFICIENTLY & EFFECTIVELY DELIVER THIS

9 BRAINSTORMING SUMMARY If interested, us & we will share once compiled REFERENCES Departments/CREOG/CREOG-Search/BUSINESS- OF-MEDICINE-TEACHING-MANUAL The Business of Medicine An Essential Guide for Obstetrician-Gynecologists ACOG, THANK YOU! 9

org/about-acog/acog- Departments/CREOG/CREOG-Search/BUSINESS-

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