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

Bottom Line Shrinking? Check Your EOBs

Posted by | Mar 2022

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

Posted by | Mar 2022

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

Posted by | Mar 2022

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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The Present and Future of Artificial Intelligence in Medicine

Posted by | Feb 2022

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, discusses current and future applications of artificial intelligence (AI) in medical practice. He describes AI as the game changer of the 21st century, and lists its numerous current uses in the clinical setting, such as reading mammograms, examining retinas of diabetic patients, reading pathology slides, screening for skin cancer, uncovering health disparity between whites and non-whites, and collating and summarizing millions of similar cases for doctors. Dr. Baum also highlights several nonclinical uses for AI, observing that AI’s ability to complete clinical data entry allows the doctor to focus on their interaction with patients. He then argues that AI will not replace physicians because clinical judgment will not be replaced by data and algorithms, patients do not want to be treated by a machine or algorithm, and AI cannot provide empathy and understanding. Dr. Baum moves on to consider the future of AI healthcare, suggesting that it will fill in the gap caused by the pending physician shortage and the aging Baby Boomer population. He claims that AI will automate routine processes that consume so much of a physician’s time, such as processing routine requests from the inbox, medication refills, and result notifications. He lists other future medical applications for AI, including improving drug compliance through home AIs like Alexa, identifying patients who are or are not eligible for certain treatments, and monitoring patients between visits. Dr. Baum concludes that AI will serve as an adjunct for physicians and help increase available knowledge while allowing doctors to focus on empathy and understanding.

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Conducting Patient Surveys

Posted by | Feb 2022

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, gives recommendations on how urologists can improve their practices by conducting patient surveys. He notes that one of the key needs and wants of urologists is to monitor the urologist-patient encounter, and he highlights two pathways to success in this area: (1) find out what the patient wants and give him/her more of it; and (2) find out what the patient does not want and avoid it. Dr. Baum explains that the best way to identify what patients do and do not want is to conduct patient surveys. He recommends using a suggestion box and notes that in his own practice, he gives patients a card with six yes-or-no questions on the front and space on the reverse side for patients to write out the three questions they would like to have answered during their visit. Dr. Baum also suggests creating online surveys with questions such as “How likely are you to recommend this practice to others?” and “How responsive were the staff and the doctors to your questions?” He concludes that urologists need to listen to their patients and need to ask them how they can serve them better.

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