| a-safer-smarter-approach-to-peer-review-and-patient-care | A Safer, Smarter Approach to Peer Review and Patient Care | Partners in Medicine | Shared_Content/News/Latest_News/2025/a-safer-smarter-approach-to-peer-review-and-patient-care | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2025/november-december/nov-dec-2025-reports-cover-cropped-645x425px.png" class="pull-right" alt="cover image from November-December 2025 issue of WSMA Reports" /></div>
<h5>Nov. 11, 2025</h5>
<h2>A Safer, Smarter Approach to Peer Review and Patient Care</h2>
<p>
By Brock Bordelon, MD And Sara Cameron
</p>
<p>
In today's rapidly evolving health care environment, peer review is no longer simply an administrative requirement. It has become a strategic necessity to ensure patient safety and clinical excellence. Whether it's deployed properly in hospitals or outpatient facilities, peer review plays a pivotal role in elevating care quality, reducing risk, and strengthening trust across clinical teams.
</p>
<h3>From punitive to proactive</h3>
<p>
In the past, peer review was often viewed as a punitive process, focused on finding fault in individual clinicians after an adverse event. Today's best practices emphasize a vastly different approach: continuous quality monitoring. Instead of looking at isolated complications in hindsight, modern peer review focuses on real-time trends and system-level concerns.
</p>
<p>
This shift encourages timely, unbiased feedback and helps organizations intervene before problems escalate. Well-designed peer review should no longer be about catching mistakes. It should be about learning from them and ensuring they don't recur. Caring for patients is the bottom line of any setting, and it's the responsibility of the medical staff to ensure that patients are receiving quality care.
</p>
<h3>A foundation of patient safety</h3>
<p>
Peer review is more than a compliance box to check. It's a frontline defense for patient safety. By evaluating care delivery through structured, objective criteria, peer review helps identify both individual and systemic issues that might otherwise go unnoticed.
</p>
<p>
This is particularly crucial in outpatient settings, where the clinical infrastructure can vary widely. Whether reviewing clinical notes, follow-up protocols, or procedural outcomes, peer review provides an opportunity to catch small concerns before they become larger risks. That goes for patients, physicians, and organizations alike.
</p>
<h3>Powered by clinical quality data</h3>
<p>
One of the most important developments in peer review is its integration with clinical quality data. Rather than relying on subjective case reviews, modern peer-review efforts draw on outcome metrics, documentation audits, and data trends. This enables reviewers to make evidence-based decisions that reflect real patterns of care.
</p>
<p>
These insights are especially powerful when combined with other quality tools like incident reports, root cause analyses, and patient satisfaction data. When seen together, they paint a more accurate, and actionable, picture of clinical performance.
</p>
<p>
Such data integration also enables comparative benchmarking, allowing clinics to evaluate how their processes stack up against peers or national standards. This can drive targeted improvement efforts and reduce unwarranted variations in care.
</p>
<h3>Credentialing, privileging, and professional practice evaluation</h3>
<p>
Another essential function of peer review is its role in credentialing and privileging. Today, regulatory bodies and accrediting organizations increasingly expect health care settings to move beyond one- time verifications and engage in continuous assessment of professional practice.
</p>
<p>
Peer review is often the cornerstone of ongoing professional practice evaluation and focused professional practice evaluation. These processes ensure that clinicians are consistently performing within the scope of their training and privileges, and that any emerging issues are addressed proactively.
</p>
<p>
Peer review helps credentialing committees make informed, fair decisions based on data and peer insight rather than hearsay or incomplete records.
</p>
<h3>Building a culture of safety and trust</h3>
<p>
Effective peer review supports both patient outcomes and clinician well- being and organizational culture. A collaborative approach to peer review can strengthen trust among the health care team, reduce burnout, and create a shared sense of accountability.
</p>
<p>
To get there, organizations must invest in reviewer training, clear processes, and psychological safety. This ensures that clinicians can give and receive feedback without fear of reprisal. Peer review should be collegial, consistent, and constructive, not a tool for turf battles or punitive actions.
