First, we are all so thankful that our family physician colleague Kent Brantly seems to be recovering from his Ebola infection. When his family left Liberia, they had to leave all of their possessions behind, which should have been burned by now. If you would like to donate to help him...
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Here we go again. There is yet another round of evidence of how the physician workforce hole we’ve dug for ourselves keeps getting deeper, but there has been still no substantive payment reform on the government side (Medicare/Medicaid) or the private payer side. One recent study appeared in the journal Academic...
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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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The evidence continues to build on how little electronic medical records (EMRs) contribute to healthcare. A Cochrane review of on-screen computer reminders found that physicians’ practices (process measures, medication ordering, vaccinations, and test ordering) improved by 4% and patients’ surrogate health measures (blood pressure or cholesterol levels) improved by 3%. Another...
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About 15 years ago Taiwan officials went around the world learning about other countries’ health care systems so they could create one almost from scratch. They decided on universal coverage, but gave its citizens unfettered access to any doctor they wanted to see. Fortunately for the Taiwanese they continued to examine...
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A study in Archives of Internal Medicine surveyed a national sample of internists and family physicians about cost issues in medicine. Over 600 responded. 42% felt that most patients in their own practices receive too much care, only 6% said too little. When asked why some patients received too much care,...
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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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One of my favorite parts in the journal BMJ is the occasional column written by Dr. Iona Heath, the president of the Royal College of General Practitioners. Her thoughts have helped me understand the similarities and differences between the U.S. and British physicians, healthcare systems, and culture. And I love her...
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I thought I’d try something different this week. Instead of me just going blah, blah, blah to the cyber world, I thought I’d ask for help compiling a list. It has always annoyed me when well-meaning special interest groups ask family physicians to give away their professional time and expertise. A...
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