March 24th, 2010 by DrRich in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays
Tags: Doctor Shortage, Healthcare Policy, Healthcare reform, PCP, Primary Care Physician, Senate Healthcare Bill
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DrRich is obviously far more intelligent than those wayward Democrat Congresspersons, whose last-minute “yes” votes Speaker Pelosi is seducing with her winning smile, and with her double-super-hope-to-die promise that the Senate will surely agree with the reconciliation package the House has finally assembled.
Unlike Pelosi’s reluctant Blue Dogs, DrRich understands that once the House has deemed the Senate bill to have been passed, and the President signs it into law, and the confetti drops and the champagne pops and the press goes into raptures and the work begins to revise Mt.Rushmore, the odds immediately become vanishingly small that the President, the Senate, or even the 200 House Democrats who really like the new law, will actually then embark on a new, prolonged, contentious spectacle of a reconciliation fight in the Senate.
Rather, once healthcare reform becomes law, political expediency dictates that we in the teeming masses never hear another word about healthcare until after the November elections. We will be distracted by more pressing matters, from which there will be many to choose — gasoline prices, Iranian nuclear weapons, economic collapses in the PIIGs, etc.
Now, DrRich does not have the stamina to study the new law all at once as a whole. He must bite off little pieces. And the first thing he sought in embarking on his study of our new healthcare system was evidence of how the new law would rescue the Primary Care Physician (PCP). Read more »
*This blog post was originally published at The Covert Rationing Blog*
March 24th, 2010 by DavidHarlow in Better Health Network, Primary Care Wednesdays, Research
Tags: IOM, Lucian Leape Institute, Medical Errors, Medical School, Morbidity, Mortality, Patient Safety, Safe Patient Care
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Ten years after the release of the IOM report To Err is Human, which documented the toll taken by medical errors in this country, the question remains: What can be done to reverse the trend of ever-increasing morbidity and mortality due to medical errors? Last December, a look back over the decade since the release of To Err is Human — and a steady medical error death rate of about 100,000 per year included a series of suggestions for tweaks to the health care delivery system that may help ameliorate the situation. Earlier this week, a gadget that enforces good handwashing technique by sniffing caregiver and clinician hands for soap before a hospital patient may be touched has been touted as potentially saving significant costs related to HAIs.
Today, the Lucian Leape Institute released a report titled Unmet Needs: Teaching Physicians to Provide Safe Patient Care which focuses on moving back the point in time where an intervention is needed to reverse the trend documented in To Err is Human and since. Leape and his colleagues at the National Patient Safety Foundation are now focused on reinventing the medical school curriculum, so that patient safety will be taught more effectively in medical schools. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
March 24th, 2010 by DrRob in Better Health Network, Health Tips, Opinion, Research
Tags: CAM, Complimentary and Alternative Medicine, Evidence Based Medicine, General Medicine, Research, Science Based Medicine, Traditional Medicine
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Here’s some advice I have given teenage boys who are going toe-to-toe with their mothers about a health issue:
Don’t go toe-to-toe with your mother; it’s a no-win situation. Either you are right, and you are looked at as a “smarty-pants” or you are wrong, and have given her a huge “I told you so.” If, on the other hand, you keep quiet and listen to what she’s saying, it’s a win-win: either she’s right and you learn something, or she’s wrong, and you have been vindicated.
Fathers often pipe in that this applies to wives as well. Mom’s don’t seem to disagree (for some mysterious reason).
While this may be sound relational advice, it also needs to be heeded by the medical community in its relationship to “complimentary and alternative medicine” or CAM. I am not saying we shouldn’t be angry and frustrated with the CAM purveyors who are harming and even killing people (such as the anti-vaccine movement). I am not saying that we should embrace CAM and put it at anywhere near equal footing with our profession. What I am saying is that in our enthusiasm to win the argument, we can undermine our own credibility. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
March 24th, 2010 by DrWes in Better Health Network, Health Tips, News
Tags: Cardiology, Concierge Care, Concierge Medicine, Internal Medicine, Pacific Heart Institute, Primary Care
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Concierge medicine isn’t just for internal medicine or primary care anymore. It seems the concept is starting to take hold in cardiology, too:
Starting April 1, patients at Pacific Heart Institute can choose one of four plans for care. In the first option, they pay no “participation fee.” In the second option, called “Select,” they pay $500 a year for priority appointments, warfarin adjustments, defibrillator and pacemaker follow-up, notification of non-urgent lab, and test results, according to Pacific Heart Institute.
In the third option, called “Premier,” they pay $1,800, for everything in “Select,” plus e-mail communication with their doctor, same-day visits during regular office hours, priority lab testing and scheduling of diagnostics, free attendance at speaker seminars on cardiovascular issues, and a dedicated phone line to reach an institute nurse.
In the fourth option, “Concierge,” they pay $7,500 for everything in “Premier,” plus direct 24-hour access to a cardiologist via pager, e-mail, text message, plus the patient’s PHI cardiologist’s personal cell phone, annual personalized cardiovascular wellness screening, night and weekend access to a PHI cardiologist for hospital or emergency services, (regardless of whether he or she is on call) same-day visits with the cardiologist, evening and weekend office appointments and personal calls from the cardiologist.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
March 23rd, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, News, Opinion
Tags: Hospitals, Legislation, Manager's Amendment to Reconcilliation, Mean Household Income, Medicare spending, Poverty
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The final House “Manager’s Amendment to Reconcilliation“ provides $400M for hospitals located in counties in the lowest quartile of Medicare spending, adjusted for age, sex and race — but not income. Coupled with annual cuts of $10B in DSH and $1.5B for re-admissions, this is bad news for the poor and the hospitals that care for them. Mayo Clinic wins!
Note that adjustments cannot be based on counties. Urban counties are too big and economically varied. When the extremes of wealth and poverty are averaged, mean household income is 128% of average in Washington DC, 113% in LA, and 108% in Chicago (Cook County), all with dense and costly poverty ghettos. Without any poverty, mean household income in Olmsted County (home to Mayo Clinic) is the same as in LA. Very few truly poor counties will qualify for such payments. This is another example of the truism that “Poverty is the Problem; Wealth is the Solution.”
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
