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July 7, 2008
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IN
THIS ISSUE
Editor's Column:
Asking The Right Questions
Docs Push Senate On Medicare
Dr. Bush Supports DWCHA
Health Authority Works On FQHCs
WSUSOM Goes Smoke-Free
Dr. Uberti Named WSUSOM Hematology-Oncology
Chief
Joint Commission Recognizes Oakwood
HFHS Doc Elected To National
Transplant Board
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Editor's
Column: Asking The Right Questions
By
JOSEPH WEISS, MD
A feature of the present pay-for-performance determinations is the
patient questionnaire.
Asking
if the waiting room décor was pleasant, the magazines clean
and up to date, the receptionist accommodating, the phlebotomist
sensitive to your pain, are tangential to quality of care.
Other questions, such as whether or not the doctor instructed
you in a good diet or laid out an exercise program, often
are not pertinent to the problems the doctor and patient
face.
The
answer to the question of recommending the doctor to family
or friends could be little more than a reflection of the
patient’s mood at the moment.
The
inquiry that best reveals the quality of care is: Can the
patient see the doctor? This inquiry ratchets down to the
basic element in the patient-physician relationship: contact
when the patient experiences the need.
That
answer provides a sampling of the philosophy and management
of the physician’s office. The ability of the patient to
obtain a timely appointment reflects the attitude of the
staff and their sensitivity to a patient’s need. The likelihood
of a patient being seen when the patient feels an appointment
is important reveals the way the physician believes he
or she should fulfill their responsibility to the patient.
Throw
out the questions that deal with the cleanliness and expected
manners of the office. Focus on the question of being seen.
The answer reveals what a health insurance company should know
about the physician being reimbursed.
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Docs
Push Senate On Medicare
Congress
returns to work this week and will work for a resolution
10.6 percent Medicare cuts
overturned by a House vote and not taken up by the Senate.
President Bush has threatened to veto the House-passed
bill negating the cuts, urging the Congress to come up
with another solution, reported the New York Times.
The American
Medical Association embarked on a massive
advertising and public relations effort last week to
stave off the cuts.
How
to pay doctors through the federal health
insurance program is an issue that Congress
wrestles with annually. There is widespread agreement that
the so-called “Sustainable Growth Rate” formula used to
determine physician reimbursement is outdated and in need
of change, but there is little agreement on a replacement.
According
to the New York Times, Democrats need just one more vote
to pass the bill, and they hope to win over Republicans
who were hit by advertisements over the recess. The advertisements
assert that Republicans have been protecting “powerful
insurance companies at the expense of Medicare patients’ access
to doctors.” The commercials were aimed at 10 Republican
senators, including seven up for election this fall.
The
threat of a Bush veto could extend the disagreement and
its resolution for weeks, reported the Times.
Many
Republicans oppose the bill because it would create an
increase in doctors’ fees by reducing federal payments
to insurance companies that offer private Medicare Advantage
plans as an alternative to the traditional government-run
Medicare program, reported the Times.
The
pending bill offers yet another in a long line of short
term fixes. It would remove the 10.6 percent cut and increase
Medicare payments to doctors by 1.1 percent in January,
similar to patch fixes enacted in recent years
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Dr.
Bush Supports DWCHA
"We
live in challenging times," notes Chris Bush, MD,
the newly elected president of the Wayne County Medical
Society. "Michigan, especially the Detroit area, is
in a crisis. Not only is it straining families day-to-day
health care, it's affecting the hospitals." Dr. Bush,
a member of the Health Authority's Provider Advisory Committee,
says one of his goals as president of the medical society
is "enhance our involvement with the Health Authority
to promote better health care coverage of the population."
Dr. Bush is doing his part in helping meet the needs of the uninsured.
As founder of Wyandotte Clinic for the Working Uninsured, he feels
a need to "give something back to the people of this community." The
struggle to maintain a profitable medical practice makes it difficult
for Dr. Bush to accept people unable to pay for their care. However,
together with volunteer physicians, nurses, podiatrists, and other
health professionals, he sees uninsured patients on Wednesdays, 4
p.m. to 7 p.m. and on Saturdays during busy periods. The clinic is
affiliated with Henry Ford Health System.
