November 3rd, 2010 by BarbaraFicarraRN in Better Health Network, Health Policy, Opinion, True Stories
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Guest post by Stephen C. Schimpff, M.D.
We are often told that the reason for the high cost of medical care is all of our new technologies and drugs. There is an element of truth in that but when used correctly, new technologies save lives and improve the quality of patient care and often improve safety. But technologies used inappropriately increase costs while not improving quality and may adversely impact safety.
A patient example
An older woman had been coming to the same primary care physician (PCP) as her daughter for over twenty years. She lived in another city about 30 miles distant but she preferred to visit the doctor with her daughter. She also occasionally saw a doctor near her home if she had an immediate problem.
On nearly every visit she said that she felt “tired.” Repeated history and exam over twenty years revealed no cause nor did logical tests such as those for anemia or hypothyroidism. She then developed syncopal episodes — times when she would black out and fall to the floor, once bruising her head when she fell against the stove, and then waking up in a few minutes. Evaluation by the PCP showed that she had intermittent episodes of bradycardia, or very slow heart rate, resulting in the drop attacks. Read more »
*This blog post was originally published at Health in 30*
June 30th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Medical schools are traditionally ranked on criteria like research funding and technological innovation. These rankings are highly significant. A place on the U.S. News‘ annual “Best Medical School” list is a coveted spot indeed.
So that’s why there was some media attention paid to a recent study from the Annals of Internal Medicine, which ranked medical schools according to their “social mission” — a phrase that defines a school’s commitment to primary care, underserved populations and workforce diversity. Using this new criterion, some of the traditionally high ranking schools fell significantly. Read more »
*This blog post was originally published at KevinMD.com*
June 28th, 2010 by BobDoherty in Better Health Network, Health Policy, Opinion
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After months of dithering, delaying, denying, and defaulting on a decision, Congress ended up…doing as little as possible to address the Medicare physician pay cut problem.
Thursday night the House of Representatives acceded to the Senate’s bill to provide physicians with a 2.2 percent update retroactive to June 1. This respite, though, lasts only through the end of November, when physicians and patients will again face another double-digit cut. And if the past is prologue, a lame-duck Congress then will wait until the very last minute to enact another short-term patch, or worse yet, allow the cut to go into effect on December 1 and then pass some kind of retroactive adjustment.
You know that the situation has gotten ridiculously bad when the President says this about the bill he just signed into law:
“Kicking these cuts down the road just isn’t an adequate solution.”
And when Speaker Pelosi (D-CA) calls it “inadequate” and a “great disappointment” and the best that any had to say about it was this from SFC ranking member Charles Grassley (R-IA):
“This action was critically needed so there’s no disruption in services for anyone.”
But it’s too late. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
June 28th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
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I have not a single thing I want to write about today. I am weary of the obvious topic: the “passage” of the 6-month extension on the SGR, but do feel I need to comment.
I am tired of this. I am tired of being jerked around by congress. I am tired of congress hitting the 6-month snooze button and somehow feeling that they are doing something good. This is procrastination, not a solution. Reassurances that something will be done are starting to be irrelevant. The problem is becoming the frustration, anger, and exhaustion that congress is thrusting upon doctors and patients, not the pay cut itself. The idea of no longer having to deal with the passive-aggressive tactics of congress is becoming increasingly appealing –- and if it’s this way for me, I’m sure it’s the same for PCPs across the country. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
June 23rd, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, Opinion
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Solutions to problems are generally sought from within the problems themselves. Two recent examples are healthcare and finance. In both cases, the solutions are believed to be better-structured and regulated systems. In blogs, articles and speeches, I have stressed that — while there are myriad ways that healthcare can be improved — the real solutions to high healthcare spending lie outside of healthcare.
Poverty and its associated manifestations are at the core of the healthcare spending crisis. The high costs of caring for the poor will continue to overwhelm the system, no matter how it’s structured and improved. Rather than looking for solutions through changes in process and regulation, the major solutions to healthcare’s excessive spending reside in areas such as K-12 education, neighborhood safety, and the creation of jobs that can lift low-income families from the cycle of poverty.
Simply stated, the U.S. does not and will not have the resources to provide equitable care for those among us who confront inequitable circumstances in every other aspect of their lives. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
