Neil H. Baum, MD

Neil H. Baum, MD

Tulane University School of Medicine, Louisiana State University Medical School, Vanguard Communications Group

New Orleans, Louisiana

Neil H. Baum, MD, is a Clinical Professor of Urology at Tulane Medical School in New Orleans, Louisiana. He is also a retired urologic surgeon. Additionally, Dr. Baum serves as the Medical Advisor to Vanguard Communications Group. Dr. Baum is the author of Marketing Your Clinical Practice - Ethically, Effectively, and Economically, which is in its 4th edition, has sold over 175,000 copies, and has been translated into Spanish. He also wrote The Complete Business Guide to a Successful Medical Practice, which was published in 2015. Dr. Baum was the columnist for American Medical News for more than 25 years. Dr. Baum also wrote the popular column, “The Bottom Line,” for Urology Times for more than 20 years. He is a requested speaker each year to the Practice Management Seminar for the American Urological Association (AUA), where he discusses techniques for making urology practices more efficient and more productive. He has written more than 9 books on practice management and over 250 peer-reviewed articles on various urologic topics. Dr. Baum is also the medical advisor to Vanguard Communications Group.

Disclosures:

Talks by Neil H. Baum, MD

The Future of Medical Marketing

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, gives 8 suggestions for marketing and promoting a medical practice in 2022. He begins by saying that old methods of promotion are no longer effective since the internet has “leveled the playing field” and patients now have as much information as physicians. Dr. Baum then lists his suggestions, starting with embracing telemedicine, which he says provides safe and effective care while allowing practices to reach new and untapped markets. Next, he recommends using video marketing, since people are 4 times more likely to watch a video than read an article, and search engine optimization (SEO) algorithms prioritize video content. Dr. Baum also suggests using psychographic marketing which, unlike demographic marketing, identifies the attitudes and mindsets of patients. He follows this by recommending a focus shift from illness to wellness, explaining that the current healthcare system focuses on symptoms and illness and is inherently reactive, while a wellness-focused practice is proactive and able to identify early transitions from wellness to disease. Dr. Baum then considers the benefits of personalized marketing and personalized medicine, highlighting the utility of the right patients receiving the right messages. He brings up the use of virtual assistants, noting that tools like Amazon’s Alexa can conduct various healthcare tasks, from tracking glucose levels to helping patients with parking at the office. Dr. Baum’s final marketing and promotion tips include carefully managing a practice’s online reputation, and embracing artificial intelligence in healthcare marketing. He notes that a practice’s marketing budget should be about 3-5% of gross revenues, and he suggests getting marketing assistance from firms with medical experience. Dr. Baum concludes that if practices want to be around in 3 to 5 years, they should consider implementing a few of these ideas.

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Lyndon Johnson and His Kidney Stone

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, highlights the importance of imagining how the United States healthcare system could change by reflecting on how different the world would be had Lyndon Johnson’s kidney stone not been successfully removed. He explains that in 1948, Johnson was running for a US Senate seat and was deadlocked against the favorite, when he developed an obstructing kidney stone in the upper third of his ureter. He thought he would require a ureterolithotomy, but did not want to since that might require him to drop out of the race. Dr. Baum explains that Johnson met with Dr. Gershom Thompson at the Mayo Clinic for a second opinion, and Thompson agreed to try an endoscopic stone removal, even though he had never before removed a stone in the upper third of the ureter. Thompson was successful, and Johnson had a prompt recovery, allowing him to return to the campaign and win. Dr. Baum notes that Johnson’s recovery raises several “what if” questions, such as “how might the world have changed if LBJ had not had a successful endoscopic retrieval of a proximal ureteral stone and been unable to win his Senate race?” Dr. Baum considers Johnson’s legacy as President of the United States, from passing the Civil Rights Act to accelerating US military involvement in Vietnam. He then asks, “what if we did not have the two government healthcare programs, Medicare and Medicaid, that were instituted and approved during the Johnson Administration?” This leads him to ask a whole series of “what if” questions, such as “what if we had a single payer system?” and “what if we could put more enjoyment back in the practice of medicine?” He concludes that it may be time to ask some “what if” questions, and he suggests that by doing so, it may be possible to find ways to repair the current healthcare system rather than seeing it as fundamentally immutable.

