July 21st, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
Tags: ADHD, Autism, Bible of Psychiatry, Bipolar Disorder, Diagnostic and Statistical Manual, Dr. Allen Frances, Dr. Daniel Carlat, DSM-IV, Duke University School of Medicine, Gary Schwitzer, HealthNewsReview.org, Mental Disorder, Mental Disorder Epidemics, Mental Health, Mental Illness, National Institute of Mental Health, NIMH, Normality, Overdiagnosis, Psychiatric Fads, Psychiatric Times, Psychiatry, Psychology, Unhinged
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There’s a noteworthy column in Psychiatric Times, “Normality Is an Endangered Species: Psychiatric Fads and Overdiagnosis,” by Allen Frances, M.D. He was chair of the task force that worked on the Diagnostic & Statistical Manual — DSM-IV — one edition of the “bible of psychiatry.” He is professor emeritus of psychiatry at Duke University School of Medicine. There’s a lot of common ground between what Dr. Frances writes and what Dr. Daniel Carlat (the subject of an earlier blog posting) writes about. Dr. Frances is concerned about the directions that might be taken in the authoring of DSM-V, now underway.
Excerpts:
“Fads in psychiatric diagnosis come and go and have been with us as long as there has been psychiatry. The fads meet a deeply felt need to explain, or at least to label, what would otherwise be unexplainable human suffering and deviance. In recent years the pace has picked up and false “epidemics” have come in bunches involving an ever-increasing proportion of the population. We are now in the midst of at least 3 such epidemics–of autism, attention deficit, and childhood bipolar disorder. And unless it comes to its senses, DSM5 threatens to provoke several more (hypersexuality, binge eating, mixed anxiety depression, minor neurocognitive, and others). Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
July 21st, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, Research, True Stories
Tags: Accessibility, Affordability, Case Report, Convenience, Cost Less, Direct Pay, DocTalker Family Medicine, Dr. Alan Dappen, Empowerment, Fixing American Healthcare, General Medicine, Got It, I Get It Moment, Internal Medicine, Just A Phone Call Away, Medical Practice Mission, Price Transparency, Primary Care, Quality, Trust
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After seven years, my wife has finally stopped asking me for “The Power of DocTalker” story of the day. Now when I start with the details of the latest case report justifying the model, she stops me with “I get it, I get it! Go write the case report up and post it on your website for others to ‘get it,’ too.”
Case reports center on the mission of our medical practice, with points regarding care that include quality, accessibility, convenience, affordability, empowerment, trust, and price transparency. Because our patients pay us directly for the service and don’t necessarily expect any insurance “reimbursement,” we are a very unique practice. We adhere to the points in our mission and also outperform all our local competition — i.e. medical offices that accept insurance payment for service in order to survive as a business.
To the patient, our services cost a lot less than services available via the insurance model. About 40 percent of our clientele have no insurance, and the other 60 percent have insurance yet chose to use our services because they believe it’s worth paying directly in order to assume control of their care. (As a quick aside — my favorite clients in this group are health insurance executives and CEOs of large companies, who have the best health insurance in the country.) Read more »
July 21st, 2010 by DrRob in Better Health Network, Health Tips, Opinion, True Stories
Tags: A Doctor's Letter, Bipolar Disorder, Chronic Disease, Chronic Pain, Cushing's Disease, Dear Patients, Diabetes, Emergency Medicine, End-Stage Kidney Disease, Family Medicine, General Medicine, Internal Medicine, MS, Multiple Sclerosis, Primary Care, Public Health, Rheumatoid Arthritis
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Dear Patients:
You have it very hard — much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I, too, can’t understand what your lives are like. How do you answer the question, “How do you feel?” when you’ve forgotten what “normal” feels like? How do you deal with all of the people who think you are exaggerating your pain, your emotions, your fatigue? How do you decide when to believe them or when to trust your own body? How do you cope with living a life that won’t let you forget about your frailty, your limits, your mortality?
I can’t imagine.
But I do bring something to the table that you may not know. I do have information that you can’t really understand because of your unique perspective, your battered world. There is something that you need to understand that, while it won’t undo your pain, make your fatigue go away, or lift your emotions, it will help you. It’s information without which you bring yourself more pain than you need suffer. It’s a truth that is a key to getting the help you need much easier than you have in the past. It may not seem important, but trust me — it is. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
July 21st, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, Opinion, True Stories
Tags: Blue Shield of California, Eligible Medical Services, EOB, Explanation of Benefits, Family Medicine, Fixing Primary Care, General Medicine, Insurance Companies, Insurance Reimbursement, Internal Medicine, Lack of Primary Care, Medical School, Medical Students, More Primary Care Doctors, Primary Care, Primary Care Shortage
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Most doctors have a love/hate (and mainly hate) relationship with health insurance companies. We struggle with their confusing and complex coding rules in an effort to be reimbursed for our care of patients. When patients leave the office, they may think that a bill is sent to their insurance company and payment follows. More often than not it rarely happens that way.
I am staring at an explanation of benefits (EOB) from Blue Shield of California for a patient I saw for a physical exam and Pap test. This patient had recently been hospitalized with a life threatening throat infection and abscess and saw me for needed follow up. I spent about 45 minutes with the patient, reviewing the events leading to hospitalization, coordinating the medications, as well as addressing the routine screening and examination of a middle aged woman with some chronic health problems. Read more »
*This blog post was originally published at ACP Internist*
July 19th, 2010 by DrWes in Better Health Network, Health Policy, News, Opinion
Tags: Cardiac Surgery, Cardiology, Central DuPage Hospital, Chicago, Chicago Tribune, Cleveland Clinic, Healthcare Competition, Healthcare Market, Heart Care, Heart Surgery, Hospital Medicine, Hospital Systems, Winfield
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All I can say is, best of luck. From the Chicago Tribune:
In a move likely to shake up the market for heart care in the Chicago area, the well-known Cleveland Clinic’s cardiac surgery program said Thursday that it has signed an affiliation agreement with Central DuPage Hospital in the western Chicago suburbs.
The internationally known Cleveland Clinic draws patients from more than 85 countries around the world for everything from open-heart surgery and valve replacement to heart transplants. Its deal with Central DuPage, in Winfield, is designed to enhance the heart care provided at the 313-bed community hospital and potentially bring Cleveland Clinic patient referrals at a time heart surgeries are less needed than they were a decade ago.
This won’t shake up the market in Chicago. After all, when you have a bunch of Cadillacs in the garage, why go after a Ford? Unless, of course, it costs a whole lot less to buy a Ford.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
