ACP Internist's wrap-up of current events turns its attention toward health care reform, and how health care policy translates into health care delivery.
Health care reform
Congressional legislation will move forward with the least controversial elements of health care reform: solving Medicare's pending insolvency and closing a gap in Medicare Part D coverage. But Democrats and Republicans differ on how to accomplish such goals. (Wall Street Journal)
Medicare's reimbursement system has long stuck in the craw of primary care physicians. As a result, they don't always accept such patients, so one in three Medicare enrollees had trouble finding a primary care doctor when entering the Medicare population, according to a June 2008 report by the Medicare Payment Advisory Commission. The impact is shortening an already pressed primary care system. In Arizona, only three of that state's 15 counties have the appropriate ratio of primary care doctors to the general population. (The Arizona Republic)
Physicians aren't waiting for health care reform that may never come. They continue to leave community practice and delve into concierge care, which they say allows them to practice the thorough, hands-on medicine they'd envisioned when they graduated medical school. ACP Fellow David Grulke, MD, of Norfolk, Va., converted his practice to a concierge model in 2002. He charges $660 to $1,080 annually (unlike some practices that charge thousands or more) and describes it as a service for ordinary people who want a relationship with their doctor. In the same article, Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, tells the Virginian-Pilot such arrangements are the symptom of a broken care system. (Virginian-Pilot)
Haitian relief efforts
ACP Member Myriame Casimir, MD, was raised in Haiti. Today, she returns there on a medical mission comprised of her and 20 other providers from Rush University Medical Center in Chicago. (Chicago Tribune)
Also, an aid worker used a first-aid app on his cell phone to survive 60 hours trapped in the rubble of a building. (CNN)
In case you missed it ...
ACP Fellow Turi McNamee, MD, blogs about the "weekend effect" and concludes that, on Satursdays and Sunday, it's better to be shot than have a heart attack. She covers her local hospital's shifts on weekends and wonders what the impact will be on her facility's relaxed atmosphere if more research leads to an increase in weekend staffing. (True/Slant)