September 16th, 2011 by BobDoherty in Health Policy, Opinion
Tags: Accountability, ACP, American College Of Physicians, Budget Cuts, Budget Office, Congress, Deficit, Doctors, Federal Government, Fiscal Responsibility, Graduate Medical Education, Lawmakers, Medical Profession, Medical School, Payments, Reform, Shortage, Specialties, Tax Cuts, Training
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Graduate Medical Education has for the most part escaped big budget cuts in the past, mainly because powerful lawmakers have aligned to protect funding for teaching hospitals in their own states and districts. Plus, the Association of American Medical Colleges, the American College of Physicians, hospital organizations, and many others long have made funding for GME a top legislative priority.
GME, though, could be on the chopping block as Congress’s new “Super Committee” comes up with recommendations to reduce the deficit by at least $1.2 trillion over the next decade. A report from the Congressional Budget Office of options to reduce the deficit to suggests that $69.4 billion could be saved over the next decade by consolidating and reducing GME payments. Earlier this year, the bipartisan Fiscal Commission on Fiscal Responsibility and Reform also proposed trimming GME payments.
How then should those who believe that GME is a public good respond? One way is to circle the wagons and just fight like heck to stop the cuts. But that raises a basic question: is GME so sacrosanct that there shouldn’t be any discussion of its value and whether the current financing structure is effective and sustainable?
Another approach, the one taken by the ACP in a position paper released last week, is to Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
September 16th, 2011 by John Mandrola, M.D. in Health Tips, Opinion
Tags: AFib, Atrial Fibrillation, Biking, Cardiology, Coronary Calcium, Death, Divorce, Endurance Athlete, Excess Inflammation, Exercise, Healthy Living, Heart Health, Inflammation, Iron Man, Life-Threatening, Marathon, Middle-aged heart, Olympic-Distance Triathlon, Prestige, Running, Swimming, Triathlon
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Before I even start, let me say this to my triathlete friends…
I really like you all. And…I am sorry for how I feel about your sport’s pinnacle, the Ironman triathlon. But I was poked into writing this post. When asked the question of whether the Ironman is safe for the middle-aged heart, what was I to do? Lie?
Each August, my hometown, Louisville, KY, gets overrun, over-swum and over-ridden with “Iron people.” No, these humans aren’t rust colored, or all that hardened, but they are indeed a determined lot. Triathletes, or iron people if you will, wake up before sunrise to swim, bike or run. Then they eat; some go to work (barely), and then they do the training thing again in the evening. Calling these athletes focused would surely be an understatement.
So it is each summer that I endure the same question: “Dr. Mandrola, did you do the Ironman?”
“No…I just ride bikes.”
But this year was different. Before I could launch into my usual dissertation on how training for Ironman-length triathlons causes excess inflammation, coronary calcium, atrial fibrillation, divorce, etc., etc., another question quickly popped up.
“What did you think of that guy who died during this year’s race?” Read more »
*This blog post was originally published at Dr John M*
September 16th, 2011 by Lucy Hornstein, M.D. in Opinion
Tags: Acupuncture, Age Management, Ancillary Service, Behavioral Health Interventions, Bioidentical Hormones, Cosmetic Services, Energy Medicine, In-Office Labs, Labs, Legal Hazards, Marketing, Medical, Medical Economics, Obesity, Reiki, Research-based, Selling, Stress Test, Weight Loss
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I’m just about through with the magazine Medical Economics. I’ve been a devoted follower ever since residency, when I used to find the occasional dollar bill stuck somewhere in one of the back pages. But now it seems that each issue is just more of the same old stuff.
Take the cover story of the current issue: “Grow Your Practice with Ancillaries,” such as labs, x-rays, behavioral health interventions, cosmetic services, and selling stuff. All the things they suggest fit neatly into one of three categories:
- Things you should already be doing (whether or not you’re getting paid appropriately for them)
- Things you shouldn’t be doing, and
- Things no one should be doing.
The behavioral intervention discussed most often in this context is obesity counseling something all doctors should already be doing. Unsurprisingly, Read more »
*This blog post was originally published at Musings of a Dinosaur*
September 15th, 2011 by Davis Liu, M.D. in News, Opinion
Tags: Back to the Future, Computers, Danielle Ofri, Doctor Patient Relationship, Electronic Medical Records, EMR, Meaningful Dialogue, New York Times, NYT, Personalized Medicine
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One of my favorite movies is Back to the Future starring Michael J. Fox. I must admit after reading this New York Times piece, titled “When Computers Come Between Doctors and Patients” I have to wonder.
Am I fortunate to be coming from the future? Because I completely disagree with Dr. Danielle Ofri, again.
I’ve had the privilege and opportunity to work in a medical group which has deployed the world’s largest civilian electronic medical record and have been using it since the spring of 2006. I don’t see the issue quite as much as Dr. Ofri did. It is possible that she examined patients in her office with a desk rather than an examination room.
If placed and mounted correctly in the exam room, the computer actually is an asset and can improve the doctor patient relationship. It is part of the office visit. The flat screen monitor can be rotated to begin a meaningful dialogue between the patient and me. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
September 15th, 2011 by AndrewSchorr in News, Opinion
Tags: Artificial Hip Joints, Clinical Trials, FDA, Food and Drug Administration, Lifesaving devices, Medical Devices, Metal-on-metal hip joints, Pharma Research, Pharmaceutical Companies, Review Process, Stents, Stroke Prevention
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I speak to people in the pharmaceutical industry much more than folks who develop medical devices. I know how pharma researchers spend years and hundreds of millions of dollars trying to develop a useful, safe new drug that the FDA will approve for marketing. Certainly there are big payoffs, but the road is filled with potholes and trapdoors and the analysis by the FDA is rigorous.
But for years we’ve been hearing that it is much less rigorous when it comes to medical devices. Artificial hip joints and stents to open blocked arteries fall into this category. And recently, the less stringent review process has been highlighted in the news. Metal-on-metal hip joints are being removed from patients who had them implanted. They thought Read more »
*This blog post was originally published at Andrew's Blog*
