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.
October 24, 2013
October 24, 2013
Atlas.md EMR — Tutorial Video — Clinic Features / Sidebar
Drs. Josh and Doug walk you through the themes of Atlas.md EMR. On the left you’ll first see icons that let you quickly access common features like dashboard, inbox, tasks and more. The sidebar’s icons change, though, as you move through different themes: Accounts, Patients, Prescriptions, etc.
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October 23, 2013
A Burnt-Out Doctor Decides To Quit
Diane W. Shannon, M.D., MPH, is now solely a freelance writer. That’s because primary care burned her out of practicing medicine entirely. She’s not burnt out on the industry, though, instead focusing on what she calls “performance improvement in health care.”
Dr. Shannon is exactly the doctor we refer to when critics mention that direct care might exacerbate a doctor shortage. To reiterate, every doctor in America doesn’t get to cut the red tape and instantaneously practice insurance-free medicine. No, direct care is about doctors cooperating collectively and acting independently to circumvent the administrative forces that swallow doc’s time, stress them out, and prohibit them from forming strong relationships with patients.
October 23, 2013
A Doctor Reminds Us that Patients Are in Control
We had to share this harrowing story of Dr. Annie Brewster, who is both a physician and patient. See, she suffers from MS, and in dealing with her condition, she’s gained amazing insight into what it’s like on the other side of the gurney. She explains:
“Being on the patient side has changed me as a doctor. Now, I see more clearly that no medical decision is simple. While my job is to make recommendations to patients based on my medical knowledge, there is no one answer.”
According to Dr. Brewster, what is ultimately “right” is based on a multitude of factors and we may not have the precise answer within our reach. Now she tells her patients when she suggests any treatment, “You are in charge.” Being as we were just reading about a healthcare future that’s been Walmart-ized and might have machines dictating our treatments, this seems especially relevant. What do you think happens if primary care physicians are to be replaced by software algorithms and nurses? Would patients be less stubborn? Would they be even less likely to listen to their own intuition?
Again, these are ambiguous, difficult issues to discern. But regardless, it’s humanizing to remember that in spite of all our education, training and experience, we are not the final call. Really, it’s up to the patient to trust us and follow a treatment plan that works for them. Our job is to take the time to make sure we’re offering the most sound advice within our own reason and skill set.
October 22, 2013
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.
October 22, 2013
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.
October 22, 2013
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.
October 21, 2013
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.
October 20, 2013
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.
October 20, 2013
WATCH: Dr. Lee Gross Explains His Direct Care Success In Florida
Check out this YouTube video of Dr. Lee Gross, MD, a family physician practicing in Florida. He presents Epiphany Health, his direct primary care plan, to medical students attending the AMSA national conference on October 12, 2013 at Rowan School of Osteopathic Medicine. His talk was sponsored by the Benjamin Rush Institute, a non-profit organization dedicated to protecting the doctor-patient relationship and preserving freedom of choice in medicine.
Just a heads up, it’s a long video, clocking in around 35 minutes. To help you out, we highlighted a few key segments.