I’ve taken some time recently to read about some of the earliest thinking about family medicine prior to its creation and into its early years. I find that for the most part, the same unresolved tensions we feel today were present 45 years ago. I’ll spend the next two weeks exploring...
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I’m not the only one who has questioned the real impact of the quality movement in healthcare. Robert Brook, MD, ScD of RAND Health has written about similar concerns. In an article in JAMA from last year, he states “ore than 40 years later it is unclear what the quality movement...
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At the TAFP conference I attended last weekend, almost all the clinically oriented speakers showed data from their EMRs they felt proved they were providing high quality care. I’m sure their quality is excellent, but this won’t make healthcare more affordable. The measures most everyone showed included: how many diabetics had...
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I attended a Payment Reform Summit sponsored by the Texas Academy of Family Physicians this past weekend. It was a good conference and provided a snapshot of current views and attempts to grow family medicine and pay for it. There were some emotional ups and downs for me as I listened...
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The PPACA (The Obama Healthcare Law) includes a provision that employers may use up to 30% of the employee’s health insurance premium for wellness incentives. An article in the NEJM discussed some of the difficulties of this seemingly straightforward effort to prevent the onset of chronic diseases and lower healthcare costs....
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One of my favorite parts in the journal BMJ is the occasional column written by Dr. Iona Heath, the president of the Royal College of General Practitioners. Her thoughts have helped me understand the similarities and differences between the U.S. and British physicians, healthcare systems, and culture. And I love her...
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All of us want to live long healthy lives, but what if the lives aren’t really healthy? A study in the Journal of Gerontology concluded that our increasing national life expectancy – which is still low compared to the rest of the developed world – has not increased lately. More disturbing...
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A recent study in Annals of Internal Medicine looked at what happened when patients were cared for in the hospital by private physicians (presumably often their personal physicians) compared to hospitalists. For a little background, hospitalists are doctors whose job is limited to taking care of patients in the hospital. They...
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One of the approaches some corporations are taking to hold down health care costs is to put more responsibility on their employees through high-deductible health insurance plans. It makes sense that they would try this. After all, this reflects the daily life of the business community as they compete for consumers...
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The Texas retired teacher healthcare fund is nearly out of money. Trustees predicted this summer that reserves will be gone in two years, and its deficit could be $580 million by 2014. This group is in a unique situation, because teachers’ retirement and medical care funds exist as stand-alone entities separate...
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