Bionic.ly put together a rather comprehensive list of Apple’s and Google’s digital healthcare milestones on their website. Even if you aren’t going to use or purchase all of them, it’s worth considering as we gain traction on the ever-changing healthcare landscape. For sure, it’s exciting. Startups are rushing to the market, both disrupting existing products — our Atlas.md EMR could definitely be considered a disruptive technology — and reifying existing problems e.g. digital EMRs that help doctors navigate exponentially crippling ICD-10 codes.
Category Archives: Thoughts
February 14, 2014
February 11, 2014
White House Delays ACA’s Red Tape (With More Red Tape)
We love the smell of Red Tape in the morning. In Washington, The New York Times is reporting that the Obama administration announced on Monday that it would “postpone enforcement of a federal requirement for medium-size employers to provide health insurance to employees and allow larger employers more flexibility in how they provide coverage.” Wow, that’s such mouthful we couldn’t bring ourselves to paraphrase it. Let’s break it into smaller parts.
January 14, 2014
Red Tape Wraps Up A Preventative Healthcare Clinic
MDPrevent closed on Dec. 27 2013. The preventive-medical practice was co-founded in Delray Beach, Florida three years ago. It’s premise was that patients would be better off if doctors focused on preventing disease instead of simply treating it. They ran into problems, though, and one of them was red tape. They claim that ultimately the three major healthcare industry players — providers, payers, and patients—all shared some responsibility for their failure, though.
Their experience with bureaucracy was costly. For every dollar they collected, their expenses were three times as much! Their vision was altruistic, and they’d assembled a team that included a health psychologist, registered dietitian, exercise physiologist, yoga instructor, health educator, and nurse practitioners. They designed a custom facility that included a teaching kitchen, a gym, and classrooms.
What turned out to be a huge mistake though was basing their business plan on insurance reimbursement rather than cash-only payments. They lost serious money, around $2 million in personal capital. When they saw how expensive operating was, they started cutting costs, trimming staff down to a health psychologist, a registered dietitian, and the founding doctor, who writes, “Medicare reimbursement we received for our services still could not cover our costs. I even abandoned the offices we had built-out and moved to less expensive quarters we shared with an internist. It still made no difference.” He adds, “Most of the third-party insurance companies in the area did not cover our services. Medicare was the exception, but reimbursement was insufficient to cover our costs.”
January 14, 2014
Infographics: Walmart Health Plans Are Cheaper And Offer More Coverage Than Obamacare
The Washington Examiner played Obamacare watchdogs recently and came back with some shocking figures. You know we’re not insurance people per se, but we are free market enthusiasts. And to be clear, these numbers might be a little misleading (no one in support of Obamacare was willing to provide data to the Examiner). That said, scroll down and check out these infographics comparing Obamacare and Walmart’s health plans.
Some highlights: Walmart employees in Chicago can find way more options for way less cash. And plans/deductibles nationwide are far cheaper for Walmart employees. Plans granting access to prestigious hospitals like the Mayo Clinic are even included. And some plans offer up to $1,000 cash for flex-spending, perfect for a family to enroll in a direct care clinic.
January 13, 2014
LISTEN: Atlas.md Podcast, Ep. 13
Happy New Year! The direct care duo starts 2014 with good news and exciting updates. We’re happy to report that we’ve been consulted by Kansas University; in the near future, more students will be getting a glimpse into the world of insurance-free medicine through their curriculum. International pins were placed on the I Want Direct Care map (including clinics and patients in the U.K., Vietnam, Argentina, and more). And a humblebrag warning: we were interviewed by Harvard Business Review, so keep an eye out for that.
January 13, 2014
Drawing Blood Draws New Job Potential
Quartz reports that there’s a new industry on the boom — phlebotomy i.e. the art of drawing blood. Phlebotomists, the medical technicians who handle transfusions, tests and donations, were added this year (for the first time) to the U.S. Department of Labor’s occupational handbook. Even though there’s only a small number in total, there is an above-average growth rate. It’s indicative of a trend in medical specialization: Supposedly, the 10 occupations expected to create the most new jobs between 2012 and 2022 include personal care aides, registered nurses, home health aides, and nursing assistants; healthcare workers will make up one-third of all new employment in that time period.
There’s a growing demand for healthcare in the U.S. — an aging population and the classic patient-mill-mentality where we “cut costs” by increasing doctor efficiency (good luck with that). As expected, more staff is needed so docs can focus on diagnosis and treatment. This is an expected externality of a flawed healthcare system that burdens docs with regulation and then demands they see exorbitant numbers of patients just to keep their doors open.
