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January 26, 2009
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IN
THIS ISSUE
Editor's Column:
Trust
Comments On: 'Trust'
Physician Leader Optimistic About Health
Care IT
Family Docs Ask President For Primary Care
Education Help
Research Sheds Light On Medical Liability
Insurance Market
Six Major Groups Link Health Care,
Economic Reform
Beaumont To Transfer CON
Health Authority, WSU
To Host Safety Net Conference In May
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Editor's
Column: Trust
By
JOSEPH WEISS, MD
The
recent Wall Street scandals revealed more than the greed
of brazen brokers and the tragedy for people who lost their
savings. For many individuals the greatest shock and most
intense anger came from being deceived in matters of trust.
Trust
is what physicians have in common with stockbrokers. Our
patients and their clients expect us to act in their best
interests. Trust is the possession we should hold most
dear while we give it to each patient without reservation.
We
need to be alert to any attack upon our reputation for
being trustworthy. Take the phrase: the Patient Centered
Medical Home. When patients come to a physician’s office,
they expect that the physician will act in their best interests.
A patient should not feel the need to go to a “patient-centered” physician’s
office to obtain a fiduciary relationship. Physicians who
label themselves as “patient centered” are giving themselves
airs or implying that those of us running the usual medical
office operate under a lesser standard of honesty.
The
scandals of the stock market show the value of trust and
its possible fragility. As physicians, we should never
hedge trust’s worth, debase it currency, trade off its
name, or exchange it for profit. Toiling in the fields
of health care should keep us aware that not even a cutting
edge patient database can substitute for integrity.
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Comments
On: 'Trust'
Comments
from Allan Dobzyniak, MD
Pertaining to (Dr. Weiss’) excellent column on Trust,
there are a couple of issues that deserve elaboration. A
cause of the recent economic calamity is dishonesty at multiple
levels. It cannot be laid simply at the foot of Wall Street.
Those who sought housing they could not afford, those who
offered inappropriate loans, government forcing home loan
parity, inadequate supervision of Fannie Mae and Freddie
Mac all participated. Trust was compromised by multiple culprits.
To
compare physicians to stock brokers is a stretch. A profession
has a code of ethics at its foundation. I would contend
that medicine might be the last true profession. The medical
profession must resist any erosion of its ethics because this
is the basis for trust.
I
worry about the “ modern internist “ not interacting with
his or her medical staff peers, never leaving the office,
dispensing responsibility to hospitalists all in the name
of improving productivity. That which causes interference
with peer-to-peer physician interaction or impairs the
physician to patient relationship could be interpreted
as ethically compromising.
If
the medical profession, as it should, evaluates all proposed
changes in health care and determines there is no violation
of ethics, trust will be assured. I do agree, physicians
should be sensitive to even the potential for negative
perception as implied by the name “Patient Centered Medical
Home.”
Indeed,
it would be a tragic outcome if the demise of the last
true profession is allowed.
Comments
from Susan Adelman, MD
Trust
in physicians has been eroded by the interposition of insurers,
competition with hospitals seeking to take credit for the
work of their doctors, and the political efforts of health
care critics who have mounted a sustained campaign to discredit
doctors in order to build a constituency for, as well as
to reduce criticism of, health care reform. Doctors have
contributed to this by not effectively addressing problems
that the public wants corrected, and by not solving problems
of integrity, access and price that constantly come up within
the profession. Now the patient-centered medical home concept
has been created in order to give a new name to what general
physicians always practiced.
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Physician
Leader Optimistic About Health Care IT
A
special section about the use of health information technology
(HIT) in the Dec. 19 issue of the Washington Post included
a foreword written by AMA Board Chair Joseph M. Heyman,
MD. In his comments, Dr. Heyman highlighted the AMA’s efforts
to help physicians adopt new technology and shared the
AMA’s optimism about the promise HIT holds for increasing
patient safety and quality of care.
“Despite
the complexity and cost of developing a secure, interoperable,
nationwide HIT infrastructure, the AMA and physicians nationwide
realize the transformative power that adoption of this
technology promises for the future of patient care,” Dr.
Heyman wrote “As advances occur, HIT can fulfill its promise
to help improve the quality and safety of patient care.”
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Family
Docs Ask President For Primary Care Education Help
President-elect
Barack Obama can significantly improve Americans’ access
to health care by making “a robust investment” in federal
programs that support medical education and primary care
physician training, according to Jim King, MD, chair of
the American Academy of Family Physicians’ Board of Directors.
In
a Dec. 24 letter to Obama, King commended Obama for “making
a strong health care workforce a key component of your
legislative agenda.” He urged the president-elect to invest
$215 million in the Title VII, Section 747, grant program
to medical schools and residency training programs and
$150 million in the National Health Services Corps. Both
programs should be a part of Obama’s economic stimulus
package, King wrote.
“Including
that level of funding for primary care training in the
stimulus bill would reinvigorate medical education, residency
programs, as well as academic and faculty development in
primary care to prepare physicians to support the patient-centered
medical home medical practice model,” King wrote.
Visit http://www.aafp.org/online/en/home/media/releases/2008/medicaleducation-lettertopresidentelectobama.html to
read more about King’s letter.
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Research
Sheds Light On Medical Liability Insurance Market
Two
new policy research perspectives (PRP) from the AMA
present information on the professional liability insurance
(PLI) market.
The
first PRP examines changes in PLI premiums during the past
few years and presents them for select geographic areas.
