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Posts Tagged ‘ primary care ’

The Myth of Student Debt and Family Medicine

3
November 14, 2017

OK, “myth” is a bit of an exaggeration. A study from 2014 by the Robert Graham Center found a U-shaped relationship between medical student debt and the likelihood of students going into family medicine. Actually, it was more of a saucer-shaped curve. Students who had debt > $150,000, but also those with...
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More Disappointing News on the PCMH

2
September 6, 2017

First, I recognize that the whole PCMH experiment was not a total failure. There were some successes. The Patient Centered Primary Care Collaborative (PCPCC) puts out an annual review on PCMH demonstration sites that is always positive. On the other hand, the AAFP PCMH National Demonstration Project was mostly a failure....
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Ways to Improve Family Physician Quality – Measure Other Aspects of Primary Care Capacity Associated With Better Outcomes

4
July 9, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Ways to Improve Family Physician Quality – Measure When Physicians Do Not Order Tests or Treatments

0
June 29, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Ways to Improve Family Medicine Quality – Target Ranges without Absolute Goals

1
June 18, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Ways to Improve Family Medicine Quality – Shared Decision Making

1
June 7, 2017

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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Industrial QI Does Not Work in Primary Care

1
March 15, 2017

Traditional industrial QI does not work in primary care. A recent publication brilliantly makes this case on both theoretical and practical levels ;-). On a theoretical level, primary care is best thought of as a complex adaptive system, not a simple linear mechanical system. Think of complex adaptive systems as kind...
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Primary Care Physicians are the Most Cost Conscious

0
November 18, 2016

A recent survey of physicians asked several questions about prescribing practices. The primary report was that only primary care physicians cited costs as one of the most important considerations in their prescribing habits. Out of 10 factors, all of the ologists ranked cost as the sixth or less most important consideration. Pulmonologists...
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Hostility Against Primary Care

6
October 16, 2016

Just about every U.S. medical student who’s ever said they want to go into family medicine, or even other primary care fields, has heard this (or something like it): “Why do you want to waste your brain?” A new study shows what we in family medicine have always known/suspected. The comments...
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Family Physician Payment – A Lesson from Switzerland

0
June 27, 2016

There was a nice opinion piece in JAMA Internal Medicine recently where the primary author talked about moving from the U.S. to Switzerland and his experience in both systems. Primary care physicians are allowed to bill based on time there. This includes travel time, phone work, and documentation time. What a concept!...
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