December 6th, 2010 by Michael Kirsch, M.D. in Better Health Network, Health Policy, Opinion
Tags: Alice Rivlin, Bipartisan Proposal, Cost of Healthcare, Dr. Michael Kirsch, Freely-Made Healthcare Decisions, Government-run Healthcare, Healthcare Decision Making, Healthcare Economics, Healthcare Politics, Healthcare reform, MD Whistleblower, Medical Entitlement, Paul Ryan, Political Dynamite, Privatizing Medicare, Privatizing Social Security
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In response to my recent post where I averred that the cigarette companies were treated as scapegoats, I have had several cyber and actual conversations about personal responsibility. I believe that folks should realize the consequences and the benefits of freely-made decisions.
While we want American society to be compassionate, we do not want to punish success and reward failure. Our goal is to do all that we can to maximize everyone’s success. We should be ready to assist those who need and deserve our private and governmental assistance, but personal effort and responsibility are necessary elements of these interventions.
In our gastrroenterology practice, when we see patients who are in financial difficulty, my physician partners and staff will do all that we can to help them. While it is not our policy to do colonoscopies for free, we will make whatever adjustments that are necessary to make sure that the patient receives necessary medical care. However, when patients who owe us money hang up on our calls, or express their view of medical entitlement with foul language, then we forward these accounts to a collection agency.
There is also a self-interest angle to supporting assistance for those in need: One day we may need a boost ourselves. Recall the concept of privatizing social security, a sound proposal that was vilified and snuffed out during George W. Bush’s presidency. Antagonism against this modest proposal was seasoned with a large measure of arrogance, a splash of hubris and a dash of paternalism. Read more »
*This blog post was originally published at MD Whistleblower*
December 6th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Opinion
Tags: Cost of Healthcare, Cost of Medical Care, Dr. Robert Wachter, General Medicine, Happy Hospitalist, Healthcare Economics, Healthcare Quality, Hospital Care, Hospital Medicine, How Hospitals Get Paid, Profit Out Of Medicine, Quality Medical Care, The Health Care Blog, Third-Party Insurance, VA Health Care
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Looking for a great story about the state of hospital care in America? Look no further. The Health Care Blog has a great article by hospitalist Dr. Robert Wachter that sums it up nicely. It’s about money. Thats how hospitals get paid. That’s how everyone gets paid. It will always be about money. We don’t pay doctors, nurses, or administrators with smiley faces and candy canes. We pay them with cold hard cash. For example:
One of the physicians, an invasive cardiologist, stopped me in my tracks. “Actually, our hospital already provides a tremendous amount of support and feedback,” he said. “When I perform a catheterization or angioplasty, a hospital staff member watches the entire procedure, she sometimes suggests mid-course corrections, and as soon as I’m done she provides me detailed feedback on whether I met all the best practice standards.”
“Wow,” I said. “Your hospital is really taking quality seriously!”
“Oh,” he replied, mischievous smile on his face, “she’s not from the quality department. She’s from the billing department.”
The question should not be how do you get profit out of medicine. The question should be how do you get quality into profit. We need profit. The last thing you want in this country is universal VA health care. Trust me on that. Americans would never stand for it. But how do you get both? Read more »
*This blog post was originally published at The Happy Hospitalist*
December 6th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Opinion, True Stories
Tags: Anti-Semitism, Charitable Organizations, Charity Work, Evan Falchuk, Faith, Freedom, Hadassah, Hanukkah, Healthcare Diplomacy, Multicultural Heritage, Nancy Falchuk, Perserverance, President Obama, Sacrafice, The Need For Healthcare, Washington DC, White House
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It’s not often you get invited to the White House. I had my chance this week, when I was a guest at the White House’s Hanukkah party. Now, when I say “guest,” I mean I was a guest of the president — of Hadassah, that is.
My mother, Nancy Falchuk, is the president of one of the largest Jewish charitable organizations in the world, Hadassah. Her organization sponsors many different charitable activities, particularly related to healthcare (here she is in Jerusalem speaking at the ceremony lighting the walls of the Old City pink in honor of the Susan G. Komen Foundation.)
