MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'american medicine'. Sat, 03 Sep 2011 02:48:32 +0100 http://www.medworm.com/index.php?rid=5130749&cid=t_102801_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-york-times-piece-about-plastic-surgery-gets-people-talking%2F2011.08.14 Monday’s New York Times tweeted a headline – “Never Too Old for Plastic Surgery” – about this story. While I’m very happy for the 83-year old woman in the piece for her happiness over her “new” $8,000 breasts, the piece was framed like an expensive billboard for plastic surgeons – only it didn’t cost them anything. The Times gave away the advertising space. The story states: “There are as many reasons for getting plastic surgery as there are older patients, experts say”…and…”some are simply sick of slackened jowls, jiggly underarms and saggy eyelids.” There are a few other perspectives in the middle of the piece: “Some critics question whether the benefits are worth the risks, which may be... Better Health blogs http://www.medworm.com/rss/comments.php?id=5130749 Sun, 14 Aug 2011 21:00:43 +0100 5130749 http://www.medworm.com/index.php?rid=2523159&cid=t_102801_113_f&fid=36504&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalRecordShow%2F%7E3%2FIAk9I7D4DpE%2F ..but in case you weren’t paying attention to President Obama’s address to the AMA, you had better be getting thee hence to an EHR system. This is no longer a matter of electronic records being an interesting but problematic alternative to paper charting. That hasn’t been the case for some time, by the way. The President of These United States has laid it out, repeatedly and often: Change is coming Beans will be counted Incentives will be aligned with desired outcomes The federal government is setting the stage to make it so, and everything else is going to follow from there. “Lesser” entities, like insurance companies, are taking note. So should you. What He Said (Italics Mine) 1. We can’t keep going on like this, and we won’t: Make no mistake... The EMR/EHR Show: Making Your Electronic Medical Records Really Work blogs http://www.medworm.com/rss/comments.php?id=2523159 Mon, 22 Jun 2009 14:00:18 +0100 2523159 http://www.medworm.com/index.php?rid=2347983&cid=t_102801_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Fwho-dares-blow-whistle-who-dares-loses.html Let us not forget that, as health care in the UK crumbles, we are not the only country that has problems. NHS BLOG DOCTOR gets a lot of comments from the USA, usually extolling their medical system and condemning the concept of “socialized (with a “z”) medicine” as the Americans call it.One of the greatest problems we face in the UK is getting people to realise that their attachment to the NHS is emotional rather than rational. Criticisms of British health care are usually met with disbelief and incredulity. I get emails and comments saying that the picture I paint of the NHS is unnecessarily gloomy. Then the writers of these comments are admitted to hospital or, more likely, their elderly grandmothers are admitted, and I get an email saying, “I had not realised…”.The governm... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2347983 Fri, 10 Apr 2009 09:29:00 +0100 2347983 http://www.medworm.com/index.php?rid=2270332&cid=t_102801_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F03%2Ftragedy-of-jade-goody-would-she-have.html A couple of days ago, we looked at the excellent article on The Tragedy of Jade Goody in the “Blog that ate Manhatten”.  It is well worth taking a look at the comments that the article has generated. Having worked in the USA, I know that there is a general assumption amongst Americans that the NHS is not competent. Americans fear anything with the word “socialist” in it, and the NHS is seen from afar as “socialised” medicine.There is a theme running through some of the comments in the Blog that ate Manhattan that Jade Goody’s problems are a direct result of the failings of the NHS and a consequent implication that “nothing like this could have happened in the USA”. None us know exactly the circumstances in which Jade Goody rejected medical intervention until it was too ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2270332 Sun, 15 Mar 2009 13:34:00 +0100 2270332 http://www.medworm.com/index.php?rid=2173739&cid=t_102801_113_f&fid=36504&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalRecordShow%2F%7E3%2FbLlWBlD0xRM%2F He had experience in Washington, and was aggressively lobbying for health care reform. He was clearly pro-medical IT. Most impressive, he emphasized the central role of primary care medicine in repairing our upside down physician reimbursement system. Naturally, he was destined to fail. It’s unclear that it’s time to stop shopping at the “political” store, as Barbara Duck put it, and start shopping at the “smart” store. It’s also not entirely clear why Daschle withdrew, other than having a modicum of fiscal impropriety, less than many. He seemed a pretty “smart” choice to me. I certainly hope that the NY Times is wrong, and that this doesn’t halt the momentum towards healthcare reform we’ve seen these past several weeks. As ... The EMR/EHR Show: Making Your Electronic Medical Records Really Work blogs http://www.medworm.com/rss/comments.php?id=2173739 Sun, 08 Feb 2009 10:43:29 +0100 2173739 http://www.medworm.com/index.php?rid=858294&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F09%2F10%2Famerican-medicine-medicaid-and-child-abuse%2F This is a picture of a teenage boy with Gynecomastia.  