Archive for July 2013

Medicare’s Most Maddening Policy… and Why CMS’s Attempts to Improve It May Make it Worse

Today is my last day as chair of the ABIM, and the end of my eight-year tenure on the Board. In this blog – a bookend to the one I wrote at the start of the year, which went near-viral – I’ll describe some of our accomplishments this year and a few of the challenges that I leave my talented successors to grapple with. I had two very tangible tasks to accomplish during my chairmanship. First, after a decade-long tenure as CEO and President of ABIM, Chris Cassel announced her intention to step down. (Chris is now CEO of the National Quality Forum, which is increasingly crucial in a world looking for robust measures of quality, safety, and value.) After an extensive search, we selected Richard Baron to become ABIM’s new CEO, and Rich began earlier this month. Rich is one of the most impressive people I’ve met in healthcare,…

A last goodbye…to a dear friend

My colleague and dear friend, Robin Dibner, moves  on to greener pastures today.  We have had a great ride together. I call her "delicious," because some people come blessed with that gene.  A wonderful soul and as good a person you will ever want to meet. I will miss her dearly--both as a trusted friend and source of supremely good counsel. Below, with her permission, I reprint her farewell message to close friends and colleagues: (more…)

The course seems obvious

A compelling clinical vignette always gets me. Those written for lay eyes grip me even more. The exceptional writer strips away the medical nuance and expresses the case in the starkest of terms. The stakes feel germane, the emotions conveyed hit close to home. We have been there we say and ask if a similar patient might occupy our bed tomorrow.  Alternatively and as applicable, we imagine if the profiled provider could be us. We also engage these accounts for comfort and solidarity. We take solace in sharing similar front line experiences with others, as atypical as they sometimes might be. Apiece with that spirit, I recently read an illuminating article in The Atlantic. The account profiles a physician and the difficult dilemma he faced caring for an acutely ill man with a tenuous, but hopeful prognosis. He had no advanced directives and the family, going against convention, wished to cease…

Drug Overdoses among Women Increased between 1999 and 2010

This CDC report found there were >15,000 fatal drug overdoses among women in 2010 alone; opiate-related fatal overdoses increased 5 fold over that time period. The editors recommend screening patients for substance abuse or mental health problems before opiate prescribing. Background: Overdose deaths have increased steadily over the past decade. This report describes drug-related deaths and emergency department (ED) visits among women.  Read the full abstract.

Gradual vs Abrupt Smoking Cessation

This meta-analysis found no significant difference in quit rates between those that abruptly quit, versus those that did a gradual taper and quit. Smoking cessation advice should be tailored to the patient, given there is no evidence of benefit of one approach over another (abstract).