</p>
<h3>Getting started</h3>
<p>
For organizations looking to implement
or improve a peer-review program, we
recommend:
</p>
<ul>
<li>Start with structure: Define clear criteria, workflows, and timelines for reviews.</li>
<li>Use multidisciplinary reviewers: Engage peers from similar specialties who understand the nuances of the clinical scenarios being evaluated.</li>
<li>Leverage quality data: Integrate peer review with clinical dashboards, risk reports, and quality initiatives.</li>
<li>Link to professional development: Use insights to guide mentoring, education, and privileging decisions.</li>
</ul>
<h3>A smarter path to safer care</h3>
<p>
In the end, peer review is more than a regulatory checkbox. It's a practical, data-informed way to make care better. As health care organizations face increasing complexity, regulatory pressure, and patient expectations, a well-run peer-review process can help clinics and other outpatient settings stay ahead of risk, strengthen clinical teams, and keep patients safer. By embracing peer review as a tool for learning, health care organizations can lead with transparency, improve outcomes, and create a culture where quality is everyone's responsibility.
</p>
<p>
<em><strong>Brock Bordelon, MD, FACS</strong>, is a surgery medical director and <strong>Sara Cameron</strong> a director of professional services with MDReview - A Hardenbergh Company.</em>
</p>
<p>
<em>This article was featured in the November/December 2025 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 11/11/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |
| career-tips-on-managing-your-retirement-account | Career Tips on Managing Your Retirement Account | Partners in Medicine | Shared_Content/News/Membership_Memo/2025/october-10/career-tips-on-managing-your-retirement-account | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2025/october/senior-couple-645x425px.png" class="pull-right" alt="Senior couple walking on the beach" /></div>
<h5>Oct. 10, 2025</h5>
<!-- ************************************* -->
<h2>Career Tips on Managing Your Retirement Account </h2>
<p><em>Jim Wilson, Northern Capital Management</em> </p>
<p>For many in the medical community, the largest retirement assets are 401(k) and 403(b) retirement plans. Making informed management decisions throughout your career can significantly impact your retirement. This article outlines key aspects of effective retirement plan management. </p>
<p>As a best practice, we recommend creating and annually updating a fee-based financial plan to help you stay on track. </p>
<p><strong>Income taxes</strong> </p>
<p>Traditional retirement plans reduce taxable income immediately but require taxes on withdrawals. Roth contributions, introduced in 1999, are made with after-tax dollars but allow tax-free withdrawals in retirement. </p>
<p>The choice between traditional and Roth depends on your financial plan and personal circumstances. In our experience, optimizing taxes in retirement generally requires a mix of both pre-tax and after-tax resources. </p>
<p><strong>To Roth or not to Roth?</strong> </p>
<p>Historically, retirees tend to be in lower tax brackets. The tax code benefits retirees through partial taxation of Social Security and favorable treatment of qualified dividends and capital gains. </p>
<p>If you anticipate a higher tax rate later, Roth contributions may be beneficial. If you expect a lower tax bracket in retirement, traditional contributions may be preferable. Tax laws change, making it crucial to assess current rates and fiscal policies. </p>
<p>Generally, taking advantage of known pre-tax deductions (e.g., 401(k), 403(b), health savings accounts, and deductible IRAs) before considering after-tax options like Roth is advisable. </p>
<p><strong>Employer match formulas</strong> </p>
<p>Employer-matching contributions provide free money-always take advantage of them! </p>
<p>Many employers offer a matching contribution up to a certain percentage of salary, helping employees boost their savings without additional personal contributions. In 2025, employees can contribute up to $23,500, with an additional $7,500 catch-up contribution for those age 50 and older. Higher catch-up limits apply for those aged 60-63. </p>
<p>Always contribute enough to receive your employer's full match. If both spouses have employer-sponsored plans, both should contribute up to the match. </p>
<p>Short-term employees should still consider contributing, especially if the plan includes a "safe harbor" match, which vests immediately. </p>
<p><strong>Vesting and last day of service</strong> </p>
<p>Employer contributions may be subject to a vesting period, typically three to five years, meaning you must remain employed for that duration to claim the full amount. Some plans also require employees to be employed on the last day of the plan year to be eligible to receive employer contributions. </p>
<p>If a new employer has a waiting period before contributions are allowed, consider alternative savings strategies such as increasing your spouse's contributions or using an IRA in the interim. </p>
<p><strong>Early year employment changes</strong> </p>
<p>If you're considering a job switch, check your new employer's plan to understand contribution rules and ensure a smooth transition to continue maximizing your retirement savings. Changing jobs early in the year can affect your ability to maximize contributions. If your new employer's plan has a waiting period for participation, you may not be able to contribute fully for that year. Consider alternative savings strategies such as increasing your spouse's contributions, maximizing prior employer plan contributions before you make the change, funding an HSA, or using an IRA. </p>
<p><strong>Retirement plan loans</strong> </p>
