June 23rd, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion, Research
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A new study published in the Annals of Internal Medicine, ACP’s flagship journal, finds that medical schools vary greatly in producing more primary care physicians and getting them into underserved communities.
– “Public schools graduate higher proportions of primary care physicians” than private schools.
– “The 3 historically black colleges and universities with medical schools (Morehouse College, Meharry Medical College, and Howard University) score at the top” in training primary care physicians who then go on to practice in underserved communities. (Click here for an interview with two recent graduates of historically black colleges and with Wayne Riley, MD, FACP, who is the president and CEO of Meharry Medical College in Nashville, Tennessee and a regent of the American College of Physicians.)
– “The level of NIH support that medical schools received was inversely associated with their output of primary care physicians and physicians practicing in underserved areas.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
June 21st, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
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Friday, the Senate — in a rare stroke of bipartisanship — voted by unanimous consent to reverse the 21 percent SGR cut and provide positive updates of 2.2 percent through November 2010. The legislation is fully paid for by offsets in other spending programs.
Unfortunately, though, the cut remains in effect and claims are being processed at reduced rates, because the House of Representatives has recessed for the weekend and won’t be back until Tuesday. At that time, I expect that the House will pass the Senate’s six-month reprieve and Medicare will make doctors “whole” for the period of time that the cut was in effect.
Not that any of this is a cause for celebration. In the meantime, claims still are being paid at reduced rates, creating havoc for physicians and patients. Kicking the can down the road for another six months doesn’t get us any closer to a permanent solution. It doesn’t lower the overall cost, now estimated at over $200 billion, to dig out of the SGR hole. It doesn’t provide the stability and reliability that physicians and patients need to view Medicare as a trusted partner. It does mean that we will be back again, this summer and fall, fighting to forestall another double-digit cut. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
June 1st, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
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Instead of blogging (again) about Congress’s failure to stop the 21% Medicare SGR cut, which went into effect today, I could just re-run my April 16 post. I wrote then:
“It is the failure of both political parties, over many years, to honestly deal with the SGR, including the cost of getting rid of it, which has resulted in the current ongoing SGR farce. And yet members of Congress wonder why the public holds them in such low regard.”
Blogging in DB’s Medicare Rants, Dr. Bob Centor captures the outrage felt by most physicians:
“I am mad. Every physician I know is mad. Patients should join us in expressing anger. Physicians cannot trust Congress if they cannot repair this absurdity.”
(Bob references ACP’s statement, released on Friday; click here to read it in its entirety.)
That Congress allowed politics again to get in the way of doing what is best for patients makes my blood boil. Voters can and should hold them accountable. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
May 26th, 2010 by BobDoherty in Better Health Network, Health Policy, Humor, Opinion, Research, Uncategorized
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Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.
— From A.A. Milne’s “Winnie the Pooh and the House at Pooh Corner.”
Internists, I expect, will identify with Edward Bear.
Richard Baron’s study in the NEJM on the amount of work he and his colleagues do outside of an office visit — the “bump, bump, bump” of a busy internal medicine (IM) practice — has resonated with many of his colleagues.
Jay Larson, who often posts comments on this blog, did a similar analysis for his general IM practice in Montana, and found that for every one patient seen in the office, tasks are done for 6 other unscheduled patients. Jay writes: “So really there [are] internists [who] are managing about 130 patients per day. Not much consolation when they only get paid for 18 per day.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
May 12th, 2010 by BobDoherty in Better Health Network, Health Policy, Opinion
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“Bold changes are needed in how the United States delivers and pays for primary care if the key goals of national health reform are to be achieved,” according to the health policy journal Health Affairs, which has released a thematic issue devoted entirely to the crisis in primary care.
(The complete articles are available only to subscribers, but Health Affairs’ blog has a good summary.)
I have spent much of the day reading the journal — 47 articles, and a combined 300 pages of text. Here are my “take-home” messages from the articles. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
