Ethel Owen, practice administrator in West Palm Beach, FL, and newly elected NORM president, has served on the board of the National Organization of Rheumatology Managers (NORM) since 2007. She spoke with Rheumatology Practice Management (RPM) at NORM’s 2015 Practice Managers Conference in Bellevue, WA, about some of the challenges facing healthcare professionals, the importance of leadership, and the power of NORM.

Can you share some of your bio for our readers?

I’ve been in healthcare for many years and have worked for outpatient centers, big industry, orthopedic groups, and a multispecialty organization. I came into rheumatology in 2006 knowing nothing about the specialty and just fell in love with it. Thankfully, I’ve been able to retain a passion for the field after all these years. It’s a great environment, and I’m going to be here until I retire.

What is it about rheumatology that makes it so special?

Rheumatology is a warm and gentle environment. Our patients are lifers, and our physicians are wonderful, they really are….It’s not always about the money. Medicine’s hard right now, but there’s a feeling of fulfillment—doing a job well and being happy with what you do. You can sense the passion from many of our attendees.

You’ve been with NORM since almost the beginning. How has it changed over the years?

When I came to my first NORM meeting in St. Petersburg, FL, I’d been at my position for only a couple of months. It was a learning experience for me. I’d been in medicine for many years, but I really didn’t understand the costs of the drugs, the market of the prior authorization for the drugs, the “buy and bill” model, etc, so it was invaluable. One of the things that I felt immediately was the relationships. There was a remarkable willingness to help and grow this organization forward.

In 2007 we had 9 managers. It was a half-day session, and they basically just took the speakers who were on the physician side and brought them over to the managers’ side….I’m proud to say that last year we had 100 managers attend the meeting, and every year we’ve grown by double digits.

What are some of the most vexing issues facing rheumatologists today?

A successful launch and implementation of ICD-10 that’s probably the immediate goal. When I look at my business model, I have an immediate to-do list of things to prepare. Then, I’m trying to look a year or 2 out. Finally, if I’m feeling ambitious, I try to look 3 to 5 years into the future. You used to be able to come up with a 5- to 7-year plan or even a 10-year plan, but that just doesn’t live in medicine anymore.

So, my biggest concerns involve the payment reform that’s out there—the value-based modifier and other [quality metrics]. The government knows where it wants to get, but it doesn’t yet have a good road map or foundation to get there.

This is something I try to get out of my NORM membership, because I think we used to feel better prepared. Now, however, there’s constant change, constant adaptation; there are so many things to keep up with.

What drives you?

I’m passionate about the NORM organization from a patient perspective. Our specialty is a small clinical specialty, but most of our patients have multiple chronic comorbidities. It’s not one-and-done treatment. We’re treating many patients over a long period of time. And it’s often generational, so we’re treating their family members, too. So, we’re very passionate about our patients, and the healthcare costs that are facing these individuals are not sustainable. Those are some of my immediate concerns—probably most important the access to care for my patients.

Can you discuss some of the issues regarding costs?

In the first presentation, Dr Larry Van Horn talked about the national debt and the costs of healthcare, and it’s alarming. I have 3 children and a 12-year-old granddaughter, and if you look at out-of-pocket expenditures, it’s just not sustainable.

At the same time, there are some great drugs out there that actually eradicate disease from the patient’s body. Who can put a cost on that? I can’t answer those questions; somebody smarter than I am has to fix the problem. But those questions live in my world…I do think there’s a lot of recognition right now, which is good, and there’s a lot of momentum that the debt crisis is real. People are finally examining these problems and trying to do an overhaul of the entire payment system, which is long overdue. But it’s still a very daunting task. I don’t know if they have it figured out yet.

Does NORM have plans to take initiatives on Capitol Hill?

Well, NORM is not a 501(c)(6), so we’re not an advocacy organization. NORM has signed on to some position papers, but it’s not the primary goal of our organization. However, we do educate about advocacy on behalf of patients or managers and how to take that back and implement that at the state level. It’s definitely an area that we’re looking into right now, but direct advocacy is not currently within the scope of our mission. But, NORM does educate about advocacy.

Patients need to become their own advocates, as well. It’s important for them to take control of their own healthcare. That’s what we try to do with our patients—we try to figure out how to meet their needs while educating them to have responsibility for some of the outcomes.

What does NORM mean to its members?

Ever since I’ve been a member, I’ve known that, if I had an issue or a problem, I could pick up the phone and call somebody. And even if they didn’t know the answer, we could work through the problem and figure it out. That’s special.

Rheumatology is such a small community, so it’s vital that we network, unite, and work together. My colleagues here are wonderful leaders, who are willing to share, and that is what makes our organization so strong.

In the end, it’s really about access to care for our patients and making a difference in people’s lives. But, we are also in the business of medicine. If I can’t run a decent business, then I’m not going to be able to keep my doors open. So, I understand the economics, but my personal philosophy and mission are just do the right thing. Do the right thing professionally, do the right thing organizationally, and don’t lose sight of the importance of the patient.

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