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Security Of Patient Records: The Weakest Link

The Queen of Soul famously wailed about being a link in a “chain of fools.” The lead story in the August 13th Boston Globe tells us about another sort of link in the chain — the weakest link in the chain of custody of patient records.

In brief, a pathology billing service bought out by another service apparently dumped all records more than a year old in a town dump. A Globe photographer taking out his own trash noticed that the paper records (which he was looking at because he thought they ought to be recycled rather than dumped) had identifiable patient data and represented at least four hospitals from across Eastern Massachusetts. Clearly, these records ought to have been shredded or otherwise destroyed before disposal. Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

Primary Care Doctors And The Medicare Boycott

I saw this interesting article linked to from a blog about angry doctors dropping out of Medicare in Texas. As one who shares the universal annoyance at congress’ failure to fix the SGR for more than 30 days at a time, I was kind of cheered by this. That’s what it will take to get the system fixed — a grassroots, full-scale rejection of the system! Good for them. And the opening lines of the article were encouraging:

Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.

An “alarming” rate. Wow. Cool. So how many is that, anyway?

More than 300 doctors have dropped the program in the last two years, including 50 in the first three months of 2010, according to data compiled by the Houston Chronicle. Texas Medical Association officials, who conducted the 2008 survey, said the numbers far exceeded their assumptions.

That’s 300, right? Hmm, not too shabby. Not exactly going to topple the state with that, but it’s a start.

Hey, I wonder how many doctors there are in Texas, anyway? I hear it’s a pretty big state, though I seem to recall it consists mostly of scrubland and swamp. Maybe there are only like 500 doctors in the state to start with. Something is tickling my head about Texas, though, I vaguely remember that they had some nice tort reform law a few years ago that I was pretty envious of. Read more »

*This blog post was originally published at Movin' Meat*

Emergency Care’s Ambiguity In The Affordable Care Act

There’s just so much hidden and buried in the Affordable Care Act (ACA) that it’s like trying the find all the goodies in an Easter egg hunt. ACEP News pointed out one hidden goodie, nicely illustrated in this article from Kaiser Health News:

Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.

The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the “prudent layperson” rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.

The provisions go into effect for every health plan issued after Sept. 23 – six months after the law was enacted — that offers emergency coverage.

This is potentially quite significant. As with so many things, the devil is in the details, and the implementation is not yet actualized. Read more »

*This blog post was originally published at Movin' Meat*

Most People Aren’t Angry About Healthcare Reform

I just got back from a wonderful week in Toronto, Canada. No, I wasn’t up there to take tips on how to impose socialized medicine on an unsuspecting public, notwithstanding what some of you may incorrectly-surmise about my political leanings.

Rather, I was there to attend ACP’s annual scientific meeting, during which I had the opportunity to serve as faculty for three separate scientific sessions that discussed the impact of the new Patient Protection and Affordable Care Act (PPACPA) of 2010 on internists and their patients. Several hundred ACP members attended these sessions.

And guess what? Rather than encountering doctors who were angry at the new law and ACP’s support for it, I instead found an engaged and curious group of internists who are looking at health reform in a reasoned, measured and open-minded way. Read more »

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

Middle Ground For Healthcare Reform

Partisan rancor was one of the signatures of the recent healthcare reform debate. Can middle ground actually be sought? That’s a question that Eric Segall asks in a recent AOL News op-ed. As is the case in Washington, both sides are to blame. Read more »

*This blog post was originally published at KevinMD.com*

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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