United States health care may need reverse innovation

Health Policy
September 15, 2011

The realization that the American health care system must simultaneously decrease per-capita cost and increase quality has created the opportunity for the United States to learn from low and middle-income countries. “Reverse innovation” describes the process whereby an inexpensive innovation is used first in countries with limited infrastructure and resources and then spreads to industrialized nations like the United States.

The traditional model of innovation has involved the creation of …

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United States health care may need reverse innovation

Patient safety in the elderly staying at home

Patient
September 15, 2011

As a geriatrician in a locale with many elderly retirees, I am frequently asked how long mom or dad (or both) can stay in their home and live safely and successfully.  It is clearly a complicated issue even if the individuals involved are cognitively and mentally intact, physically capable and financially able to pay for support and help.

There is much to consider. Are the patients physically able to maneuver within …

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Patient safety in the elderly staying at home

AMA: A new opportunity to fix the SGR

Health Policy
September 15, 2011

A guest column by the American Medical Association, exclusive to KevinMD.com.

Every year since 2001 the threat of severe physician payment cuts, imposed by Medicare’s failed sustainable growth rate formula (SGR), have jeopardized the stability of the Medicare system and compromised access to care for patients. And every year – sometimes several times a year – Congress has put in place short-term …

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AMA: A new opportunity to fix the SGR

Patients should care about physician stress and burnout

KevinMD
September 15, 2011

Physicians are human, like everyone else.

And when things go wrong, like making a medical error or having a patient die, they suffer like most people would.

Pauline Chen writes about Schwartz Rounds in the New York Times, where, in a confidential environment, doctors and other health professionals can discuss challenging cases.

As Dr. Chen writes, “the discussions that ensue are …

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Patients should care about physician stress and burnout

How health reform is reshaping health care markets

Health Policy
September 15, 2011

The current reorganization of health care could make it better and cheaper for everyone, harnessing real creative and competitive energies to build the “next health care” —or it could lead to local monopolies, higher prices and less real competition where it matters. The many and various moves toward accountability, competition and transparency could defeat themselves.

The theme of the reorganization is clear: new types of cooperation between physicians, hospitals and other …

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How health reform is reshaping health care markets

Using the emergency room for routine physicals

Patient
September 15, 2011

One of my patients thanked me for saving his life.  Apparently, many years ago I had told him that most men’s first complete physical is in the emergency room in the midst of their heart attack or stroke.  I have been in practice long enough to have forgotten many of the things I have told patients.  I try to capture the pearls I have learned over the last 30 …

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Using the emergency room for routine physicals

Unexpected medical bills on a graduate student’s budget

Patient
September 15, 2011

Last
 July,
 I
 found
 myself
 needing
 to
 visit
 a
 doctor
 for
 an
 urgent
 medical
 issue.
 My
 period
 had
 started
 in
 April
 and
 never
 stopped.
 It
 was
 light,
 so
 it
 wasn’t
 too
 much
 of
 an
 annoyance, 
but 
after 
three 
months 
I 
figured
 I
 needed 
professional 
help.

I
 had
 started
 graduate
 school
 in
 Michigan
 the
 year
 before
 and
 was
 back
 home
 in
 California
 for
 the
 summer.
 I
 wasn’t
 sure
 if
 the
 new
 insurance
 …

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Unexpected medical bills on a graduate student’s budget

Does longer physician training merit more pay?

Physician
September 14, 2011

One of the main considerations in physician pay under CMS’ relative value system is the training required to complete a task. This is generally thought to be well understood but is, in fact. a quagmire of controversy.

Take for example the specialty of family medicine compared with dermatology, anesthesiology, or ophthalmology. Family physicians make between 1/2 and 1/3 of what these other specialties make, so one would think that there …

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Does longer physician training merit more pay?

Social gaming to engage patients and improve wellness

Health Technology
September 14, 2011

Social connectivity to engage patients has real the potential to impact health through improvements in lifestyle, the main driver of wellness. This is in increasingly shorter supply as we collectively increase pounds, cholesterol, and blood pressure readings.

Many have written compellingly on why social matters for health. The best I’ve seen are a post by Jay Parkinson (of Hello Health and Fast Company fame) that borrows from Atul …

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Social gaming to engage patients and improve wellness

How to talk to teens about tanning beds

Patient
September 14, 2011

You’ve had the sex talk, the smoking talk, and the drugs and drinking talk. But have you talked to your kids about tanning beds?

You should. Tanning bed use can cause skin cancer, including the deadliest form, melanoma. And, using tanning beds before age 30 increases a person’s risk of melanoma by 75%.

Equally worrisome: tanning beds can become addictive. A recent study showed that 80% of college-age tanning beds users couldn’t kick the habit.

