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Non-Endorsement Of The National Nurse Act: A Letter To The ANA

Office of the National NurseTo the American Nurses Association,

I am a member of the American Nurses Association (ANA) and a dedicated supporter of HR 4601 The National Nurse Act. For the life of me, I cannot understand ANA’s reluctance to endorse the National Nurse Act. The infrastructure already exists, in fact the position already exists. The Act seeks to have the Chief Nursing Officer of the U.S. Public Health Service designated as the National Nurse.

There is nothing political about this –- the nominating procedure for the position does not change. It is not a presidential appointment, nor is it a Cabinet position. And it costs nothing to implement -– it’s already funded. It takes no resources away from other nursing initiatives and competes with no other nursing organization. But more importantly, it gives the public a visible nurse leader as our healthcare delivery system transitions to one that focuses on health and the prevention of disease.

And yet, the ANA doesn’t endorse the Chief Nurse Officer of the U.S. Public Health Service being known as the National Nurse. Why? Read more »

*This blog post was originally published at Emergiblog*

“Whoop-De-Do!” To The Medicare Physician Pay Cut Problem

After months of dithering, delaying, denying, and defaulting on a decision, Congress ended up…doing as little as possible to address the Medicare physician pay cut problem.

Thursday night the House of Representatives acceded to the Senate’s bill to provide physicians with a 2.2 percent update retroactive to June 1. This respite, though, lasts only through the end of November, when physicians and patients will again face another double-digit cut. And if the past is prologue, a lame-duck Congress then will wait until the very last minute to enact another short-term patch, or worse yet, allow the cut to go into effect on December 1 and then pass some kind of retroactive adjustment.

You know that the situation has gotten ridiculously bad when the President says this about the bill he just signed into law:

“Kicking these cuts down the road just isn’t an adequate solution.”

And when Speaker Pelosi (D-CA) calls it “inadequate” and a “great disappointment” and the best that any had to say about it was this from SFC ranking member Charles Grassley (R-IA):

“This action was critically needed so there’s no disruption in services for anyone.”

But it’s too late. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

SGR: Tired Of Congress Hitting The 6-Month “Snooze” Button

I have not a single thing I want to write about today. I am weary of the obvious topic: the “passage” of the 6-month extension on the SGR, but do feel I need to comment.

I am tired of this. I am tired of being jerked around by congress. I am tired of congress hitting the 6-month snooze button and somehow feeling that they are doing something good. This is procrastination, not a solution. Reassurances that something will be done are starting to be irrelevant. The problem is becoming the frustration, anger, and exhaustion that congress is thrusting upon doctors and patients, not the pay cut itself. The idea of no longer having to deal with the passive-aggressive tactics of congress is becoming increasingly appealing –- and if it’s this way for me, I’m sure it’s the same for PCPs across the country. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Medicaid In A Squeeze

New reports peg Medicaid’s future as dismal and unsustainable, as states struggle for ways to pay for the rising costs of caring for their poorest residents. The Deloitte Center for Health Solutions study, “Medicaid Long-Term Care: The Ticking Time Bomb,” estimates Medicaid costs will nearly double as a percentage of state budgets by 2030, or perhaps nearly triple.

Meanwhile, the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured estimates Medicaid expansion will cost $464.7 billion by 2019. The federal government will cover $443.5 billion (95.4 percent) and the states will cover the remaining $21.2 billion. Minnesota won’t expand its Medicaid program until 2014 because of budget fears. Connecticut will. (The Fiscal Times, MedPage Today, Reuters, U.S. House Rep. John B. Larson)

U.S. Senators, meanwhile, are looking to phase out federal subsidies Medicaid as a way of pushing through stalled legislation — the same package that had included the “doc fix.” Speaking of that, Sen. Majority Leader Harry Reid said the Senate may soon turn its attention away from that toward other issues. (Wall Street Journal, The Hill, ABC News)

*This blog post was originally published at ACP Internist*

Is Doctor-Patient Communication Better In “Medical Homes?”

Probably not yet. I think everyone would agree that Group Health of Seattle probably has a pretty good “take” on issues dealing with primary care redesign and the patient-centered medical home (PCMH). That’s why I surprised by a recent comment on a Group Health blog from by Matt Handley, M.D., in response to an earlier post here about patient question-asking. Dr. Handley is an Associate Medical Director for Quality and Informatics at Group Health.

Dr. Handley writes:

“While doctors often take pride in how open they are to patient questions, our self assessment doesn’t match up very well with empirical evidence. A recent post on Mind the Gap summarizes a small study that is relatively terrifying to me –- the take home is that doctors spend very little time explaining their recommendations, and that patients rarely ask questions.”

I picked up the phone and talked with Dr. Handley about his comments and work being done on PCMH at Group Health. Read more »

*This blog post was originally published at Mind The Gap*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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