Public Policy

Crowdsourcing My New Book on How Computerization is Changing the Practice of Medicine in Surprising Ways

I have been in blog-silence mode of late, for which I am sorry. Rumors that I’ve taken my Elton John act on the road are, I’m pleased to assure you, incorrect. [caption id="attachment_2406" align="alignleft" width="240"] 7 yr old's depiction of MD visit (Toll, JAMA 2012)[/caption] Instead, I’ve been hard at work on my new book, tentatively titled “The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age.” I’m about one-third finished, and am on my way to Boston for a six-month sabbatical at the Harvard School of Public Health to keep working on it. This is the most journalistic book I’ve ever attempted. I’ve already completed about 25 interviews for the book, and will do about 30 more by the time I’m done. And they have all been fascinating. It seems a shame to leave so much great stuff on the cutting room floor. So for…

Q&A with David Meltzer MD, PhD: Back to the future with the hospital prone patient

Firstly, thank you David for taking the time to answer questions for the blog.  You got my attention when you expressed, "the greatest excitement you have ever had in your career," for your current CMS Innovation Center endeavor.  Given your list of accomplishments, that is a tall order. Secondly, I want readers to take note of David's latest paper in Health Affairs describing his project, Redesigning Care For Patients At Increased Hospitalization Risk: The Comprehensive Care Physician Model, as well as his presentation at the accompanying publication briefing. 1.  Let me say, if your paper delivers on its promise, we will see a real shake up in the way we deliver care to chronically ill, hospital prone patients.  Based on the oversized attention you received at the Q&A following the briefing, others felt similarly.  Can you review your project and give us the nidus behind developing the intervention? The basic…

We dont need studies on whether P4P works. Just read these quotes!

  The United States does not possess sole propriety on P4P.  The NHS has been at the endeavor for years, with mixed results. The NEJM released a short review, Successes and Failures of Pay for Performance in the United Kingdom, and after reading the author's conclusions, one might wonder why we need more study. American exceptionalism aside, across the pond, the UK has done a portion of the scrubbing for us. (more…)

Hospitalists and the Federation of State Medical Boards (FSMB): A CEO Q&A

Humayun J. Chaudhry, D.O., M.S., MACP, FACOI, President and Chief Executive Officer, Federation of State Medical Boards    1. Firstly, Hank, thanks so much for spending a few minutes with our readers.  As you know, hospitalists devote most of their time in acute and subacute settings. Many of their clinical apprehensions relate to hospital and physician regulation and quality monitoring and how these rules intersect with inpatient care.  The Federation of State Medical Boards (FSMB) has a broad mission. What should hospitalists know about your organization given these concerns and do you have a role to play in assisting inpatient providers to improve patient care? To understand the mission of the Federation of State Medical Boards (FSMB), it’s helpful to understand the mission of state medical boards. States are authorized under the 10th Amendment to the U.S. Constitution to establish laws and regulations protecting the health, safety and general welfare of their citizens. To…

Broken RAC System Continues to Hurt Patients, Providers

by Dr. Bart Caponi MD, FHM “Inpatient” and “Observation” are terms familiar to every hospitalist, and to increasing numbers of patients and lawmakers.  The difference can be significant--while “inpatients” are covered by Medicare Part A, people in “observation” are not; nor do they gain access to other benefits, like nursing home rehabilitation.  Until recently, no one paid any attention to status, but now patients and doctors are oppressed by it.  Why? Recovery Audit Contractors (RACs). (more…)
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