August 11th, 2010 by admin in Better Health Network, Health Policy, Opinion
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By John Henning Schumann, M.D.
The Patient Protection and Affordable Care Act (aka “Health Care Reform”) signed by President Obama in March will revolutionize primary care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market.
This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in primary care: Incentives to encourage graduates to enter primary care fields (family medicine, internal medicine, and pediatrics) and practice in underserved areas (through scholarships and loan forgiveness), and money to re-format the way that primary care is practiced and paid for. Read more »
*This blog post was originally published at ACP Internist*
August 11th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion
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In their most recent piece at Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines tackle the issue of bouncebacks — that is, the re-admission of recently-discharged hospitalized patients. They bring up good some good points, and point out that until recently hospitals really didn’t have any incentive to reduce bouncebacks:
…hospitals have never had a compelling reason to try to prevent bouncebacks. Hospitals are typically paid a flat sum for each inpatient stay — shorter stays equal higher profits. When patients bounce back, hospitals can charge the insurance company twice for the same patient with the same problem. Many hospitals also view bouncebacks as out of their control: If a patient boomerangs back because she doesn’t follow doctor’s orders, it’s not the hospital’s fault.
With health reform, however, things are changing. In an effort to reduce bouncebacks, hospitals are paid less for re-admissions, and they must publish their bounceback rates. Read more »
*This blog post was originally published at KevinMD.com*
August 11th, 2010 by Davis Liu, M.D. in Better Health Network, Health Tips
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As a practicing primary care doctor, I continue to work incredibly hard on making my bedside manner even better so that patients feel heard. The other reason is because as most doctors learned in medical school 90 percent of getting the right diagnosis comes from taking a good history from a patient.
Unfortunately with shorter doctor office visits and doctors interrupting patients within 23 seconds of starting, you need to know how to get your concerns across. While I don’t believe this is the responsibility of patients, the reality is not everyone has access to doctors with great bedside manner.
How to talk to your doctor is quite easy if you follow three simple steps. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
August 11th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, News, Opinion, Research
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This is something: A study published in the July 20, 2010 Annals of Internal Medicine finds that 5 percent of residency applications contain plagiarized content. The study from Boston’s Brigham & Woman’s Hospital is based on the personal statements of nearly 5,000 residency applicants that were matched against a database of published content.
The authors comment that the study is limited, among other things, by the fact that it was done in just one institution. It makes me wonder if the number is artificially high or potentially too low.
So why would medical students lie? Read more »
*This blog post was originally published at 33 Charts*
August 11th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Research
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Office-based practices are focusing increasingly on patients 45 and older, reports the Centers for Disease Control and Prevention.
In 2008, those 45 and older accounted for 57 percent of all office visits, compared to 49 percent in 1998. Prescriptions, scans and time spent with the doctor also became increasingly concentrated on those middle aged and older, according to data from the CDC’s National Center for Health Statistics.
Also, physician visits increasingly concentrated on medical and surgical specialists and less on care provided by primary care practitioners for those ages 45 and older. Furthermore, for patients ages 65 and older, the percentage of visits to primary care specialists decreased from 62 percent to 45 percent from 1978 to 2008, while the percentage of visits to physicians with a medical or surgical specialty increased from 37 percent to 55 percent. Read more »
*This blog post was originally published at ACP Internist*
