February 1st, 2011 by DrWes in Better Health Network, Opinion
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It came as a Twitter “follow” from @coldfeet65, a self-proclaimed “Nurse Practitioner Hospitalist.” I had never heard this term before. Does it mean a nurse practitioner who cares for hospitalists? Or is it a hospitalist who is a nurse practitioner? Or maybe it’s a nurse practitioner who helps hospitalists? (Honestly, I think I know which one she means, but you get my point.)
Perhaps this is a prescient glimpse to healthcare of the future, where our more typical nurse and doctor labels are supplanted by more and more monikers that serve to confuse, rather than clarify, each of our roles in healthcare delivery. As specialists in cardiology, we’ve seen a similar trend with cardiology hospitalists. But we should be clear what this means to the patients and doctors going forward.
No doubt most people in America still expect to see a doctor when they come to the hospital. Increasingly, it appears that might not be the case. Your doctor might be a robot while a nurse (aka, nurse practitioner) will be the one providing the hands-on care in the inpatient setting. Is that a good thing? Honestly, I’m not sure.
No one argues that the costs in healthcare need to be cut. No doubt the central authority has deemed that doctor salaries will be a big part of that effort. Already, 20 states have cut physician Medicaid payments for fiscal year 2010 and, given the current economic pressure on our states both now and after they start feeling the financial impact of the “Affordable” Care Act in 2019, this trend is not likely to improve anytime soon. As a result, we are seeing that the world is full of “creative solutions” to our healthcare access crisis and the evolution to “nurse practitioner hospitalists” might be one of these. Read more »
*This blog post was originally published at Dr. Wes*
January 24th, 2011 by EvanFalchukJD in Opinion, Research
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The worst healthcare system in the world is the United States, of course. Oh no, wait — it’s Canada. Actually, it could be Germany. Geez, now I think it might be the UK.
You could go on and on like this, but you know what? No matter how good or bad your healthcare system is, there are certain universal truths. Here are four of them that might make you look at global healthcare a little differently:
First, healthcare is getting more expensive, all over the world. A new study by the global consultant, Towers Watson (disclosure: Towers Watson is a Best Doctors client) found that the average medical cost trend around the world will be 10.5 percent in 2011. In the advanced economies costs will rise by an average of 9.3 percent. While Americans tend to think of rising medical costs as a uniquely American problem (they’ll rise by 9.9 percent here), it’s just not true. Canadian costs will rise by 13.3 percent. In the UK and Switzerland, they will increase by 9.5 percent, and in France by 8.4 percent.
Why is it happening? As ever, the main drivers are the increasing availability of new medical therapies — and inappropriate use of care. We see the same phenomenon at Best Doctors in our global experience. Across the world, our data for 2010 showed that just over 20 percent of patients had an incorrect diagnosis, and about half were pursuing inappropriate treatment plans. Read more »
*This blog post was originally published at See First Blog*
January 20th, 2011 by RyanDuBosar in Health Policy, Research
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While public opposition to healthcare reform has diminished since its passage, physician opinions are still negative, especially among specialists who see their value to the healthcare system decreasing as reform emphasizes primary care.
A survey reports that 65 percent of nearly 3,000 physicians in all specialties said the quality of healthcare in the country will deteriorate in the next five years. Seventeen percent of respondents believe the quality of healthcare will stay the same and 18 percent believe it will improve. Meanwhile, 30 percent of healthcare consumers believe that the quality of healthcare will improve.
Physicians cited as reasons for their pessimism personal political beliefs, anger at insurance companies and a lack of accurate planning in the reform act. Other reasons include that primary care physicians won’t have the time to keep up with the extra workload, forcing more patients to depend upon nurse practitioners for primary care. When asked who will likely handle the 32 million Americans expected to receive healthcare following passage of the reform, 44 percent said primary care physicians will handle the load and 44 percent said that nurse practitioners will see them. (Physicians could vote for more than one category; options include physicians assistants and specialists, for example.) Read more »
*This blog post was originally published at ACP Internist*
January 10th, 2011 by RyanDuBosar in Better Health Network, Health Policy, News
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Repealing healthcare reform has become a way of stockpiling ammunition for the campaign trail. The Republican-led House has scheduled a repeal of healthcare reform for Wednesday, Jan. 12, and they’d garner as allies some but not all 13 Democrats that voted against healthcare reform to begin with. The House’s quixotic vote would then promptly die in the Democrat-held Senate.
But recording votes on repeal would put pressure on already vulnerable lawmakers, as well as give a quick boost to incoming ones. A Gallup poll shows 46 percent of Americans want healthcare reform to be repealed, 40 percent don’t want repeal.
Unfortunately, not only can’t the law be passed, it would add $230 billion to the federal debt by 2021, according to the Congressional Budget Office. House Speaker John Boehner said, “I don’t think anyone in this town believes that repealing Obamacare is going to increase the deficit,” although Republicans have already exempted a repeal of the healthcare law from new rules prohibiting legislation from adding to the federal debt. (Politico, Kansas City Star, [Aurora, Ill.] Beacon-News, USA Today, CNN)
*This blog post was originally published at ACP Internist*
January 10th, 2011 by DavedeBronkart in Better Health Network, Health Policy, News
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In December, the Society for Participatory Medicine’s executive committee appointed health law attorney David Harlow to represent the Society in public policy matters. Regular readers of HealthBlawg::David Harlow’s Health Care Law Blog know what a patient-centered, participatory thinker David is. This is his first report.
I am delighted to offer my first report as Public Policy Committee Chair for the Society of Participatory Medicine. I encourage all of you who are not yet Society members to join, and I encourage new and old members to consider volunteering to help with the wide range of public policy issues facing us today.
Over the past couple of months, the Public Policy Committee has gotten its sea legs. We are beginning to add the Society’s voice to the national discourse on patient engagement in a formal manner. As planning for health reform and related initiatives becomes more concrete, it is clear that patient engagement and patient-centeredness are key issues to be considered. For example, it was encouraging to hear Centers for Medicare and Medicaid Services (CMS) Administrator Don Berwick speak about the “Triple Aim” at the Accountable Care Organization (ACO) workshop this fall, and explicitly link the achievement of the triple aim — better care for individuals, better health for populations, and reduced per-capita costs — to patient engagement and empowerment.
There will be many opportunities for the Society to engage with policymakers, payors and provider organizations as this work continues. CMS and its many related organizations, as well as many provider and private sector payor organizations recognize that without maintaining a focus on the patient at the core, health reform and related health IT initiatives cannot be successful. We’ve kicked things off on two fronts — ACOs and Stage 2 Meaningful Use rules. Read more »
*This blog post was originally published at e-Patients.net*
