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January 8, 2007 |
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IN THIS ISSUE
Editor's Column:
Playing Monopoly MSMS-Style
What You Don't
Know Can Hurt Them
Disparities
Conference Announcement
Childeren's Hospital Named
Among Best
Cancer Center Gets Boost
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Editor's Column:
Playing Monopoly MSMS-Style
By JOSEPH WEISS, MD
As my
November editorial indicated, I was skeptical when MSMS stated
it would challenge BCBS’ acquisition of M-CARE . The contention
by MSMS, and it’s a good one, is that that the purchase gives
BCBS a monopoly in health insurance. That monopoly is unfair to
people looking for health insurance and threatening to
physicians who contract to provide services for BCBS.
My skepticism did not come from doubts over the MSMS
perspective. I thought that the Blues, with a roster of 4.5
million Michigan subscribers, had their monopoly already. What
would the 289,000 additional M-CARE subscribers mean to the
state insurance commissioner’s office when it reviews the
M-CARE/BCBS deal?
I am wrong. MSMS, through its law firm Kerr, Russell and Weber,
has mounted an impressive argument against that acquisition.
Intensive research by Kerr, Russell reveals that economic
measures exist to determine the degree of monopoly power the
M-CARE acquisition would give BCBS, particularly in the PPO
market. The analysis indicates the result for BCBS is a monopoly
of the highest concentrated level.
The MSMS brief to the insurance commissioner goes further. The
brief states that if the Insurance commissioner should allow the
acquisition the following shall apply: approval be conditioned
on granting participation for any licensed Michigan physician,
contracts between BCBS and physician pertain only to network
under contract, dropping a physician from a network be limited
to the conditions set for allowing participation, each
participating physician receive a schedule of fees in detail
and, finally, unilateral amendment of a contract be limited to
clerical matters only.
The work going into this MSMS brief and the thought contained
within it is a tribute to the state organization. We should be
pleased for the value our dues give us. We can be proud that the
organization we depend on is not just supporting us but
advancing the cause of all physicians in Michigan.
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What You Don't Know Can Hurt Them
By SOPHIE WOMACK, MD
WCMSSM President-Elect
One of the major contributors of rising health care costs in
southeast Michigan is the disparities in health care experienced by
underserved populations. As the demographics of the country have
changed, so have patient profiles. Culture shapes beliefs, behavior
and values. A physician who is unaware of the ways in which culture
impacts health is only treating one dimension of the patient.
There are many factors that contribute to health care disparities,
racial discordance has been identified as one factor. Approximately
92 percent of Michigan's physicians are either Caucasian or
Asian/Pacific Islander (within this subcategory we suspect that they
are primarily Eastern Indian). This statistic translates into a
majority of cross-culture patient/provider dyads among underserved
populations.
Cultural competency is an emerging tool for addressing health care
disparities. An understanding of cultural tenets, health seeking
behaviors and healing practices aids in obtaining more qualitative
health histories and diagnoses. Gaining insight regarding our
patients' explanatory models for disease and disorders provides
vital information. Seek opportunities to ask the following
questions:
1. What do you think caused your problem?
2. Why do you think it started when it did?
3. What do you think your sickness does to you?
4. What are the chief problems your sickness has caused you?
Although not formally recognized, curanderos, shamans and faith
healers are our partners in the provision of health care. Teas,
oils, liniments and vinegar are supplements to the prescription
drugs we prescribe. Culture travels. Underserved populations bring
their cultural body of knowledge and shared beliefs and
understanding regarding health and wellness with them to the
physician office visit. Culture often dictates how patients respond
to treatment of health issues.
Becoming better informed regarding how cultural beliefs impact
health may result in greater adherence to treatment plans, better
patient satisfaction and ultimately improved outcomes.
A conference will be held January 24, 2006 at the Charles Wright
Museum of African American History. Dinner and CME will be provided.
A formal invitation will follow. See announcement below.
