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February 2, 2009
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IN
THIS ISSUE
Editor's Column:
Health Care: Right Or Privilege?
Response: The Debate Is Not So Simple
Doctor And Senator Tom George Ponders Gubernatorial
Run
Dr. Wozniak Named To Karmanos Education
Post
WSUSOM Dean, Faculty Member To Appear
In Web Course
Several SE Michigan, Detroit Hospitals
Among Top In Nation
HFHS Physician Named To National Committee
On Electronic Data
MSMS Connect Is Live: Try A Demo
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Here To Contact Us
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Editor's
Column: Health Care: Right Or Privilege?
By
JOSEPH WEISS, MD
Physicians should no longer waste time listening to or taking part
in debates on whether health care is a right or a privilege. What
the constitution states or does not state on the matter has no bearing.
Access to health care as a right has becomes a part of the
fabric of this nation. People believe that health care
is a right. When the marketplace fails to offer adequate
health care insurance, the populace turns to its elected
representatives to do what is needed to fulfill expectations.
The Association of American Physicians and Surgeons (AAPS)
will fail in its campaign to stop Congress from enacting
health care “reform.” The AAPS is correct when it calls
for vigorous and vigilant lobbying. Congress needs careful
scrutinizing to prevent new legislation that, like the
Sustainable Growth Rate (SGR) formula, can prove to be
a catastrophe for physicians.
However, the AAPS rails against the very idea that government
should intervene in health care; AAPS believes Medicare
represents a takeover of health by the government, and
urges a physician revolt by mass refusal to accept Medicare
as a payer.
Refusing to acknowledge Medicare is not good policy by physicians.
The American public embraces Medicare as a way to obtain
the health care people believe is their right. Where physicians
need to put money and time is into seeking changes in programs
such as the Physicians Quality Reporting Initiative (PQRI)
to make government administration sensible to both government
and physicians.
The medical community should seek to modify excesses of government
participation in health care. However, to expect a complete
end to the presence of government funding and regulation
is a bad read of the American public’s concern on health
care for others and their conception of health care due
for themselves.
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Response:
The Debate Is Not So Simple
By
SUSAN ADELMAN, MD
I agree that the AAPS is wrong to try to oppose any health care reform. The
question of whether health care is a right has always been approached
in too simplistic a manner, however. There is a big difference
between the easy to agree upon position that access to vaccinations
must be a right and the question of whether or not hair transplants
are a right. When you try to tease apart the components of health
care, it all becomes murky. Is health care a right for illegal immigrants?
For the rest of the population, what about sex change operations,
Viagra, cosmetic surgery? What about the right for the elderly to
have joint replacements when medical treatments achieve some palliative
benefit?
There is a danger in quickly agreeing that health care is a
right, and that it is the responsibility of the government Then the
government, as it does in Britain, begins to ration care, claiming
that there is not enough money to pay for everything for everyone.
That is how Britain got age limits on eligibility for organ transplants
and coronary bypass surgery. Suddenly the right to these procedures
has a limit.
Who do we want to decide on which patients have which rights? Is
it the government, or doctors plus their patients? Should rich elderly
who can pay for these procedures, be similarly limited? They will
simply travel to Singapore or India, of course, to get their surgery.
Poor people of course cannot do this. Does the government have the
right to thus discriminate against them? Or do rich people not have
the right to travel abroad for health care?
Do patients have a right to obtain care without long waits? Do they
have a right to choose their doctors? Do they have a right to an
MRI when an X-ray will diagnose their condition 70 percent of the
time, or 85 percent of the time? Think about it. It is not
so simple.
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Doctor
And Senator Tom George Ponders Gubernatorial Run
State
Sen. Tom George (R-Kalamazoo) on Jan. 26 announced he is
considering a run for Michigan’s top elected office, according
to published reports.
Dr.
George would join a quickly crowding field to replace term-limited
Jennifer Granholm in 2010. A partial list of those who
are considering throwing their hats I the ring includes
state Attorney General Mike Cox, Oakland County Executive
L. Brooks Patterson, Lt. Gov. John Cherry and Michigan
State University Trustee George Perles.
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Dr.
Wozniak Named To Karmanos Education Post
The
Barbara Ann Karmanos Cancer Center has announced that Antoinette
Wozniak, MD, professor of Internal Medicine in the Division
of Hematology and Oncology for the Wayne State University
School of Medicine, has been named associate center director
for Education.
