Nursefriendly.com: Primary Care Physician

Showing posts with label Primary Care Physician. Show all posts

Sunday, July 31, 2011

Why doctors can sometimes be their own worst enemies

“I don’t have the time … I don’t get reimbursed for that.” This is an all too common refrain from primary care physicians and practice managers when ever the subject of improving physician-patient communications comes up.

I get it. Primary care physicians in particular are under tremendous pressure to produce. Just imagine, physicians in small primary care practices spend about 3.5 hours per week just on dealing with insurance-related paperwork. Then there’s keeping up with recommended treatment guidelines, journals, and IT issues and routine staffing issues — not to mention routine patient care, much of which they in fact don not get paid for. Physicians do have it rough right now.

But doctors can sometimes be their own worst enemies.

via kevinmd.com

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Friday, June 10, 2011

Top 5 Don’ts for Doctors in Primary Care - By RONI CARYN RABIN-NYTimes.com

Antibiotics for sore throats and CT scans for minor head injuries in children are among the most wasteful practices in primary care medicine, a national physicians’ group said last week. Among the others are electrocardiograms performed routinely on healthy adults and widespread prescribing of brand-name statins to reduce L.D.L., or “bad” cholesterol.

Related

More Vital Signs Columns

The group issuing the report, the National Physicians Alliance, an organization of some 22,000 physicians, developed three separate “Top 5” lists for primary care doctors — internists, family doctors and pediatricians — that were essentially lists of medical “don’ts.” The lists were published online in The Archives of Internal Medicine.

via nytimes.com

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Friday, May 27, 2011

More primary care tied to lower death rates | Reuters

Seniors living in areas with more primary care have slightly lower death rates and are less likely to end up in the hospital with a preventable disease, U.S. researchers have found.

In contrast to some earlier studies, which have yielded mixed results, the new work looked at how much primary care was actually delivered to patients -- not just how many primary care physicians were in a certain area.
"The magic is not in how many primary care physicians there are, it is what they do," said Dr. Barbara Starfield of the Primary Care Policy Center at Johns Hopkins University in Baltimore, who was not involved in the study.

via reuters.com

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Monday, April 11, 2011

Patient complaints do not fit the primary care office visit

by Kevin Pho, MD
Primary care physicians often have to see patients with a litany of issues. Often within a span of a 15-minute office visit.
This places the doctor in the middle of a tension — spend more time with the patient to address all of the concerns, but risk the wrath of patients scheduled afterwards, who are then forced to wait.
And, in some cases, it’s simply impossible to adequately address every patient question during a given visit.
It’s a situation that internist Danielle Ofri wrote recently about in the New York Times.
In her essay, she describes a patient, who she initially classified as the “worried well”:

via kevinmd.com

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Wednesday, April 6, 2011

Electronic Health Records: Status, Needs and Lessons – 2011 Report Based on 2010 Data

The use of electronic health records (EHRs) by medical practices and other organizations in the United States has increased measurably in the past decade. Despite the potential to improve the quality of patient care and enhance practices' financial performance, the technology remains far from universal.

To better understand the current state of EHR use, MGMA conducted a study funded by PNC Bank to explore the barriers and benefits of EHR adoption. MGMA collected data between Oct. 1, 2010, and Nov. 9, 2010, from 4,588 healthcare organizations nationwide that responded to the survey. The data represent the aggregate experience of more than 120,000 physicians in medical practice.

via blog.mgma.com

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Sunday, April 3, 2011

Men avoid the doctor, survey finds - Chicago Sun-Times

Almost half of men 18 to 50 don’t have a primary-care physician, and a third haven’t had a checkup in more than a year, a new survey shows.
About 40 percent of men in their 40s have never had their cholesterol tested, and 70 percent have never had a prostate exam, according to the national survey of 519 men commissioned by Esquire magazine.

“It’s a stereotype about men that they don’t like to go to the doctor, that they’d rather just go when there’s a problem,” says Esquire’s Ryan D’Agostino.

The survey found that 45 percent of the men surveyed didn’t have a primary-care doctor. Among other findings:

via suntimes.com

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Wednesday, March 2, 2011

How patients and doctors can improve the primary care office visit

Consumer Reports recently released a survey of both patients and primary care doctors, regarding their perceptions of each other.
Some interesting findings, as summarized by the WSJ’s Health Blog:
On the issue of respect and appreciation, 70% of doctors said they were getting less of it from patients than when they started practicing. For patients, meantime, the more they reported being treated respectfully and listened to, the more satisfied they were with their physician.
Respect matters. Treating health professionals in a courteous manner definitely helps when receiving medical care. On the flip side, physicians also need to respect patents, as it positively impacts patient satisfaction. Both parties need to improve in this area.
Doctors said insurance paperwork topped their list of things that interfere with their ability to provide the best possible care. Financial pressure was No. 2.

