Most chronic diseases don’t have an easily definable beginning point. Children’s personalities vary widely from quiet and focused to rambunctious and distractible. At what point do we say they have ADHD? There is an association between higher blood pressures and higher stroke and heart attack rates across a wide spectrum of...
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As the suits in the healthcare industry continue to try to change the healthcare system in their own MBA image, words such as targets and metrics are commonly used. A recent commentary from the BMJ reminds us of how sometimes when one process is improved another suffers. Patients want quick access...
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At the TAFP conference I attended last weekend, almost all the clinically oriented speakers showed data from their EMRs they felt proved they were providing high quality care. I’m sure their quality is excellent, but this won’t make healthcare more affordable. The measures most everyone showed included: how many diabetics had...
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Many well-meaning patient advocates want patients to become more empowered in their own care, which could take many forms. The technology companies and EMR supporters of course want this to happen electronically. “Smart” cards could contain every detail of a person’s medical history and records. But do patients really want this?...
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A buzzword circulating in the health policy world is value-based insurance design. This phrase sounds like something the business world might latch on to. It sounds  very businessy–companies in control of maximizing shareholder value. Two studies were published in Health Affairs dealing with aspects of this approach. They studied the effect...
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Most observers of the American healthcare system conclude there is a primary care shortage, though opinion varies on what to do about it. Nurse practitioners and other mid-levels such as physician assistants have been suggested to fill the gap. Could they become the primary care providers of the future? I think...
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