<p>Many plans allow participants to borrow up to 50% of their vested balance (maximum $50,000). While loans may seem attractive, they come with risks. Withdrawn funds stop earning market returns, which can hinder long-term growth. Loan repayments are typically deducted from payroll, but if employment ends before the loan is fully repaid, the outstanding amount may be taxed as an early withdrawal and subject to penalties. Other considerations include: </p>
<ul>
<li>Loan origination and annual fees </li>
<li>Fixed interest rates (usually tied to prime) </li>
<li>Maximum loan term </li>
<li>Payroll deduction repayment </li>
<li>Opportunity cost of lost investment gains </li>
</ul>
<p>Always evaluate alternative borrowing options before tapping into retirement savings. </p>
<p><strong>Beneficiary designations</strong> </p>
<p>Your beneficiary designations dictate who inherits your retirement savings. These selections override wills and trusts, so updating them regularly is crucial, especially after major life changes such as marriage, divorce, or childbirth. Spouses typically receive favorable tax treatment when inheriting retirement accounts, while naming minor children can create legal and financial complexities. </p>
<p>Consult with your estate planning attorney to ensure your designations align with your broader goals. </p>
<p><strong>Diversifying beyond retirement accounts</strong> </p>
<p>While tax-deferred accounts are essential, high earners should also consider taxable investment accounts for additional flexibility. Relying solely on tax-advantaged accounts can limit options in retirement. </p>
<p>A diversified approach, including taxable accounts, Roth IRAs, and real estate investments, can provide more withdrawal flexibility while minimizing tax burdens in retirement. Prioritize maximizing deductible retirement contributions first, followed by strategic after-tax investments. </p>
<p><strong>How much should I save?</strong> </p>
<p>A common question without a one-size-fits-all answer. </p>
<p>Many plans automatically enroll new employees at a default contribution rate, typically 2-4%. While this ensures immediate participation, the default rate is often insufficient to meet long-term retirement goals. </p>
<p>Financial experts generally recommend a contribution rate of 20% of gross income, including employer contributions, to stay on track for retirement. Increasing contributions over time is advisable. This "back of the napkin" calculation assumes some reliance on Social Security. </p>
<p>A comprehensive financial plan is a way to definitively determine your ideal savings rate. </p>
<p><strong>Working beyond your required minimum distribution (RMD) age</strong> </p>
<p>Pre-tax retirement accounts require withdrawals starting at age 73 (or 75 for those born in 1960 or later).</p>
<p>
Birth Year: 7/1/1949-1950<br />
RMD Age: 72
</p>
<p>
Birth Year: 1951-1959<br />
RMD Age: 73
</p>
<p>
Birth Year: 1960 or later<br />
RMD Age: 75
</p>
<p>If you continue working, you may defer RMDs by rolling funds into your current employer's plan. Another option is making Qualified Charitable Distributions (QCDs), which allow direct donations to charities, reducing taxable income while fulfilling RMD obligations. Proper RMD planning can help minimize taxes and maximize the longevity of your savings. </p>
<p><strong>Asset allocation</strong> </p>
<p>Retirement plans typically offer two primary investment approaches: </p>
<ul>
<li><strong>Do-It-Yourself (DIY)</strong>: Selecting mutual funds across different asset classes, including domestic and international stocks, bonds, and specialty investments. DIY investors should periodically rebalance portfolios to maintain an appropriate risk level. </li>
<li><strong>Do-It-for-Me</strong>: Designed for investors who prefer a hands-off approach, these funds automatically adjust allocations based on the target retirement date. While convenient, target-date funds may not align perfectly with individual risk tolerances or broader financial goals. </li>
</ul>
<p>For those working with a financial advisor, a customized investment strategy may offer better alignment with retirement planning needs and long-term financial objectives. </p>
<p><strong>Questions?</strong> </p>
<p>Northern Capital Management advisors are Certified Financial Planners with experience working with medical professionals. </p>
<p>You may reach us by utilizing our WSMA Member Contact <a href="https://northernwelcome.com/wsma-contact">Form</a>. </p>
<p>Washington State Medical Association is a client of Northern Capital Management and Northern Capital Retirement Services and receives compensation for promoting our services. As a result of the compensation arrangement there is an inherent conflict of interest. Disclosure </p>
<p><a href="https://northernwelcome.com/wsma-members">Northern Capital Management</a> </p>
</div> | 10/10/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |
| its-not-what-you-say-its-what-the-patient-hears | It's Not What You Say, It's What the Patient Hears | Partners in Medicine | Shared_Content/News/Latest_News/2025/its-not-what-you-say-its-what-the-patient-hears | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="WSMA Reports September-October 2025 cover" src="/images/Newsletters/Reports/2025/september-october/cover-wsma-septoct-2025-645x425px.jpg" class="pull-right" /></div>
<h5>Sept. 3, 2025</h5>
<h2>It's Not What You Say, It's What the Patient Hears</h2>
<p>
From Physicians Insurance
</p>
<p>
Communication is a core clinical competency. Communication competencies are necessary to build and sustain relationships with our patients, enable patient engagement and to optimize patient adherence to treatment plans and recommendations. Communication is complex and often changing, therefore developing a general understanding of these core competencies can be applied in multiple situations.
