August 18th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News
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New primary care arrangements show how primary care is evolving — or splitting apart, depending upon one’s perspective.
Retainer fees let one practice handle more patients by phone or email. But, points out Richard Baron, FACP, affluent communities can take advantage of such arrangements, and not every community is. And Sam Fink, FACP, of southern California says tele-visits are no substitute for hands-on care. In another model, nurse-led facilities service the poor in north Philadelphia, and more states are expanding the power of the pen to cover shortages.
Another trend is the shared medical appointment. Led by physicians and conducted by “behaviorists,” the sessions cover a half-dozen or more patients at a time for both primary and specialty care.
Even pharmacists are getting in on primary care. Blue Shield of California is trying a pilot project of pharmacists, believing they have the clinical and patient communication skills to be as effective as doctors, but for less cost. But primary care doctors aren’t completely ceding their profession. There are also pilot projects in California to train more doctors and steer them into communities facing a shortage of primary care services. (USA Today, Fox News, ACP Internist, New York Times, Whittier Daily News)
*This blog post was originally published at ACP Internist*
August 18th, 2010 by RamonaBatesMD in Better Health Network, Health Policy, News, Opinion, Research
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This article was written more for family medicine physicians, but all of us can benefit from self-assessment of potential biases that might affect our judgment. It was also written with the potential bias towards the obese patient in mind, but the article could have been written with any “fill in the blank” bias as the topic.
The article points out that bias among physicians tends to “be implicit rather than explicit because of social pressure for healthcare providers to show tolerance and cultural sensitivity.” Read more »
*This blog post was originally published at Suture for a Living*
August 17th, 2010 by KevinMD in Better Health Network, Health Policy, News, Research
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The hospital is never a quiet place. Walk through the wards on a typical day and you’ll hear a cacophony of alarms, bells, and other tones coming from both computers and medical equipment.
American Medical News recently discussed so-called “alarm fatigue.” They cite a study showing find that “16,934 alarms sounded in [a medical] unit during an 18-day period.” That’s astounding, and for those who are wondering, that’s about 40 alarms an hour.
It’s not surprising that doctors become desensitized to these alarms, and that has potential to harm patients, as physicians may miss legitimate, emergent findings. Read more »
*This blog post was originally published at KevinMD.com*
August 17th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, Opinion
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I present interesting cases to colleagues often because it’s educational and good for patient care and because I like to. But it has been many years since I was mandated to present a case.
It seems that I’m not the only doctor exasperated by a pesky new barrier to patient care: Doctors in cubicles.
An old friend and mentor, Dr. Richard Kovacs, now chair of the American College of Cardiology’s Board of Governors (and IU guy), has written about these same pre-certification barriers. Dr. Kovacs, being a professor and distinguished ACC official, kindly terms these obstructionists “radiology benefit managers” (RBMs). Read more »
*This blog post was originally published at Dr John M*
August 17th, 2010 by DrWes in Better Health Network, Health Tips, News
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Sending a child off to college? Call your lawyer first. From the Weekend Wall Street Journal:
After a few clients ran into difficulty getting information about adult children who were ill, Sheila Benninger, an attorney in Chapel Hill, N.C., began recommending that clients’ children designate a health-care power of attorney after they turn 18 to identify who can speak for them if they can’t.
She also includes a Health Insurance Portability and Accountability Act, or HIPAA, release form that allows patients to determine who can receive information about their medical care and whether information about treatment for substance abuse, mental health or sexually transmitted diseases can be disclosed.
You don’t have to use a lawyer. Generic health-care power-of-attorney forms can be found online. If the school has a HIPAA release online, it’s best to use that more-tailored document.
Parents should keep a copy in an email folder, where it can be easily accessed in an emergency. And students should designate a general power of attorney so someone can pay bills or handle other issues if they go abroad.
It’s good advice for those of us shipping one more child back to college this week.
-WesMusings of a cardiologist and cardiac electrophysiologist.
Hat tip: Instapundit
*This blog post was originally published at Dr. Wes*
