Articles Posted in Medical Practice Management

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In recent times, one of the issues most complained about by patients comes down to this: Why does my doctor zip through my office visit and fail to give me the attention I need and deserve?

To be sure, doctors these days struggle ever more with “efficiency” pushes in medicine by profit-obsessed business interests and private investors, combined with administrative demands — especially those tied to electronic health records.

These and other factors devour doctors’ frontline practice time. High-level policy makers, politicians, and regulators eventually may be forced to grapple with the rightful concern by regular folks that, as patients, they now confront the reality that a primary care doctor will spend on average 18 minutes with them in an office visit.

ACEP-300x98Almost three dozen leading groups representing a range of doctors, specialists, and other health workers have called on the Biden Administration to deal urgently with the long-running but increasing and dangerous practice of hospitals allowing their emergency care facilities to be overwhelmed because they also are parking patients waiting for rooms and treatment.

This “boarding” crisis, already at breaking points for many exhausted ER staffs, will worsen and imperil patients even more if the nation gets hit — as growing indicators suggest is occurring — with a “tripledemic,” a choking load of coronavirus, flu, and other respiratory infections serious enough to require hospitalization.

The American College of Emergency Physicians (38,000 members), has been joined by the American Medical Association, the American Nurses Association, American Academy of Emergency Medicine (8,000 members) and groups representing family doctors, allergists, anesthesiologists, radiologists, osteopaths, psychiatrists, and many others in a recent letter to the administration, reporting:

Medical leaders and politicians carp endlessly about medical malpractice suits, but when an emergency medical specialist diagnosed staffing shortfalls that threatened patient safety, guess what legal mechanism became crucial to his corrective crusade? Why, yes, of course, it was a lawsuit. A big one over wrongful termination.

Let’s not over-focus on the irony of a legal process that has won the doctor at long last a $26-million judgment, and, instead, pay keen attention to the blaring alarm raised by Dr. Raymond Brovont, an emergency medical specialist in Missouri (shown, right). In brief, he was fired after objecting to persistent understaffing in a hospital’s emergency department as part of the policies of a private contracting firm. As NBC News reported of this increasingly pernicious health care problem:

“What happened to … a former Army doctor named Ray Brovont … isn’t an anomaly, some physicians say. It is a growing problem as more emergency departments are staffed by for-profit companies. A laser focus on profits in health care can imperil patients, they say, but when some doctors have questioned the practices, they have been let go. Physicians who remain employed see that speaking out can put their careers on the line.

creditagencylogos-300x227Patients battered by sky-high health care costs are getting a bit of promising news:

ecrilogo-300x112The coronavirus pandemic and the wrenching demand this public health nightmare has put on the U.S. health care system and its people have become such a worry that staffing shortages and workers’ mental health have become top safety concerns in 2022.

That is the evidence-based view of ECRI, aka the nonprofit, independent Emergency Care Research Institute. It has provided rigorous research to the public and parties in health care to better safeguard patients and their medical care for more than a half century.

The organization issues a Top 10 annual list of patient safety concerns, which is “typically dominated by clinical issues caused by device malfunctions or medical errors,” ECRI reported. But the group is raising different alarms this year about “crises that have simmered, but [that] Covid-19 exponentially worsened.”

deptvetaffairslogo-300x183One of the largest, most important health care systems in the country has plans in the works for a huge revamp, including shutting down many of its big, aging hospitals or slashing services there, shifting to smaller clinics, and refocusing its caregiving to parts of the country where its patients live.

Taxpayers will want to pay attention to these plans because they will pay tens of billions of dollars for them — likely with gratitude. That’s because this reimagined system provides care to millions of current and past U.S. service personnel and their families and is best known as the VA, aka the Department of Veterans Affairs, the Washington Post reported.

The Biden Administration has launched the VA on potentially decades of changes in the way it provides the nation’s sacred commitment to those who have fought with honor for their country and earned the right to quality care for what can be considerable, long-term health needs.

cashflush-150x150While the folks who toil in the front lines of U.S. health care deserve the highest praise and support in the continuing battle against the coronavirus pandemic, those who run care systems deserve a Bronx cheer and worse for their rapacious pursuit of profits — at the expense of patients:

femalemd-300x209They excel through four years of rigorous undergraduate study, then battle their way through four more years of tough, tough medical school. They cram to pass their medical boards and  grind through exhausting internships. They also pursue years more of exacting, sleep-deprived training in residencies and fellowships.

But, wait a minute: Women doctors earn over a professional lifetime an estimated $2 million less on average than their men counterparts? They experience gender pay gaps of 25% to as much as 50% over the course of a 40-year career?

Yes, those are the disconcerting findings of published research that analyzed data from surveys of 80,000 doctors between 2014 and 2019, the New York Times reported:

primary-care-300x199The U.S. health system is in dire need of dramatic reforms to put patients first, most notably by ensuring that everyone in this country has a formally designated primary care physician to help monitor, navigate, and oversee their medical treatment.

That is the latest recommendation of yet another blue-chip experts’ group: the National Academies of Sciences, Engineering and Medicine, a self-described collective of “private, nonprofit institutions that provide expert advice on some of the most pressing challenges facing the nation and the world.”

An expert panel from the academies, after deep research and in issuing a 448-page report, has expressed disappointment that policy makers seemingly ignored the 1996 recommendations of its independent, nonpartisan sister group, the respected Institute of Medicine. The institute offered a blueprint for moving Americans into an approach, built on primary care, that has shown major benefits elsewhere in the world.

bucksfloating-300x167Who wouldn’t want $352 billion in health care savings in 2021?

Insurers — and more importantly employers — could see that hypothetical big chunk of change staying in their pockets, if somehow they could persuade hospitals to forgo their sky-high and ever-increasing prices, tying those charges instead to rates established and paid in the federal Medicare program that covers millions of the nation’s seniors, a new study reported.

The independent Kaiser Family Foundation (KFF) concedes it is unlikely that hospitals, insurers, and businesses would adopt the nonprofit organization’s newly published research any time soon.

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