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Disparities Conference Announcement
MPRO -- Michigan's Quality
Improvement Organization and the Wayne County Medical Society in
collaboration with Blue Cross Blue Shield of Michigan present a
Continuing Medical Education Program:
2007 Health & Health Care Disparities Physician Conference:
Quality Improvement Strategies for Crossing the Cultural Divide
Wednesday, January 24, 2007
5 - 8:30 p.m.
At the Charles H. Wright Museum of African American History
In the Ford Freedom Rotunda
315 E. Warren Ave., Detroit, MI 48201
Purpose and Intended Audience
The purpose of this program is to update medical providers and other
healthcare professionals on the need to reduce health care
disparities in Michigan. Some of the strategies will focus on
cultural competency and health literacy in the clinical arena.
Issues related to cross-cultural relationships between patients and
their physician providers and their impact on compliance and
outcomes will be included. With the growing demographic changes in
the USA, the increased incidence of health care disparities is
affecting health care quality, patient safety and health outcomes.
Conference Presenters Include:
John Flack, MD, MPH
Wayne State University
Interim Chair- Department of Internal Medicine
Hugo Alvarez, MD
Access Community Health Network, Chicago
Mary "Toni" Flowers, RN, BA
MPRO
For additional information or to register, please call Nancy
Tadajewski at
(248) 465-7318 or e-mail
ntadajew@mpro.org.
Space is limited to the first 200 attendees. There is no cost for
this program.
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Child Magazine recently dubbed
Children's Hospital of Michigan as one of its top 40 providers of
pediatric health care in the United States.
Children's ranked 27th on the magazine's annual list, which will be
published in the February issue available on news stands Jan. 9.
The magazine spent almost a year compiling the data for the list.
Among the criteria for candidates was completing a 247-question
survey that asked for information such as survival rates, the number
of complex procedures and intricate surgeries conducted and steps a
facility takes to ensure a patient receives error-free care.
"Children's is the first and most experienced
hospital in Michigan created 120 years ago just for kids. With the
backing and expertise of our inspired healthcare team of pediatric
medical and surgical specialists, we have provided advanced
pediatric care to millions of families," stated Dr. Herman Gray,
president of Children's Hospital. "It's rewarding to be nationally
recognized for the work that we do everyday to ensure that every
child gets the best care possible."
To view the list of the top 10
children's hospitals in the country, visit Child Magazine at
http://www.child.com/child/story.jhtml?storyid=/templatedata/child/story/data/1130522345565.xml
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Cancer Center Gets Boost
Today, Hearts of Livonia President
Tom Celani will present a donation of $255,000 to St. Mary Mercy
Hospital, Livonia, Michigan, earmarked for the hospital’s new Cancer
Center, slated to open in August 2007. The Hearts of Livonia was
established in 1978 to provide support for emergency equipment at
St. Mary Mercy Hospital and has been dedicated to giving back to the
community. Started by Tom Celani’s father, Ben Celani, its
fundraising efforts have been supported by the Hearts of Livonia Ben
Celani Golf Outing, the longest running charity golf benefit in
Michigan (30 years.)
The St. Mary Mercy Cancer Center will offer comprehensive treatment
and services to cancer patients in an innovative and coordinated
fashion using the latest technology and a multidisciplinary team
approach. The new facility has been designed to treat the body,
mind, and spirit through advanced diagnostic procedures and
personalized wellness therapies.
The donation from the Hearts of Livonia, a Livonia-based community
charitable organization, will provide resources in support of cancer
care, specifically for the “Hearts of Livonia Infusion Center,” a
key component of the new Cancer Center.
St. Mary Mercy Cancer Services is an accredited Community Hospital
Cancer Program by the American College of Surgeons Commission on
Cancer. This certification demonstrates the dedication and
commitment of the cancer providers at St. Mary Mercy Hospital, as
well as the quality of cancer care available.
The Cancer Center will include:
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Infusion Services * “Hearts of
Livonia Infusion Center”
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Exam and treatment rooms
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Physician offices
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Radiation Therapy with the latest
in radiation oncology equipment
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Image Recovery Center with
complementary therapies such as counseling, massages, wigs, and
more Cancer Resource Education computers for patient and family
use
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