US Doctors Less Sanguine About Health IT’s Benefits

Jane Sarasohn-Kahn

Posted 1/10/12 on Health Populi

To doctors working in eight countries around the globe, the biggest benefit of health IT is better access to quality data for clinical access, followed by reducing medical errors, improving coordination of care across care settings, and improving cross-organizational workflow.

However, except for the issue of health IT’s potential to improve cross-organizational working processes, American doctors have lower expectations about these benefits than their peers who work in the 7 other nations polled in a global study from Accenture‘s Eight-Country Survey of Doctors Shows Agreement on Top Healthcare Information Technology Benefits, But a Generational Divide Exists. Accenture polled over 3,700 doctors working in Australia, Canada, England, France, Germany, Singapore, Spain and the US.

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Paying for Insurers’ “Choice?” A Look at Physician Practice Administrative Costs

Patricia Salber

Posted 1/08/12 on The Doctor Weighs In

A number of years ago, a family doc friend of mine took me on a tour of his small group practice.   He proudly showed me the exam rooms, his medical equipment, and other parts of the facility that related to patient care.  Then, we came to a large room with a bunch of desks piled high with paper.  He explained, bitterly, that this part of his office was for the people he had to keep on the payroll to do nothing but deal with insurers.  This administrative expense was cutting his margins to the bone and did not help him take better care of his patients.  He eventually left practice, to pursue a second career as a physician executive – a job that was, for him, more remunerative and more satisfying.

Continue reading “Paying for Insurers’ “Choice?” A Look at Physician Practice Administrative Costs”

How Doctors Die: Its Not Like the Rest of Us, But It Should Be

Ken Murray

Posted on Zocalo Public Square on 12/30/11

Brian’s Note: This article was alluded to in a NY Times blog post called “When Doctors Face Death.” In a clear and rational tone, the author, an experienced family physician, points out that, when American physicians face death, they often don’t want the excessive care that their patients generally receive. As I understand it, the article, part of a series for Zocalo Public Square, has gained tremendous traction. Rightly so. Read it below.

bio-ken-murray.jpgYears ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

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Why Medicare Access Is In Jeopardy In Both Salaried and Physician Owned Settings

Jaan Sidorov

Posted 12/21/11 on The Disease Management Care Blog

Don’t underestimate the physician dismay over the looming “Doc Fix” debacle. Unless some budget compromise gets hammered out, Medicare is about to stick it to a lot of docs.

Ever since the passage of the Balanced Budget Act of 1997, Congress has been repeatedly delaying a yearly mandated cut in Medicare’s physician fees. That statutory reduction has been slowly accumulating through no fault of the physician community and is now estimated to be more than 27%.  Assuming most physicians’ practices are made up by a majority of Medicare beneficiaries, that represents a huge hit to their cash flow. KHN has a good summary of the partisan mutual assured destruction that has led us to this crisis here.

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Sustainable Health Care: Patients, Doctors and Hospital Executives See Different Futures

Jane Sarasohn-Kahn

Posted 11/16/11 on Health Populi

There is broad consensus among doctors, patients and health administrators that the current U.S. health system is broken and unsustainable; preventive services is under-utilized and -valued, quality is highly variable from region to region and patient to patient, and costs continue to spiral upward without demonstrating value.

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America Needs Different Doctors, Not More Doctors

Merrill Goozner

Posted 11/10/11 on Gooz News

Matt Yglesias at Think Progress took a look at some OECD data comparing U.S. physicians to their international counterparts and concluded we need more doctors. The evidence? There’s only 2.4 practicing physicians per 1,000 population in the U.S., second lowest in the OECD and somewhat below the 3.0 median (the range is from 2.2 physicians per 1,000 population in Japan to 4.0 in Norway). At the same time, the average U.S. medical consumer sees a physician only 3.9 times a year compared to the 6.3 OECD median. Yes, we pay a lot for health services including physician services (he reprints a chart showing average pay for U.S. physicians, whether highly paid orthopedic surgeons or relatively poorly paid primary care docs, that shows they are the highest paid among six well-off OECD countries). But his conclusion that America therefore needs more docs is off the mark.

CMS Wants Docs To Ante Up To CMS Poker Game

Michael Millenson

Posted 10/20/11 on Forbes

In a high-stakes political, clinical and economic poker game that goes by the name of Accountable Care Organizations (ACOs), the Centers for

Medicare & Medicaid Services (CMS) has just issued a call for doctors and hospitals to grab some chips and ante up.

The set-up goes like this: one of the biggest potential changes in how health care is actually delivered contained in the Accountable Care Act was ACOs.

They’re voluntary, but they allow doctor- or hospital-led organizations that take responsibility for coordinating the care of at least 5,000 Medicare beneficiaries to get reimbursed at a higher rate for providing better-quality, lower-cost care. It’s supposed to be a win-win-win for providers, patients and taxpayers and part of a more general move towards “value-based purchasing.”

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