This …

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How to talk to teens about tanning beds

Andrea Mitchell breast cancer thoughts

Conditions and Diseases
September 14, 2011

For the past 24 hours I’ve squirmed about whether to or how to criticize NBC’s Andrea Mitchell about her on-air announcement of her breast cancer diagnosis and treatment. How can you criticize someone who is dealing with what she – and so many other women – are dealing with? But it’s now clear that some breast cancer survivors and others who know the science are critical of the message …

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Andrea Mitchell breast cancer thoughts

Care costs a lot and it’s not straightforward what the cost is

Patient
September 14, 2011

Up until last May, my experience of medical costs was limited to the $100 per month premium I contributed towards my employer-sponsored insurance and the nominal co-pays associated with well-child checkups and generic prescriptions. There was never any hesitation in seeing a doctor or filling a prescription. That all changed when went I back to school.

I blindly signed up for the school-recommended family insurance and naïvely assumed myself, my …

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Care costs a lot and it’s not straightforward what the cost is

Targeting physician salaries is a poor strategy for health care costs

KevinMD
September 14, 2011

A recent study from Health Affairs took aim at physician salaries.

Well, not exactly their salaries, but fees. It’s a subtle difference, but that nuance is lost in the mainstream media narrative.

According to the study, “American primary care and orthopedic physicians are paid more for each service than are their counterparts in Australia, Canada, France, Germany and the United Kingdom.”

Thankfully …

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Targeting physician salaries is a poor strategy for health care costs

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To connect with patients is key

Patient
September 14, 2011

con·nect (from dictionary.com)

verb (used with object)

1. to join, link, or fasten together; unite or bind: to connect the two cities by a bridge; Communication satellites connect the local stations into a network.

2. to establish communication between; put in communication: Operator, will you please connect me with Mr. Jones?

To connect with your patients is truly the key solution.

Connect takes on two meanings:

  1. Establish a relationship; develop, dig, pursue
  2. Maintain via all available tools: email, …

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To connect with patients is key

All of us are role models, whether we see ourselves that way or not

Patient
September 13, 2011

All of us are role models, whether we see ourselves that way or not.  Of course I love to imagine myself as a positive role model, but my eleven-year-old daughter has already informed me that things will be way different at her house when she’s a mama.  However, we’re not going to focus on how uncool I am, instead, I’m going to share the stories of a couple of people …

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All of us are role models, whether we see ourselves that way or not

How hospitals can avoid readmissions

Physician
September 13, 2011

An interview by Curaspan Health Group with Stephen Jencks, MD, MPH.

Stephen Jencks is lead author of the 2009 landmark study of the multibillion-dollar cost of readmissions, says there’s “been a great deal of movement” on readmissions since his work was published in The New England Journal of Medicine, but there’s more that hospitals and communities can do.

Dr. Jencks, an independent consultant in health-care safety and quality, and …

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How hospitals can avoid readmissions

ACP: Current and future payment and practice trends in medicine

Health Policy
September 13, 2011

A guest column by the American College of Physicians, exclusive to KevinMD.com.

In April 2011 I finished seven years on the Board of Regents of the American College of Physicians (ACP) including two years as Chair of the ACP Health and Public Policy Committee and serving during the last year as President. During that time I had the opportunity to …

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ACP: Current and future payment and practice trends in medicine

The problem of inadequate discussions of end of life wishes

Physician
September 13, 2011

The Annals of Internal Medicine occasionally reviews the articles and studies of note in a particular field of internal medicine for those of us who don’t read all of the specialty journals. Recently, there was an update in pulmonary and critical care medicine, the internal medicine specialty that is most intimately involved with caring for the very ill and those people who are at the ends of their lives. …

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The problem of inadequate discussions of end of life wishes

Children who curse, and the power of words

Patient
September 13, 2011

Today was a rough day at work.  My schedule of 10 patients for the afternoon rapidly ballooned into 17.  People were sick and miserable.  Those who were healthy were frustrated by the long wait.  I heard myself apologizing over and over to each family.

The day was mostly a chaotic blur.  Babies crying, phones ringing, parents reprimanding children on the brink of a meltdown.  I don’t remember much of it, except …

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Children who curse, and the power of words

Essential tips for medical journalists

Potpourri
September 13, 2011

We’re five years old. We’ve been doing the same thing the same way for five years and have analyzed over 1,488 stories using our ten standardized criteria on HealthNewsReview.org.

We’ve recently returned from the annual Association of Health Care Journalists (AHCJ) conference in Philadelphia, where we led a two-hour workshop, and where we received a tremendous amount of gratifying feedback on our work and many terrific suggestions about …

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Essential tips for medical journalists

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