May 12th, 2010 by BobDoherty in Better Health Network, Health Policy, Opinion
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“Bold changes are needed in how the United States delivers and pays for primary care if the key goals of national health reform are to be achieved,” according to the health policy journal Health Affairs, which has released a thematic issue devoted entirely to the crisis in primary care.
(The complete articles are available only to subscribers, but Health Affairs’ blog has a good summary.)
I have spent much of the day reading the journal — 47 articles, and a combined 300 pages of text. Here are my “take-home” messages from the articles. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
May 12th, 2010 by KevinMD in Better Health Network, Health Policy, Research
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There’s been a lot of commentary on a recent article from the New England Journal of Medicine, detailing the undocumented tasks that a typical primary care physician performs.
For those who haven’t read the piece, entitled, What’s Keeping Us So Busy in Primary Care? A Snapshot from One Practice, it’s available free at the NEJM website. I highly recommend it.
To summarize, primary care doctors are responsible for much more than seeing patients in the exam room. In the cited practice, which has a fairly typical makeup, physicians were responsible for an average of over 23 telephone calls and 16 e-mails per day. Many practices don’t engage their patients over e-mail, so it’s conceivable that the number of telephone calls is lower than average here. Read more »
*This blog post was originally published at KevinMD.com*
May 12th, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
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A common problem in healthcare is the number of times that small adjustments are needed in a person’s care. Often for these little changes, a physical exam and face-to-face time have nothing to do with good medical decision making.
Yet the patient and doctor are locked in a legacy-industrialized business model that requires the patient to pay a co-pay and waste at least half of their day driving to and from the office, logging time in a waiting room, and then visiting five minutes with their practitioner for the needed medical information or advice.
Today I’d like to visit the case of a patient I’ll call “DD,” who I easily diagnosed with temporal arteritis (TA) through a 15-minute phone call after she’d spent four weeks as the healthcare system fumbled her time with delays and misdirection via several doctors without establishing a firm diagnosis. Read more »
May 11th, 2010 by JessicaBerthold in Better Health Network, Health Tips, Opinion
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Medicare has a handy guide to help patients and their caregivers take control of the discharge planning process. It might be good for hospitals to have a stack of these at the ready and a plan to make sure every patient gets one:
Planning for your discharge: A checklist for patients and caregivers preparing to leave a hospital, nursing home, or other health care setting
*This blog post was originally published at ACP Hospitalist*
May 11th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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Babies born between the 34th and 36th week have more complications and cost the U.S. $26 billion annually. These children have more risk of death, cerebral palsy, cognitive impairment, or respiratory problems.
In the United States, nearly 13% of infants are born before they reach 37 weeks gestation. According to the Society for Maternal-Fetal Medicine (SMFM), that rate is much higher than other developed nations, and physicians may be partially to blame for the early deliveries.
Some of the reasons may be older moms or the increased use of artificial reproductive technology and multiple births, but some physicians are choosing to deliver between 34 and 37 weeks even when there is no clear medical indication. Read more »
*This blog post was originally published at EverythingHealth*
