July 17th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
No Comments »
The old joke in medicine goes, ‘don’t get sick on July 1st.’ That’s because it’s the day when new resident physicians, freshly graduated from medical schools across the land, begin their training programs. Although they have spent four years in undergraduate school and four years in medical school, it’s residency where physicians are made from the raw material of knowledge-rich, experience poor high achievers.
However, even in residency physicians are seldom told the entire story of how the practice of medicine, and their lives, will look and feel as their careers evolve and they enter the medical work-force.
Since our profession changes from year to year and administration to administration, it seems a good time to mention some of the things upcoming young physicians will face. Sadly, these are things seldom mentioned by pre-med advisors or academic medical educators.
You see, physicians are struggling. Due to falling reimbursements and the ongoing federal mandate to see non-paying patients on call, it is increasingly difficult for physicians to cover costs like malpractice insurance, licensure, professional memberships and office overhead. (Well, if they want to have a house, family and food, that is.)
Many physicians are Read more »
*This blog post was originally published at edwinleap.com*
April 14th, 2010 by JessicaBerthold in Better Health Network, Health Policy, Opinion
No Comments »
The following post is by Jamie Newman, FACP, editorial advisor of ACP Hospitalist:
I read the April 6 Annals of Internal Medicine with great interest. In it, many readers responded to Howard Beckman’s previously published essay on the relationship between hospitalists and primary care physicians. Many physicians bemoan their loss of inpatient control of patients, and perceived lack of communication.
I think back to my own private/university hybrid practice. When my patients were admitted to the resident services, I never heard a word. There was absolutely no communication. I would say that most hospitalists do a much better job of communicating with the outpatient physician then any resident team. It’s a double standard. Read more »
*This blog post was originally published at ACP Internist*
January 29th, 2010 by Gwenn Schurgin O'Keeffe, M.D. in Better Health Network, Opinion
No Comments »
Last night, ABC’s Private Practice took on the very challenging issue of teenage pregnancy in a story arc that began with last week’s show when 15 year old Maya announced to Addison that she was pregnant. The show well depicts the shock, the emotion and the difficulty of handling the pro-choice/pro-life discussion when a teenager is at the center of the discussion. It was a raw episode at times and in the end we are left with a 15 year old opting to keep her pregnancy. It’s tempting to criticize the writers for not focusing enough on Maya but, in truth, the show was more realistic than you may realize.
In the episode, Maya’s mom, Naomi, basically freaks out from the start. This pro-life mom first storms out of the room then tries to force an abortion onto her daughter. When that doesn’t work, she shows Maya a woman in labor only to have Maya entranced by the sight of a baby and determined to keep the pregnancy even more. The show concludes with Naomi leaving the building not talking to anyone, in tears. True to life? You bet. Read more »
*This blog post was originally published at Dr. Gwenn Is In*
September 30th, 2009 by DrWes in Better Health Network, Health Policy, Opinion
No Comments »
It’s the holy grail of physician payment reform: ending fee-for-service payments to doctors and, instead, pay doctors based on the quality of care they perform. Remarkably, Congress feels they’ve found the answer:
Thus, the new language in the Senate Finance bill would finally connect Medicare reimbursements to quality, as opposed to volume.
The measure gives the secretary of Health and Human Services, working with the Centers for Medicare and Medicaid Services, the power to develop quality measurements and a payment structure that would be based on quality of care relative to the cost of care. The secretary would have to account for variables that include geographic variations, demographic characteristics of a region, and the baseline health status of a given provider’s Medicare beneficiaries.
The secretary would also be required to account for special conditions of providers in rural and underserved communities.
Additionally, the quality assessments would be done on a group-practice level, as opposed to a statewide level. Thus, the amendment would reward physicians who deliver quality health care even if they are in a relatively low quality region.
The secretary of Health and Human Services would begin to implement the new payment structure in 2015. By 2017, all physician payments would need to be based on quality.
Wow. That sounds great! But there’s just one problem…
… how do we define “quality?”
Read more »
*This blog post was originally published at Dr. Wes*
