A study was recently published in the New England Journal of Medicine about the cost-effectiveness of treating hypertension based on the most recent JNC 8 guidelines. This study particularly caught my eye, because previous cost-effectiveness analyses found that screening and treating for hypertension did not save money. The upfront costs of...
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I’m back to my usual comments after my long series on the many ways family physicians deliver better care at a lower cost. When our article came out that I’ve been commenting on, I was in the middle of griping about Dr. Oz again. I’ll pick up where I left off....
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I took the longest time off from posting on this blog site that I ever have since I launched it in 2010. I had a good reason. I spent a week in England learning more about their National Health Service. I’ll share some of those experiences later. Plus, I’m working on...
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How can a family physician send home from clinic an 18-year-old woman who reports she’s been having chest pain? Couldn’t she be having a heart attack? Absolutely. How can a family physician reassure a person with hand tingling and numbness without ordering any tests? Couldn’t this be a stroke? Of course....
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This post is the 3rd in a series discussing our findings in a recently published study on the ways family physicians deliver better care at a lower cost than a multi-ologist model. Family physicians told us they are more comfortable with uncertainty than the ologists. For a little history, the Future...
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It’s not too late. If you haven’t had a flu shot yet you can still get one. But what does it do for you? A Cochrane review in 2010 looked at all influenza vaccination trials in adults. In the background of the report, the authors reminded us that even if the...
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The GIMeC (Government Industrial Medical Coalition) ignorance fairy has been busy lately, flying around waving her crooked wand at the unsuspecting public. The claim this time is that efforts to prevent diabetes save money. Two articles making this claim were published at nearly the same time. The first was an article...
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A normally very respectable and reliable source of healthcare observations, the Center for Studying Health System Change (CSHSC), had a bad day recently. A report by one of its fellows for the Commonwealth Fund modeled “real-world” parameters found that if primary care physicians were paid more, Medicare could save 2%. Two...
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I’m not the only one who has questioned the real impact of the quality movement in healthcare. Robert Brook, MD, ScD of RAND Health has written about similar concerns. In an article in JAMA from last year, he states “ore than 40 years later it is unclear what the quality movement...
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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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