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The Affordable Care Act: What’s Not Being Reported About Preventive Screening Benefits

One part of the health care law that took effect this week is widely reported as “establishing a menu of preventive procedures, such as colonoscopies, mammograms and cholesterol screening, that must be covered without co-payments.” For example, one of my local papers, the [St. Paul, Minnesota] Star Tribune, wrote: “Some people will no longer have to pay for copays, coinsurance or meet their deductibles for preventive care that’s backed up by the best scientific evidence.” (emphasis added)

That phrase should always include a huge asterisk, like the one hung on Roger Maris’ 61st home run. The best scientific evidence according to whom?

Time magazine reports, “Procedures, screenings and tests that are considered ‘preventive’ will be determined by the U.S. Preventive Services Task Force, the Centers for Disease Control (for vaccines) and the Health Resources and Services Administration.” As written, that is incorrect and inaccurate at worst and misleading at best. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Emergency Rooms Overused For Routine Care

The Patient Protection and Affordable Care Act (our government’s name for healthcare reform) may make our already crowded emergency rooms swarm with more patients.

A new study from Health Affairs shows that more than a quarter of patients who currently visit emergency departments in the U.S. are there for routine care and not an emergency. New complaints like stomach pain, skin rashes, fever, chest pain, cough or for a flare up of a chronic condition should not be treated in emergency rooms. They are best worked up and treated by an internist or family physician, preferably one who knows the patient. So why are these patients waiting for hours and spending up to 10 times as much money for emergency department care? Read more »

*This blog post was originally published at EverythingHealth*

Accountable Care And Doctor-Patient Communication Go Hand In Hand

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*

The Primary Care Shortage: What We Can Do Today

The new healthcare reform law, which is called the Patient Protection and Affordable Care Act (PPACA), will be a huge disappointment to the millions of previously-uninsured people who finally purchase insurance policies when they try to find a doctor.

Primary care physicians are already in short supply and the most popular ones have closed practices or long waits for new patients. Imagine when 2014 hits and all of those patients come calling. Who is going to be available to treat them? Read more »

*This blog post was originally published at EverythingHealth*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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