A 69-year-old woman who swims in my master program came back to the pool after a total knee replacement. I asked her how she was doing. She said she is still in a lot of pain because of her physical therapy. She said that her physical therapist was disappointed that she still was still unable to achieve full flexion of 120 degrees. Why 120 degrees? Did you set that goal I asked her? “No,” she said, “the therapist did.”
She went on to tell how she already had more range of motion in her knee than she did before the surgery. My friend was quite satisfied with her progress and wanted to stop physical therapy. The pain from the PT was worse than anything she had experienced before the knee replacement. I knew she and her 80-year-old boy friend were going on a cruise and she didn’t want to still be hobbling around.
It turns out that patients and physicians disagree on quite a few things. We hear a lot about patient-centered care. You know, that’s where the provider is supposed to consider the patient’s needs, preferences, and perspective when diagnosing and treating health problems. But medicine is still very provider-centered. Read more »
*This blog post was originally published at Mind The Gap*
This video was recorded at the American Academy of Family Physicians (AAFP) meeting in Denver last week. Hughes Melton, M.D., was awarded the “2011 Family Physician of the Year” award. The video below shares his story. I also encourage you to read more of his story from the news article on the AAFP website.
I have always been inspired by hearing the stories of the “Family Physician of the Year.” One of my wild and crazy dreams is to achieve this award someday, but I know that I definitely have a long way to go.
“We want our employees to spend their time on real issues,” said Charlie Salter, VP of Benefits at ConAgra. He means it. Charlie and ConAgra have built their healthcare benefits around some simple concepts that are yielding impressive results. How impressive? Close to flat healthcare cost trend since 2007.
Charlie’s work is part of a growing trend among America’s most innovative companies: Designing healthcare benefits in ways that have a real impact on quality and cost. It’s why I [recently] asked Charlie to share the podium with me in Boca Raton. ConAgra is showing it’s possible to control healthcare costs by helping people do the right thing.
The vision behind ConAgra’s programs is simple: Employees have to be responsible for managing their own care. But, says Charlie, this is easy to say, harder to do. “So we do as much as we can to make it as easy for people to do the right thing.” ConAgra gives its employees a significant financial stake in their well-being, through a health plan that has a $1,500 deductible. ConAgra supplements the plan with a health savings account (HSA) that lets workers use pre-tax dollars to pay for the deductible. Like other HSAs, any money the employee doesn’t spend is theirs to keep. It means employees are more engaged in healthcare decisions. Read more »
*This blog post was originally published at See First Blog*
The implication was obvious. Simple tool determines an individual’s risk for heart attack or death from heart attack. It over estimates risk. Patients treated unnecessarily. To be also clear, the program did underestimate risk as well.
Unfortunately, the article missed an important point. While the simplified calculator may not be as accurate as the more complex algorithm used by the National Cholesterol Education Program, the truth is doctors are likely to be overtreating patients not because the former program is presented by the pharmaceutical roundtable, but for another reason. Read more »
Some states are finding it tough to retain physicians. Take Virginia for instance:
A recent study found Virginia retains only 35 percent of its medical school graduates and ranks 31st among other states in retaining doctors.
In 2008, Virginia spent more than $50 million from the general fund to support medical education and had nearly 600 new physicians graduate from Virginia’s four medical schools.
Despite this, Virginia still struggles to retain medical graduates, with less than 25 percent of Virginia’s physicians graduating from medical schools in the Commonwealth.
Some feel incentives might work:
Dr. Greenawald says other states including North Carolina have incentives to keep medical students in state. He hopes Virginia considers following suit. Dr. Greenawald also said the over burden of paperwork and insurance company oversight have taken doctors away from what they love doing which is providing care to patients. He said that’s prompted many doctors to retire early.
I’m not so sure. Until more medical students feel primary care is worth the effort, the mass exodus to specialties (and the out-of-state training that is often required) will continue.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
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