June 28th, 2011 by Happy Hospitalist in Humor, Opinion
Tags: Billing, Critical Care Medicine, Doctor Patient Relationship, ICD-9 Codes, ICU, Physician Preferences, Sedation, Ventilation
No Comments »
You ever wonder what doctors really think but are afraid to say out loud? Here’s one example:
“I wish all my patients were on a ventilator”
There’s a reason vented and sedated patients are considered desirable. In addition to the obvious economic benefits of
There are the less talked about, but equally pleasant side effects most hospitalists, ER doctors, cardiologists, gastroenterologists, pulmonologists, surgeons, infectious disease doctors, endocrinologists, psychiatrists, rheumatologists, dermatologists, nurses, respiratory therapists and physical therapists wouldn’t admit, but would agree, without hesitation. As a general rule:
- Patients on ventilators are just faster, easier and more pleasant to take care of. Read more »
*This blog post was originally published at The Happy Hospitalist*
June 26th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
Tags: Affordable Care Act, Employer-sponsored health benefits, Employer-sponsored Insurance, ESI, Healthcare System, Insurance, McKinsey Quarterly, Obama, Obamacare, Public Option, Survey, Universal Healthcare
No Comments »
McKinsey Quarterly has reported its survey concluding there will be a radical restructuring of employer-sponsored health benefits (ESI) as a result of President Obama’s following the 2010 passage of the Affordable Care Act.
Healthcare insurance rates have already skyrocketed as a result of anticipating the conditions of Obama care. President Obama has been powerless to do anything about the increases.
Thirty percent (30%) of companies providing ESI to their employees will drop healthcare insurance coverage once Obama care takes effect in 2014.
The survey included 1300 employers providing ESI across industries, geographies, and employer sizes. Other surveys have found that as we get closer to 2014, President Obama’s Healthcare Reform Act will provoke a much greater number of employers to drop employer sponsored healthcare insurance.
The penalty for not providing healthcare insurance coverage is much cheaper than providing healthcare coverage.
McKinsey’s survey suggests that when more employers become aware of the new economic and social incentives embedded in Obamacare the percentage of employers dropping ESI will Read more »
*This blog post was originally published at Repairing the Healthcare System*
June 26th, 2011 by DrWes in Opinion, Research
Tags: American Journal of Infection Control, Bacteria, Bacterial Colonization, Cell Phone, Health Care Worker, Hospital Visitor, Infection, Medicine, Mobile Phone, Pathogens, Patient, Phone
No Comments »
Alright doctors, time to give up the cell phones. (Never mind that there has not been a study linking cell phones and hospital acquired infections).
From the American Journal of Infection Control:
A cross-sectional study was conducted to determine bacterial colonization on the mobile phones (MPs) used by patients, patients’ companions, visitors, and health care workers (HCWs). Significantly higher rates of pathogens (39.6% vs 20.6%, respectively; P = .02) were found in MPs of patients’ (n = 48) versus the HCWs’ (n = 12). There were also more multidrug pathogens in the patents’ MPs including methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Escherichia coli, and Klebsiella spp, high-level aminoglycoside-resistant Enterococcus spp, and carabepenem-resistant Acinetobacter baumanii. Our findings suggest that mobile phones of patients, patients’ companions, and visitors represent higher risk for nosocomial pathogen colonization than those of HCWs. Specific infection control measures may be required for this threat.
What specific measures might they consider?
They better be careful what they wish for or they might also have to take away all those dirty EMR computer keyboards, too.
*This blog post was originally published at Dr. Wes*
June 26th, 2011 by Toni Brayer, M.D. in Health Policy, Opinion
Tags: AMA, American Academy of Family Physicians, American College Of Physicians, medicaid, Medicare, Primary Care, Primary Care Shortage, Reimbursement, RUC
1 Comment »
An article by Brian Klepper and Paul Fischer at Health Affairs has me all fired up. Finally these two health experts are calling it like it is. The Wall Street Journal, New York Times and EverythingHealth have written before about the way primary care is undervalued and underpayed in this country and how it is harming the health and economics of the United States.
A secretive, specialist-dominated panel within the American Medical Association called the RUC has been valuing medical services for decades. They divvy up billions of Medicare and Medicaid dollars and all insurance payers base their reimbursement on these values also. The result has been gross overpayment of procedures and medical specialists and underpayment of doctors who practice primary care in internal medicine, family medicine and pediatrics). These payment inequities have led us to a shortage of these doctors and medical costs skyrocket as a result. As Uwe E. Reinhardt says, “Surely there is something absurd when a nation pays a primary care physician poorly relative to other specialists and then wrings its hands over a shortage of primary care physicians.”
Klepper, Fischer and author Kathleen Behan make a bold suggestion. Let’s quit complaining about the RUC and their flawed methodologies. Let’s quit admiring the problem of financial conflicts of interest and the primary care labor shortage. It’s time for the primary care specialty societies, Read more »
*This blog post was originally published at ACP Internist*
June 25th, 2011 by Michael Kirsch, M.D. in Opinion
Tags: Communication, Consultative Services, Discharge, Emergency Room, ER, Follow Up, Hospitalization, Specialist
No Comments »
I received a call recently from an emergency room (ER) physician about a patient who presented there with rectal bleeding. Does this sound blogworthy? Hardly. We gastro physicians get this call routinely. Here’s the twist. The emergency room physician presented the case and recommended that the patient be discharged home. He was calling me to verify that our office would provide this patient with an office appointment in the near term, which we would. We had an actual dialogue.
This was a refreshing experience since the typical emergency room conversation of a rectal bleeder ends differently. Here’s what usually occurs. We are contacted and are notified that the patient has been admitted to the hospital and our in-patient consultative services are being requested. In other words, we are not called to discuss whether hospitalization is necessary, but are simply being informed that a decision has already been made.
There is a tension between emergency room physicians and the rest of us over what constitutes a reasonable threshold to hospitalize a patient. I have found that many ER docs pull the hospitalization trigger a little faster than I do. What’s my explanation for this? Here are some possibilities. Read more »
*This blog post was originally published at MD Whistleblower*