One of the terms she uses a lot is “healthcare diplomacy” — the idea that part of the solution to intractable problems of war and peace is building bridges through something that we all share — the need for healthcare. Her organization does incredible work to realize this mission. She has been a regular guest at this annual event at the White House. Read more »
*This blog post was originally published at See First Blog*
December 5th, 2010 by CodeBlog in Better Health Network, Interviews, True Stories
Tags: Autism, Cerebral Palsy, Certified Nursing Assistant, CNA, CodeBlog, Developmental Disabilities Nurse, Direct Support Professional, Down Syndrome, DSP, ICU Nursing, Intensive Care Nurse, Mental Impairment, Mental Retardation, Nurses Aide, Nursing Care, Nursing Profession, Physical Impairment
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For my first interview, I thought I’d interview someone who would tolerate my novice interviewing abilities — my mother. Ginny, RN, BS, DDRN has been a nurse for over 30 years, most of that time in the Intensive Care Unit. (The apple did not fall far, did it?) She currently works as Developmental Disabilities Nurse and has done so for nine years.
A developmental disability is defined by Wikipedia as “a term used in the United States and Canada to describe life-long disability attributable to mental and/or physical impairments, manifested prior to age 18.” Ginny says that her clients have a range of mental and physical disabilities including cerebral palsy, Down Syndrome, mental retardation, and autism, with autism being the most prevalent. Her clients live in normal houses along with nurse’s aides and “direct support professionals” (DSPs).
How did you get started as a Developmental Disability Nurse?
A friend encouraged me to come work with her after I lost my job when they closed the children’s home where I had been working.
Do you like it?
I have had other nursing jobs including med-surg, peds, ICU, factory nurse, WIC nurse, children’s home nurse, and finally this job. I have liked all of my jobs but this has been the most rewarding. The people I care for just love it when the nurse comes around. There is always a “thank you” in their eyes.
What frustrates you about your job?
It is, of course, a job which requires state controls. Their idea of “nursing” is an awful lot of useless paperwork that makes no sense to me. The pay is not commensurate with other nursing jobs considering the reponsibilites of delegating nursing tasks to laypersons. There are so many things these people need and it’s hard to get. There are so many state mandates that are designed to move people toward being as independent as possible but the mandates also make us take many steps backward in that process. Read more »
*This blog post was originally published at code blog - tales of a nurse*
December 5th, 2010 by DavedeBronkart in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
Tags: Clinical Studies, comparative effectiveness research, Dave deBronkart, Dr. Pauline Chen, Dr. Wu, e-Patient Dave, e-Patients.net, Empowered Patients, Gangadhar Sulkunte, Healthcare Reform Bill, Healthcare Transparency, Listening To Patients, New York Times, Participating in Medical Research, Participatory Medicine, Patient Empowerment, Patient Participation, Patient Perspective, Patient-Centered Care, Patient-Centered Outcomes, Patient-Centered Outcomes Research Institute, Patient-Reported Outcomes, Transparency In Medicine
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A year ago Gangadhar Sulkunte shared his story here about how he and his wife became e-patients of necessity, and succeeded, resolving a significant issue through empowered, engaged research. As today’s guest post shows, he’s now actively engaged in thinking about healthcare at the level of national policy, as well – and he calls for all patients to speak up about this new issue. – Dave
I recently came across a Pauline Chen piece in the New York Times, “Listening to Patients Living With Illness.” It refers to a paper by Dr. Wu et al, “Adding The Patient Perspective To Comparative Effectiveness Research.” According to the paper and the NY Times article, Dr. Wu and his co-authors propose:
- Making patient-reported outcomes a more routine part of clinical studies and practice and administrative data collection.
- In some cases requiring the information for reimbursement.
Patient-Centered Outcomes is outcomes from medical care that are important to patients. The medical community/research focuses on the standard metrics related to survival and physiological outcomes (how well is the part of the body being treated?). In the patient-centered outcomes research, they will also focus on outcomes important to patients such as quality of life. In other words, the care experience will be viewed through the eyes of the patients and their support groups to ensure that their concerns are also addressed. Read more »
*This blog post was originally published at e-Patients.net*