Obviously, gynecomastia is an abnormal enlargement of the male breasts.  It happens in some teenagers - and is worse in those with obesity.  Just how cruel do you think these kids are treated in high school and middle school? I have a young boy who is 13 and has marked gynecomastia which has been present for over two years.  I requested a plastic surgery consult (which is usually my practice) in this situation and the surgeon agreed that he was a good candidate for a surgical fix and submitted the request to our Medicaid managed care provider.  I have never had a denial of this when the situation clearly seemed to warrant this.  In fact, this child had been approved to have the procedure done a year prior ... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=858294 Mon, 10 Sep 2007 17:25:39 +0100 858294 http://www.medworm.com/index.php?rid=797936&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F08%2F13%2Famerican-medicine-can-we-talk%2F So we have a construction project ahead of us.  American Healthcare is like an old road with two lanes.  The asphalt is cracking and there are potholes every few feet.  The demand could easily fill an interstate highway, but all we have is a curvy slow road.  We need to fix it without making things worse.  We can’t wait long for this to be fixed, since people are being inconvenienced, injured, and even killed by the poor quality of road.  Plus, we need to fix it while leaving it open for traffic. So what is the first step to get this construction going?  The very foundation of healthcare that is broken at the root is communication.  In previous posts I have documented many areas of breakdown in communication: Between doctors and patients.&nb... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=797936 Tue, 14 Aug 2007 03:31:49 +0100 797936 http://www.medworm.com/index.php?rid=781337&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F08%2F05%2Fhospitalists-a-deal-with-the-devil%2F I am a Med/Peds physician.  That means that my training was in both internal medicine and pediatrics.  I do basically what a family physician does (a little more pediatrics, and less procedures and well-woman care).  My internal medicine residency training was mostly inpatient in nature.  We spent most of our time on the wards in the hospital, often taking care of intensive care patients.  I never spent much time taking care of patients in the outpatient setting, with a half-day each week alternating between adult and pediatric clinics.  So by the time I was done with residency, I was very comfortable in taking care of inpatients - even ICU patients - but with relatively little experience taking care of patients in the office. I quickly adjusted, however, wit... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=781337 Mon, 06 Aug 2007 03:11:40 +0100 781337 http://www.medworm.com/index.php?rid=776126&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F08%2F03%2Famerican-medicine-construction-ahead%2F On my way to work I have to drive through a construction zone. The construction project is huge. The first step is to widen about four miles of one road to four lanes, adding an extra bridge to cross the interstate. The second step will be to totally reroute the interstate exits to do away with some dangerous intersections. I love watching the process of a big construction process like this. The amazing organization and coordination necessary to pull things off is very impressive to me. Workers are simultaneously working on totally different aspects to the project on opposite ends, while being completely coordinated with each other. To effectively and efficiently finish the project, thousands of jobs must be done, each in a specific order. Certain jobs are foundational and must be done pr... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=776126 Fri, 03 Aug 2007 10:00:36 +0100 776126 http://www.medworm.com/index.php?rid=765739&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F07%2F29%2Famerican-medicine-free-market%2F In a recent editorial in the Washington Post, Walter E. Williams states: Do we want the government employees who run the troubled Walter Reed Army Medical Center to be in charge of our entire health-care system? Or, would you like the people who deliver our mail to also deliver health-care services? How would you like the people who run the motor vehicles department, the government education system, foreign intelligence and other government agencies to also run our health-care system? After all, they are not motivated by the quest for profits, and that might mean they’re truly wonderful, selfless, caring people. As for me, I would choose profit-driven people to provide my health-care services, people with motives like those who deliver goods to my supermarket, deliver my overnight ma... