This is the second in a series of conversations I had with some open-minded colleagues who also deeply want to seen meaningful change in the U.S. healthcare system. The person I primarily responded to mentioned a chapter in Pursuing the Triple Aim. Here is what I wrote back to him: I...
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I’m in an email group that is all in agreement that the U.S. healthcare system is exorbitantly expensive and needs reform. We come from wildly different backgrounds. The variety of perspectives is wonderful. However, a claim of some of the contributors is that aggressive medical therapy of cardiovascular disease (CVD) chronic...
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A very smart person in the healthcare benefits space wrote that family physicians can’t influence much the top 25 most costly DRGs in hospitals. Here was my response: There are many reasons this isn’t true. But it’s understandable that a benefits or administrative person would have no inkling of this, because...
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I’ve complained before about the uselessness of traditional industrial QI/Metrics in primary care. There is now more proof in the literature. The National Health and Nutrition Examination Survey (NHANES) is the annual comprehensive assessment of American health. They enroll about 10,000 people each study year and ask them a thousand questions,...
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Two more state-level experiments to support primary care have failed. Before I go over the findings, let me first say that I appreciate that some states are willing to think big and take risks by trying new approaches. Change is hard. One of the real strengths of America has been its...
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A new study from the Robert Graham Center examined the rate of low-value care services across the country. A LVC service could be a number of things, but the recent wave of research in this area is based off the Choosing Wisely campaign, which asked the major medical societies to come up with at...
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What I’m about to tell you is based on good insider information. But I also disclose that this is an amalgamation of a few reports of teledoc companies to me and their crony insurance companies, not a thorough analysis of the entire industry. I just assume there are other business models...
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I have complained about the stupidities and excesses of the American health scare system for over 5 years now on this blog. Today, I present a concrete, novel, disruptive solution. I have created an entirely new way for family physicians (and internists) to document, code, and bill for their work. It’s...
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First, a history lesson. Back in the mid 2000 oughts, the AAFP launched a wholly owned subsidiary called TransforMed. It was originally started to help practices implement the “new model of care” from the Future of Family Medicine Report. Soon after it was launched, the joint principles of the patient-centered medical...
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A fantastic new study 😉 has once again documented the incredible burden of EMRs on U.S. family physicians. Researchers observed 982 family physician-patient encounters in clinics associated with 10 family medicine residencies. They recorded the times required for the physicians to complete each clinic visit. They did not record times for...
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