October 2nd, 2009 by KevinMD in Better Health Network, Opinion
Tags: Comfort, Discussions, Emotional, Psychiatry, Relationships, Surgery, Time
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“Psychiatrists may be the last batch of physicians who are still granted a luxurious amount of time with patients.”
So says Maria, a psychiatrist who blogs over at intueri.
And because time is so undervalued in our health system, some doctors are relying on psychiatrists to counsel patients in the hospital. She cites an example with surgeons, saying that “it is entirely unfair to both the patient and the psychiatrist for the surgeon to completely emotionally ‘turf’ the patient.”
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*This blog post was originally published at KevinMD.com*
October 1st, 2009 by Peter Lipson, M.D. in Better Health Network, Opinion, Quackery Exposed
Tags: Alternative Medicine, Bayes Theorem, Complementary And Alternative Medicine, Depression, Fibromyalgia, Placebo, Plausibility, Reproduceability, Research, Statistics
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One of the common themes regarding alternative medicine is the reversal of normal scientific thinking. In science, we must generally accept that we will fail to validate many of our hypotheses. Each of these failures moves us closer to the truth. In alternative medicine, hypotheses function more as fixed beliefs, and there is no study that can invalidate them. No matter how many times a hypothesis fails, the worst that happens is a call for more research.
Sometimes this is the sinister and cynical intent of an alternative practitioner—refuse to let go of a belief or risk having to learn real medicine. Often, though, there are flaws in our way of thinking about data that interfere with our ability to understand them.
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September 30th, 2009 by DrWes in Better Health Network, Health Policy, Opinion
Tags: Cardiology, CMS, Healthcare reform, Medicare, Payment Reform, Primary Care, Private Practice, Quality
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It’s the holy grail of physician payment reform: ending fee-for-service payments to doctors and, instead, pay doctors based on the quality of care they perform. Remarkably, Congress feels they’ve found the answer:
Thus, the new language in the Senate Finance bill would finally connect Medicare reimbursements to quality, as opposed to volume.
The measure gives the secretary of Health and Human Services, working with the Centers for Medicare and Medicaid Services, the power to develop quality measurements and a payment structure that would be based on quality of care relative to the cost of care. The secretary would have to account for variables that include geographic variations, demographic characteristics of a region, and the baseline health status of a given provider’s Medicare beneficiaries.
The secretary would also be required to account for special conditions of providers in rural and underserved communities.
Additionally, the quality assessments would be done on a group-practice level, as opposed to a statewide level. Thus, the amendment would reward physicians who deliver quality health care even if they are in a relatively low quality region.
The secretary of Health and Human Services would begin to implement the new payment structure in 2015. By 2017, all physician payments would need to be based on quality.
Wow. That sounds great! But there’s just one problem…
… how do we define “quality?”
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*This blog post was originally published at Dr. Wes*
September 29th, 2009 by Dr. Val Jones in Health Policy, Opinion
Tags: 360, Administrative Burden, Anderson Cooper, CNN, Documentation, Family Medicine, Forms, Health Insurance, Paper Weight, Paperwork, Payment, Primary Care, Reimbursal, Submit
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Ever wonder why your physician only spends 5-10 rushed minutes with you during your office visit? You may think it’s because there are simply too many patients vying for her time, but that’s not the real reason. The root cause is that health insurance companies are stealing time from your visit by requiring excessive documentation from your doctor. She can’t give you the time you need, because doing so would put her out of business.
In a special report on the administrative burden of healthcare, MedPage Today revealed that PCPs spend about one third of their income on documentation required by health insurers. Because they run a business with thin margins, they must increase the volume of patients they treat in order to cover the salaries of the staff required to manage this “paper weight.”
About 49% of all physicians have said that they are considering retiring or quitting medicine in the next two years (the rate is lower for specialists), largely because of increasing documentation requirements and decreasing reimbursement. Read more »
September 29th, 2009 by DrRob in Better Health Network, Health Policy, Opinion
Tags: AAFP, ACP, AMA, Cost, Healthcare reform, Medical Home, Medical Homelessness, Patient Empowerment, Price, Primary Care
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Please allow me to coin a new term:
Medical Homelessness – Not having access to a consistent familiar medical setting. Not having a care location where one is known or where the medical information is accurate.

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I think medical homelessness is one of the main problems in our system.
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*This blog post was originally published at Musings of a Distractible Mind*