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=765739 Mon, 30 Jul 2007 03:40:06 +0100 765739 http://www.medworm.com/index.php?rid=714705&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F07%2F05%2Fan-open-letter-to-consultants%2F Dear Consultant: Thank you for agreeing to see my patients. I send them to you with confidence that you can help me in the overall care for them. While I understand that you had a few extra years of training above me, and certainly have extensive knowledge in the area of your expertise (that is why I send people to you in the first place), I would like to share with you a few important points about our relationship. Understanding these things will help you better care for the patients I send your way and will greatly help me get what I want from the consultations I send to you. I am not a moron. I typically try to anticipate what you will do for the patient and order all appropriate tests before sending them to you. There are almost always has been a number of visits and several tests ord... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=714705 Thu, 05 Jul 2007 05:37:55 +0100 714705 http://www.medworm.com/index.php?rid=710277&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F07%2F02%2Fnews-flash-free-care-makes-no-money%2F Conclusions: This large survey of physicians, practicing in ambulatory settings, shows only modest advances in the adoption of email communication, and little adherence to recognized guidelines for email correspondence. Further efforts are required to educate both patients and physicians on the advantages and limitations of email communication, and to remove fiscal and legal barriers to its adoption. The reason for this is obvious: the payment system penalizes good care.  Patients want access outside of the office and want their physicians to spend time with them when they do come in.  How are doctors rewarded for meeting these desires of our patients?  Less pay.  There will never be widespread adoption of technology when adoption of that technology harms those involve... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=710277 Mon, 02 Jul 2007 18:02:08 +0100 710277 http://www.medworm.com/index.php?rid=700703&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F06%2F27%2Fgeneric-gouge%2F The party-line statement for the pharmaceutical industry regarding the high cost of prescription drugs is that a large amount of money is needed for research and development.  From their own website: Significant time and money is needed to researchand develop new, safe and effective medicines.Economists estimate that it takes an average of 12 to15 years to discover and develop a new medicineand, on average, it costs $800 million (Figure 2). On average, only five of every 10,000 compoundsinvestigated are tested in clinical trials. Of those five,only one is ever approved for patient use. Revenuesfrom one successful medicine must cover the costs ofthe vast number of ?dry holes.?   Graphically stated:     So if this is the case, please explain to me the following: Bran... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=700703 Thu, 28 Jun 2007 02:25:32 +0100 700703 http://www.medworm.com/index.php?rid=675465&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F06%2F13%2Fstupid-marketing%2F Holly thinks the drug companies are really dumb. We got this huge box from a drug company advertising a drug that was released simply to extend the patent of a previously successful drug that went OTC and generic (hint: call it Claritin XP - for extend patent).  So she got her evil bunk-detecting eyes (which happens every time she is around something that is wasteful or over-the-top) and motioned for me to open it and see what was on the inside.  Such a big box must have something fantastic inside.  So I opened it. Then she got really disgusted. The “prize” is in a little section of the box marked by the circle and arrows (that Holly nicely included for you). Here is what the whole box was delivering to me: What is it?  It’s a thingy that you ... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=675465 Thu, 14 Jun 2007 00:23:05 +0100 675465 http://www.medworm.com/index.php?rid=675470&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F06%2F06%2Favandia-and-hrt%2F Dr. Nissen is going to be on CBS Nightly News tonight.  He gets to talk to Katie. In truth, I have nothing against Dr. Nissen himself, and my complaints are not about the man, or about the study he did.  My real complaints are against the practice of trying these issues in the public forum.  The practice now makes interpretation of scientific study secondary to running a PR machine to promote or question the legitimacy of a scientific claim.  While this becomes (in my opinion) a fight between those who hate the FDA and Pharma in the public forum and those who defend their practices, the private physicians such as myself are left to actually look at the studies and deal with the emotional aftermath of patients at whom the PR machines are aimed. This whole situation ... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=675470 Wed, 06 Jun 2007 17:16:58 +0100 675470 http://www.medworm.com/index.php?rid=654451&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F06%2F02%2Fbook-review-sick%2F Title: Sick: The Untold Story of America\?s Health Care Crisis?and the People Who Pay the Price Author: Jonathan Cohn Amazon Link: Click Here My Rating: 9 out of 10 Summary: This book summarizes the crisis in American Healthcare. It offers vignettes giving examples for the different areas where the current system is causing financial and/or physical harm to Americans. The vignettes are accompanied by the historical facts as to what has brought on the specific area of crisis. Examples of areas covered in the book: Working Uninsured Managed Care Medicare Medicaid Psychiatric Care Charity Care Public/County hospitals At the end of the book, Mr. Cohn gives his suggestion as to how the situation can be improved. What is good about the book: I think that overall this is a tremendously helpful... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=654451 Sat, 02 Jun 2007 19:00:40 +0100 654451 http://www.medworm.com/index.php?rid=637988&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F05%2F24%2Fthoughts-on-avandia%2F When you read headlines like “Link found between diabetes drug and heart attack risks,” give a sympathetic thought  toward offices like mine. A recent article in the New England Journal of Medicine raised this possibility for the drug Avandia.  The study, done by Dr. Steven Nissen of the Cleveland Clinic, is a meta-analysis of previous studies done on the drug.  From MedPage Today: CLEVELAND, May 21 — A meta-analysis of data from 42 clinical trials found a 43% increase in relative risk of myocardial infarction among type 2 diabetics treated with rosiglitazone (Avandia). The odds ratio for MI was 1.43 (95% confidence interval 1.03-1.98, P=0.03), said Steven E. Nissen, M.D., of the Cleveland Clinic, lead author of the meta-analysis, which was released on... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=637988 Thu, 24 May 2007 17:24:15 +0100 637988 http://www.medworm.com/index.php?rid=612024&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F05%2F16%2Famerican-dysfunctional-medicine%2F I am really frustrated.  I have a patient with significant chronic pain for whom I am trying to prescribe long-acting narcotic pain medications.  The reason you prescribe longer acting pain medications (like Fentanyl patches, MS Contin, or OxyContin) is to decrease addiction.  These medicines are to be used on a scheduled basis to help prevent pain from coming (or significantly decrease it).  Proper use of these medications can greatly decrease the use of short-acting pain medications (like Lorcet or Percocet) which are much more associated with addictive behavior. For those who do not know, there is a difference between addiction and dependency.  While you often hear the terms used interchangeably, addiction generally refers to a pattern of behavior where a pers... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=612024 Thu, 17 May 2007 22:19:57 +0100 612024 http://www.medworm.com/index.php?rid=601915&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F05%2F09%2Famerican-medicine-is-p4p-evil%2F Conclusion It may sound like I have “drunk the Kool-Aid” for P4P. I understand the shortcomings of the current P4P systems, I just do not think that the argument about the changes needed in our system is being carried out with much thought. It is easy to criticize the ideas of others; it is far harder to defend your own ideas. All I hear from physicians on the whole P4P discussion is criticism and very few ideas. Here are my thoughts on this whole issue: The current system is terrible. It is unfairly paying physicians - rewarding bad care and penalizing those who try to do the right thing. The current system needs changing. Pay for performance is not “the answer” for the problem, but any solution must take quality of care into the reimbursement formula. We need to ... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=601915 Thu, 10 May 2007 13:20:22 +0100 601915 http://www.medworm.com/index.php?rid=587887&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F05%2F02%2Famerican-medicine-play-nicely%2F I have written much about what is wrong with the American healthcare system.  Many of the problems, I believe, are systemic.  Change the system, and there are many problems that will go away.  Today, however, I encountered a problem for which there are no solutions. Human nature. Our practice has been very involved in working on the cutting edge of change.  We were early adopters of EMR, blazing a trail for many who have followed.  We have struggled hard to make a system that works better within the current payment system and have largely succeeded.  We are in the top quartile of pay among primary care physicians and have done so while achieving a quality of care that surpasses that of most other offices.  We have been recognized nationally for both our u... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=587887 Thu, 03 May 2007 01:39:35 +0100 587887 http://www.medworm.com/index.php?rid=572898&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F04%2F26%2Famerican-medicine-no-representation%2F I should be in Washington, DC today. I was asked to co-chair a task force for the National Governor’s Association regarding privacy in sharing medical records.  It was a great honor to be asked, and I greatly enjoyed my first two months’ involvement.  It seemed that the perspective of a practicing physician was not something people were used to, and I was able to greatly help the direction of the task force - doing a task that is of utmost importance. I had to step down. Why?  There are several reasons for this, but one of the main reasons is that I cannot afford the time off to serve.  I was required to take 1-2 days off of my practice each month to serve on this task force.  The problem is that each day I take away from my practice, I lose money;&nbsp... