October 11th, 2010 by GruntDoc in Better Health Network, Health Policy, News, Opinion
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According to the Standard of Care Project at EP Monthly:
The Power of Agreement
We can stop baseless malpractice suits before they get started. How? By having a majority of practicing emergency physicians go on record as to the baseline “standard of care,” beneath which is negligence.
This has been rolling for a while, and I’ve been late to blog it. That does not in any way mean I’m not 100 percent FOR it.
The idea is beautifully simple: The standard of care in emergency medicine (EM) should be set by practicing EM physicians, not case-by case in courts before lay juries with battling experts. (AAEM had the “remarkable testimony” series as a retrospective attempt to shame “experts” who gave, well, remarkable statements under oath, which to date has two cases in it.)
This has the very real advantage of being a clear, concise peer statement that this is/is not the standard of care.
I voted (while at ACEP). If you’re an emergency physician (and you have to cough up some information to determine your bona-fides before you can vote), go to the Standard of Care Project and cast your vote. They’ve set the bar at 30,000 votes, which is ambitious. It’s also worth it.
*This blog post was originally published at GruntDoc*
October 4th, 2010 by GruntDoc in Better Health Network, Health Policy, News, Opinion
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Texas is at the center of a heated national battle over the training emergency physicians need in order to advertise themselves as “board certified.” Via the Houston Chronicle:
At stake is the welfare of patients requiring immediate medical attention. Leaders of the traditional board say allowing physicians without proper training to advertise themselves as board-certified would mislead the public. Leaders of the alternative board say the proposed rule change will undermine the ability of Texas’ rural hospitals to staff their emergency departments with board-certified ER physicians.
A final verdict may only come, given one board’s already delivered threat, in a court of law.
At stake also are the careers of a lot of practicing Emergency Physicians, many of whom I’m proud to call friends and colleagues. (And it’s not just docs at rural hospitals, they’re in nearly every ED in Texas, and your lesser state). They practice high quality Emergency Medicine, and I have no qualms about the practice of those who are alternately boarded. Read more »
*This blog post was originally published at GruntDoc*
June 14th, 2010 by Shadowfax in Health Policy, Opinion
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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*
March 24th, 2009 by GruntDoc in Better Health Network
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I’ve never cooked lobsters but was reminded of the trick to the recipe today: if you try to put lobsters into boiling water you’ll have a big fight and it won’t go well, but put them in cool water and slowly turn up the heat, by the time they realize there’s a problem they’re cooked.
I thought about this while turning sideways between gurneys in the hall to get through to the next patient of many.
The temperature in my ED continues to climb, but I’ve been here so long it just seems like it’s getting a little warm.
ED’s everywhere have rising census, increasing demands, physical plants that aren’t keeping up with the crush.
Coal mines have canaries. Medicine has lobsters.
It’s getting warm, but there’s plenty of time.
Right?
