January 8, 2007

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.

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.

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.

Children's Hospital Named Among Best

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

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:

Infusion Services * “Hearts of Livonia Infusion Center”
Exam and treatment rooms
Physician offices
Radiation Therapy with the latest in radiation oncology equipment
Image Recovery Center with complementary therapies such as counseling, massages, wigs, and more Cancer Resource Education computers for patient and family use

This publication brought to you by Natinsky Publishing Network.

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