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April 21, 2008
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IN
THIS ISSUE
Editor's
Column: Ask Not For Whom The Budget Tolls, It Tolls For
Thee
WSUSOM
Lays Off Docs, Calls In Expert In DMC Dispute
Children's
Hospital Awarded 'Magnet Status'
Mercury Spills
Pose Danger In Physician Offices
Henry
Ford Hospital Doc To Head National Group
Comedy
Castle Night To Benefit Infant Mortality Program
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Editor's
Column: Ask Not For Whom The Budget Tolls, It Tolls
For Thee
By
JOSEPH WEISS, MD
Physicians are likely to agree as to why the cost of medical
care continues to rise. Technology compounded by longevity
makes spiraling expense inevitable.
Now comes the New England Journal of Medicine to the rescue.
In its April 3, 2008 issue the editors present: Options
for Slowing the Growth of Health Care Costs (pp. 1509-1514).
The article presents 12 ways to control health expenses,
but the list really provides the medical community with
12 cliches that are best ignored if the country is to achieve
rational health care financing.
The authors give the highest priority to capitation and pay-for-performance.
Physicians know that capitation restricts patients to an
extent unacceptable to Americans. Pay-for-performance is
not intended to save dollars, as the concept is based on
benefits not cost control.
The other cost savers include strategies such as electronic
medical records, case management of patients with chronic
disease, health savings accounts, and enhanced preventive
medicine counseling. All these measures combined are unlikely
to counter the effect that technology and aging exert on
driving up the cost of care.
The designs for savings the NEJM presents come from
business models or the discussions among think tank leaders
in Aspen and Palo Alto. We need a different approach. We
should look to what MSMS is doing now: convening doctors
to design basic insurance coverage, that is, to answer
what should health care cover for the individual? When
we have defined appropriate coverage, then we can determine
the funds needed to provide that coverage. Until we know
what expenditures are in order, we have only the weak efforts
to brake expense that the NEJM offers.
The reasons for the cost of care comes from us, the answers
to controlling these expenses will also come from us.
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WSUSOM
Lays Off Docs, Calls In Expert In DMC Dispute
The
Wayne State University School of Medicine is continuing
with plans to lay off an as yet undisclosed number of physicians,
reported the Detroit News Friday.
The
layoffs come as part of a dispute regarding $10 million
to $12 million in payments to WSU doctors from the DMC
for services provided to Medicaid patients. The DMC says
WSU physicians are receiving other state money that makes
the DMC payments redundant and resulting in physicians
receiving double payment. WSU argues that the state budget
money is similar to that received by other organizations
and even when it is combined with the DMC payments it comes
up short of market value for physician reimbursement.
The
parties met Friday, reported the News, and have agreed
to bring in an independent expert. There is an apparent
delay in the selection process for the expert, but WSU
officials are reportedly bringing in an independent expert
termed a ‘valuator’ despite the lack of an agreement on
the matter with the DMC.
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Children's
Hospital Awarded 'Magnet Status'
The
American Nurses Credentialing Center (ANCC) has awarded
DMC Children’s Hospital of Michigan Magnet designation
for excellence in nursing. Recognized as one of the highest
distinctions a hospital can receive, only 288 or less than
5 percent of all US hospitals have achieved this status.
The designation is valid for four years.
“This
is an outstanding achievement for Children’s Hospital of
Michigan,” says Herman Gray, MD, president, Children’s
Hospital of Michigan. “Magnet status is awarded only to
hospitals that exceed professional standards in nursing
practice, leadership, education and research, and are able
to document them. So this is truly a momentous achievement
in the long and storied history of Children’s Hospital.”
“The
designation is public recognition that Children’s provides
quality patient care, promotes nursing excellence, and
encourages innovations in professional nursing practice.
It is considered the gold standard in nursing and is the
highest level of recognition possible from the ANCC,” said
Rhonda Foster, EdD, MPH, MS, RN, vice president of patient
care services at Children’s Hospital. “We’ve always known
that our nurses are among the best in the country, this
designation simply affirms their work and dedication to
patient care.”
