July 17th, 2011 by Jessie Gruman, Ph.D. in Opinion
Tags: Compliance, Consultation, Doctor's Directives, Empowerment, Engagement, Jessie Gruman, Medication Adherence, Participation, Patient Engagement, Prescription, Shared Decision-Making
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Twenty percent of people who leave their doctors’ offices with a new prescription don’t fill it. Up to one-half of those who do fill their prescriptions don’t take the drugs as recommended. These individuals are considered non-compliant. But does that mean they are not engaged in their health care? Engagement and compliance are not synonyms.
I am compliant if I do what my doctor tells me to do.
I am engaged, on the other hand, when I actively participate in the process of solving my health problems. This new prescription is an element in that process. If I am engaged in my care, I might want to learn about this medication. Such as: what it can and cannot do to ease my pain or slow the progress of my disease; what side effects it might produce and what I should do about them; how long it will take to work; when I should take it and how; how much it may cost; and what will happen if I don’t take it. I might want to consider the barriers to taking it and weigh the risks and benefits of alternatives. Could I instead make changes in my physical activity level or diet, try a dietary supplement or watchfully wait to see if the symptoms subside?
If my clinician has done more than just hand me the prescription – if she has, for example, raised these questions and discussed these concerns with me, I probably won’t have a prescription in my hand if I don’t intend to fill it.
But I can be engaged in my health care even if I don’t have that conversation with my provider. I can Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
July 17th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
Tags: Administrative Costs, Data-entry, Electronic Medical Records, EMR, July, Licensure, Malpractice Insurance, Medical Innovation, Medical School, Non-paying patients, Private Practice, Regulations, Residency, Residents, Training Programs
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The old joke in medicine goes, ‘don’t get sick on July 1st.’ That’s because it’s the day when new resident physicians, freshly graduated from medical schools across the land, begin their training programs. Although they have spent four years in undergraduate school and four years in medical school, it’s residency where physicians are made from the raw material of knowledge-rich, experience poor high achievers.
However, even in residency physicians are seldom told the entire story of how the practice of medicine, and their lives, will look and feel as their careers evolve and they enter the medical work-force.
Since our profession changes from year to year and administration to administration, it seems a good time to mention some of the things upcoming young physicians will face. Sadly, these are things seldom mentioned by pre-med advisors or academic medical educators.
You see, physicians are struggling. Due to falling reimbursements and the ongoing federal mandate to see non-paying patients on call, it is increasingly difficult for physicians to cover costs like malpractice insurance, licensure, professional memberships and office overhead. (Well, if they want to have a house, family and food, that is.)
Many physicians are Read more »
*This blog post was originally published at edwinleap.com*
July 17th, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
Tags: Harry Truman, health care, Medical Quality, Medicare, Obama, Obamacare, Patient Protection and Affordable Care Act
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Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity…The poor have more sickness, but they get less medical care. People who live in rural areas do not get the same amount or quality of medical attention as those who live in our cities.
The above quote wasn’t taken from an Obama administration policy proposal. These words are from a 1945 speech by President Harry Truman. It is astonishing that over 60 years later, the health care crisis is not only still with us, but is slowly smothering us. How many years of oxygen do we have left until health care in America is entirely asphyxiated? Each year, the challenges deepen and multiply, which pushes necessary solutions and reform further out of reach. The financial costs of simply maintaining the current system are sailing beyond the stratosphere. The ‘reform’ strategies in my adult lifetime have been to promise, procrastinate and pray, methods which provide politicians with short term gains at our long term expense.
As I write this, Read more »
*This blog post was originally published at MD Whistleblower*
July 16th, 2011 by AndrewSchorr in Opinion
Tags: Communication, Connection, Human Contact, Interview Process, Interviews, iPad, Medical Errors, Medical School, Problem Solving, Smartphones, Teamwork, Techno-doctors, Technology
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What? Just what am I talking about? Give me a minute.
More and more people are telling me too often they are encountering doctors who 1) don’t look them in the eye 2) don’t listen to them 3) don’t touch them or get anywhere near them and 4) stay focused on their a) computer b) smartphone or c) iPad.
More of us are saying we are “mad as hell and are not going to take it anymore” just like the character in the movie “Network” years ago. We find another doctor. 
I am happy to report that an increasing number of the gray haired doctors who run medical schools are agreeing with us. Doctors need to be better communicators. They need to celebrate human contact rather than devote themselves to only technology and leading edge science. The professors also want tomorrow’s doctors to know how to work as part of a team. That’s the core of multi-disciplinary care that we talk about all the time these days. It’s smart minds working together for you and me – and to avoid medical errors – which, by the way are estimated to kill 98,000 U.S. patients a year. The idea is Read more »
*This blog post was originally published at Andrew's Blog*
July 16th, 2011 by Michael Sevilla, M.D. in Health Policy, Opinion
Tags: AAFP Speak Out, Budget Cuts, Family Medicine, GME, Graduate Medical Education Funds, Medicare, Midlevel Providers, Primary Care, Residency Programs, SaveGME
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Every day in the news, you hear about the United States federal budget and the potential political complications if something is done or if nothing is done. And every day in the news you hear about possible cuts in Medicare. What you don’t know is that some cuts in Medicare can significantly impact the training of future Family Physicians. What do I mean by this? Well, did you know that residency programs are paid Medicare funds (called Graduate Medical Education funds) going to hospitals? Check out this great article about how residency programs are funded.
So, let’s play this out with its potential complications for Family Medicine. If GME funds are cut as they are proposed, then many hospitals with only one residency program (usually a Family Medicine program), may be forced to close the program – thereby decreasing the number of Family Physicians being trained. In those hospitals with multispecialty programs (like large university hospitals), cuts in GME funding would force hospitals to cut their Family Medicine residency slots in favor of more specialty residency slots, which are more lucrative for hospitals. Again, this would decrease the number of Family Physicians being trained.
With GME funding being cut, there are two other disturbing possibilities that may happen. First, Read more »
*This blog post was originally published at Family Medicine Rocks Blog - Mike Sevilla, MD*