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=572898 Thu, 26 Apr 2007 16:50:40 +0100 572898 http://www.medworm.com/index.php?rid=564717&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F04%2F23%2Famerican-medicine-the-death-of-primary-care%2F   Primary care is dying.  If and when it does, will anyone notice?   In a paper entitled: “The Impending Collapse of Primary Care Medicine and Its Implications for the State of the Nation’s Health Care: A Report from the American College of Physicians.”  the following observations are made: Too Few Physicians Are Going into Primary Care The demand for primary care is increasing, while at the same time there has been a dramatic decline in the number of graduating medical students entering primary care Over the past several years, numerous studies have found that shortages are occurring in internal medicine. vii viii ix x xi xii Factors affecting the supply of primary care physicians, and general internists in particular include excessive administrative ha... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=564717 Mon, 23 Apr 2007 15:52:19 +0100 564717 http://www.medworm.com/index.php?rid=530930&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F04%2F09%2Famerican-medicine-perverse-incentives-hold-the-mayo%2F In a recent Op. Ed. in the Wall Street Journal, John Goodman, president of the National Center for Policy Analysis compares the American healthcare system to the American education system: Our public-school system and our health-care system may seem as different as night and day. Yet both systems share something in common: Mediocrity is the rule and excellence, where it exists, is distributed randomly. In both cases the reason is the same. There is no systematic reward for excellence and no penalty for mediocrity. As a result, excellence tends to be the result of the energy and enthusiasm of a few individuals, who usually receive no financial reward for their efforts As a physician who has railed against the systemic problems for years, these two opening paragraphs were like the sound of ... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=530930 Mon, 09 Apr 2007 21:00:12 +0100 530930 http://www.medworm.com/index.php?rid=483536&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F03%2F19%2Fa-simple-solution-to-the-healthcare-crisis%2F I know it. You know it. Harvard guys are just smart. Dang smart. So I figure that when a guy from the “Big-H” puts his mind to solving healthcare, it is done with the grace of a Michael Jordan slam dunk. He just makes it look easy. Hmmm… Harvard economist proposes team approach on healthcare Focus would shift to central services By John Donnelly, Globe Staff | March 14, 2007 WASHINGTON — A renowned Harvard economist unveiled a plan yesterday to revamp the US healthcare system by focusing on the value of care to patients, arguing that improving the quality of medical services can by itself save money and provide a road map to a national health plan. Michael E. Porter , a specialist in competition and strategy at Harvard Business School , said that doctors should wo... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=483536 Tue, 20 Mar 2007 01:54:40 +0100 483536 http://www.medworm.com/index.php?rid=478786&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F03%2F12%2Famerican-medicine-the-income-gap%2F I have to make a confession. I am bitter. I know this may sound strange for those who know my usual laid-back demeanor, but I am really frustrated with how it seems my profession is under-valued. What I am talking about is the widening salary gap between primary care physicians and specialists. The Problem In a recent article in the Annals of Internal Medicine they discuss this gap (emphasis mine): A large, widening gap exists between the incomes of primary care physicians and those of many specialists. This disparity is important because noncompetitive primary care incomes discourage medical school graduates from choosing primary care careers. The obvious question is: what is the big deal with this?  The article goes on: Does this income gap matter? Yes. Although income... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=478786 Tue, 13 Mar 2007 01:40:46 +0100 478786 http://www.medworm.com/index.php?rid=478791&cid=t_102801_123_f&fid=34879&url=http%3A%2F%2Fdistractiblemind.ambulatorycomputing.com%2F2007%2F03%2F07%2Famerican-medicine-p4-what-you-will%2F The payment system in the US is complex. There are multiple payers, uninsured patients, concierge care, CMS, e/m coding, CPT, ICD-9 (soon to be 10), EMR, CPOE, and a multitude of other nuances that make the alphabet soup of American medicine. Confused by it all? You are not alone. It seems that solutions to the current mess just make the situation more of a mess. Perhaps the hottets topic in medicine is Pay for performance (P4P). While P4P has gotten lots of attention, as well as taking much fire from critics, it is not the only way to pay physicians. To help you through the quagmire I have set up a table of some of the more common forms of payment: Acronym What it stands For What it looks like in Real Life Pay P4P Pay for Performance Paying money to doctors for meeting certain “... Musings of a Distractible Mind blogs http://www.medworm.com/rss/comments.php?id=478791 Wed, 07 Mar 2007 13:01:11 +0100 478791