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Latest Posts

Patient Follow-Up: What Doctors Can Learn From Dentists

I have to give my dentist credit. He and his staff know when I am due for a cleaning and call me to schedule an appointment without fail. They also call to remind me the day before an appointment. Many dentists, I understand, do similar kinds of things for their patients.

As a patient, I like being reminded — it’s a great service. I also like the fact that someone’s looking out for me. From a business perspective it makes a lot of sense as well. Fewer “no shows,” more cleanings, more billings, and so on.

It’s too bad that more physicians don’t routinely follow up with their patients, particularly when it really counts. Read more »

*This blog post was originally published at Mind The Gap*

How To Reduce Hospital Readmission Rates In Poor Cities

The Philadelphia Inquirer had an interesting piece Monday about a successful initiative in Camden, NJ (one of the poorest cities in the U.S.) that has dramatically reduced ED visits and readmissions. Among other things, a coalition of primary care providers has banded together to get more patients to see PCPs instead of going straight to the ED. (Appropriate patients are referred from the ED to these providers, for eg). Open-access scheduling, electronic prescribing and chronic disease registries also further the goal of preventive medicine that keeps patients from getting to the point where they need to go to the ED, or need to be admitted to the hospital.

The result? Monthly ED visits down by 32%, hospital admissions–and charges–down by 56%. Read more »

*This blog post was originally published at ACP Hospitalist*

Legislating to Reduce Readmissions – Safety Net Hospitals Will Be Cut First

According to MedPAC, 18% of hospitalizations among Medicare beneficiaries resulted in readmission within 30 days, accounting for $15 billion in spending. Since treatable chronic illnesses are responsible for many such hospitalizations, it is assumed that they represent failures of the health care system. MedPAC claims that 84% of readmissions are potentially preventable. However, as will become evident, most readmissions reflect differences in co-morbidities, poverty and other social determinants, all of which deserve attention, including better transition care, but few of which are under the control of hospitals. Nonetheless, health care reform assumes that regulators can accurately adjust for such risks and estimate the “excess.”

Both the House and Senate bills include reductions in payments to hospitals with “excess” readmissions. Payment would be reduced 20% for “excess” readmissions within seven days and 10% within fifteen days. Hospitals with 30-day risk-adjusted readmission rates above the 75th percentile would incur penalties of 10-20%, scaled to the time to readmission. Read more »

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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