This
newly created position will provide oversight to the Graduate
Medical Education Program for residents and fellows, as
well as provide oversight to the various medical and graduate
student educational programs at Karmanos and the Wayne
State University School of Medicine.
Dr.
Wozniak has extensive experience in educational programming,
having served as the leader of Karmanos’ Medical Oncology
Fellowship Program for many years. She is also president
of Karmanos’ Medical Staff.
Due
to her new position, Dr. Wozniak will step down as leader
of the Thoracic Multidisciplinary Team.
Replacing
Dr. Wozniak as the Thoracic Team leader is Shirish Gadgeel,
MD, associate professor of Internal Medicine in the Division
of Hematology and Oncology for the School of Medicine.
Dr.
Gadgeel completed his residency at Wayne State University
in 1996 and was named the outstanding fellow in the division
of Hematology and Oncology in 1997.
Cassann Blake, MD, MPH, was named team leader of the Breast Multidisciplinary
Team, and Zeina Nahleh, MD, was named co-leader.
An
assistant professor of Surgery at the School of Medicine,
Dr. Blake joined Karmanos in 2002 and is co-director of
the Walt Comprehensive Breast Center.
Dr.
Nahleh, an assistant professor of Internal Medicine in
the Division of Hematology and Oncology at the School of
Medicine, joined the Karmanos Cancer Center in 2007. She
is active in clinical research and teaching.
All
are members of the Wayne State University Physician Group.
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WSUSOM
Dean, Faculty Member To Appear In Web Course
Two
faculty members of the Wayne State University School of
Medicine took part in creating a web course that will be
viewed worldwide by cardiothoracic surgeons treating patients
with antiplatelet therapies.
Robert
M. Mentzer Jr., MD, dean of the School of Medicine and
senior advisor to the president for medical affairs; and
Salik A. Jahania, MD, associate professor of Surgery and
associate program director of the Cardiothoracic Residency,
Division of Cardiothoracic Surgery, collaborated in the
webcasting of “The Impact of Antiplatelet Therapy in Cardiac
Surgery: Current Practices, Conundrums and Controversies.” Dr.
Jahania presented for the course, filling in for Dean Mentzer,
who was suffering a bout of laryngitis at the time of taping.
Dean Mentzer developed content for the course.
“The
Web will be used more and more by physicians to share information,” Dean
Mentzer said. “It’s a tool that doctors are tapping into
more frequently, and it definitely helps provide a venue
through which physicians can update their information and
skills without having to incur the costs of travel for
traditional seminars and courses.”
The
course acknowledged that the benefits of dual antiplatelet
therapy in patients with acute coronary syndrome prior
to coronary angiography are proven, and discussed the risks
of excess bleeding should these patients require coronary
artery bypass grafts. The course covered current guidelines
to minimize bleeding risk in these patients.
“The
Web has been increasingly seen as the favored portal for
medical professionals worldwide to seek up-to-date medical
information at the convenience of their time and place,” Dr.
Jahania said. “It is used as a lecture tool, and a lot
of colleges and residency programs routinely use the webcasts
at their weekly conferences instead of actual invited speakers
to disseminate medical information.”
Dr.
Jahania said that while he has not previously participated
in the taping of such courses, he is interested in utilizing
the Web as a medium for education. “I have thought about
using the Web to teach overseas medical students as part
of an outreach effort,” he said.
Robert
W. Emery, MD, editor in chief of the Journal of Heart Valve
Disease and director of Cardiovascular & Thoracic Surgery
at St. Joseph’s Hospital in St. Paul, Minn., served as
course moderator. In addition to Dr. Jahania, the other
presenter is Christopher P. Cannon, M.D., F.A.C.C., senior
investigator of the TIMI Study Group at Brigham and Women’s
Hospital in Boston, Mass.
The
course was developed under the auspices of the Potomac
Center for Medical Education, which is accredited by the
Accreditation Council for Continuing Medical Education.
The course will be available for viewing through Dec. 30,
2009, and can be viewed by registering at http://www.potomacme.org/index.php/online/cabg-2008/.
