Tuesday, November 10, 2009
QD: News Every Day--more time, more patients, more quality
ACP Internist's daily digest of news and events continues with a snapshot of health care reform, as well as a look at an ACP member's findings that doctors are spending more time with more patients, and still providing better care across nine quality measures.
Health care reform
The focus has now shifted to the Democrats for health care reform.
--Some Democrats don't think it slows health spending enough.
--Some Democrats think it pits young constituents against elderly ones.
--It's either pragmatic and flexible or just as good as it gets.
As the debate moves back to the Senate next week, there's five "flash points" to consider. (New York Times, Wall Street Journal, Politico, The Hill, Cristian Science Monitor)
Patient encounter
Doctors are spending more time with their patients--21 minutes in 2005 compared to 18 minutes in 1997, reports Lena Chen, ACP Member. And, primary care visits increased 10%, from about 273 million visits in 1997 to 338 million in 2005. Yet, quality is improving across nine performance measures. The population is aging, which requires more time, but also health care in general is more complex now. And, patients are better informed and more engaged. (U.S. News & World Report)
In case you missed it ...
Medical education is changing to focus on health care reform, the patient-centered medical home and patient communication, and leaving anatomy for later. Genetics, demography and the environment are being included. Students are helping design the curriculum, too. What's going on? (Washington Post)
Kaiser Health News looks back to 1977 for a familiar scenario--politicizing living wills that might lower unneeded or unwanted health care use at the end of life.
Labels: health care reform, living wills, medical education, patient communication, patient-centered medical home, QD
posted by Ryan DuBosar at
11:25 AM
0 Comments
Wednesday, October 21, 2009
The future is now.
Yesterday morning, I still thought the patient-centered medical home (PCMH) was the abstract future of primary care. But to hear Edwina Rogers, of the Patient-Centered Primary Care Collaborative, talk, the future is already here.
She reported that there are 27 multi-stakeholder (as in more than one insurer) pilots of the PCMH being conducted in 18 states. In all, 44 states and DC have some kind of PCMH activity underway, and one of the laggards, Nevada, promises to be up and running very soon. The details of all these programs are available in a new report that came out today, in conjunction with the PCPCCC's annual summit in DC.
Labels: patient-centered medical home
posted by Stacey Butterfield at
2:57 PM
0 Comments
Wednesday, October 14, 2009
QD: News Every Day--The disconnect of health reform
ACP Internist's daily digest of internal medicine in the news continues with the disconnect on health care reform, a larger analysis of who was hospitalized for H1N1, and more on the primary care shortage.
Health care reform
Americans want health care reform to change, but they don't want to pay for it.
Meanwhile, the Economic Policy Institute, a think tank focused low- and middle-income Americans, points out that Medicaid and the SCHIP held in check the number of children who would have gone without health between 2000 to 2008. Children without insurance dropped 1.7% between 2000 and 2008, while adults less than 65 without insurance rose 3.1%. By contrast, children with public coverage grew 8.8%, compared to a 3.5% increase for the adult population under 65.
H1N1 influenza
Health officials now say that 46% of 1,400 adults hospitalized with H1N1 influenza did not have a chronic underlying condition, according to the largest analysis to date. The study looked at adults and children hospitalized from April through August in 10 states at medical centers participating in a special disease surveillance network. Anne Schuchat, FACP, who heads the CDC's National Center for Immunization and Respiratory Diseases, said the larger analysis looked at underlying conditions not previously examined. Among adults, 26% had asthma, 10% had diabetes, 8% had some other chronic lung disease, 8% had weakened immune systems and 6% were pregnant.
Primary care shortage
A financial advisor chimes in with his analysis of why primary care doesn't pay, including input from his own internist. The doctor says, "The average income of a primary care doctor in Massachusetts is about $86,000. Why do I do it? Because I love it."
The medical home
Profiles of practices trying the patient-centered medical home include Greenhouse Internists in Mt. Airy, Pa. and the Adirondack Regional Medical Home Pilot, which also an effort to stop the loss of primary care practitioners in the region. And for a lighter note, don't miss ACP Internist's own Stacey Butterfield's report from the MGMA meeting in Denver.
In case you missed it ...
In Minnesota, the Vitality Project prompted one town to build sidewalks and bike trails; restaurants, groceries and schools to push healthier foods; and employers to give workers time to exercise. The experiment added an average 3.1 years to the longevity of about 2,300 residents who calculated their lifespans by answering 36 lifestyle questions.
Labels: diet, exercise, flu, H1N1, health care reform, health insurance, health policy, patient-centered medical home, primary care shortage, QD
posted by Ryan DuBosar at
11:53 AM
0 Comments
Tuesday, October 13, 2009
Spotted in the exhibit hall.
Could it be the long-awaited medical home?
Labels: MGMA conference, patient-centered medical home
posted by Stacey Butterfield at
3:02 PM
0 Comments
Monday, May 18, 2009
Evidence for the PCMH
An article in today's Philly Inquirer offered an update on the patient-centered medical home pilot that we recently covered in ACP Internist. A year into the Pennsylvania program, the percentage of participating diabetics with their "blood sugar under control" (the article doesn't specify what measure) increased from 33% to 44%. Sounds pretty good.
However, there does seem to be debate about whether practicing in a PCMH is fun or not. Two quotes from the article:
"It has been fun to create a system where there is a real strong interdisciplinary approach to managing diabetes," said the executive director of one practice.
"I can't say we are having a lot of fun," said a doc from another practice.
Lucky they decided against calling it the fun-centered medical home.
Labels: patient-centered medical home
posted by Stacey Butterfield at
1:50 PM
0 Comments
ACP Internist hosted Grand Rounds on June 16, wrapping up the best of the medical blogosphere. Click here for the complete wrap-up.
Contact ACP Internist
Send comments to ACP Internist staff at acpinternist@acponline.org.
Previous Posts
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- QD: News Every Day--Santa's take on H1N1 influenza...
- QD: News Every Day--when evidence and politics col...
- Ghostwriting haunts Congress' hallowed halls
- QD: News Every Day--payment fix inches forward (fo...
- QD: News Every Day--not the intended effect
- Medical news of the obvious
- QD: News Every Day--flu's growing tally
- QD: News Every Day--no holidays for Congress
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American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
Clinical Correlations
A collaborative medical blog started by Neil Shapiro, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.
db's Medical Rants
Robert M. Centor, FACP, contributes short essays contemplating medicine and the health care system.
Everything Health
EverythingHealth is designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
Getting Better with Dr. Val
Getting Better is the continuation of Dr. Val Jones' previous blog at Revolution Health. It is devoted to helping people understand health issues from a balanced, scientifically sound perspective.
HealthHombre
A roundup of health policy news drawn from a database of hundreds of Web sites.
Interact MD
Michael Benjamin, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.
Kevin, MD
The alter ego of Kevin Pho, ACP Member, is the closest thing to royalty in the medical blog world.
LSUHSC-S Medical Library Evidence Alert
Major guidelines, systematic reviews, meta-analyses and/or major reviews by national and international organizations.
PLoS Blog
The Public Library of Science's open access materials include a blog.
White Coat Rants
One of the most popular anonymous blogs written by a doctor.
