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.
I often am asked how I incorporate wellness in our family medical practice, and I must admit that I’ve mixed feelings when it comes to the question because it implies that I’m not already trying to practice wellness simply by practicing medicine. I feel that the two are synonymous.
To those who want to know more about wellness and primary care, here’s my approach:
• I never try to sell anyone on a “wellness” program.
• I follow specific guidelines on certain chronic illnesses, mostly adhering to evidence-based guidelines and not expert opinion or opinion by committee.
• I offer the best advice I can to patients and try to guide them in the right direction when I feel they are taking pathways that worry me and that could be harmful (e.g. like using megavitamin and nutrient therapies or colonics, to name a few).
• I try to be as cost effective as possible when it comes to treatment.
• I see our patients once a year to comply with the legal definition of “face-to-face visits,” but not because scientific evidence substantiates this time honored ritual as “wellness.”
• I use calendar reminders in our electronic health record, MD-HQ to set up needed labs like cholesterol or Hgba1C or to schedule flu shots based on guidelines.
“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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