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Several
SE Michigan, Detroit Hospitals Among Top In Nation
Fourteen
Michigan hospitals are ranked among the top 5 percent in
the nation for clinical quality, according to an item appearing
on the Detroit Medical Center website.
Overall,
270 hospitals across the U.S. earned the 2009 Distinguished
Hospital Award for Clinical Excellence presented by the
health-care rating organization HealthGrades.
"The
hospitals that have been designated as Distinguished Hospitals
for Clinical Excellence have, across the board, been leaders
in their commitment to delivering the highest quality patient
care," HealthGrades senior physician consultant Rick
May said. "Consumers can choose where they receive
their health care and our study again highlights the tremendous
disparity in quality between hospitals."
Michigan
hospitals recognized were:
• Bronson Methodist Hospital, Kalamazoo
• Genesys Regional Medical Center, Grand Blanc
• Hackley Hospital, Muskegon
• Henry Ford Hospital, Detroit
• Henry Ford Macomb Hospital, Clinton Township, including Community Hospital
Foundation in Almont
• Huron Valley Sinai Hospital, Commerce Township
• McLaren Regional Medical Center, Flint
• Munson Medical Center, Traverse City
• Providence Hospital, Southfield
• Saint Mary Mercy Hospital, Livonia
• Sinai Grace Hospital, Detroit
• Spectrum Health Hospitals, Grand Rapids
• William Beaumont Hospital-Royal Oak
• William Beaumont Hospital-Troy
Using
data from Medicare cases, HealthGrades rated hospitals
based on 26 procedures and diagnoses.
The
winning hospitals collectively had a 27 percent lower risk-adjusted
mortality rate and an 8 percent lower risk-adjusted inpatient
complication rate for Medicare patients. If all hospitals
met the performance of the HealthGrades winners, 152,666
lives would have been saved between 2005 and 2007.
(Courtesy
Mark Sanchez of the Business Review Western Michigan)
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HFHS
Physician Named To National Committee On Electronic
Data
Kathleen
L. Yaremchuk, MD, chair of Otolaryngology-Head & Neck
Surgery at Henry Ford Hospital, has been appointed to serve
as a member of the National Quality Forum's Steering Committee
for a project seeking to identify top ambulatory care practices
using electronic clinical data.
The
project will study quality measures for ambulatory care
based on administrative data, enriched by laboratory and
pharmacy data and other electronic clinical data.
The
goal of the NQF project is to provide additional tools
for purchasers, health plans, consumers, clinicians and
other stakeholders working to create more feasible approaches
to ongoing performance measurement and quality improvement.
Funding for this project has been provided by Aetna Foundation,
United Health Foundation, Cigna Foundation, Wellpoint Foundation
and the Pacific Business Group on Health.
Dr.
Yaremchuk is a national expert in quality and managed care.
She is a surveyor for the National Committee for Quality
Assurance of Health Care Organizations and sits on its
Review Oversight Committee. She has led Henry Ford Medical
Group in national and regional pay-for-performance initiatives
and organized HFMG's efforts in HMO contracting and performance
management. She also pioneered the HFHS vendor policy,
which has been adopted by many organizations nationally.
In
her surgical specialty, Dr. Yaremchuk has achieved subspecialty
certification in Sleep Medicine and has been awarded leadership
roles in national professional societies and journal editorial
boards.
The
NQF is a not-for-profit membership organization created
to develop and implement a national strategy for health
care quality measurement and reporting. A shared sense
of urgency about the impact of health care quality on patient
outcomes, workforce productivity, and health care costs
prompted leaders in the public and private sectors to create
the NQF as a mechanism to bring about national change.
To learn more, visit www.qualityforum.org.
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MSMS
Connect Is Live: Try A Demo
MSMS
has established a statewide, physician-sponsored electronic
portal called MSMS Connect. The basic portal is a free
benefit to MSMS members that securely connects physicians
to patient information, each other (for referrals and consultations),
labs, patient registries, and other resources – all through
a convenient single sign-on. It will expand to connect
to insurance companies, state agencies, other medical practice
management resources, and other networks. Organizations
interested in linking from the portal may contact MSMS
at 517-324-2518 for information. Also, if you belong to
a physician organization (PO), you may wish to explore
whether your PO provides further discounts on portal services.
View training sessions schedule, an online demo, and read
FAQs at www.msms.org/msmsconnect.
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