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.
Tag Archives: Direct Care
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.
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.
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.
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.
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.
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.
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.
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.