Now that I’m well out of my reckless youth phase of my life, I try to preserve the efficacy of my brain. With my lifestyle, there’s three actions I take to ensure the integrity of my brain.
The first two …
Direct primary care and a do it yourself health plan
I hate infant sleep positioners. They are not safe or helpful. If you have one or know a family/friend who uses one for their infant, throw it out. Trash compact it. Stomp on it. Cut it up in bits. This is one rare thing you should feel good about putting in landfill.
When I was first started in practice, I didn’t even know sleep positioners existed; I …
How the fear of SIDS keeps infant sleep positioners on the market
Whenever I speak about social media to doctors across the country, I often get asked, “How do I deal with a negative online review?”
Here’s one way not to handle it: sue the patient writing the review.
There’s a well publicized case in Minnesota, where a resident posted a screenshot of …
Dealing with a negative online review on a physician rating site
by Jeffrey L. Cohen
The current fixation on Accountable Care Organizations (ACOs) is causing an enormous amount of two things: 1) talking, and 2) inactivity.
Yes, the concept of delivering care in a manner that reduces or at least controls costs is important and interesting. Yet, the marketplace is replete with people and businesses that have adopted …
Physician responsibility and leadership is critical for ACO implementation
I didn’t expect to bump into “Max” on the streets.
“I was kicked out of the house by my wife,” he sighed. Max shifted around on his feet, eyes puffy and cheeks pink.
“Did you start using again?” I asked.
Max looked down and didn’t say anything. In the three years I had known Max, an alcoholic and former drug user, he had been clean. But recently he had started struggling. He lost his …
How a model of multidisciplinary team based care may save primary care
In a recent Wall Street Journal article, Barbara Levy, Chairwoman of the Relative Value Scale Update Committee (RUC), commented on the American Medical Association’s (AMA’s) decision to have minimal primary care participation on the RUC, saying the committee is an “expert panel” and not meant to be representative.
Since the committee is made up of 27 specialists, one …
A simpler coding system proposal with a focus on primary care
by Justin Chang, MD
I think we can all agree — physician, payer, provider, patient, etc. — that the ultimate goal of regulations and reform should be to improve the delivery of healthcare, lowering costs and ultimately, making patients healthier and more satisfied.
Coupled with driving toward the results defined by CMS, this requires some fairly significant changes …
How the ACO model can be successful
As a young primary care doctor in Kiev, Ukraine (then part of the Soviet Union), Dr. Elena Rogova learned her craft well, working in a hospital that catered to scientists, celebrities, artists, musicians and senior government officials.
As a top medical student, this hospital had sought her services, and she enjoyed her work there. Dr. Rogova had no intention of leaving …
Interviewing a primary care doctor to better understand her professional day
A reader, Dr. Scott Monteith, a psychiatrist, shared his thoughts on government-mandated ‘Meaningful Use’ of Electronic Medical Records (‘MU’) with me after reading a number of my EHR posts, and asked if he could share his thoughts via Health Care Renewal.
Dr. Monteith is a graduate of the University of Michigan and Michigan State University where he was chief resident.
He is a board certified psychiatrist, clinical assistant professor in the departments …
Doctors find incentives elusive for meaningful use of electronic records
What medical condition is the most costly to employers? I’ll give you a hint. It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.
If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both …
Why depression continues to go undiagnosed and untreated in primary care
It’s easy to get caught in the surf on the Web. But plug these URLs into your browser and explore some simple tools that can help not only keep your practice above water but help it ride high.
www.digitalassent.com
Digital Assent automates the patient intake process with a PatientPad instead of the clipboard and an online tool for advance registration. It does integrate with EMR systems, but it provides another strong operational …
9 websites that savvy medical practices use
On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual wellness visit.
Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could …
The advance directive is only a part of end of life decision making
I’m a physician assistant, having graduated from PA school over thirty-six years ago. There is angst in my profession, but many PAs don’t openly voice it. I felt compelled to write to you because I still believe in my profession, and I believe in yours, as well. Sometimes I think it might be time to embrace a new belief system. …
A physician assistant writes to the doctors of America
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Accountable Care Organizations (ACOs) are supposed to be provider-led (physician groups +/- hospitals) and, they are supposed to inject a new accountability, at the provider level, for the value of services delivered.
You know the old equation. Value=Quality/Cost. Those of us inside the health policy “beltway” know this mantra well. We have been talking about it for years (decades, really).
I spent almost …
An ACO must make the patient experience meaningful
Occasionally, you may encounter patients who you no longer wish to treat. Reasons for ending the physician-patient relationship may include chronic non-compliance, rudeness to office staff, or non-payment of bills.
While these patient behaviors can affect the interactive care-giving process, they may also identify patients with a propensity to file a claim against you. To help reduce the risk …
How to discharge a patient from your practice
A recent blog post in Health Affairs proclaimed The End of Internal Medicine As We Know It. What the article is really asking is the future of primary care in the world of health care reform and the creation of Accountable Care Organizations (ACOs).
While doctors should be naturally concerned about change, I don’t completely agree with this …
The future of primary care in Accountable Care Organizations
by Vanessa Hurley
Like many American patients, the American health care delivery system suffers not only from acute crises, but also from a chronic, poorly managed and debilitating disease.
Primary care is in trouble. Not only are primary care physicians (PCPs) fleeing the profession in droves, but fewer and …
Primary care providers are needed to support health reform
At the age of 56, Jules Levin felt pretty invincible, despite being HIV positive. He went to the gym regularly and controlled his disease well by taking his antiretroviral medicines every day.
Then he slipped one day while on vacation and broke his wrist.
He underwent an operation to insert pins in his bones and needed to wear a cast for a month, keep his arm …
Osteoporosis in patients with HIV
The desire to be touched by and connected with others is among our most primal and, until recently, our most untapped qualities.
There have always been powerful signs of it. Those of us who remember exchanging letters with distant friends and family know the palpable anticipation when a letter arrived.
Years ago I visited the senior center at Pan American Hospital in Miami, an institution beloved by the “abuelos” (grandparents), mostly elderly …
Integrating social media into everyday health care
by Christina Palmer
It never surprised me when my medical school classmates said they would “never do family medicine.”
I knew exactly how they felt: why would we choose to go into a field where physicians are undervalued, underpaid, buried under administrative paperwork, and where patients do not get the time or attention that they need?
Despite the warnings against it, I am pursuing family medicine as …
Family medicine is the kind of revolution we want to join
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