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Proposed SGR Fix: An Interesting Twist

This is something I haven’t seen reported on elsewhere, but according to the ACEP 911 Legislative Network Weekly Update, there was an interesting twist in the Democrats’ proposed SGR fix:

The latest plan increases physician payments by 1.3% for the remainder of this year and by an additional 1% in 2011. In 2012 and 2013, physician services would be separated into two categories, or “buckets.” One bucket would be for E&M services (including emergency department, primary and preventive care) and the other group would include all other services. The E&M bucket would increase at the same rate as the U.S. gross domestic product (GDP) plus 2%, while the other group would receive a payment increase of GDP plus 1%.After 2013, the payment formula would revert back to the current SGR formula, which means physicians would face cuts in the range of 30-35% unless Congress intervenes.

So it’s another temporary fix, kicking the can past the next presidential election. But it’s the first one I have seen that attempts to address the gross disparity in reimbursement for procedural services compared to the cognitive services. It bypasses the RUC and almost every other existing mechanism for determining reimbursement under the MPFS.

I’m not sure what happened with this proposal. I don’t think it was in the version of legislation the House passed, so I think it might be dead. But the situation is so in flux that who really knows? If nothing else, it’s an encouraging sign that policymakers know the problem exists and are willing to throw out possible solutions. This one may be dead, but it’s a good start.

*This blog post was originally published at Movin' Meat*

Teaching ‘Til The Very End: Carol Rivers, M.D.

Carol Rivers, MD

To those who haven’t heard, an icon of emergency medicine has passed away.

Carol Rivers, M.D. died last week following a cardiac procedure. Carol was an outstanding clinician and educator, and one of the founders of modern emergency medicine as we’re fortunate to know it today.

Carol was perhaps best known for her board preparation guides, which helped many a terrified physician to navigate his or her emergency medicine board exams. I know her expertise helped me when I took my first American Board of Emergency Medicine (ABEM) exam. Read more »

*This blog post was originally published at edwinleap.com*

The ACEP’s Failure To Take A Position On Healthcare Reform

Last year when I interviewed then-American College of Emergency Physicians (ACEP) President Nick Jouriles I was disappointed that the ACEP had not staked out a clear position on healthcare reform. However, it wasn’t terrible that they didn’t have a position at that time, because the House bill was still being finished up and the Senate was still mired deeply in the fruitless “Gang of Six” negotiations. If ACEP wasn’t going to endorse reforms sight unseen, that was pretty reasonable, I thought. President Jouriles suggested that, in time, ACEP would weigh in with a position, one way or the other.

But we never heard ACEP take a position in the intervening months. So when I saw this post appear over at The Central Line, linking to this letter on the ACEP web site from ACEP’s current president, Angela Gardner, I was not surprised to see that ACEP has taken the weasel’s path and abstained from taking a position on the more or less final healthcare reform package. It’s pathetic, and brings into question whether ACEP can fulfill one of its most crucial functions: advocating for emergency room patients and advocating for emergency medicine physicians. The excuses offered by Dr Gardner for ACEP’s reticence to take a stand are fairly lame. Read more »

*This blog post was originally published at Movin' Meat*

Board Certification May Not Be A Good Proxy For Quality Care In Emergency Medicine

The American Board of Emergency Medicine (ABEM) describes itself as:

Welcome to the American Board of Emergency Medicine (ABEM) public website.  ABEM certifies qualifying physicians who specialize in Emergency Medicine and is a member board of the American Board of Medical Specialties (ABMS).  ABMS certification is sought and earned by physicians on a voluntary basis. ABEM and other ABMS member boards certify only those physicians who meet high educational, professional standing, and examination standards.  ABEM and other ABMS member boards are not membership associations.

The thing I’d like to bring your attention to is that it’s a Voluntary organization.  For a voluntary organization they’re adding lots of requirements without asking members… Read more »

*This blog post was originally published at GruntDoc*

Walking While Texting And The NYT’s Typo

Today the NY Times printed a piece that pokes fun at, and highlights the dangers of, the new habit of texting-while-walking:

This summer, the American College of Emergency Room Physicians released a statement expressing concern about the issue, citing a Chicago doctor who was seeing a lot of face, chin, eye and mouth injuries among young people who reported texting and tumbling.

Hmm… I’m a member of ACEP, but I’ve never heard of ACERP. Is it some rival organization of emergency physicians whose practice is confined to four walls? Or, in its rush to condemn new technologies that enable communication on-the-go, has the New York Times abandoned the traditional practices of editing and fact-checking? 

*This blog post was originally published at Blogborygmi*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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