The Fusobacterium story as of 2018 – a very long post
Conclusion:Fusobacterium necrophorum–positive pharyngitis occurs more frequently than group A ?-hemolytic streptococcal–positive pharyngitis in a student population, and F. necrophorum–positive pharyngitis clinically resembles streptococcal pharyngitis.
Since Fusobacterium necrophorum recovery increased as the Centor score increased we argued that we had sufficient circumstantial evidence that this organism explained many of the 3s and 4s and that the score really reflected bacterial pharyngitis. Our subsequent recently published paper on the pharyngitis microbiome strongly supports our contentions.
So where ...
Source: DB's Medical Rants - February 11, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Are family physicians the best weapon against opioid crisis?
As the national opioid crisis takes center stage, I want to make a case for the authority of the family physician in managing and treating this problem.
I am a family physician and have been treating patients with opioid dependence and addiction for 12 years. These patients comprise about half of my practice. The other half is representative of a typical primary care practice. I have patients who have been treated at methadone clinics, dedicated buprenorphine clinics and pain clinics. My patients have participated in hospital-based detox programs as well as outpatient and inpatient rehabilitation programs. Most of my patie...
Source: Kevin, M.D. - Medical Weblog - December 31, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/layne-kamalu" rel="tag" > Layne Kamalu, MD < /a > Tags: Physician Pain Management Primary Care Source Type: blogs
CVS + Aetna. Are we sure this adds up?
CVS and Aetna. Love at second sight?
Many of the stories I’m reading about CVS’s acquisition of Aetna suggests the deal is a bold move to expand CVS’s retail clinic business. See for example, CVS-Aetna deal has major implications for retail health, primary care practices in FierceHealthcare.
If the merger goes through, CVS plans to expand health services at its retail pharmacies, according to CVS and Aetna officials. Although it will take several years to accomplish, CVS will increase its number of clinics and add staff and equipment for a wider variety of treatments.
This seems like silly reasoning. If...
Source: Health Business Blog - December 5, 2017 Category: Health Management Authors: dewe67 Tags: Economics Health plans Aetna cvs merger Source Type: blogs
Prioritize primary care this open enrollment season
This open enrollment season, patients will be considering their health care coverage for the coming year. To ensure they are fully utilizing their primary care benefits and building relationships with health care teams that will keep them healthy, we need to encourage them to connect with a primary care practice or medical home.
A medical home is a place where a patient can seek treatment from primary care physicians and other professionals, and coordinate any needed care with sub-specialists and hospitals. It should always be the first stop — and in many cases a one-stop shop — for medical care. The primary c...
Source: Kevin, M.D. - Medical Weblog - November 23, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/glen-r-stream" rel="tag" > Glen R. Stream, MD < /a > Tags: Physician Primary Care Public Health & Policy Source Type: blogs
Hypertension Control Champions
EvidenceNow is an initiative from the Agency for Healthcare Research and Quality (AHRQ) with the goal of improving heart health by helping small and medium sized practices use the most recent heart health evidence. The Primary goal of EvidenceNow is to improve the heart health related care at more than 1,500 primary care practices in the United States with the hope that every practice will achieve a national target of 70% of patients following the ABCs of heart health prevention. The ABCs of heart health prevention include aspirin use, blood pressure control, cholesterol management and smoking cessation.
Five primary care ...
Source: BHIC - November 13, 2017 Category: Databases & Libraries Authors: Erin Seger Tags: General Source Type: blogs
The Dunning-Kruger Effect, Or the Real Reason Why the Guys Trying to “ Fix ” Health Care Are Driving You Crazy
By HANS DUVEFELT, MD
“The fool doth think he is wise, but the wise man knows himself to be a fool.”
– Willam Shakespeare
I learned about the Dunning-Kruger effect at a medical conference recently. It certainly seems to apply in medicine. So often, a novice thinks he or she has mastered a new skill or achieved full understanding of something complicated, but as time goes on, we all begin to see how little we actually know. Over time, we may regain some or most of our initial confidence, but never all of it. Experience brings at least a measure of humility.
Just the other day I finished a manuscript for an article i...
Source: The Health Care Blog - November 3, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Dunning-Kruger Effect Medicine practice of medicine Source Type: blogs
Giving Urban Health Care Access Issues The Attention They Deserve In Telemedicine Reimbursement Policies
A May 2017 Wall Street Journal analysis highlights the plight of rural America: People there who are sick are getting sicker because health systems are struggling to deliver care in rural areas. The challenges are multifactorial, but a key driver is the availability of providers. Only 10 percent of physicians serve rural populations, and the number of specialists per capita is a third of the number that practice in urban areas. The Centers for Medicare and Medicaid Services (CMS) considers the per capita physician shortage to be an important health care access problem. In an effort to improve access to care, CMS has create...