</p>
<h3>Developing communication competencies </h3>
<p>
Once words are spoken you have no control over how those words are understood. This is particularly challenging in difficult conversations, when there is a natural reaction to become defensive. This means is that the physician or practitioner will have to be deliberate in setting aside defensive mannerisms by engaging in active listening, ensuring the patient is understanding, and using appropriate vocal elements.
</p>
<p>
Difficult conversations may be met with unintentional meaning and therefore engaging the patient through the following active listening techniques may foster empathy by demonstrating that you are reflecting on the patient's thoughts and feelings. The patient's thoughts and feelings are believed, supported, and respected, instead of diminished or challenged. The patient will remember how they felt during the conversation.
</p>
<ul>
<li><strong>Paraphrasing:</strong> Restate the information you received in your own words. For example, "You understood that the medication was going to take two weeks to fully work."</li>
<li><strong>Verbalize emotions: </strong>Reflect on the patient's feeling and emotions in words. For example, "This made you feel unsure that the treatment was working."</li>
<li><strong>Ask questions: </strong>For example, "How are you feeling today?"</li>
<li><strong>Summarizing: </strong>Restating the patient's ideas, including the feelings they expressed. "You are concerned the medication isn't working and your symptoms are making you feel uncomfortable."</li>
<li><strong>Clarifying:</strong> Ask questions to clarify vague statements or restate your interpretation to acquire further clarification. "Was this on the same day?"</li>
<li><strong>Encouraging:</strong> Give space for the patient to keep talking. For example, "This appointment is yours, so we can talk about whatever you'd like."</li>
<li><strong>Balancing:</strong> Help the patient evaluate their own feelings by asking questions. For example, "How does that make you feel?"</li>
</ul>
<p>
Patient understanding is a huge piece of communication. Medical jargon should be avoided or explained in lay terms. Your words should be simple so if there is a complex issue, consider using visual aids to help explain. Check in with your patients understanding by using frequent pauses and asking questions, especially if explaining a complex process. A patient repeating back their understanding of what you said can also identify areas of needed improvement in communication.
</p>
<p>
Vocal elements include pitch, inflection, tone, rhythm, tempo, and pronunciation. There are some types of conversations that can be emotional and can impact tone which may result in an unintended consequence where the patient deciphers the message differently than how it was intended to be conveyed. There are strategies that can be used to alleviate fear and facilitate the physician or practitioner's ability to authentically convey emotions such as caring, empathy, and sincerity. These strategies include engaging in deep breathing exercises picturing talking to a loved one about the incident and having appropriate eye contact.
</p>
<p>
Body language is equally important in communicating with your patients. Some elements of body language to consider your use of are:
</p>
<ul>
<li>Blank facial expression (not having an expression deters a physician's efforts to create rapport and empathy).</li>
<li>Crossing your arms or legs (can come across to patients as if you are closed off, uninterested).</li>
<li>Sitting versus standing (standing over the patient while they are seated can be seen as intimidating).</li>
</ul>
<h3>Navigating multigenerational communication</h3>
<p>
Physicians and patients span generations, and it is imperative that communication preferences are understood for barriers to be removed. While there is no formula for effective and successful multigenerational communication, improved multigenerational communication requires an understanding of what shaped the generation, generational values and communication preferences and expectations. The following are generally recognized characteristics of four generations:
</p>
<p>
<strong>Baby boomers (1945-1964)</strong> grew up and were shaped during dramatic social change. They relate to public recognition and respect titles. Their focus is on process.
