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Long waits to access primary care are avoidable

Physician

June 12, 2012

“Cheers!” “To good health,” my girlfriend and I toasted in the living room of our apartment joined by my parents on speakerphone.

It had been 12 years since my last radiation treatment—my last treatment for Hodgkin’s Lymphoma. Tonight was the anniversary of my remission, and in the case of Hodgkin’s—a cancer with an exceedingly low relapse rate—tonight was my anniversary of being cured.

I kissed my girlfriend goodbye and tread the dark …

Why isn’t shared decision making standard practice?

Patricia Salber, MD

Physician

June 12, 2012

Pretty much everyone chats up shared decision making these days. And that is good. It seems intuitive that people (patients) who are knowledgeable about their condition and buy in and/or help to shape the treatment plan are more likely to follow it.

Here is an example from my seatmate on today’s flight from SFO to our nation’s capitol. Her son, let’s call him Alex, is a teen with cystic fibrosis (CF). …

The selfless people in medicine are the people a patient never sees

Ryan Stewart, DO

Physician

June 12, 2012

It’s been two days now since I basked in the glory. I still find myself floating above the ground. I can still feel the weight of the heavy gown and the velvet tam. I can feel the tickle of the tassel on my ear. My eyes fill with tears at the thought of my classmates – those who toiled alongside me – experiencing the same emotions. The reminders of our …

Physician disrespect impedes patient safety

Jessie Gruman, PhD

Patient

June 12, 2012

“I just love working here!” my nurse told me. “We have great supervision, I have wonderful colleagues – we all help each other in an emergency. The doctors are really responsive and I feel like I am doing important work. I thought I would only stay for a year because oncology is so hard, but I’ve been here ten and I still love it.”

This is what we want to hear …

Patients must speak up at the doctor’s office

Kevin R. Campbell, MD

Physician

June 11, 2012

While reading the New York Times I stumbled upon an article by Pauline Chen addressing issues with doctor patient communication.

In the article, Dr. Chen describes a highly educated, articulate patient who was unwilling to speak up and discuss care related issues with her doctor. The reasons given for not wanting to speak up included not wanting to anger the physician and not giving the perception of questioning judgement.

I immediately began …

Reduce health costs by reducing waste

Stephen C. Schimpff, MD

Health Policy

June 11, 2012

There is enormous waste in American healthcare delivery. One estimate is anywhere from 20% to nearly 50% of total expenditures are frankly unnecessary. What is this waste? Is it real? Could it be eliminated or at least reduced? How difficult would such a reduction be to achieve? And what would be the unintended consequences?

Donald Berwick, the former administrator for the Centers for Medicare and Medicaid Services, along with Andrew Hackbarth …

Read more…

Reduce health costs by reducing waste

AMA: Moving past a failed Medicare formula to focus on quality care

Peter W. Carmel, MD

Health Policy

June 11, 2012

The Medicare physician payment formula is a case-study in failed policy. Physicians have long known that it is not working. Polls show that an overwhelming 94 percent of Americans believe the massive cuts it schedules are a serious problem for seniors. Even members of Congress from both parties agree – and that is no small accomplishment – that it is …

The impact of prescription drug costs on health spending

Cathleen London, MD

Medications

June 10, 2012

I am employed by a hospital, and have health insurance through my job. The coverage is comprehensive, and the cost has an employer contribution and employee contribution. I still get confused (though I have the hospital’s own plan) about what is covered and what is not. I can only imagine how hard it must be for my patients.

The prescription plan that comes with this insurance is straight forward: $40 for …

Is there a harm to not seeing drug reps?

Matthew Mintz, MD

Medications

June 10, 2012

Now more than ever, the growing consensus among many is that doctors should avoid seeing pharmaceutical sales representatives, otherwise known as drug reps. A position statement from the AAMC, the head organization of all US medical schools and residency programs, recommends that all academic health centers avoid having drug reps on their campuses, hospital and clinics. Many medical institutions including the VA and Kaiser have also enacted similar policies banning …

Is there a future for smaller physician practices after health reform?

Bob Doherty

Health Policy

June 10, 2012

The medical profession has always been marked by division: town versus gown, primary care versus specialty medicine, states versus national. But the real fault line today is not defined by specialty, geography, or teaching versus practice, but by size of practice.

