August 23rd, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, News, Opinion, Research
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Accountable Care Organizations (ACOs) figure prominently in the new Patient Protection and Affordable Care Act (PPACA). The concept behind ACOs is that by tying both physician and hospital compensation to outcomes via a bundled fee (say for pneumonia) we can expect to see an improvement in quality and value.
In principal, accountable care makes a lot of sense. Practicality speaking, however, doctors and hospitals must address a huge challenge before they can expect benefit financially. Before doctors can be held accountable for the care they deliver, they must first be held accountable for the quality of their communication with patients.
Take hospital readmissions, which are a big healthcare cost driver today. According to a recent study in the New England Journal of Medicine, 20 percent of all Medicare patients discharged from hospitals were readmitted within 30 days, and 34 percent percent within 90 days. The Joint Commission and others rightly believe that inadequate communication between physicians — as well as between physicians and patients — is a major contributing factor. Read more »
*This blog post was originally published at Mind The Gap*
August 23rd, 2010 by DrRich in Better Health Network, Health Policy, News, Opinion, Research
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DrRich has pointed out several times that it is very important to our new healthcare system, as a matter of principle, to be able to discriminate against the obese.
The obese are being carefully groomed as a prototype, as a group whose characteristics (ostensibly, their lack of self-discipline, or their sloth, or their selfishness, or whatever other characteristics we can attribute to them to explain how their unsightly enormity differentiates them from us), will justify “special treatment” in order to serve the overriding good of the whole.
The obese are a useful target for two reasons. First, their sins against humanity are painfully obvious just by looking at them, so it is impossible for them to escape public scorn by blending in to the population, unlike some less obvious sinners such as (say) closet smokers, or pedophiles. And second, since true morbid obesity almost always has a strong genetic component, successfully demonizing the obese eventually will open the door to the demonization of individuals with any one of a host of other genetically mediated medical conditions. Read more »
*This blog post was originally published at The Covert Rationing Blog*
August 23rd, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Research
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Cancer is the world’s costliest disease, sapping the equivalent of 1.5 percent of the global gross domestic product through disability and loss of life, according to the American Cancer Society (ACS). Cancer cost $895 billion in 2008, and that’s before factoring in the cost of treating cancer.
Cancer and other chronic diseases cost more than infectious diseases and even AIDS, according to a report the ACS [presented last] week. While chronic diseases are 60 percent of all deaths globally, they receive only 3 percent of private and public research funding. The organization is calling for a new look at priorities by the United Nations and the World Health Organization. (Associated Press)
*This blog post was originally published at ACP Internist*
August 22nd, 2010 by Happy Hospitalist in Better Health Network, Humor, Opinion, True Stories
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I just had my ten-year medical school reunion. It’s hard for me to imagine it’s been ten years since my last medical school class. It’s been fourteen years since that first week of gross anatomy. That class was so hard, I almost dropped out of medical school after one week.
A bunch of us local docs from my medical school class of 2000 rode to academic mecca in a stretch limo. What did I learn from my experience at my ten-year medical school reunion? Other than forgetting a few names:
- When I was in medical school, lots of medical students, on occasion, would drink heavily. I learned ten years later some doctors, on occasion, still drink heavily and get drunk.
- When I was in medical school, lots of medical students smoked cigarettes. I learned ten years later some doctors, on occasion, still smoke (but only when they’re drinking). Apparently.
- When I was in medical school, some students were really funny. I learned ten years later some doctors, on occasion, are still really funny, even when they aren’t drunk.
- When I was in medical school, some students were really smart. I learned ten years later some doctors, on occasion, are still really smart. Most of us others have been dumbed down with years of practice.
It was fun to learn about what my colleagues have been doing. Ten years later the cellphones are a bit fancier, everyone’s talking about their Facebook page, and I’m completely content sitting on the couch with Mrs. Happy watching everyone else get drunk like it was yesterday.
*This blog post was originally published at The Happy Hospitalist*
August 22nd, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
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I recently got into a discussion with a couple friends about doctors and blogging. Why don’t we see more doctors out there? Of the hundreds of thousands of doctors, I’d expect more to be taking a voice. Even during the U.S. healthcare reform debate — crickets.
Of course there are doctors who blog, but the numbers are slim. What’s behind it?
Passion. Pushing great content requires a passionate interest in changing ideas and making a difference. There’s malaise in medicine right now. Margins are slim. Physicians are losing control of what’s happening around them. The fire in the belly that drove so many doctors to choose medicine has given way to a preoccupation with survival.
Late adopters. Most doctors think a blog is something that deviant teens do on a cellphone. There’s endemic ignorance in the medical community surrounding social technology. Can we teach ‘em? Maybe. But I think this is a generational issue that will work itself out with time. The use of social technology to facilitate dialog between doctor and patient will evolve over the next several years as: 1) technology evolves and 2) digital communication becomes a standard. Keep in mind that many of us still work with doctors who grew up using rotary phones. Read more »
*This blog post was originally published at 33 Charts*
