Posted by: AtlasMD

February 15, 2016

Hitting Measurements and Failing Patients


We recently posted about The Virtual Quality Myth, so we were really excited to see this New York Times article about how measurements are failing our doctors and teachers.

When Measurements Don’t Cut It

Most of the doctors that we talk to on a daily basis understand this basic principle: measurements that are based on outdated standards can’t possibly lead to positive patient results. The NYT brings up a good point: With all the rules and paperwork and documentation, doctors still speak to their patients — they still consult and provide treatment, but now they have to be really accurate with how and when they mark this information down. It becomes nearly impossible to have a long conversation with a patient when you’re worried about tracking every issue, instance, and idea. Once the systems entered the game, the personal interaction and connection moved out of sight.

We saw this as a problem many years ago, though it seems like the idea is spreading a little quicker now that we’re seeing the failure of the “measurement method,” as we’re calling it.

“…the objections became harder to dismiss as evidence mounted that even superb and motivated professionals had come to believe that the boatloads of measures, and the incentives to “look good,” had led them to turn away from the essence of their work. In medicine, doctors no longer made eye contact with patients as they clicked away.” (New York Times)

We’re obviously behind Robert M. Wachter, the author of the New York Times article, and we were excited to read this quote in particular, since it’s exactly what we try to do with our DPC:

“Last week, Andy Slavitt, Medicare’s acting administrator, announced the end of a program that tied Medicare payments to a long list of measures related to the use of electronic health records. ‘We have to get the hearts and minds of physicians back,’ said Mr. Slavitt. ‘I think we’ve lost them.”

The best part about this is that DPC doctors are already doing exactly what this NYT article is hoping for:

“In health care, [minimization of measurement burdens] will come through advances in natural language processing, which may ultimately allow us to assess the quality of care by having computers “read” the doctor’s note, obviating the need for all the box-checking. In both fields, simulation, video review and peer coaching hold promise.

Sometimes it’s good to know that we’re doing the right thing. And we think other DPC doctors will be excited to hear that their choices are not only positive, but they’re measuring up! Check out some more ideas and see how our EMR can help you get your practice moving.

Direct Care Is Growing In Greeley, Colorado

Dr. Frank Morgan has been practicing medicine for 13 years in Greeley. Like many of his fellow primary care purists, he wanted to spend more time with his patients and less time dealing with insurance paperwork.

That’s why he founded his new direct primary care clinic, Balance Health, 1709 61st Ave. Here, like us, he treats his patients without accepting insurance. Instead, patients pay a $99 monthly subscription for access to his personal primary care services, as well as access to the clinic’s gym and nutritional advice services.

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Direct Care Opponents Claim Our Patients Are “Exposed”? Tell That To A Surprising Proponent (The Healthcare Exchange).

In South Portland, Maine — Roxanne Pettigrow chooses not to buy health insurance. She visits her doctor in South Portland every few weeks, though, paying $50 up front, once per month for regular checkups, office visits and preventive health screenings. It’s care that those who lack health coverage often skip.

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Myth Buster, Cash-Only Medicine Edition

Some people have a knee-jerk reaction when asked about direct primary care: “Only the rich can afford direct primary care” and the end result will be “fewer doctors seeing fewer patients”. These statements are true but ironically only in context with the current dysfunctional system that impairs quality by reducing actual patient care time. It’s this patient mill mentality that drives doctors away from a career in primary care, and further exacerbates the problem. Its leads to efficiency delusions like Meaningful Use Stage 2, and ICD-10 billing codes and fast-talking EMR vendors which all to the red tape that makes healthcare so needlessly expensive.

The current insurance-driven primary care system is underfunded and overburdened and gives poorer quality care than a direct care system would. The top 9 conniptions about direct care are as follows:

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Now Chicago Tribune Is Praising Direct Primary Care

Now Chicago Tribune Is Praising Direct Primary Care

Chicago Tribune writer Christopher Gearon opened his recent piece about direct primary care with a question? “Ever need to wait a week or more to see your primary care doctor?” He then recommends that you take a cue from Debra Sallee, 58, a Seattle hair salon owner. She pays a flat fee of $79 a month and can see her family physician unlimited times — with no co-payments or health insurance forms.

“It’s just so convenient. They are at my beck and call,” she says.

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