The business of medicine. (Editorial).

Expertise in management of the business aspects of a medical practice is often the weakest area of a physician's education. Most doctors must learn quickly on the job about business or end up working for someone else who does it for them. The complexities of CPT and ICD-9-CM coding; managed care; CMS-855 forms that are frequently required; federal, state, and local laws; and third-party payer requirements make the care and healing of the sick the easiest and, of course, the most gratifying part of our day.

This month EAR, NOSE & THROAT JOURNAL introduces Practice Management Clinic, authored by Steven F. Isenberg, MD. Dr. Isenberg is well qualified to advise physicians about the business of running a medical office successfully. He has had a thriving otolaryngology practice in his native Indianapolis for more than 20 years. He is the author or editor of four books on practice improvement, has authored many scientific papers, and is chair of the Practice Management Committee of the AAOHNS. He is the founder and director of Isenberg Medical Communications, which markets the Practice Improvement Program through a new for-profit division of the AAO-HNS.

The first Clinic introduces the most important business issue facing otolaryngologists--the high cost of collecting reimbursement. A totally unproductive artificial situation has been purposefully created by third-party payers as a scheme to delay, reduce, or avoid payment altogether. The annual cost of collecting our fees amounts to one-fourth of a typical otolaryngology practice's total income, an unacceptably high amount. The losses and the harassment of dealing with third-party payers is compelling many physicians to switch to a cash-only business. I believe that this new Clinic will be of great practical value to our readers. Please let us know what you think. We wish you a happy and prosperous New Year.

JACK L. PULEC, MD

Editor-in-Chief

EAR, NOSE & THROAT JOURNAL