via kevinmd.com

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Wednesday, February 9, 2011

Hello Doctor! (Can I Call You M.D.?) - Health Blog - WSJ

The medical profession feels like it is under siege. The traditional MD trained, post residency doctor was trusted and looked up to as a pillar of knowledge and achievement.
In a vast array of ways there have been efforts to dislodge these professionals from their perch. Obfuscation of roles, privilege creep, payer acceptance, degree inflation, DTC advertising along with mid-level focused detailing(generally more corruptible), push of “universal health care”, push of generic terminology such as “providers” used in ways to commoditize then devalue the services. The push of EHR and protocol driven care, etc are all parts of the efforts to this end.
The problem is that this is leading to fall in standards, unfortunately not just in affiliated providers but even amongst MDs in my observation over the years. The approach of younger doctors appears to be that “if I am merely a provider I will just show that level of commitment” . Many no longer take out of hours call. They choose lifestyle specialties, prefer shift work, generally refuse anything more than minimal responsibility etc.
The old guard is aging and as they are phased out, the true unfortunate ramifications of this will become clear. We are being very short sighted undercutting such a venerable profession in such ways.

via blogs.wsj.com

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Friday, January 28, 2011

Healthy Habits Are Hard to Maintain—Even if You Know What Lies Ahead - Healthcare Headaches (usnews.com)

"It's about that time of the month," a physician colleague of mine said to me a few days ago, "when our patients start to let go of their New Year's resolutions." That is, all those well-intentioned promises we make to ourselves year after year to eat more fresh fruits and vegetables, to spend 30 minutes in the gym each day, or to start a walking program. Breaking unhealthy habits and starting healthy ones is hard, and most people require several attempts to succeed. As I discussed in a previous blog post, there's good evidence that even multiple intensive lifestyle counseling sessions led by trained professionals are only mildly helpful.

Compounding matters is the fact that every individual is different. You probably know people who’ve lived to ripe old ages in perfect health despite having eaten eggs every day of their lives or not exercising. My great-grandfather smoked cigarettes for 80 years, but died peacefully in his sleep in his late 90s. (Maybe he would have made it to the century mark if he'd quit.) Some researchers have suggested that a more effective way to motivate patients to change their lifestyles could be to give them personalized information about their risk for common chronic conditions such as cancer and heart disease. Others, though, have worried that this knowledge could encourage complacency among those who learn they’re at below-average risk. Why quit smoking, for example, if you think your genes will protect you from lung cancer?

[6 Ways to Boost Willpower]

via health.usnews.com

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Monday, January 3, 2011

More Patients Making Appointments Online As Doctors Embrace Web - Kaiser Health News

After relocating to Washington, D.C., Clint Morrison needed a doctor to follow up a tonsillectomy he had a few weeks earlier in California. But when he started calling specialists in his health plan’s directory, he struck out: they either weren't taking new patients or had no openings for several weeks.

So in September Morrison went to a website called www.zocdoc.com. He could see doctors' appointment calendars and identify those that took his insurance and were located near his office. With a couple clicks, Morrison, 24, scheduled an appointment for the next day with Mark Dettelbach, an ear, nose and throat doctor. "It was painless," Morrison says of the experience.

Dettelbach's group practice is one of a growing number that allow patients to schedule appointments online — eliminating multiple calls, waiting on hold and increasing the likelihood of finding someone with an opening.

About 16 percent of family doctors used online scheduling in 2009, up from 6 percent in 2005, according to the American Academy of Family Physicians. Most are doing it on their own or through health systems where they work.

Several factors drive the trend. On the doctors' side, it's mostly the need to add patients and reduce overhead costs. They're also growing more comfortable with computers. About half of family doctors use electronic health records and 44 percent prescribe electronically, according to the academy.

via kaiserhealthnews.org

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Friday, December 31, 2010

Primary care needs more than 15 minutes for patients, KevinMD.com

Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.
More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of what we do in my specialty.
In primary care we seldom spend more than 15 minutes at a time with an established patient. Yet we are required to cover infinitely more details and consider more outside authorities in every visit today than when I first started practicing medicine. Between health insurance and office administration, there are now many more mouths to feed from the office charges than there were then. Sometimes it feels like we are not alone in the exam room even for the short time we do have.
Except for doctors in concierge medicine or micropactices, most of us cannot change the amount of time we have with each patient. Even if we hope to change the system, the patients we see today deserve the best we can give them in today’s 15-minute visits.

via kevinmd.com

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Sunday, July 31, 2011

Why doctors can sometimes be their own worst enemies

Friday, June 10, 2011

Top 5 Don’ts for Doctors in Primary Care - By RONI CARYN RABIN-NYTimes.com

Related

More Vital Signs Columns

Friday, May 27, 2011

More primary care tied to lower death rates | Reuters

Monday, April 11, 2011

Patient complaints do not fit the primary care office visit

Wednesday, April 6, 2011

Electronic Health Records: Status, Needs and Lessons – 2011 Report Based on 2010 Data

Sunday, April 3, 2011

Men avoid the doctor, survey finds - Chicago Sun-Times

Wednesday, March 2, 2011

How patients and doctors can improve the primary care office visit

Wednesday, February 9, 2011

Hello Doctor! (Can I Call You M.D.?) - Health Blog - WSJ

Friday, January 28, 2011

Healthy Habits Are Hard to Maintain—Even if You Know What Lies Ahead - Healthcare Headaches (usnews.com)

Monday, January 3, 2011

More Patients Making Appointments Online As Doctors Embrace Web - Kaiser Health News

Friday, December 31, 2010

Primary care needs more than 15 minutes for patients, KevinMD.com

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