Dr. Bush, a graduate of the Wayne State University School of Medicine,
is a past member of the Michigan State Medical Society Board of Directors,
and currently serves as Secretary of the society.
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Health
Authority Works On FQHCs
It
was a breakthrough moment, of sorts. Every federally-qualified
health center (FQHC) chief executive officer met with Detroit
and Wayne County Medicaid qualified health plans at
the Health Authority offices, June 20, to talk about directing
more Medicaid HMO members to the health centers. Representatives
from the Michigan Department of Community Health included
Cheryl Bupp, Director of the Managed Care Plan Division,
Medical Services Division; as well as Bill Hart and Bob
Esdale, of the Bureau of Health Policy Planning and Access
to Care.
Increasing the volume of Medicaid patients in FQHCs is critical to
creating the financial infrastructure allowing the health centers
to absorb more uninsured patients. The Health Authority has focused
on increasing enrollment of Medicaid patients and directing them
to FQHCs as an essential first step in providing more access
points for the uninsured.
The FQHCs indicated that they would be able to accommodate 60,700
new Medicaid patients. QHP executives stated that they were willing
to direct patients to FQHCs but that there are several obstacles,
including: A sound framework would need to be created to begin an
FQHC assignment system.
The group agreed that a framework for this effort would include criteria
for quality, cost-effectiveness, access and care for the uninsured.
The group will start by reviewing state criteria in these areas.
Considerations such as geography and contracts should also be included
in the criteria.
The group agreed to create a smaller workgroup to work between meetings
and present recommendations for the next meeting. The group will
meet next on Aug. 7.
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WSUSOM
Goes Smoke-Free
Students,
staff and visitors to the Wayne State University School
of Medicine will no longer be allowed to smoke on any campus
grounds starting this summer.
Wayne
State University officials have approved a complete no-smoking
policy for the School of Medicine campus.
The
smoking ban takes effect July 7, 2008. On that date, smoking
will no longer be allowed anywhere on the School of Medicine
campus, including areas inside and outside of Scott Hall,
the Lande Building, the Elliman Building, the Mott Center,
and facilities at 101 East Alexandrine, 110 East Warren
Ave., 2751 East Jefferson and 2761 East Jefferson.
One
of the last refuges for smokers was a designated outdoor
area adjacent to Scott Hall. That area will be eliminated
and off limits to smokers under the new policy.
Chuck
Pokriefka, director of facilities and support services
for the School of Medicine, said posters and signs indicating
the campus no longer allows smoking will be posted in a
number of areas, including those where smokers generally
congregated. A poster counting down the days to the policy’s
implementation will be located in the lobby of Scott Hall.
Employees were notified via email and a notice accompanying
paychecks. Students were notified of the policy through
email and a posting on the school’s website.
The
no-smoking policy was recently approved by the Wayne State
University Provost and the university’s general counsel,
said Dr. Kertia Black, assistant dean for Student Affairs
and chairwoman of the Smoking Ban Committee of the Wayne
State University School of Medicine.
Dr.
Black said the policy was developed in response to a petition
drive conducted last year by the School of Medicine Student
Senate to ban smoking on the entire School of Medicine
campus.
Joseph
Burkett, Student Senate executive president and a proponent
of the petition drive, said 1,300 signatures supporting
a complete smoking ban were collected.
As
medical students, “we learn about the ill effects of smoking
every day,” said Burkett, 25, of Dearborn. “It was an inconvenience
before, but once the Detroit Medical Center became a non-smoking
campus, there were just too many smokers in front of the
entrance of the medical school, around the library and
at our picnic tables to allow it to continue.”
To
enforce the no-smoking policy, a cadet will patrol the
campus grounds. The cadet will remind any potential breakers
of the policy that they are in a no-smoking area.
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Dr.
Uberti Named WSUSOM Hematology-Oncology Chief
John
Flack, M.D., M.P.H., F.A.H.A., chair of the Department
of Internal Medicine, has announced the appointment of
Joseph P. Uberti, M.D., Ph.D., as division chief for Hematology-Oncology
in the Department of Medicine at the Wayne State University
School of Medicine.
Dr.
