Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog] The Problem of Pain: When Best Medical Advice Doesn’t Equal Patient Satisfaction

From the 4 April 2014 post by Karen Sibert, MD at The Health Care Blog


The problem of pain, from the viewpoint of British novelist and theologian C. S. Lewis, is how to reconcile the reality of suffering with belief in a just and benevolent God.

The American physician’s problem with pain is less cosmic and more concrete. For physicians today in nearly every specialty, the problem of pain is how to treat it responsibly, stay on the good side of the Drug Enforcement Administration (DEA), and still score high marks in patient satisfaction surveys.

If a physician recommends conservative treatment measures for pain–such as ibuprofen and physical therapy–the patient may be unhappy with the treatment plan. If the physician prescribes controlled drugs too readily, he or she may come under fire for irresponsible prescription practices that addict patients to powerful pain medications such as Vicodin and OxyContin.

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May 3, 2014 Posted by | health care | , , , , , , , | Leave a comment

[Reblog] Fight for access to Medicare payments to physicians nearly over

From the 15 January 2014 article at Covering Health-Monitoring the Pulse of Health Care Journalism

Charles Ornstein

Charles Ornstein is a senior reporter with ProPublica in New York. The Pulitzer Prize-winning writer is a member of the Association of Health Care Journalists’ board of directors and past president.

(Editor’s note: This is a revision of the original post, which is available on Ornstein’s Tumblr site.)

The Centers for Medicare and Medicaid Services (CMS) said yesterday that it will soon begin releasing data on payments to individual physicians in the Medicare program.

Why is this such a big deal?

Because it overturns a longstanding agency policy that for more than three decades had barred the release of this very information. And, it follows advocacy for greater transparency by numerous news organizations, including the Association of Health Care Journalists.

CMS-9-3-13-1AHCJ’s board of directors last September sent a letter of comment to CMS asserting the public’s interest in release of this information. “As long as patient confidentiality is protected, we see no reason why taxpayers should not know how individual physicians are spending public dollars,” said the letter, signed by AHCJ executive director Len Bruzzese.

As this fight has played out, CMS released data to ProPublica on which drugs physicians prescribe in Medicare’s drug program, known as Part D. You can now look up your doctor’s prescribing patterns online.

 

Read the entire article here

 

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January 19, 2014 Posted by | health care | , , , | Leave a comment

The problem with transformative technologies in medicine

http://www.healthxchange.com.sg/healthyliving/HealthatWork/Pages/top-5-health-apps-to-download.aspx

Yesterday I reflagged an item about the  Free UMSkinCheck Mobile App.
While these self check apps are wonderful consumer and patient tools, they are not without “problems”.
This KevinMD.com post outlines health app use challenges as folks gathering data without knowing what to do with and reimbursement issues (physician consultations outside of the office).

Article ends with statement “Until our system puts more value on avoiding unnecessary treatment and keeping people well we will be stuck in this struggle between patients who want to avoid seeing the doctor and doctors who can’t afford to let patients do that.”.

The problem with transformative technologies in medicine

by (KevinMD.com post, 17 July 2012)

Eric Topol wrote a post on The Health Care Blog where he looks to a future enabled by emerging technology: “Just as the little mobile wireless devices radically transformed our day-to-day lives, so will such devices have a seismic impact on the future of health care. It’s already taking off at a pace that parallels the explosion of another unanticipated digital force — social networks….

large number, if not the majority, of ear infections are undiagnosed and clear on their own at home without intervention.  Now add to this a technology which gives us the ability to see all of those undiagnosed ear infections, and we have to muster even more willpower to resist the urge to treat them all.  This is the same problem as we have encountered with PSA testing: be careful gathering data you don’t know how to handle.

But even without considering this important objection to improved data-gathering, there is another problem which stands in the way of this type of technology: reimbursement.  It sounds great to enable people to avoid visits to the doctor’s office by having tools that previously were only accessible at an office visit.  It sounds like a very good way to save money and wasted time spent in waiting rooms with outdated magazines.  But this technology presumes that doctors will be willing to act on this information without seeing the patient in the office.  It presumes we will be willing to offer free care.  If the time I spend sifting through patient-collected data rises exponentially, the payment I get for that time cannot remain at the present level: zero.

If our goal (as it should be) is to spend less money on unnecessary care, we will get to it much faster if we somehow give proper incentive.  Our encounter-based payment system stands in the way of any progress in this area.  The only way most of us get paid is to see people and deal with problems.  This makes doctors reluctant to offer any care outside of this setting, and puts undue pressure on intervention (to justify the encounter to the payors).  Until our system puts more value on avoiding unnecessary treatment and keeping people well we will be stuck in this struggle between patients who want to avoid seeing the doctor and doctors who can’t afford to let patients do that….

What is significant about the finding cited above is that patients at least get it.  They understand the value of a having a relationship with a knowledgeable physician or similar health care provider.  In spite of, and for some, because of the plethora of health information outlets on the web people want to know that they always have access to your family doc when the chips are down.”

“Here’s what I mean…based upon some 20+ years working in health care:

From the get go…going back to Hippocrates…health and health care delivery has been about the relationships between people starting with the  physician-patient.relationship.

The most important diagnostic tool a physician has at their disposal is not a smart phone…but their ability to talk with and observe  patients verbal and non-verbal behavior.

 “Talk” is not only how physicians diagnose problems and recommend the appropriate treatments…talk is also how patients are able to engage in the health care.  Perhaps the most overlooked aspect of talk (and touch) during the medical exam is the therapeutic benefits patients derive from being able to express heart-felt fears and concerns to someone who hopefully cares.”

July 18, 2012 Posted by | Consumer Health | , , , , , | Leave a comment

Fewer U.S. Docs Accepting Perks from Industry

HealthDay news imageBut nearly 84% still report some relationship with companies, results show

From a November 8, 2010 Health Day news item By Robert Preidt

MONDAY, Nov. 8 (HealthDay News) — U.S. physicians‘ links with drug makers, medical device manufacturers and other health-related companies have decreased since 2004, but many doctors still have ties to these businesses, new research shows.

A 2004 survey found that about four out of five doctors accepted gifts of food and beverages from industry in their workplaces and more than 75 percent were given drug samples. In addition, more than one-third accepted reimbursement from companies for professional meetings or continued medical education, and more than one-quarter accepted payment for consulting, speaking or clinical trials.

The new 2009 survey of 1,891 primary care physicians and specialists found that nearly 84 percent reported some type of relationship with industry in the previous year. Nearly two-thirds (63.8 percent) accepted drug samples, about 70 percent received food and beverages, 18 percent received reimbursements, and 14 percent were paid for professional services.

The findings are published in the Nov. 8 issue of the journal Archives of Internal Medicine [free full text article].

Certain types of specialists were more likely to have industry ties. For example, these connections were more common among cardiologists (92.8 percent) than psychiatrists (79.8 percent). The type of practice also made a difference.

“Physicians in solo or two-person practices and group practices were significantly more likely than those in hospital and medical school settings to receive samples, reimbursements and gifts. However, physicians in medical schools were most likely to receive payments from industry,” the researchers wrote.

“These data clearly show that physician behavior, at least with respect to managing conflicts of interest, is mutable in a relatively short period,” the study authors concluded. “However, given that 83.8 percent of physicians have physician-industry relationships, it is clear that industry still has substantial financial links with the nation’s physicians. These findings support the ongoing need for a national system of disclosure of physician-industry relationships.”

SOURCE: JAMA/Archives journals, news release, Nov. 8, 2010

 

 

November 10, 2010 Posted by | Uncategorized | , , , , | Leave a comment

   

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