Is Being Nice Part of Being Ethical as a Healthcare Provider?
Being on the other side of the healthcare equation is always
illuminating. That is, last week I was a
patient at our institution having major, elective, abdominal surgery. Most of the care I received was kind and
humane, but when it was not the negative effects were not small. Before I “go negative” I would like to say
that every nurse I encountered treated me with respect and empathy, and most
did not know I was an attending physician.
But now to the negative.
An attending anesthesiologist came into my pre-operative cubicle to
interview me prior to the surgery. She
started speak...
Source: blog.bioethics.net - June 8, 2016 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care empathy medical education professionalism syndicated Source Type: blogs
Medicare Access and Chip Reauthorization Act (MACRA) Proposed Rule, MIPS, APM’s and Advanced Care Information
Discussion
Welcome news is the elimination of the all or nothing criteria of the meaningful use program. The exclusion of most ACO's under Medicare shared shavings is probably the most controversial part of the proposed rule as health systems have invested millions in the current Medicare shared savings program. That CMS is estimating that 87% of solo practitioners will be paying a penalty will also not be well received. Under MIPS CMS is estimating that non MD providers with the exception of nurse practitioners and physician assistants fare the worst including Chiropractors, Podiatrists and Dentists. Overall the propose...
Source: Policy and Medicine - April 28, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
How Well Do Parents Know What You Do As a Pediatrician?
During the summer months, I posted on our practice’s Facebook page, a note encouraging parents, to schedule their children’s wellness visits.
Although the message was for our entire Facebook community, I wanted to catch the eye of parents with teenagers. Don’t know how well you manage teens in your office, but in our office, we have decent wellness visit numbers with younger patients. The teen population?
Not so much. Once the teen years kick in, we mostly see them when they are sick.
I wanted to encourage parents to make their wellness visits but also throw in a subtle nudge to parents with teens.To get thei...
Source: Pediatric Inc - April 27, 2016 Category: Pediatrics Authors: Brandon Tags: Marketing Practice Improvement Social Media The Business of Medicine challenge Change Facebook leadership lesson medical practice Patient Interactions Pediatric Pediatricians Pediatrics Practice Management strategy Source Type: blogs
New doctors should listen to this advice if they want to last
A few years ago, the hospital where I work started new residency programs in internal medicine and family practice. Many of the residents do rotations in anesthesiology and surgery where I have an opportunity to meet and talk with them. They are eager to learn medicine of course, but they are also interested in the perspective that many of us who have been practicing medicine for many years have to offer them. Given the opportunity to speak to a large group of early career physicians or medical students, I think I would offer the following advice.
First and foremost, do not be afraid to take care of yourself. With all ther...
Source: Kevin, M.D. - Medical Weblog - March 15, 2016 Category: Journals (General) Authors: Chris Cantilena, MD, MMM Tags: Physician Medical school Residency Source Type: blogs
Integrating Specialty Care Into Accountable Care Organizations: Perspectives From The Field
Integrating specialty care can be key for high performance and financial success for ACOs, as the most complicated and costly patient care usually is managed by specialists. A large portion of the cost in our health care system is driven by specialists. Specialists are responsible for most medical and surgical procedures, involving both inpatient and outpatient care. Even for office visits, spending for specialists is higher than for primary care physicians. For example, while 45.7 percent of visits to office-based physicians in 2009 were to primary care physicians in general practice, family practice, internal medicine, o...
Source: Health Affairs Blog - January 19, 2016 Category: Health Management Authors: Leslie Korenda and Sarah Thomas Tags: Costs and Spending Health Professionals Innovations in Care Delivery Organization and Delivery Accountable Care Organizations ACOs healthcare leaders Primary Care specialty care Source Type: blogs
7 new Medicare codes primary care doctors can use to increase payments
The fact that primary care is undervalued by Medicare and other payers has been long understood to be driving the precipitous decline in the numbers of new physicians choosing primary care internal medicine or family practice, and a growing exodus of established primary care physicians.
Efforts to address this undervaluation have traditionally been to, 1) bump up the payments (relative value units) for the office visit codes traditionally billed by primary care physicians; 2) explicitly fund, usually on a temporary basis, higher payments for primary care that do not require offsets from others, like was the case with t...
Source: Kevin, M.D. - Medical Weblog - December 14, 2015 Category: Journals (General) Authors: Bob Doherty Tags: Policy Primary care Source Type: blogs
Post #43 My Father the Pediatrician
I recently wrote a new book geared to help parents have more meaningful conversations with their pediatrician and which will hopefully save them a copay or two as well! As I reflect back on the five year journey in writing this book, I wanted to highlight the contributions of my biggest influence – my dad.In the summer of 1973, my father, thirty years at the time, boarded a plane with his best friend to fly overseas for the very first time in his life. Having recently finished medical school and his mandatory army training in South Korea, he was headed to the United States to begin his residency in Passa...
Source: A Pediatrician's Blog - December 10, 2015 Category: Pediatrics Source Type: blogs
#43 My Father the Pediatrician
I recently wrote a new book geared to help parents have more meaningful conversations with their pediatrician and which will hopefully save them a copay or two as well! As I reflect back on the five year journey in writing this book, I wanted to highlight the contributions of my biggest influence – my dad.In the summer of 1973, my father, thirty years at the time, boarded a plane with his best friend to fly overseas for the very first time in his life. Having recently finished medical school and his mandatory army training in South Korea, he was headed to the United States to begin his residency in Passa...