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Mercury
Spills Pose Danger In Physician Offices
Editor’s
note: The following is an alert from the Michigan Department
of Community Health. It was forwarded to WCMSSM by James
Blessman, MD, MPH, medical director, Detroit Department
of Public Health and Wellness Promotion, with the suggestion
that medical societies work to get mercury out of physician
offices.
The
Michigan Department of Community Health Division of Environmental
Health has responded to two large mercury spills (more
than one pound, which is about two tablespoons) in medical
clinics within the last month. The spills were caused
by broken mercury sphygmomanometers (blood pressure devices),
causing evacuation of the buildings, employee medical testing,
closure of the clinics until cleanup was complete, and
thousand of dollars in cleanup costs. Mercury is
a neurotoxin. Short-term (several hours) exposure
to high levels of mercury vapor can cause irritation of
the eyes, nose, throat and lungs, nausea, vomiting, diarrhea
and skin rashes. Mercury spilled on a hot surface, such
as a stove or heater, can quickly produce high concentrations
of mercury vapor that can lead to death. Extended
exposure to lower levels of mercury vapor can cause brain
damage, memory loss, tremors, numbness in the fingers and
toes, mood changes and kidney damage. Poison Control
Centers have reported treating people, most often children,
who showed symptoms after being exposed to mercury from
broken fever thermometers or other sources. MDCH
urges medical providers and the general public to replace
mercury containing devices with those that do not contain
mercury. For more information, contact MDCH at 1-800-648-6942.
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Henry
Ford Hospital Doc To Head National Group
The
incoming president of the prestigious American College
of Cardiology says the current state of health care costs
are unsustainable, despite medicine’s technological innovations
and treatment advancements.
“We
have been working harder, seeing more patients, providing
newer and more testing and treatment options. This just
simply cannot continue. We now have to focus on value,” said
W. Douglas Weaver, MD, division head of Cardiovascular
Medicine at Henry Ford Hospital, who was installed as president
of the American College of Cardiology on March 31. The
presidency is a one-year term.
In
the coming year, Dr. Weaver expects to continue the ACC’s
push for national health care reform. By 2010, health care
is projected to cost $2.7 trillion – a 30 percent increase
since 2004, he says.
“The
increased cost of health care will soon result in health
care becoming unaffordable for the lower middle class.
It could reduce the standard of living for retirees and
reduce state spending for education in order for states
to keep up with the rising costs of state health and pension
benefits,” Dr. Weaver said.
Dr.
Weaver says improving patient quality and safety and increasing
the value of medical care is crucial to reforming health
care in the United States, which spends an estimated $500
billion more annually than other industrialized countries.
“To
lower costs and provide more value, we must make health
care more convenient, rely on much more self care and use
only effective technology. Ironically, putting patients
first is the only effective way to increase our respect
and practice viability,” Dr. Weaver said.
The
American College of Cardiology, a 34,000-member nonprofit
medical society, is a leader in the formulation of health
policy, standards and guidelines, and is a staunch supporter
of cardiovascular research. It also provides professional
education and operates national registries for the measuring
and improving quality patient care.
Dr.
Weaver received his medical degree from Tufts University
School of Medicine and residency training at the University
of Washington. He has been at Henry Ford for the past 10
years, and he has clinical interests in cardiac resuscitation,
heart failure and acute coronary syndromes. He has also
published more than 250 articles.
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Comedy
Castle Night To Benefit Infant Mortality Program
13th Annual
Infant Mortality Program
“Night at
Comedy Castle”
Thursday,
May 8, 2008 8 p.m.
Mark Ridley’s
Comedy Castle
269 Fourth
Street
Downtown
Royal Oak
Featuring
“Last Comic
Standing Winner”
Alonzo Bodden
VIP “Gold
Circle” Seating $45
General
Seating $25
Payments
can be made in cash, by check, Visa and Mastercard
All proceeds
go directly to the IMP programs Parent-Infant Partner,
Jubilee Parenting Support Group and Read Write Now.
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