And here’s one more reality worth noting: Is phlebotomy a job we’d highly recommend? Probably not. Quartz writes, “All those people rushing into phlebotomy can expect a median wage of only $29,730.” That’s practically poverty. We’d rather see more primary care docs choose direct care, and draw blood themselves. You might say we’re unsympathetic, but that’s not true. We want those theoretical phlebotomists to learn skills and contribute to society. We’d just like to see a society where docs get more done without all the red tape, and students learn something else, something that bodes better for their wellbeing, and isn’t the result of a flawed healthcare system demanding their work in the first place.
Seriously, we don’t want to be totally negative, but why would doctors need more help with phlebotomist? Probably because they’re dealing with bureaucratically-induced headaches.
January 10, 2014
The Free Market Can Be A Crazy Place
More than 50% of US pets r obese… hence pet activity trackers! #dhces #ces2014 #1stworldproblems pic.twitter.com/rfBPTgtJ0F
— Lygeia Ricciardi (@Lygeia) January 9, 2014
Wow. We’re pretty sure that most of our staff, and patients, haven’t bought trackers for their pets’ activity levels. Although, I guess if they really wanted to, they could attach a FitBit to an animal and send us the results via Atlas.md. Either way, a proprietor entered this niche market because they believed some people would buy it. Given the restricted nature of healthcare, it’s nice to be reminded that the free market is still ticking, oddities and all.
January 9, 2014
CDC Study Finds Lung Cancer On The Decline
Finally, some good news in healthcare! The CDC writes on their weekly Morbidity and Mortality Weekly Report, “Lung cancer incidence decreased to a statistically significant extent from 2005 to 2009 among men in all U.S. Census regions and 23 states, and among women in the South and West U.S. Census regions and seven states. By state and age group, lung cancer incidence rates decreased or were stable in most states.”
But bittersweet already seems to be the theme of 2014. Two statements to look at:
“CDC has declared reducing tobacco use a ‘winnable battle’ and supports comprehensive efforts to prevent the initiation of tobacco use, promote quitting, and ensure smoke–free environments.”
“Although many factors might have contributed to this decline, a study of 44 states showed that strong tobacco control indicators were correlated with lower lung cancer incidence rates among adults age 20–44 years.”
From a doctor’s perspective, and a health perspective, this news is worth celebrating. However, the cause of the celebration is debatable. How much of this reduction in smoking was the result of strong patient-doctor relationships, versus decades of anti-tobacco PSAs? Again, we don’t have a problem with public service announcements or even people freely electing to smoke (although we’d never advise it). It’s just worth pointing out that there’s still room for family physicians to make an impact on our nation’s health — by getting to know our patients, earning their trust, and helping them make their own healthy lifestyle choices.
January 9, 2014
High Notes In Family Medicine 2013
The AAFP published a year-end summary that’s definitely worth checking out. Here’s a list of things they’re celebrating (excerpted from aafp.com):
- A survey showed that median first-year guaranteed compensation for FPs not doing obstetrics rose from $163,000 in 2011 to $170,000 in 2012.
- In September, a Merritt Hawkins survey showed that family physicians topped the list of the most highly recruited physicians for the seventh straight year.
- New survey results released on Dec. 18 revealed that Americans want physicians handling their healthcare:
- 72 percent of American adults surveyed said they preferred physicians to non-physicians, such as nurse practitioners, when it came to their healthcare.
- 90 percent of adults would choose a physician to lead their “ideal medical team” when given the choice.
- By greater than a two-to-one margin, adults viewed physicians and family physicians as more knowledgeable, experienced, trusted and up-to-date on medical advances than non-physicians.
It’s apparent that our work in direct care is paying off. Back in May, the AAFP created its first DPC policy. And because so many people are interested in our work, they developed a document to answer family physicians’ questions. Although, even in family physicians’ successes, there’s something bittersweet – the fact that patients have to choose between liking a physician and a non-physician is exemplary of our aberrant healthcare system, one that’s heavily regulated, and preposterously inefficient. One thing that Atlas MD and direct care can promise is that you’re always going to see a doctor when you come in. That’s what you’re paying for, and what you’re getting. In the other places, it’s what someone’s paying for, and you MIGHT be getting, in varying degrees.
January 9, 2014
Is The Answer To The Doctor Shortage In Our Pocket?
BlueStar, a prescription-only smartphone app, is hitting the market this year. They’re banking on consumers who want to get medical advice directly from their phone. According to a Quartz article, the app was created by app-maker WellDoc and is the first to require a doctor’s prescription. Anyone can download the app but a prescription code provided by a pharmacy is required to use it. The cost varies by prescription, but is predicted to go much higher than $100 per month.
Since 2010 the app has been helping people with type 2 diabetes, by nudging them to check their blood sugar levels, reiterating tactics to moderate levels, and offering periodic advice. For instance, it might remind patients when to eat or commend them for tracking their glucose levels routinely.