Flack said Dr. Uberti’s appointment culminates an exhaustive
national search.
A
professor of Medicine since 2004, Dr. Uberti heads the
Adult Bone Marrow Transplant Program and co-directs the
Bone Marrow and Stem Cell Transplant Program at the Barbara
Ann Karmanos Cancer Institute.
Dr.
Uberti attended Wayne State University as an undergraduate,
securing a bachelor’s degree in biology and a doctorate
in biochemistry. He graduated the Wayne State University
School of Medicine in 1983. He served as chief medical
resident at Detroit Receiving Hospital from 1986-87. Dr.
Uberti completed his fellowship in Hematology-Oncology
at Wayne State University/DMC from 1987 to 1989. Since
completion of his training he has, at different times,
been on the faculty of both Wayne State University and
the University of Michigan.
“I
have the utmost confidence that Dr. Uberti will do an exemplary
job as chief of the Division of Hematology-Oncology,” said
Dr. Flack. “He understands the Department of Medicine and
the Cancer Center, as well as the crucial interface between
these two entities.”
Dr.
Flack said that Dr. Uberti, in addition to maintaining
a deep loyalty to the School of Medicine, is highly respected
both within the Division of Hematology-Oncology as well
as throughout the Department of Medicine, the medical center
and the medical community. “I have long admired and respected
Dr. Uberti for his honesty, integrity and clinical excellence.
I feel very fortunate that the combined efforts of the
Wayne State University School of Medicine, the Department
of Medicine and the Barbara Ann Karmanos Cancer Institute
culminated in landing Dr. Uberti to lead the Division of
Hematology, the largest division within the Department
of Medicine.”
John
Ruckdeschel, M.D., president and CEO of the Barbara Ann
Karmanos Cancer Institute, said, "Joe Uberti will
make an outstanding division head. He understands the delivery
of high quality care and its constant interface with research
and education. He has helped lead one of the premier bone
marrow transplant programs in the country and we look forward
to his role in the cancer center as chief of the Hematology-Oncology
Service."
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Joint
Commission Recognizes Oakwood
Oakwood
Hospital & Medical Center (OHMC) in Dearborn and Oakwood
Heritage Hospital (OHH) in Taylor have recently been
recognized for excellence in quality and safety by The
Joint Commission – the nation’s leading accrediting body
dedicated to the continuous improvement of safety and
quality in a healthcare setting. Both Oakwood campuses
received the Gold Seal of Approval after successfully
completing The Joint Commission’s on-site survey in June.
“Oakwood’s
success thus far is proof of an organization-wide commitment
to provide quality care on an ongoing basis,” said Michael
Geheb, MD, division president of OHMC and OHH. “I am
extremely proud of our physicians, employees and volunteers
who each played a significant role by participating in
the survey and interacting with the entire team of surveyors.”
According
to the Joint Commission, the national standards are intended
to stimulate continuous, systematic and organization-wide
improvement in an organization’s performance and outcomes
of care. Participation in this process shows an organization
is focusing on the most challenging goal – to continuously
raise quality and safety to higher levels.
For
more information on either OHMC or OHH, visit www.oakwood.org.
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HFHS
Doc Elected To National Transplant Board
Kimberly
A. Brown, MD, division head of Gastroenterology for Henry
Ford Health System, was elected to the 2008-2009 board
of directors of The American Society of Transplantation.
The Society is an international organization of transplant professionals
dedicated to advancing the field of transplantation through the promotion
of research, education, advocacy, and organ donation to improve patient
care. The Society comprises more than 2,800 transplant physicians,
surgeons and allied health professionals.
Dr. Brown is an active physician with specialty expertise in hepatology
and liver transplantation. She is the Program Director for the Gastroenterology
fellowship program at Henry Ford Hospital and serves on the Board
of Governors for the Henry Ford Medical Group.
As a national and international presenter in liver diseases, Dr.
Brown has served on the boards of many community and professional
societies, and currently is a member of the American Board of Internal
Medicine for Advanced Hepatology and Transplantation.
Dr. Brown completed her residency and Gastroenterology fellowship
at the University of Michigan Medical Center and joined the Henry
Ford Medical Group 14 years ago.
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