</p>
<p>
<strong>Generation Xers (1964-1980)</strong> grew up and were shaped during political and institutional instability. They relate fairness and define themselves by their broader life responsibilities. They respect ideas more than titles. Their focus is on results.
</p>
<p>
<strong>Millennials (1980-2000)</strong> grew up and were shaped by technology and instant gratification. They relate to ways that they can make a difference. They respect skills more than titles or ideas. Their focus is on involvement. Millennials outnumber Boomers. They are high-touch and consumer-centric. They are confident, have high expectations and aspire to make a difference. They appreciate partnerships and open communication.
</p>
<p>
<strong>Generation Z (approximately 1995 - 2010)</strong> are digital natives. They grew up and were shaped by access to technology from a young age. They communicate via instant messaging, texts, and social media. Generation Z values ethics, individuality, and independence. Gen Z forgoes labels for self-expression. They are focused on health, the environment, and social justice. They make their decisions in analytical and pragmatic ways. They are the most ethnically and racially diverse.
</p>
<p>
Understanding intergenerational communication can be rewarding. Here are some ways to bridge the generation gap:
</p>
<ul>
<li><strong>Active listening: </strong>Utilize nonverbal body language to convey listening and understanding.</li>
<li><strong>Empathy:</strong> Try to understand the perspectives and experiences of the patient's generation.</li>
<li><strong>Clear language:</strong> Slang may not be understood by another generation. Using straightforward language that is clear and simple to understand by any age is best practice.</li>
<li><strong>Technology: </strong>Ask questions and learn your patient's threshold for technology and preferred use.</li>
<li><strong>Ask questions:</strong> Show interest and appreciation in your patient's experiences and opinions to reach a meaningful relationship.</li>
<li><strong>Seek training:</strong> Improve your skills in providing intergenerational care through training.</li>
</ul>
<h3>Sex and gender identity in communication</h3>
<p>
Historically, health care focused on a patient's sex, their biology. In today's world, the inclusion of a patient's gender, which reflects the psychological orientation of a person, matters. As this area grows, we encourage attention to be given to a patient's preferred gender when communicating. Adding this can benefit your patient's mental health as well as lead to positive patient outcomes. A patient can feel respected and "seen" or "heard" when you honor their preferred gender while treating their biological needs.
</p>
<h3>Incorporating cultural sensitivity</h3>
<p>
While a very complex area, the significant barriers related to cross- cultural communication can be patient safety risks and ethical matters. Culture includes traditions, customs, norms, beliefs, values, and thought patterns that are often passed down throughout generations. Incorporating cultural sensitivity into your medical practice allows you to better understand and meet your patient's clinical needs. This can aid in positive health outcomes and greater patient safety. A patient's culture can influence their attitudes and even willingness to disclose information or consent to a treatment. Being culturally sensitive can enhance your trust with patients. In case of a language barrier a medical interpreter should be offered and used and documented in the medical record.
</p>
<p>
Focusing on the below principles can help improve cultural sensitivity when communicating with your patients.
</p>
<ul>
<li>Recognize your own ethnocentrism (believing that the customs and practices of your culture are superior to those of other cultures).</li>
<li>Develop a higher tolerance for ambiguity.</li>
<li>Reduce the level of evaluation in your messages.</li>
<li>Prepare your message. The roles and rules of the patient's culture should drive the communication. Physicians and practitioners should prepare their message by adapting to the patient's culture.</li>
<li>Remove assumption. Do not assume that nonverbal communication such as eye contact, gestures, posturing, touch, and physical distance are common to all cultures.</li>
<li>Seek training and education on diversity, equity, and inclusion to improve skills in providing culturally competent care.</li>
</ul>
<p>
None of us are perfect at communication. Practicing with colleagues, friends, and family to strengthen our skillset and application is recommended. Being aware of our shortcomings in communication is half the battle.
</p>
<p>
<em>This article was featured in the September/October 2025 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 9/3/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |