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Hopefully to no one's surprise, it has been shown in a study of over 23,000 progress notes that EHR stuff is copy pasted. They found that 18% only of notes was truly entered and the rest either copy paste or imported.
The VA has decided on replacing its own EHR with Cerner. This was a contract worth many hundreds of millions of dollars and will put the VA with the same vendor as the DOD.
Medpage Today had an article titled "death by a thousand clicks". It discusses the huge waste of time that is required by the EHRs of today. This is due to the systems not being compatible with real life. It says that physicians are now type and click bots.
A study has shown that about 16% of Ocare consumers dropped their coverage by March. Only 10.3 million were still signed up. The numbers are fairly stable over the years.
California's Medicaid population is seeking care in EDs more than ever before. This is directly against Obama's statement that Ocare would keep people out of the Ed. The visits are up 75% over 5 years. The reason is simple, more got Medicaid under Ocare and no physicians would see them due to the very low payments.
Canada is back in the news. In the socialist state one may not buy private health insurance. Therefore people are paying out of pocket to get treatments and surgery faster than under the socialized system. This is causing a major problem for the governments of the provinces and the country. They refuse to acknowledge the rationing is causing huge delays in treatment causing a significant patient suffering. The physicians are now speaking up detailing the lack of operating rooms and the need for patients to have surgery in private clinics paid for either by patient pay or by the hospitals. The federal health minister, a physician, is also an ostrich with her head in the ground. Top
Hospitals are now hiring attorneys to help patients do some legal things while at the hospital. This is low fee stuff but very important to the patients. It includes name changes for those undergoing gender change surgery, order of protection from a violent spouse or other such things. This is part of the value based paradigm of payments. Top
Anthem BCBS of Georgia will no longer cover ED visits that THEY think are unnecessary. They say they will use the prudent layperson standard. However , that standard will be applied by one who is paid by the company and whose job depends on the company. The company has this in place in Kentucky, Missouri and Virginia.
Kaiser Health News has a story regarding what happens when an insurer stops paying for an expensive treatment and that causes the cessation of the treatment. They notice the case, now in the law suit stage, of Gillen Washington who has an immunodeficiency disease and Aetna refused to cover the medicine any longer. He ended up hospitalized with a collapsed lung. The insurer required Washington to stop taking his meds so new tests could be done to prove they still needed the meds. Of course, this is hugely detrimental to the patient. None of these patients get better on their own. In this case the medical director who made the decision knew nothing about the disease and had not even read the chart.
In a blow to the state of Connecticut Aetna will move out of state. This is directly tied to the state's unfriendly corporation laws. They also have lost GE who is moving to Boston as well as many high earners. Their state finances are on a steep downturn. Top
The number of physicians that now own their own practices has gone below 50%. The AMA study showed the percentage at 47.1%. This is especially true of the younger physicians.
Dr. Terry Millette was terminated from employment at Singing River Hospital in Mississippi and has now opened an office nearby the offending hospital. He should take most of the patients away from the institution. He does remain on staff.
The NYT has an article on concierge medicine. Their yellow journalism headline talks about a $40,000 co-pay. The article focuses on a special type of concierge medicine that gives services above what the usual concierge physician offers. It is only for very wealthy families as the practice is limited to 50-70 families per physician. The physician will meet the patient at home, office or even an airport if necessary. If necessary they will arrange appointments with the top physicians in the nation on an expedited basis and even accompany them to see the physician. A concierge practice opened in Silicon Valley in 2013 and had a waiting list in moths. The cost is $25,000 per year. The large fee usually covers all in office costs including in office lab fees, essentially all but hospitalization. One doctor calls himself an asset manager for the body.
Medscape has an article on the Hippocratic Oath. The older physicians still believe in it and the younger ones do not.
The SF Chron has an article about why physicians hate electronic medical records. The main reason is the amount of time necessary for the poor return. They are now only for billing. Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented.