August 25th, 2010 by BobDoherty in Better Health Network, Opinion, True Stories
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I’m going to do something unusual: Reprint in its entirety a commentary from a fourth-year medical student, Jonathan. He posted it in response to comments from other readers to my blog about Dr. Berwick’s commencement address to his daughter’s medical school class.
I tweeted about Jonathan’s post, calling it a needed voice of idealism at a cynical time. This is what Jonathan had to say to his physician colleagues:
“To begin, I am a fourth-year medical student going into primary care and this directly applies to me. We have two options when reading [Dr. Berwick’s] address. We can take, in my opinion, the weak road or the strong road. Our new generation, as well as the one that raised us, is one of apathy and selfishness. We are only concerned about how changes affect us. We have lost the sacrifice and the consideration of our patients and fellow staff. This address, no matter how hard your heart may be, springs up a humanism in you that is undeniable. You can choose to brush it off and make excuses about policies and money, or you can stand up and be the physician that is described. I agree that there are a lot of issues in medicine today (billing, paperwork, bureaucracy to name only a few). However, if those issues render you cold and uncaring, my friend, I strongly suggest you find another profession. This profession is one of nobility. It is one of selfLESSness. This is a high calling. A good book states, ‘To whom much has been given; much will be expected.’ Well, if you are a physician, much has been given to you. What are you going to do with it?”
Today’s question: How would you answer Jonathan?
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
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 9th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
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One of the more effective criticisms of the health reform law (Affordable Care Act, or ACA) is that it hurts Medicare. It also is wrong.
Effective, in that it has been widely reported that seniors are more likely to express negative views of the ACA than other age groups. (Although the Kaiser Family Foundation’s Drew Altman, citing the group’s most recent tracking polls, writes that seniors’ opposition to health reform “is at least somewhat over played.”)
Effective, but wrong: The ACA actually helps Medicare in three important ways. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
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*
August 2nd, 2010 by RyanDuBosar in Better Health Network, Health Policy, Health Tips, News, Research
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Monitoring vital signs remotely saves time and money for everyone: patients, physicians, facilities and insurers. Heart failure is a particular target because its increasingly common, its easily triggered (by as little as too much salt on food, for example), it costs so much to manage in the hospital, and it’s so easily avoided.
Remote monitoring equipment made even easier with wireless connections can take vital signs, and even ask standard questions every morning. The equipment puts patients in contact with nurses once they detect warning signs. That human touch is key. Case managers can screen out false alarms (avoiding alert fatigue) and can direct patients to the physician when needed. ACP Internist covered remote monitoring technology in its March issue. (Wall Street Journal, ACP Internist) Read more »
*This blog post was originally published at ACP Internist*
