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Primary Care: Has It Been “Oversold?”

September 21st, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion, Research

Tags: ACP Advocate, American College Of Physicians, Bob Doherty, Dartmouth Atlas, Family Medicine, Fixing Primary Care, General Medicine, Internal Medicine, More Primary Care Doctors, Patient-Centered Medical Home, Primary Care Crisis, Primary Care Oversold, Primary Care Shortage, Wall Street Journal

Citing a new study by the Dartmouth Atlas, the Wall Street Journal’s health blog provocatively asks: “Has the notion of ‘access’ to primary care been oversold?”

The Dartmouth researchers found “that there is no simple relationship between the supply of physicians and access to primary care.” That is, they found that having a greater supply of primary care physicians in a community doesn’t mean that the community necessarily has better access to primary care. Some areas of the country with fewer primary care physicians per population do better on access than other areas with more primary care physicians.

The researchers also report that the numbers of family physicians is more positively associated with better access than the numbers of internists, although they call the association “not strong.” Although both general internists and family physicians are counted as primary care clinicians, “in [regions] with a higher supply of family physicians, beneficiaries were more likely to have at least one annual primary care visit. In [regions] with a higher supply of general internists, fewer beneficiaries had a primary care visit on average.” Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

To Change Patient Behavior, Change How You Talk To Them

September 20th, 2010 by StevenWilkinsMPH in Better Health Network, News, Opinion, Research

Tags: Barriers to Weight Loss, Behavior Change, Changing Patient Behavior, Doctor-Patient Communication, Family Medicine, General Medicine, HBM, Health Belief Model, How To Lose Weight, How To Talk To Patients, Internal Medicine, Obesity, Overweight, Primary Care, Talking to Patients

According to Marshall Becker, PhD, MPH, a one-time professor of mine and prime mover behind the Health Belief Model (HBM), four things must be in place for health behavior change to occur. I am paraphrasing here: 

1. A person has to know that they have a particular health condition.
2. A person has to believe that having said health condition is bad.
3. A person must perceive the benefits of behavior change to outweigh the difficulties of behavior change.
4. There must be a “call to action” to spark the change.

Absent any one of these steps and the likelihood that behavior change will occur is diminished. Read more »

*This blog post was originally published at Mind The Gap*

Less-Invasive Science: Not Always Better Science

September 20th, 2010 by IsisTheScientist in Better Health Network, Health Policy, Opinion, Research

Tags: General Medicine, Invasive Physiological Measurement Techniques, Isis the Scientist, Medical Studies, Non-Invasive Measures, Physiology, Pulse Oximeter, Testing Methods, Vitals

One of the disturbing trends I have been observing in physiology is the tendency to move away from many of the gold standard, invasive measurements classically described in the scientific literature to non-invasive measures which may or may not accurately reflect the parameter of interest.

One of these non-invasive measurements (which is not used in any of the manuscripts on my desk) that has become the bane of my existence is to use the saturation of hemoglobin in arterial blood (SPO2) as a surrogate for the partial pressure of arterial blood (PO2). SPO2 is measured with a device called a pulse oximeter.

 Figure 1: A fingertip pulse oximeter. This device indicates that this individuals arterial hemoglobin is 98 percent saturated and his heart rate is 73 beats/min. Read more »

*This blog post was originally published at On Becoming a Domestic and Laboratory Goddess*

Patient Empowerment: Is It What Americans Really Want?

September 19th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Opinion

Tags: Consumer-Driven Healthcare, Dr. Davis Liu, Empowered Patients, Fixing American Healthcare, Health of Americans, Patient Empowerment, Transparency In Medicine, U.S. Healthcare System

Empowered patient. Consumer driven healthcare. Transparency. Access to their full medical records online. Review the latest news and you’ll discover more books and articles recommending patients be advocates for themselves. The pitch? The only way to get the best care is to be thorough, informed, and always asking questions.

This perspective is understandable because advocates have observed a healthcare system that provides inconsistent quality, too many preventable medical errors, and overtreatment resulting in unnecessary injuries and deaths. Even I’ve written a book saying the same thing, and I hate to write. 

The public is urged to take charge of their health and their healthcare. When they have a problem, ask the doctor questions. Do research. If they need a procedure, shop around to get the best deal. Adopt good habits. Eat more fruits and vegetables. Stop smoking. Maintain a healthy weight. Exercise regularly. These will improve health and be less costly in the long run.  

But is this what Americans really want? Do they want to be empowered patients? Can they be empowered patients? Frankly, no. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Mayo Clinic’s Social Media Advisory Board Has No Physicians

September 19th, 2010 by KevinMD in Announcements, Better Health Network, Health Policy, Medblogger Shout Outs, News, Opinion

Tags: Doctors and Social Media, Mayo Clinic Center for Health Care Social Media, Social Media In Medicine

The Mayo Clinic has always been at the forefront of the social media and health care intersection, and is the first institution to have an official Center for Social Media.

When they recently announced the invited first 13 members of their Advisory Board for the Mayo Clinic Center for Health Care Social Media, the first thing I noticed that there were zero physicians, and few with clinical experience. What a slap in the face.

There’s little question that the qualifications of the selected members are beyond reproach, and all are respected luminaries in the health care social media field. But this is the Mayo Clinic, one of the leading health care institutions in the country, so it’s odd that clinician-bloggers were blatantly ignored. Read more »

*This blog post was originally published at KevinMD.com*