June 23rd, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion, Research
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A new study published in the Annals of Internal Medicine, ACP’s flagship journal, finds that medical schools vary greatly in producing more primary care physicians and getting them into underserved communities.
– “Public schools graduate higher proportions of primary care physicians” than private schools.
– “The 3 historically black colleges and universities with medical schools (Morehouse College, Meharry Medical College, and Howard University) score at the top” in training primary care physicians who then go on to practice in underserved communities. (Click here for an interview with two recent graduates of historically black colleges and with Wayne Riley, MD, FACP, who is the president and CEO of Meharry Medical College in Nashville, Tennessee and a regent of the American College of Physicians.)
– “The level of NIH support that medical schools received was inversely associated with their output of primary care physicians and physicians practicing in underserved areas.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
June 9th, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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In a recent blog posting, I described Group Health’s medical home for 8,000 patients. It proved to be a boon for primary care physicians, who were able to reduce the size of their patient panels, see fewer patients per day, refer more patients to specialists, and maintain or increase their incomes.
Patients liked it, too. And Group Health was happy because expenditures per patient were 2 percent lower. But poor patients had trouble getting through the front door of the medical home, so based on demographic differences alone, expenditures should have been lower by 10 percent or more. Nonetheless, they declared victory.
Now news filters south from Ontario’s eight-year experiment with medical homes for 8,000,000 patients, and the news is similar. Participation is skewed to healthier and wealthier patients who, in the absence of risk adjustment, yield profitable capitation for primary care physicians. Incomes have soared an average of 25 percent. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
May 26th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion
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Much has been recently made about the bureaucratic obstacles that primary care doctors face. With good reason. The impetus was a recent New England Journal of Medicine paper from Richard J. Baron that I mentioned recently.
The New York Times’ Pauline Chen interviewed Dr. Baron, who shared some interesting insights on what needs to be done. He contrasts the inertia in primary care to drug manufacturing.
If you took the resources that went into drug development, for instance, “and put them into a program like this that achieves meaningful levels of behavior change, a lot more patients could be better off.” In other words, research into new primary care models isn’t taking off because the money isn’t there.
But Dr. Baron also notes that money isn’t everything, since “primary care practitioners have been saying that we either already do or would do certain things if you paid us more. It’s true that you can’t do things consistently, reliably and across scales without additional payment. But payment is not enough. People have to change what they are thinking about when they go to work.” Read more »
*This blog post was originally published at KevinMD.com*
May 12th, 2010 by BobDoherty in Better Health Network, Health Policy, Opinion
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“Bold changes are needed in how the United States delivers and pays for primary care if the key goals of national health reform are to be achieved,” according to the health policy journal Health Affairs, which has released a thematic issue devoted entirely to the crisis in primary care.
(The complete articles are available only to subscribers, but Health Affairs’ blog has a good summary.)
I have spent much of the day reading the journal — 47 articles, and a combined 300 pages of text. Here are my “take-home” messages from the articles. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
May 5th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, Opinion, Research
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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*
