March 19th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
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The Jobbing Doctor, a primary care doctor in the UK, writes about the British version of what Americans call “Pay for Performance,” or “P4P.”
He says something I’ve said many times before (like here, here, and here). Which is this: incentives fail because they try to treat medicine as an assembly line process, when it’s not.
But what’s most interesting about his post is that it could have been written by a doctor from anyplace on the planet Earth.
The Jobbing Doctor talks about a UK program that started in 2004 called the Quality and Outcomes Framework, or “QoF.” Now, the American “P4P” is a much more catchy name, so score one for American marketing. But it doesn’t matter what you call it – that which we call a rose would, by any other name smell as sweet. Read more »
*This blog post was originally published at See First Blog*
February 2nd, 2010 by BobDoherty in Better Health Network, Health Policy
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Yesterday, I borrowed liberally from Dr. Seuss’ “Oh, the Places You Will Go” to describe the “weirdish, wild space” - The Waiting Place - in which we now find health reform.
This got me thinking about The Waiting Place in a different context: the time it takes to get an appointment with a physician. Anyone one of us who has had to wait weeks, or even months, for an appointment would agree that The Waiting Place is, as Dr. Seuss described it, a “most useless place” to be.
Critics of the pending health reform bills, like Conservatives for Patient Rights argue that they will lead to longer wait times for appointments. Their argument being that “government-run” health care, as exists in Canada or the United Kingdom, has been demonstrated to result in long waits for medical appointments.
I would dispute the premise that the reforms being considered by Congress are akin to the systems in place in Canada or the United Kingdom. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
January 30th, 2010 by Berci in Better Health Network, News
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You may have heard about Andrew Wakefield who tried to find a link between MMR vaccines and autism. He has published several papers. Now it turns out he acted unethically in carrying out his research according to a medical regulator.
Doctor Andrew Wakefield’s 1998 study, published in the Lancet medical journal, said there might be a connection between the measles, mumps and rubella (MMR) injection and autism.
The suggestion horrified parents and led to a slump in the number of youngsters getting the jab, as well as triggering heated debate in medical circles.
In a ruling Thursday, the General Medical Council attacked Wakefield for “unethical” research methods and for showing a “callous disregard” for the youngsters as he carried out tests.
This included taking blood samples from children at his son’s birthday party for five-pound payments.
Why am I writing about it?
Because we all have to learn from this. Read more »
*This blog post was originally published at ScienceRoll*
January 11th, 2010 by DrRich in Better Health Network, Health Policy, Opinion
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As has been pointed out (pointedly) to DrRich, we do not have death panels in the United States. And indeed, considering that we’re not conducting military tribunals for Islamist terrorists who have tried (or succeeded in) killing and maiming as many of us as possible, it seems relatively unlikely that we’d assemble death panels (which sound even less due-process-friendly than military tribunals) for American patients.
What we will have, however, is a federally-mandated assembly, body, committee, commission, board, diet, parliament, or posse (but not a panel) of experts which will carefully evaluate all the objective clinical evidence regarding a particular medical treatment, and make “recommendations” to doctors about whether or when to use that treatment. The model which frequently has been offered up for our consideration, as we contemplate the workings of such a non-death-panel, is the British National Institute for Clinical Excellence, or NICE. Read more »
*This blog post was originally published at The Covert Rationing Blog*
November 22nd, 2009 by DrDavidKroll in Announcements, Better Health Network
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No matter how early I wake up, it’s always five hours later in the UK and I’m overwhelmed by the thought that I’m already behind (I won’t even get into the feeling I have when I think of our Australian readers).
So when I start the day reading my Twitter stream, it’s usually populated by midday news from England. I follow the NHS - National Health Service - “one of the largest publicly funded health services in the world,” and their superb health information site, NHS Choices.
This morning I saw this tweet about the launch of their new sexual health site:
@NHSChoices Our new sexual health hub includes advice on contraception, good sex guides, sex & young people, STIs and much more http://bit.ly/3wtJwL Read more »
*This blog post was originally published at Terra Sigillata - PostRank (PostRank: All)*
September 30th, 2009 by DrToniBrayer in Better Health Network, Health Tips
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I heard an interview with T.R.Reid and can’t wait to read his book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. He traveled the world and compared how developed countries manage health care. He makes the point that all other developed countries have universal coverage. No-one is left out.
He found four basic systems (some named after their founders):
Read more »
*This blog post was originally published at EverythingHealth*
July 9th, 2009 by Berci in Better Health Network, News
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If you are a hospital, healthcare facility or parent system considering social media, please take the time to learn what is happening in the “Twittersphere”, and do pay attention to the evolving “agreements” of Twitter-etiquette.
*This blog post was originally published at ScienceRoll*
May 18th, 2009 by DrJonathanFoulds in Better Health Network
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I’ve previously written about what face-to-face smoking cessation services typically do, largely based on my own experience. However, while at the SRNT annual conference I met two Smoking Cessation Advisors working in Lancashire, England who appeared to have a successful service, so thought it worth sharing some of their information.
Jan Holding and Eileen Ward manage a UK National Health Service (NHS) Stop Smoking Service in Lancashire in the north of England. Both are nurses by training and many of the 14 staff providing the treatment have primarily a nursing background. Their service sees around 450 new clients per month (i.e. over 5000 new clients per year). Services are provided at “community sessions” at various locations all over their catchment area, and clients are given their own hand-held record which they keep, and take with them to sessions, enabling them to attend whichever community location suits them at the time. While clients can make scheduled appointments, the service is also flexible, allowing clients to “drop-in” to community sessions without an appointment. Although some initial assessment sessions take place in a group format, most of the sessions are delivered in a one-to-one format via a relatively brief discussion with a smoking cessation advisor. These community sessions often take place in a large community room from 4pm to 8 pm in the evening, with multiple types of services being provided in the same room at the same time at different corners (e.g. initial assessments in one corner, prescribing of varenicline in another, and nicotine replacement therapy in another). It is not uncommon for around 200 clients to attend a single community session.
Clients are frequently encouraged to use NRT prior to quitting smoking (about half do this) and usually use more than one smoking cessation medicine (more than half do). Nicotine replacement therapy is provided via a voucher system requiring either no cost to the client, or just a co-pay (around $10 USD).
The service runs 6 days per week and includes evening sessions, and aims to reduce most of the usual barriers to entering treatment. Their “3 As” approach emphasizes “Accessibility, Availability and Adaptability”. They also specifically try to develop smoking cessation advisors who are passionate about their role, have a positive attitude to the importance of quitting smoking, and are therefore very committed to that work, as well as being knowledgeable about it.
My understanding is that the quit rates at this service are pretty good. But perhaps the best testimony to its success is the fantastic volume of clients who attend…..largely influenced by positive word-of-mouth via other clients. The success of this service reminds us that there isn’t just one way to do it, that all smoking cessation counselors and systems may need to be flexible and adaptable in order to help as many smokers to quit as possible.
For further information on what a smokers’ clinic does, see: What does a tobacco treatment clinic do?
This post, Smoking Cessation Programs: Lessons From The UK, was originally published on
Healthine.com by Jonathan Foulds M.A., M.App.Sci., Ph.D..
