October 19th, 2011 by KennyLinMD in Health Policy, Opinion
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The past few months have offered encouraging signs that physicians and physician organizations are belatedly recognizing the need to take an active role in controlling health care costs by emphasizing “high-value” care and minimizing the use of low-value interventions with high costs and few clinical benefits. On the heels of a best practice guideline issued by his organization, American College of Physicians Executive VP Steven Weinberger, MD recently called for making cost-consciousness and stewardship of health resources a required general competency for graduate medical education.
In light of a recently published estimate that the top 5 overused clinical activities in primary care specialties led to $6.7 billion in wasted health spending in 2009, Dr. Weinberger’s call comes none to soon. Below is an excerpt from my post on this topic from April 13, 2010. Read more »
*This blog post was originally published at Common Sense Family Doctor*
October 9th, 2011 by DrWes in Health Policy, Opinion
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If you want to grow the expense of health care delivery in America very quickly, then create two government agencies to do the same job.
From the 28 September 2011 issue of the New England Journal of Medicine, we read about a small paragraph in our new health care law that created the Patient-Centered Outcomes Research Institute (PCORI). From that same article, here’s the PCORI’s mission:
PCORI responds to a widespread concern (eds note: emphasis mine. Really? What about the internet?) that, in many cases, patients and their health care providers, families, and caregivers do not have the information they need to make choices aligned with their desired health outcomes.
PCORI funding is set at a total of $210 million for the first 3 years and increases to approximately $350 million in 2013 and $500 million annually from 2014 through 2019. With more than $3 billion to spend between now and the end of the decade, PCORI will support many studies encompassing a broad range of study designs and outcomes that are relevant to patients, aiming to assist people in making choices that are consistent with their values, preferences, and goals.
We should recall that Read more »
*This blog post was originally published at Dr. Wes*
September 1st, 2011 by DrWes in News
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With the publication of “Apixaban versus Warfarin in Patients with Atrial Fibrillation” (the ARISTOTLE trial) in the New England Journal of Medicine, the third drug in a series of medications designed to attack thrombin in the clotting cascade. The study was announced with quite a fanfare in Europe as cardiologists, financial analysts and reporters gushed forth with ‘mega-blockbuster’ praise this past weekend.
And for good reason.
This is the first trial to conclude that Read more »
*This blog post was originally published at Dr. Wes*
August 28th, 2011 by Michael Kirsch, M.D. in Opinion, Research
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Medical malpractice reform is in the news again. Of course, for the medical profession, the medical malpractice system is the wound that simply will not heal. For the plaintiffs bar, in contrast, the medical liability system is the gift that keeps on giving. I have argued that the current system fails on four important fronts.
- Efficiency
- Cost
- Fairness
- Quality Improvement
I admit readily that my profession has not been as diligent as it should be in holding ourselves accountable. We have not been forthright in admitting our medical errors, although can you blame us under the current medical liability construct? Read more »
*This blog post was originally published at MD Whistleblower*
August 26th, 2011 by Davis Liu, M.D. in News, Opinion
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The New York Times recently published an article titled, Finding a Quality Doctor, Dr. Danielle Ofri an internist at NYU, laments how she was unable to perform as well as expected in the areas of patient care as it related to diabetes. From the August 2010 New England Journal of Medicine article, Dr. Ofri notes that her report card showed the following – 33% of patients with diabetes have glycated hemoglobin levels at goal, 44% have cholesterol levels at goal, and a measly 26% have blood pressure at goal. She correctly notes that these measurements alone aren’t what makes a doctor a good quality one, but rather the areas of interpersonal skills, compassion, and empathy, which most of us would agree constitute a doctor’s bedside manner, should count as well.
Her article was simply to illustrate that “most doctors are genuinely doing their best to help their patients and that these report cards might not be accurate reflections of their care” yet when she offered this perspective, a contrary point of view, many viewed it as “evidence of arrogance.”
She comforted herself by noting that those who criticized her were “mostly [from] doctors who were not involved in direct patient care (medical administrators, pathologists, radiologists). None were in the trenches of primary care.”
From the original NEJM article, Dr. Ofri concluded Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
