Posted by: AtlasMD

October 30, 2013

And The Survey Says… Doctors Are Resistant To The Affordable Care Act

According to a new survey reported on by the New York Post, “New York doctors are treating Obamacare like the plague.” The poll surveyed 409 physicians and was conducted by the New York State Medical Society. The results were ghastly. Here are the highlights:

  • 44 percent of MDs said they are not participating in the nation’s new healthcare plan
  • 33 percent of MDs are still undecided about whether or not to become Obamacare providers
  • Only 23 percent said they’re taking patients who signed up through health exchanges

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Prepare Yourself for the Fork in the Road

Prepare Yourself for the Fork in the Road

We found a great blog post from The Happy MD that clarifies a schism that’s likely to develop here in the American healthcare system. With an influx of patients gaining insurance through Obamacare (assuming those exchange websites finally work), primary care docs have essentially two directions they will be pushed in:

  • One group of docs will be part of the patient mill, who due to the inherent volume of patients coming through a clinic will only see the very sick; here the doctor will spend a majority of time in a management position, overseeing nurses and physician assistants who actually interact with patients.
  • Another group of docs will be part of the concierge medicine/direct care movement, and will see all of their patients for longer durations; here the doctor will free up this time by removing the red tape and operating their practice with limited assistance.

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STREAM: Atlas MD on The Sean Hannity Show

In case you missed it, we were invited back as guests on The Sean Hannity Show last Friday. We’re honored to be recognized as a solution to an overwhelming healthcare debacle. Afterwards, we were flooded with emails from people interested in learning more about our model and where they can find a direct care clinic in their own community.

As we mentioned on the program, you can visit IWantDirectCare.com to express your interest in joining a direct care clinic, or, if you’re a direct care doctor, where your clinic is located. And wouldn’t you know, the map’s filling up fast! We think this disproves a direct care criticism, that healthy people subscribing to a direct clinic is like paying for an unused gym membership. We’re wondering, where do these arguments originate? Our patients constantly praise the services we provide and our accessibility. And the question we keep hearing from people who first come across our business is, Where can I find my own direct care doctor? We’re hoping that within the next few years, patients can find direct care almost anywhere. Really, it’s up to the doctors to meet the demand and interest that’s growing as we speak.

As always, thanks to everyone who tuned in to The Sean Hannity Show on Friday, and to those who spread the word on social media. It may not seem like much, but every patient who demands affordable primary care makes direct care more viable for the doctors who want to provide it.

Research Shows Top 10 States And Top 25 Cities To Practice Insurance-Free Medicine

Are you curious if your state or city made one of the lists? Keep in mind, we’re having a great time practicing direct care here in Wichita, KS, and get this–we didn’t make either one! On top of that, not all of these states are eligible to dispense prescriptions (New York, Montana, Texas, and Utah prohibit it). In our experience, the real value in running a direct practice comes from offering wholesale prescription discounts. Over time the savings add up, especially for patients with chronic conditions (diabetes, thyroid disease, asthma, migraines, etc.) where it becomes cheaper to subscribe to your clinic and stop using insurance to pay for prescriptions.

Given these facts, we’re not treating this as the ultimatum for who or where one should or shouldn’t open a direct care clinic. However, the research brings up some good reminders. According to Dr. Chris Ewin, Founder and physician at 121MD in Fort Worth, TX:

“Direct practices should be successful in most cities and states where there is an inadequate supply of primary care physicians.” He adds, “… Most important, a physician needs to have social skills to sell him/herself and their new practice model to their patients and their community.”

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Posted by: AtlasMD

October 24, 2013

Health Care Exchange Website Builders In The Hot Seat

USA Today reports from Washington that many of the problems that have plagued the HealthCare.gov website stemmed from high demand for health insurance coupled with confusion between contractors. So an official with a top government contractor will say in prepared testimony to a House panel on Thursday.

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Will Medicine Be Walmart-ized?

In his new essay, David M. Cutler prognosticates an intriguing, yet impersonal healthcare future. He says, “the idea that technology will change medicine is as old as the electronic computer itself.” And we agree with his proposal.

