August 4th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion, Research
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When I was a much younger man I had a 1968 Chevy Impala. I loved its V-8 engine and spaciousness, but I paid a steep price for it. It consumed gas like a drunk on a binge. It was prone to breakdowns, usually in the left lane of a busy highway. Even as it consumed my limited financial resources, I couldn’t count on it to reliably get me to where I wanted to be. Yet I held onto it. One day, though, its transmission gave out, and I finally had to resign myself to buying a new, more reliable, more modern, and efficient vehicle. Yet to this day, I miss my clunker.
I am reminded of this when I think about the state of primary care today. Many of us are attached to a traditional primary care model that may no longer be economically viable — for physicians, for patients, and for purchasers.
We hold onto a model where primary care doctors are paid based on the volume of visits, not the quality and value of care rendered. We hold onto a model where patient records are maintained in paper charts in voluminous file folders, instead of digitalizing and connecting patient records. We hold onto a model that generates enormous overhead costs for struggling physician-owners but generates insufficient revenue. We hold onto a model that most young doctors won’t buy, as they pursue more financially viable specialties and practices. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
March 20th, 2010 by JessicaBerthold in Better Health Network, Health Policy, Research
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Hospital costs for treating septicemia increased by an average of almost 12% yearly from 1997 to 2007, the AHRQ said today, citing data from its Healthcare Cost and Utilization Project. Costs jumped from $4.1 billion in 1997 to $12.3 billion in 2007. Other costly conditions in the same time period:
Osteoarthritis: 9.5% annual increase ($4.8 billion to $11.8 billion)
Back problems: 9.3% annual increase ($3.5 billion to $8.5 billion)
Acute kidney failure: 15.3% annual increase ($1 billion to $4 billion)
Respiratory failure: 8.8% annual increase ($3.3 billion to $7.8 billion)
The most important driver of cost increases in the hospital was the greater intensity of services provided during a hospital stay, which grew 3.1% per year from 1997 to 2007 and accounted for 70% of the total rise in hospital costs, the AHRQ said.
*This blog post was originally published at ACP Hospitalist*
March 12th, 2010 by StaceyButterfield in Better Health Network, News
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As one would expect from such a diverse group, comparisons were a common topic at the co-located National Medical Home Summit, National Retail Clinic Summit, and Population Health and Disease Management Colloquium this week.
During an opening session, Carolyn Clancy, head of the AHRQ, updated us on some of the comparison work her agency has been doing. Last year’s stimulus bill dedicated a lot of funds ($300 mill directly, more through the Secretary of HHS) to the agency’s work on comparative effectiveness. Read more »
*This blog post was originally published at ACP Internist*
October 19th, 2009 by EvanFalchukJD in Better Health Network, Opinion
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Last night, I saw a commercial produced by the federal government. Called “Questions are the Answer,” it’s a call for patients to be engaged in their medical care, to ask questions of their doctors in order to be sure of their medical condition.
The commercial was excellent – it showed a man asking dozens of increasingly arcane questions about a cell phone he was thinking of buying. Then, it showed him in his doctor’s office, apparently after getting a diagnosis. “Do you have any questions?” the doctor asks. “Nope,” says the man.
The government agency that produced the commercial is the Agency for Healthcare Research and Quality. There are a series of other videos and tools that can help you be a better, more informed consumer if you get sick.
The only catch: it’s almost impossible to find any of this great material. Read more »
*This blog post was originally published at See First Blog*
March 3rd, 2009 by Dr. Val Jones in Health Policy, Opinion, Uncategorized
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Rumor has it that Sanjay Gupta is no longer in the running for the office of Surgeon General. Many people had voiced their concerns about his potential nomination (including Paul Krugman, Maggie Mahar, Gary Schwitzer, Dr. David Gorski, and myself) and it looks as if his lack of experience or training in matters of public health, along with a history of industry ties has put the kabosh on his nomination.
So who will be our next Surgeon General? It’s hard to say, but a petition is circulating on behalf of Dr. George Lundberg – a fine nominee for the position in my opinion. Let me explain why.
A review of Dr. Lundberg’s curriculum vitae easily establishes his professional qualifications for the position. Not only has he been one of the longest standing Editors-In-Chief of all the American Medical Association journals (including JAMA), and the founder of the world’s first open-access, peer reviewed online medical journal (Medscape Journal of Medicine) but has served in an advisory capacity to everyone from the World Health Organization, to AHRQ, the Joint Commission, Harvard’s School of Public Health, the Department of Health and Human Services, Food and Drug Administration and the Surgeon General of the US Navy. He is also a prolific and influential writer, having authored 149 peer-reviewed articles, 204 editorials, and 39 books or book chapters. Dr. Lundberg has a large and devoted national and international audience and is highly esteemed by all who know him.
Dr. Lundberg has provided editorial leadership since the mid 1980s in American healthcare reform, campaign against tobacco, prevention of nuclear war, prevention and treatment of alcoholism and other drug dependencies, prevention of violence, changing physician behavior, patient safety, racial
disparities in medical care, health literacy, and the ethics of medical publishing and continuing medical education.
However, what may not be obvious from Dr. Lundberg’s list of extraordinary accomplishments, is his extraordinary character and wisdom. I had the privilege of working with George at the Medscape Journal of Medicine and reported directly to him. From this vantage point I was able to to observe his impartiality, his commitment to honesty and integrity, and his ability to walk the line between inclusivity of opinion and exclusivity of falsehoods. George is a defender of science, a welcomer of ideas, and an impartial judge of content. He can capture an audience, nurture imagination, and see through deception. George is exactly the kind of person we need as Surgeon General – he can be relied upon to discern truth, and maintain his faithfulness to it under political or industry pressure.
But best of all, George understands the central role of trust in healthcare. In his recent book, Severed Trust, George analyzes the policy decisions that have shaped our current healthcare system, and laments their inadvertent collateral damage: the injury to the sacred trust between physicians and patients.
If we want to come together as a nation to restore hope and trust in America – and we want to create an equitable healthcare system that leaves none behind, restores science to its rightful place, and heals the wounds endured by both providers and patients, then we need a Surgeon General like George Lundberg to help us.
I can only hope that his candidacy will be given the full consideration it deserves.
