Posted by: AtlasMD

January 10, 2014

The Free Market Can Be A Crazy Place

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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.

Posted by: AtlasMD

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.

READ THE COMPLETE CDC REPORT HERE

Posted by: AtlasMD

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.

Posted by: AtlasMD

January 9, 2014

Is The Answer To The Doctor Shortage In Our Pocket?

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.

Read more

Posted by: AtlasMD

January 6, 2014

The Logic Of Obamacare: Small Business, Unintended Consequences

In his Kevin MD post, Stephen C. Schimpff asks, “Is this affordable health care or is it is the law of unintended consequences?”

Schimpff is former CEO, University of Maryland Medical Center; chair, advisory committee, Sanovas, Inc.; and the author of The Future of Medicine – Megatrends in Healthcare and The Future of Healthcare Delivery- Why It Must Change and How It Will Affect You. He’s got plenty of clout behind him. And he says, “The Affordable Care Act is not so affordable if you own or if you are an employee of a small business.” Read his full explanation of what he believes will happen to small businesses in 2014 and 2015 based on the ACA.

Read more

Posted by: AtlasMD

January 3, 2014

Fox News Asks, Is This The Worst ObamaCare ‘Glitch’ Yet?


Fox News interviewed the mother of a family of five who lost their insurance. They now face “uncertainty” thanks to endless glitches on the Obamacare website. For years they elected to carry a high deductible, low cost insurance plan i.e. the type we encourage our patients to buy. According to Obama they’ve been “underinsured” though.

Their philosophy on healthcare mirrors our outlook. They’ve been paying for minor issues out of pocket for years and putting aside the the money they save on their deductible. They didn’t mention direct care, but this family would benefit greatly from an Atlas MD-style of medicine. All seven members could see Drs. Josh, Doug or Michael ANYTIME for $150/mo. Colds, flus, sprains and more could all be treated in-house, at rates much lower than average clinic costs, saving them countless dollars over the course of a year.

This new layer of ACA red tape seems problematic. Really, should the government have the right to determine HOW MUCH insurance people need? We’re not opposed to them prosecuting companies practicing unethical business; there are insurance plans on the market that willfully misrepresent their offering (Forbes wrote about these junk plans here). However, this family in question was TAKING CARE OF THEMSELVES WITH THEIR OWN MONEY. The fact our administration is willing to actually throw them under the bus in order to help those in need disappoints us. And unless the ACA starts actually helping people get healthcare this sentiment seems likely to spread.

Posted by: AtlasMD

January 3, 2014

You Won’t Believe This Reddit Tape

ABC reported on a recent Reddit post of a $55,000 appendectomy bill. Yes, 55 THOUSAND dollars. Although the 20-year-old man in question got over the pain of his appendix removal, his hospital bill probably won’t be feeling better anytime soon. Fortunately, the patient was insured, so he only had to pay $11,119.23 of the outstanding bill. The shocked man of course took to the best place on earth to document all things ridiculous.

“I never truly understood how much health care in the U.S. costs until I got appendicitis in October,” he wrote on Reddit. “I’m a 20-year-old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the U.S.” The recovery room cost $7,501.00, which surprised the man because he spent only two hours in there. The actual surgery cost $16,277.

Read more

Posted by: AtlasMD

January 2, 2014

Study Suggests More Insurance, More ER Visits

Sabrina Tavernise writes in The New York Times about a new study that flips a steadfast assumption on its head. At first glance, you’d think that giving people more access to Medicaid would lower the frequency of ER visits. However, a study conducted in Oregon has proven the exact opposite.

The study was published in the journal Science. It compared two groups of people — a 2008 lottery randomly selected thousands of low-income people in the Portland area and provided them Medicaid coverage; a second group entered the lottery but received no insurance. Here’s the shocker. “Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts,” writes The Times. The pattern was strong, holding true across most demographics, times of day, and types of visits. These even included conditions that we could have treated here in our Atlas MD office.

Read more

Posted by: AtlasMD

January 2, 2014

Direct Care Thought Of The Day

“A single sunbeam is enough to drive away many shadows.”

— St. Francis of Assisi

Remember, the hegemonic nature of healthcare and its associated red tape means it can’t be wished away. However, it can be untangled one cash-only clinic, one dedicated doctor, one unhurried visit at a time. In the long run, healthcare in America can mean actual care.

Posted by: AtlasMD

December 28, 2013

Free Market’s Free Reign — Company Succeeds By Making Exercise And Vacation A Priority

Okay, so we’re putting in a caveat right out of the gate — Atlas MD WILL be checking emails during vacations and probably won’t be sending our limited staff to the gym during lunch. However, we do applaud one company that does EXACTLY that.

David Morken is the sparkling Co-founder and CEO of Bandwidth, a 15-year-old tech company. It was his idea to instate these policies: the company has (and enforces) a complete embargo on email to and from the company during vacation. Oh, well how about I just stay at the office all year? Nope. He also forces employees to take their vacations. And don’t forget the 90-minute lunches. They are paid, if you workout, along with your gym membership, shuttle to and from, your personal trainer, and a comprehensive assessment of your physical condition.

So why’s this cool? Well, for starters, Bandwidth was set to make $150M in 2013 – a 20% increase from 2012 – and, get this, they expect $200M in profitable revenues in 2014. So while yes, these policies might seem Draconian, they began with the proprietor and ended up positively influencing his staff, their work, and his bottom line. And no one in the White House told him how to do his job.

READ FORBES’ COVERAGE OF BANDWIDTH CEO DAVID MORKEN