Source: A Pediatrician's Blog - December 10, 2015 Category: Pediatrics Source Type: blogs
It’s time to start the era of the super-generalist
Over the last few decades, medicine has become more and more targeted. We now have not only the “ologists” like cardiologists, endocrinologists, and rheumatologists, but also subspecialists. Forget orthopedic surgeons, you now have specialists in hips, fingers, and feet.
This tendency has been due to a number of driving factors, most notably perhaps a desire for evidence-based medicine, and perhaps a sprinkling of prestige. Friends who have recently been through medical school and residency have told me the neurology residents don’t think much of the family practice residents, as an example.
This system has worked to...
Source: Kevin, M.D. - Medical Weblog - October 23, 2015 Category: Journals (General) Authors: James Maskell Tags: Physician Primary care Source Type: blogs
Creating The Next Generation: The Payment Model We Need From Medicare
Four years of nation-wide testing by The Centers for Medicare and Medicaid Services (CMS) has now proven that the current shared savings payment models do not work effectively for low-cost Accountable Care Organizations (ACOs). High-cost ACOs have more room to improve and therefore more opportunity for savings.
For those organizations that have already developed efficient, low-cost care delivery systems, Shared Savings is retrogressive. In this model, inefficiency is rewarded and lower-cost systems are penalized. In fact, we have lost about 40 percent of the members of the first cohort of ACOs—the Pioneer programR...
Source: Health Affairs Blog - October 5, 2015 Category: Health Management Authors: David Krueger and John Toussaint Tags: Costs and Spending Equity and Disparities Featured Hospitals Insurance and Coverage Long-term Services and Supports Population Health Quality ACOs Bellin-Thedacare HealthPartners CMS global payment payment schemes risk-adjusted p Source Type: blogs
Disruptive Innovation in Childbirth Care
In considering what to write for Disruptive Women in Health Care, I couldn’t stop thinking about the idea of disruption juxtaposed with the experience of birth and the US maternity care system.
In the context of maternity care, the concept of “disruption” hints at intriguingly different possible meanings: the consequences of a newborn entering a family, disruption during the childbirth process, or the urgent need for disruptive innovation in maternity care.
Birth itself is an absolute disruption of the status quo. Birth can be tumultuous, even when it is a joyous occasion. It is a turning point, beyond which things a...
Source: Disruptive Women in Health Care - September 16, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Access Childbirth Innovation Source Type: blogs
Perfect Job, perfect specialty??
I remember how difficult it was for me to choose a specialty. Initially (as in before medical school), I wanted to be a dermatologist. I loved cosmetics and hair products, and as a college student I thought I'd go into some sort of 'beautifying' medical specialty.Once in medical school they forced upon us that primary care crap tried to encourage us to consider careers in primary care. And I did...seriously. I really, really liked the idea of family practice. The doctor that sees the entire family, and watch the kids grow up, and have continuity of care, and keep the family healthy, yadda yadda yadda.Then, I started having...
Source: EM Physician - Backstage Pass - September 8, 2015 Category: Emergency Medicine Authors: Taylor Source Type: blogs
Perfect Job, perfect specialty??
I remember how difficult it was for me to choose a specialty. Initially (as in before medical school), I wanted to be a dermatologist. I loved cosmetics and hair products, and as a college student I thought I'd go into some sort of 'beautifying' medical specialty.Once in medical school theyforced upon us that primary care crap tried to encourage us to consider careers in primary care. And I did...seriously. I really, really liked the idea of family practice. The doctor that sees the entire family, and watch the kids grow up, and have continuity of care, and keep the family healthy, yadda yadda yadda.Then, I started having ...
Source: EM Physician - Backstage Pass - September 8, 2015 Category: Emergency Medicine Authors: Taylor Source Type: blogs
Why physician assistants are critical as health systems evolve
I have a long history with family medicine as my father was an early pioneer – heading up the family medicine program at Chicago’s Cook County Hospital in the 1970s. Even back then my dad was using physician assistants (PAs) — many of them former military medics in the Vietnam War era — who were part of what was at that time a brand new profession.
Family medicine as a whole was early to recognize the value of PAs and how they could extend our ability to help people in an outstanding manner. As a family practice physician, I work with PAs on a daily basis to coordinate and deliver comprehensive care for our...
Source: Kevin, M.D. - Medical Weblog - August 31, 2015 Category: Journals (General) Authors: Francisco Prieto, MD Tags: Physician Primary care Source Type: blogs
CMS Proposed Fee Schedule for 2016 Overview
As we previously published, on July 15, 2015, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update the Medicare physician fee schedule for 2016. Among the many proposals, CMS seeks comment on whether to add Open Payments data to its “Physician Compare” website. Additionally, the proposal includes funding previously controversial advance care planning codes, the first regulations implementing the post-SGR legislation, Stark Law exceptions, and more.
Comments are due no later than 5 p.m. on September 8, 2015. You may submit electronic comments on this regulation to www.regulations....
Source: Policy and Medicine - August 21, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
