Thursday, October 22, 2009
QD: News Every Day--health care reform and H1N1
ACP Internist's daily digest of news and events continues with health care reform, H1N1 influenza and how primary care shortage issues play out regionally.
Health care reform
Halts to the annual cuts to physician reimbursement under Medicare died in the Senate because legislators objected to $247 billion in unfunded costs over the next decade. Enough legislators from both parties objected to an effort to freeze reimbursement for 10 years while Congress found an alternative to the sustainable growth rate formula. ACP President Joseph W. Stubbs, FACP, said, "Although many [legislators] will claim that their vote against cloture was a vote for fiscal responsibility, there is nothing fiscally responsible about pretending that Medicare will save money, from cuts that Congress has no intention to let go into effect, in order to make it seem like Medicare will spend less than it really will."
Meanwhile, some versions of health care reform legislation in the U.S. House would raise the rate of medical spending, not lower it, reports the Office of the Actuary, an independent arm of the Centers for Medicare and Medicaid Services. Spending would increase by 2.1% over 10 years, or $750 billion, because 34 million more people would have health coverage, according to the report. (Wonks can read it here.)
A lesson can be taken from Massachusetts physicians, who support their health care reform laws by a 5-to-1 margin, albeit with some desired changes, reported the Boston Globe. That's slightly higher than in the rest of the public, according to the most recent general poll by Robert Wood Johnson Foundation and Blue Cross Blue Shield of Massachusetts Foundation. Highlights include:
--Two-thirds of doctors say the law has not diminished the quality of care;
--19 percent say it has improved quality;
--62% say the law has not affected the amount of time they spend with their patients; and
--Nearly 80% say the law had no negative impact on their practice overall or had a positive impact.
The original study was published in the New England Journal of Medicine. Health care reform can expand access but not reduce costs, if lessons from Massachusetts teach us anything, reports The Christian Science Monitor.
H1N1 influenza
Production of a vaccine for swine flu virus is behind schedule, said Anne Schuchat, FACP, director of CDC's National Center for Immunization and Respiratory Diseases. Officials expect "widespread availability" by mid-November.
Meanwhile, public radio presents more on "presenteeism" and how a lack of sick days forces some sick workers to show up.
Primary care shortage
ACP's governor of its Connecticut Chapter addresses why so much money is spent on some health care items, such as prescription drugs, medical scans and durable medical equipment, and not on more important areas such as public health education and training medical students. The consequences are dire, as this profile of the Sacramento, Calif. area shows. California has 59 primary-care physicians per 100,000 citizens, whereas 60-80 considered sufficient.
Labels: flu, H1N1, health care reform, primary care shortage, QD
posted by Ryan DuBosar at
12:22 PM
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- QD: News Every Day--the H1N1 fist bump
- Medical News of the Obvious
Blog log
Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:
Albert Fuchs, MD
Albert Fuchs, MD, FACP,
graduated from the University of California, Los Angeles School of
Medicine, where he also did his internal medicine training.
Certified by the American Board of Internal Medicine, Dr. Fuchs
spent three years as a full-time faculty member at UCLA School of
Medicine before opening his private practice in Beverly Hills in
2000.
David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned
authority on nutrition, weight management, and the prevention of
chronic disease, and an internationally recognized leader in
integrative medicine and patient-centered care.
DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about
health topics for patients and health professionals.
Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more
than a decade and is an Associate Professor of Medicine at an
academic medical center on the East Coast. His time is split
between teaching medical students and residents, and caring for
patients.
Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science,
medicine, health and healing in the 21st century.
FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the
Internal Medicine Residency and Assistant Dean of Scholarship &
Discovery at the Pritzker School of Medicine for the University of
Chicago. Her education and research focus is on resident duty
hours, patient handoffs, medical professionalism, and quality of
hospital care. She is also an academic hospitalist.
Glass
Hospital
John H. Schumann, MD, FACP, provides transparency on the workings
of medical practice and the complexities of hospital care,
illuminates the emotional and cognitive aspects of caregiving and
decision-making from the perspective of an active primary care
physician, and offers behind-the-scenes portraits of hospital
sanctums and the people who inhabit them.
Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the
University of North Carolina School of Medicine, and the Program
Director for the GI & Hepatology Fellowship Program. He
specializes in diseases of the esophagus, with a strong interest in
the diagnosis and treatment of patients who have
difficult-to-manage esophageal problems such as refractory GERD,
heartburn, and chest pain.
I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic
hospitalist with an interest in basic and clinical science and
education, with interests in noninvasive monitoring and diagnostic
testing using novel bedside imaging modalities, diagnostic
reasoning, medical informatics, new medical education modalities,
pre-code/code management, palliative care, patient-physician
communication, quality improvement, and quantitative biomedical
imaging.
Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.
KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites
for influential health commentary.
MD
Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of
medical practice, including controversies in the doctor-patient
relationship, medical ethics and measuring medical quality. When
he's not writing, he's performing colonoscopies.
Medical
Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education,
ethics in medicine, health care news and culture. Her views on
medicine are informed by her past experiences in caring for
patients, as a researcher in cancer immunology, and as a patient
who's had breast cancer.
Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a
small community hospital in Connecticut. His blog is a series of
musings on medicine, medical care, the health care system and
medical ethics, in no particular order.
Reflections
of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being
a doctor in a community hospital in Atlanta.
Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in
education, social media and networking, practice management and
evidence-based medicine tools, personal information and knowledge
management.
White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and
teaching physician in Southeast Michigan. The blog, which has been
around in various forms since 2007, offers musings on the
intersection of science, medicine, and culture.
ACP Internist and ACP Hospitalist also contribute to and draw upon content from Get Better Health, a network created by Val Jones, MD, to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the clinician's point of view on health care reform, science, research and patient care.
Other blogs of note:
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, MD, 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, MD, FACP, contributes short essays contemplating
medicine and the health care system.
Interact
MD
Michael Benjamin, MD, 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.
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 an emergency
room physician.
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