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Bottom Line Shrinking? Check Your EOBs

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, discusses the importance of reviewing explanations of benefits (EOBs) in a medical practice to ensure the practice is receiving appropriate compensation. He defines EOBs as feedback on the effectiveness of a practice’s billing/coding, and argues that failing to review EOBs will result in a decrease in cash flow. Dr. Baum claims that reviewing EOBs strengthens management of the billing team and helps practices know why they are or are not successful, since “what gets measured gets managed.” He gives the example of an overwhelmed biller who failed to submit 10% of claims for 12 years and rarely appealed denials. By reviewing EOBs, Dr. Baum explains, the managing partner can identify the problem and gather proof that billing needs improvement. He discusses several other benefits of reviewing EOBs, noting that EOBs show deficiencies and how to correct them, as well as provide tracker data on a practice’s payor mix and frequency of highly paid procedures. Dr. Baum recommends that practices review EOBs approximately every three months, using an exception report to track any deviation in compensation. He says that doing so will take little more than an hour per month and help practices ensure they are paid what they deserve in an era of decreasing reimbursements and increasing overhead expenses.

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The Elephant and Chains: Adding New Technology

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, argues that medical doctors often become artificially constrained by old practices, comparing them to an elephant whose weak chains only hold it down because it has been conditioned to believe so. Dr. Baum begins by elaborating on this metaphor, explaining that when elephants are babies, they are chained to large posts or trees, and are genuinely held fast. This conditions them not to pull when chained, and therefore, when they are older, they will not attempt to escape even when chained to a small peg they could easily pull out. Dr. Baum argues that perhaps medical doctors are conditioned like elephants, and suggests that they tend to play it safe, practice defensive medicine, take a long time to implement technology, rarely leave their comfort zone, and use old skills and medications. He then looks at some examples of areas where doctors have been slow to implement change and provides evidence for why doctors should embrace these new developments. Dr. Baum begins with the electronic medical record (EMR), which he acknowledges originally made it harder for doctors to focus on patients, but which he believes can be made a lot more palatable with the adoption of voice recognition software. He then looks at delegation of care to physician assistants and nurse practitioners, which he argues improves productivity. Dr. Baum moves on to telemedicine, which he claims the majority of patients have had positive experiences with since the COVID pandemic began. He concludes by looking at artificial intelligence (AI), which can read tests like prostate biopsies more accurately than the majority of general pathologists and which may improve efficiency and reduce costs.

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‘Hand Size’ and Healthcare

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, considers how common healthcare metrics can be faulty, much like the idea that larger hand size signifies a better quarterback. He explains that many in the football industry have long assumed that small hands result in fumbles and bad throws, and have therefore used hand size as a metric when drafting quarterbacks. However, as a recent article about successful, small-handed quarterbacks Patrick Mahomes and Joe Burrow demonstrates, this metric is inherently flawed. Dr. Baum suggests that this is a useful story to keep in mind when considering certain common healthcare metrics and concepts that are not as infallible or relevant as they seem. For instance, he notes that urologists commonly measure erectile dysfunction post-retropubic radical prostatectomy or external radiation therapy, but patients are actually far more interested in continence than sexual function. Dr. Baum also argues that common metrics like resting heart rate and body-mass index actually provide less useful health information than heart rate variability and waist circumference, respectively. He then observes that even one of the most widely-held beliefs in healthcare—that doctors have to see and touch a patient in order to properly treat them—has proven inaccurate with the rise of efficient, affordable telemedicine. Dr. Baum concludes that healthcare professionals should challenge conventional wisdom, and that doing so may help with finding new metrics and new methods for treating patients.

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