Source: Health Affairs Blog - October 12, 2017 Category: Health Management Authors: Yash S. Huilgol, Aditi U. Joshi, Brendan G. Carr and Judd E. Hollander Tags: Featured Health Equity appointment timeliness health care access Medicare reimbursement Telemedicine Source Type: blogs
Diffusing Innovation: A Case Study Of Care Management In Louisiana
Conclusion
The diffusion of innovation in health care doesn’t happen on its own. As we learned in Louisiana, it takes strong support for early adopters and gleaning from their experiences to tailor workflows as implementation efforts are spread to other practices. It also takes a collaborative learning environment, inclusive of both online and in-person forums, and standardized training content that can be tailored to the unique needs of each practice.
With local leaders, a dedicated team in the field, support from a growing national value-based care network, and comprehensive population health technology that helps prac...
Source: Health Affairs Blog - October 11, 2017 Category: Health Management Authors: Charisse Hunter, Nadine Robin and Erin Flowers Tags: Diffusion of Innovation Accountable Care Organization chronic care management Louisiana value based care Source Type: blogs
The 2017 ACO Survey: What Do Current Trends Tell Us About The Future Of Accountable Care?
This article presents an overview of the results from the inaugural 2017 Annual ACO Survey and provides important insights into the current and future state of the ACO industry.
Overall, we found that a large number of ACOs are currently considering or have firm plans to participate in future risk-based contracts (47 percent planning for shared savings/shared risk and 38 percent planning for capitation), although care management strategies are largely unchanged. This and the data below suggest that ACOs are slowly becoming willing to accept increased financial risk, but they are largely still learning how to actually manag...
Source: Health Affairs Blog - October 4, 2017 Category: Health Management Authors: Kate de Lisle, Teresa Litton, Allison Brennan and David Muhlestein Tags: Medicare Payment Policy Quality Accountable Care Organizations delivery reform NAACOS Payment Reform Source Type: blogs
Bringing Behaviorial Health Into Primary Care Settings
BY MARTHA WHITECOTTON SPONSORED POST
The integration of behavioral health into the primary care setting has resulted in a number of benefits. Traditionally, behavioral health and medical health operated separately, but in recent years, the integration of these two systems has improved access to care, ensured continuity of care, reduced stigma associated with seeking care and allowed for earlier detection and treatment of mental health and substance abuse issues. By bringing behavioral health specialists into primary care facilities, healthcare systems have streamlined care and brought down...
Source: The Health Care Blog - October 2, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Bringing Behavioral Health into Primary Care Settings
BY MARTHA WHITECOTTON SPONSORED CONTENT
The integration of behavioral health into the primary care setting has resulted in a number of benefits. Traditionally, behavioral health and medical health operated separately, but in recent years, the integration of these two systems has improved access to care, ensured continuity of care, reduced stigma associated with seeking care and allowed for earlier detection and treatment of mental health and substance abuse issues. By bringing behavioral health specialists into primary care facilities, healthcare systems have streamlined care and brought down costs, w...
Source: The Health Care Blog - September 22, 2017 Category: Consumer Health News Authors: Matthew Holt Tags: Hospitals Patients Behavioral Health Carolinas Healthcare Systemh Mental Health primary care Source Type: blogs
Stop the patient leakage in primary care practices
Yesterday, we had a meeting about leakage.
No, it was not about urinary or fecal incontinence, but it was about care that could have been provided within our institution that ended up, for a multitude of reasons, happening with providers beyond the walls of our institution.
Representatives from our accountable care organization had requested a meeting to go over some issues they’ve been having with our practice, including low levels of usage of HCC coding and limited use of Open Notes (a column for another day), and eventually we got to talking about leakage and its effect on the accountable care organization and its...
Source: Kevin, M.D. - Medical Weblog - August 24, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Physician Practice Management Primary Care Public Health & Policy Source Type: blogs
Repair and Reboot
NIRAN AL-AGBA, MD
I told you so. I also told the POTUS in my open letter, but he did not read it.
Who could honestly believe the nation would support dumping coverage for 22 million people? As David Leonhard wrote recently op-ed in the New York Times: “They [Republicans and President Trump] had only one big weakness, in fact: They weren’t dealing in reality.” When faced with reality, it is interesting what a few good Senators with a conscience will refuse to do.
Success is never attained by taking shortcuts. We do not need reform of health care; we need to reboot the entire system. Special interests d...
Source: The Health Care Blog - July 27, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Niran Al-Agba Source Type: blogs
Diffusion Of Community Health Workers Within Medicaid Managed Care: A Strategy To Address Social Determinants Of Health
Clinic notes from a Community Health Worker:
A 63 year old client and her 70 year old husband had been evicted from their apartment while they were hospitalized and were living in a motel. I was able to assist the elderly couple in finding a new apartment… I’ve helped other clients find housing, jobs, and medical homes, no longer living on the streets.…Another client has been sober for one month, attending church which helped her through the trauma of being a victim of human trafficking…We then helped a woman escape a violent relationship and obtain affordable legal help. We…helped [her son] grapple with his own ...
Source: Health Affairs Blog - July 25, 2017 Category: Health Management Authors: Carolina Nkouaga, Arthur Kaufman, Charlie Alfero and Claudia Medina Tags: Diffusion of Innovation Featured Medicaid and CHIP Organization and Delivery Population Health Public Health Quality Medicaid Managed Care Social Determinants of Health Source Type: blogs