Physicians in smaller practices, without regard to specialty or where they are located, are embattled and defensive—and therefore are more skeptical when someone tries to peddle the need for delivery …

The truth about reduced risk smokeless tobacco

George Lundberg, MD, Gilbert Ross, MD and Elizabeth Whelan, MS, MPH

Medications

June 10, 2012

Willful blindness of our public health officials on tobacco is still killing hundreds of thousands of Americans each year.

Here are the facts:

i) There are approximately 46 million tobacco smokers in the United States.
ii) While three-quarters say they want to quit smoking, and about one-third try to quit each year, fewer than 10% succeed.
iii) The FDA-approved smoking cessation aids simply do not work: They improve quit rates only minimally, if at …

Should you consider an EHR in the cloud?

Rosemarie Nelson

Health Technology

June 9, 2012

Which electronic health record system should I select?

Among physicians and managers in small-group practices today, there is no more common question.

But lately, another vexing question has emerged: Whether to install EHR software on servers in your office, or subscribe to an Internet-based system maintained in “the cloud.”

What Is “the cloud”?

When EHR vendors began offering their products via the cloud, many physicians were puzzled. Some think that the cloud is simply …

What can be done for children with migraine headaches?

Mark W. Green, MD

Conditions and Diseases

June 9, 2012

Recently, as I finished up a visit with one of my patients who has migraine, she asked me the following: “My 10 year old daughter gets headaches. Is it possible that she has migraines too? I had headaches as a child and was always told it was nothing to worry about, but now I have headaches several times a month. Is there anything I can do to prevent this from …

What can local groups do to prevent obesity in children and youth?

Donald Tex Bryant

Conditions and Diseases

June 9, 2012

Obesity is becoming a major health issue in the United States across all age groups. It is well known that obesity is a major contributor in the occurrence of type 2 diabetes and heart conditions. Although physicians and other clinicians are often called upon to become the primary players in the prevention and treatment of chronic conditions, it is not possible for them to do so alone when it comes …

What does an ACO mean in small town America?

Robert Provenzano, MD

Health Policy

June 9, 2012

At the end of long days I often stand gazing out my window at the beautiful, timeless Rocky Mountains in Colorado Springs and am taken by their sense of permanence. I recently returned from Nampa, Idaho, where I presented hospital Grand Rounds on Accountable Care Organizations.

The parallels between the timeless mountains and the physicians I met in Nampa struck me. Strange, you say? Maybe, but I am accustomed to the …

Finding the right model for patient satisfaction

Michael Kirsch, MD

Physician

June 8, 2012

Patient satisfaction is an important element of medical care. It was always important, but it has taken on a new significance since hospitals and physicians will be graded on their bedside manners. And, these grades count for cash. Money motivates. Who believes that a leopard can’t change its spots? Throw a leopard into the pay-for -performance arena, define spots as inferior quality, and watch what happens. We would all witness …

Being on the other end of finding a good doctor

Rob Lamberts, MD

Physician

June 8, 2012

My in-laws are in town for my daughter’s graduation. When I came home yesterday I was greeted with a big smile and vigorous handshake from my father-in-law. ”I just want to thank you,” he said, standing up from his chair, “for finding us a good doctor. The one you found for us is wonderful.”

My wife smiled at me warmly. I just earned myself big points. Yay!

Her parents and mine are …

The reasons our future doctors are choosing medicine have changed

Anonymous

Medical Education

June 8, 2012

Why would anyone want to become a doctor? Seriously. Think about it, because this is a very important question for the future of healthcare in our country.

The future of medicine is somewhat unclear in this age of healthcare reform, but we do know a few things. Physician compensation is currently falling while lawsuits and malpractice premiums are rising. Doctors must see many more patients in a day to maintain their …

My pediatrician inspired me to become a physician

Reflex Hammer

Medical Education

June 7, 2012

I recently learned the sorry news that my childhood pediatrician has died. Not only was he my pediatrician, but he was also my father’s pediatrician. Our family became rather close to him over the years.

He came from a different generation of doctors, one that made house calls, that served in wars abroad, and that learned how to diagnose patients in the days before MRIs and CT scans. Even though I …

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