The Impact of COVID-19 on US and International Retina Specialists, Their Practices, and Their Patients

Purpose: This work analyzes data from a series of surveys developed by the American Society of Retina Specialists (ASRS) that assesses the impact of COVID-19 on physicians, their practices, and their patients. Methods: Five surveys were sent by the ASRS between March and July 2020 to more than 2600 US and international retina specialists. Data and trends from these surveys were analyzed. Results: Most responding retina specialists (87%-95% in the United States and internationally) reported having no known COVID-related symptoms despite reported limitations in personal protective equipment. Clinic volumes globally were drastically reduced in March 2020 with only partial recovery through July 2020, which was slower internationally than in the United States. Practices were compelled to reduce staff and physician employment levels. Most respondents estimated some degree of delay in patient treatment with corresponding declines in vision and/or anatomy that were attributed most frequently to patients’ fears of the pandemic and least frequently to office unavailability. Conclusions: The reported impact of COVID-19 on retina specialists, their practices, and their patients has been substantial. Although retina specialists were quickly resilient in optimizing delivery of patient care in a manner safe for patients and providers, the reduction in clinic volume has been devastating in the United States and internationally, with negative impacts on patient outcomes, reductions in practices’ volume and employment, and risk to practices’ financial health. Future studies will be required to quantify losses associated with these unprecedented and ongoing circumstances caused by the pandemic.

Physicians Working Conditions Under Brazilian Labor and Employment

In Brazil, Physician employment is regulated by several federal laws. However, it is common to find physicians working in hospitals under contracts signed with individual companies. In such cases, there are no restrictions to maximum working hours. In addition, in 2017, Brazilian Labor and Employment laws passed through deep flexibility, making it easier for employers to decrease the protection of workers against the power of the capital, which worsened the health conditions of both physicians and patients. In 2018, right before the presidential elections, voters pointed out that violence and health are the worse problems in Brazil. One year after that, most Brazilians, who answered a new survey, indicated that health was the country’s worse problem. In this article, I will analyze the relationship between physicians' working conditions and the situation of the Brazilian health system.

Employed for Higher Pay? How Medicare Payment Rules Affect Hospital Employment of Physicians

Hospitals employ an increasing number of physicians and bill for a growing share of outpatient procedures. We exploit a plausibly exogenous increase in Medicare prices for hospital-employed physicians relative to Medicare prices for other physicians to show that payer reimbursement rules explain part of this trend. The shock we study explains 20 percent of the increase in physician employment and 75 percent of the increase in hospital-billed outpatient procedures between 2009 and 2013.(JEL G22, I22, I13, J23, J31, J44)

Contracts and Negotiation: The Fundamentals for Interventional Radiologists

There are numerous situations in which a physician may be in a position to negotiate a high-value contract. For an interventional radiologist, these may include personal employment contracts, vendor contracts for capital equipment, show-site agreements, research contracts, group partnerships, professional services agreements, and other types of relationships. Opportunities for physicians to learn about the nuances of contracts, themselves, are limited, and most will learn about negotiation and contracts through experience and sometimes through failure. This article will review contracting as it relates to physician employment relationships, with the goal of reviewing the fundamental principles of contracting and negotiation, exploring the prerogatives of hospitals, physician groups, and individual physicians as they relate to building mutually beneficial and productive relationships, and examining common pitfalls of contracting.