August 15, 2013
Dr. Michael Painter and his wife Mary each lost a parent. In his wife’s case, her mom died peacefully at home. But Painter’s dad experienced something far more traumatic. He received an early morning call from paramedics regarding his otherwise healthy and vigorous 72-year-old. His dad had fallen at home. Because the responders on the scene presumed a stroke, he was taken to a hospital with a neurosurgery speciality rather than one with a trauma center.
This decision proved fatal.
August 14, 2013
François de Brantes is the Executive Director of the Health Care Incentives Improvement Institute (HCI3), and a staunch advocate of incorporating new motivations within healthcare.
According to Brantes, motivation fuels any professional, with morals and ethics steering the ship so to speak. As people, our motivation is to achieve certain goals. And as doctors, we’re guided by at least two primary goals–stay in business and take care of patients. Thanks to falling Medicare payments and rising cost of overhead, though, the staying in business part has taken precedence, and led to primary care physicians bringing on more and more patients. In turn this compromises the more satisfying, and important, concern–making patients healthier. Ideally, if health care professionals were free to realize that second motivation, we’d have a situation where really good care is readily available, and affordable. But that’s not the situation. And it’s clear that something’s gone wrong.
August 7, 2013
I wanted to share our follow-up with a doctor who recently wrote into us asking about direct care. Here’s her query:
Dr Josh,
Thanks again for speaking to me a couple of weeks ago about DPC. It was very helpful. I will be using your EMR program in my practice. Was wondering if the ICD codes are generated /accessible by/from your EMR?? Also, I was advised by the local lab I will be using to ask you if your EMR has a “HL7 feed” for importing lab results. One last thing, could we see what forms you are using in your new patient information packet? I have created my own from basic forms I have used in the past but was interested in seeing what you use. Thanks again for all your help and being a champion for the DPC movement. Wish you much continued success!
[name omitted]
These are fantastic questions. I’ll address them one at a time.
August 5, 2013
We had a quick update on the survey asking doctors to gauge their responsibility in keeping healthcare costs down. Fox News followed up with a write-up regarding the study. They reference additional research relating to the findings and one quote caught our attention:
“Dr. Ezekiel Emanuel, a professor of bioethics and health policy at the University of Pennsylvania, said the survey’s findings are somewhat discouraging, and suggested that doctors must lead health care transformations.” He went on to argue in an editorial accompanying the study that physicians do not have the ‘all-hands-on-deck’ mentality that true reform would demand.
We think his statement could use a modifier. Most, even many, physicians might not have the all-hands on deck mentality. At least not yet. But direct primary care physicians do. Seriously, when Jeannie is sick we run our practice with just three doctors. That’s because we’re not above answering a phone, scheduling an appointment, or cleaning out the fridge if that’s what needs to happen.
August 1, 2013
We came across an article from The Wall street Journal addressing patient communication. It’s worth reminding our doctors: evidence has mounted that good communication helps patients stick to recommended treatments and manage chronic diseases. It also improves outcomes in the management of diabetes, hypertension and cancer. As primary care physicians in DPC, we’re not always dealing with conditions this serious. However, we’re still prescribing medications. Our ability to be clearly dictate when to take them, and why we’re recommending our patient take them MATTERS.
In a separate but related issue, we mentioned last week that poor communication is more likely to get you sued than making mistakes. Evidently patients don’t want to sue a doctor they like. Although they are willing to file lawsuits against the unfriendly, un-empathetic doctor who harried them through their visit. The WSJ points this out as well, saying “lack of communication, after all, isn’t just frustrating for patients. It can hurt the quality of care, drive up costs and increase the risk of lawsuits. And under new Medicare rules, providers won’t get as much money if they rack up poor patient-satisfaction scores or too many preventable readmissions.” Thankfully, in our line of work this last sentence need not apply. We can’t begin to express how glad we are to NOT have to fill out ICD-10 codes or have our patients pencil in score sheets regarding our service.
July 26, 2013
Have you checked out Mind The Gap yet? It’s a blog written by Stephen Wilkins, MPH. He’s interested in physician-patient communication that’s both personal and professional. His most recent post (Via Health Works Collective) addresses the issue of relevancy, something that you might immediately think, that? Oh, I know that. But the truth is, if you’ve been a healthcare professional running through what Michael Tetreault called the “hamster wheel” then you might have developed some bad communication habits.
July 23, 2013
A Deloitte survey reports that a majority of physicians believe many doctors will retire earlier than planned in the next one to three years. The same percentage think medical experts losing control of their clinics will jeopardize the healthcare administration. This group also believes strongly that implementation of the Affordable Health Care for America Act, or Obamacare, will push doctors out of the primary care industry altogether.
A spokeswoman for the Association of American Physicians and Surgeons, Dr. Jane Orient, was not surprised by the results at all. In a recent WND article, it was reported that she said doctors already have started leaving the profession through early retirement. Of course, some will instead seek alternatives to what they see coming in the federal government’s takeover of health care. And that’s why we’ve been championing our model of direct care. Because the worst outcome is a doctor not practicing at all. And if that’s what an overregulated market will encourage, then we have a serious problem.
July 11, 2013
Dr. Doug and Dr. Josh have been spreading the gospel of direct care on Fox News, late night podcasts and CNN. But Concierge Medicine Today (CMT) has some data showing the downside in concierge medicine. They’re finding that the number of patients seeking concierge medical care exceeds the actual number of primary care and family practice doctors on the market.
“Despite what we hear in the media about the increase in concierge and private-pay physicians growing across America, there are simply not enough of these [concierge-style, direct care or membership medicine-style] physicians in the U.S. to meet the current demand,” says Michael Tetreault, Editor-In-Chief of Concierge Medicine Today “At the end of the day, the marketplace is still falling short.”