The PRP finds that premium increases have become less common
and that increases in premiums have become smaller. In
recent years, premiums in a growing number of markets either
fell or did not change, with about half remaining the same
in 2008. However, the increases that occurred during
the recent liability crisis were large enough that the
small recent decreases have not been enough to offset them.
Therefore, although the PLI market appears to be softening
in recent years, premiums remain at historic highs in many
states.
Visit http://www.ama-assn.org/ama1/x-ama/upload/mm/363/mlm2008-summaryjguardado.pdf to
view this paper.
The
second PRP examines changes in indemnity and expense payments,
the manner in which claims close (settled/tried and paid/unpaid)
and claim policy limits. The PRP finds that average indemnity
and expense payments increased from 1998 to 2007 at a rate
faster than inflation. Although most claims resulted in
no indemnity payment in 2007, 9 percent of paid claims
involved payments of $1 million or more. The vast majority
of trial verdicts were won by the defendant, while very
few claims resulted in a plaintiff verdict. Finally, claims
with a policy limit greater than $1 million have become
more common over time.
Visit http://www.ama-assn.org/ama1/x-ama/upload/mm/363/prp2008-2indemexppymts98-07.pdf to
view this paper.
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Six
Major Groups Link Health Care, Economic Reform
A
Multi-million dollar television ad buy unveiled earlier
this month promotes health care reform as a top domestic
priority for the next president and the new Congress.
Six
organizations representing consumers, physicians, insurers,
patients and pharmaceutical research companies are banding
together to launch a new multi-million dollar national
television advertising buy (Media file). Their common message:
In order to fix the ailing economy, the nation needs health
care reform that addresses the related problems of health
care costs and people losing health coverage.
The
groups are the American Cancer Society Cancer Action Network
(ACS CAN), the American Medical Association (AMA), Families
USA, the Pharmaceutical Research and Manufacturers of America
(PhRMA), Regence BlueCross BlueShield, and the Service
Employees International Union (SEIU).
The
ad will air at least until Feb. 5 and focuses visually
on the nation’s manufacturing sector, but the organizations
all agree that every sector of the economy will benefit
from health care reform. The ad opens with: “At a time
when American businesses are hurting, why should we worry
about fixing health care? Because quality, affordable health
care can save money and make businesses more competitive.”
“Cancer
patients across the country—including those with insurance—often
must dig deep into their savings and risk financial ruin
to pay for cancer treatment and care,” said John R. Seffrin,
PhD, Chief Executive Officer of the American Cancer Society
and its advocacy affiliate, ACS CAN. “Elected officials
should recognize what American families already know—that
fixing the economy requires that we fix the broken health
care system.”
“Healing
our health care system is a key component to jumpstarting
our national economy. As our new ad makes clear—quality,
affordable health care is good for families and it's good
for businesses,” said AMA President Nancy H. Nielsen, MD.
“While
businesses and families cope with unaffordable health care
costs, many workers are losing their jobs and health coverage,” said
Ron Pollack, Executive Director of Families USA. “As a
result, it’s clear that America’s economic difficulties
require meaningful health care reform. It’s this message
that animates our ad campaign.”
“Expanding
access to quality and affordable health insurance is good
for patients and good for our economy,” Billy Tauzin, President
and CEO of PhRMA, said today. “Improved access means we
can do more to promote prevention and more to detect and
treat conditions at an early stage, when we can do the
most to avoid poor health outcomes and costly complications
of chronic diseases, which account for seven out of every
ten deaths in America.”
“Given
the nation’s economic and health care crises, now is the
time to bring meaningful, lasting change to our health
care system,” said Mark Ganz, President and CEO of Regence. “We
urge President-elect Obama and Congressional leaders to
bring together stakeholders who are willing to discard
outdated concepts and collaborate on practical solutions.”
“As
the economy sputters, the need to fix healthcare is becoming
more and more urgent. The clock is ticking,” said Andy
Stern, President of SEIU, the nation's largest union of
healthcare workers. “It will take all of us—individuals,
corporate leaders, healthcare providers and the government—working
together to solve America's healthcare crisis.”
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Beaumont
To Transfer CON
Beaumont
West Bloomfield Ambulatory Surgery Center L.L.C., a for-profit
joint venture with William Beaumont Hospitals received
state certificate-of-need approval to transfer the surgical
services CON from the Royal Oak-based hospital, reported
Crain’s Detroit Business. The center has 17 surgeons on
staff.
The
surgery center is at the Beaumont Medical Center at 6900
Orchard Lake Road in West Bloomfield Township.
Beaumont
Hospital owns 60 percent of the partnership with the physicians
owning 40 percent, according to Crain’s.
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Health
Authority, WSU To Host Safety Net Conference In May
Together
with the Wayne State University School of Medicine, the
Health Authority plans to bring together leaders of health
authorities and safety net organizations throughout the
country at a conference planned for May 14-15, 2009, called "Weaving
a Seamless Fabric of Services for the Uninsured"
The conference will include the follow topical areas:
- Application
of the medical home concept nationwide
- A
perspective on the new president's health policy
- The Michigan and
local Detroit-area experience of safety net providers
- Clinical
issues in chronic disease management, the role of clinical
protocols.
- The
use of technological innovation such as electronic medical
records, e-prescribing, and telemedicine to enhance the
delivery of care
For
more information on this conference, call 871-3751, ext.
110.
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