However, there’s a lot of information out there, and for the most part, it’s not made available at the right time. Think about it: how many times do we hear about a patient receiving an incorrect dosage or a drug that causes an allergic reaction? And, as more docs “get wired” and adopt EMRs, there will be even more parties contributing to the collective consciousness of medicine. Just look at the numbers. Since the 2009 American Recovery and Reinvestment Act created the HiTech program, billions of dollars have been allocated for doctors and hospitals to purchase EHR software/systems. According to Cutler, “Since the program was enacted, rates of ownership of such systems have tripled among hospitals and quadrupled among physicians.”

Okay, but what happens when all of medicine gets connected?

Cutler says healthcare will be delivered in a more standardized fashion, with less overall cost, but less of a personal touch.

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EMRs Still Not Very Loved

David Carr is on the beat to find doctors who actually like their EMR. We’re in the process of reaching out to him since we’re excited about the new updates to our Atlas.md EMR. However, we also kind of proved his point. He interviewed a Doctor Denton, who said:

“In contrast, commercial EHR software has to be generic enough to work in many hospitals and all specialties. The result is a compromised design that doesn’t serve anyone’s needs really well.”

As a medical student interning at Intermountain Healthcare in the 1990s, Dr. Denton worked with an early electronic medical records system that was custom built for the hospital. He said it didn’t have everything you wanted, but “it worked in a way that allowed you to really do your job better.” However, he clarified, “But… they spent years and years developing it.”

It seems that the big fight in health care, in IT, in primary care, almost everywhere, is for time to make good stuff and to make stuff good. We’re fighting that fight, and here to assist any doctors who want time to practice medicine again. And we’re working on digital software that succeeds by MAKING MEDICINE MORE POSSIBLE, not by rushing to the market to collect Meaningful Use incentives.

Oh the irony, for being rewarded for mediocrity. Ayn Rand must be rolling in her grave.

READ ABOUT DAVID CARR’S SEARCH FOR SATISFACTORY EMR

Imagine a World Where Docs Blog, “I LOVE MY EMR!”

Unfortunately, that world is imaginary, for the time being. We’re still in our beta launch of Atlas.md EMR, although we’ve already rolled out some helpful updates. For everyone who has signed up for our EMR, here’s what’s available in the newest version of the app.

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The Direct Care Doctor Will See You Now

Thanks to @jsgoldmd20 who linked us to a relevant Huff Post story. Ann Brenoff’s “The Doctor Will See You … When Her Boss Says She Can” documents her experience with an overly commodified fee-for-service doctor. It’s not the same old story, of long waiting rooms, harried visits, obscene fees, and dodgy insurance claims… Well, it does have the long waiting room, but for a different reason: Brenoff’s doctor refuses to spend less than 30 minutes with her patients, even when the company she works for demands she book appointments every 10-15 minutes.

The problem, though, is that patients back up in the waiting room. Even when her appointments are booked four weeks in advance, Ann Brenoff is forced to wait over an hour to see her doctor. Recently she got fed up and tried to take her business elsewhere. Her time was too valuable. She couldn’t be made to wait.

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Even The New York Times Is Suggesting Catastrophic Insurance Plans

In his new New York Times healthcare piece, “Driving a New Bargain on Health Care,” Tyler Cowen spells out the hard truth of Obamacare failings. Based on his prognosis, a lack of states extending Medicaid coverage will leave millions uninsured. This isn’t something that should excite anyone. However, it’s leading to wake up calls from top journalists. In his assessment Cowen offers a reaction to this shortcoming:

“At the same time, I’d recommend narrowing the scope of required insurance to focus on catastrophic expenses. If insurance picks up too many small expenses, it encourages abuse and overuse of scarce resources.”

As you know, we’ve been suggesting this for years now. When we as a nation can’t provide care for our own, that’s failing. But when we know something isn’t working (health insurance as health maintenance, for one) and we keep doing it, that’s even worse. So yes, while we’re nowhere near a solution, we’re moving towards a society that recognizes one thing: coverage is not care. It’s a point worth mentioning, because to many people, the idea that EVERYONE is insured sounds like utopia. For now, we’ll be the squeaky wheel reminding you that this isn’t really the case.

READ THE FULL NEW YORK TIMES ARTICLE HERE