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End-of-life care: New MA survey shows deep chasm between what we know and what we do Print E-mail
Written by FHI's Week in Review   
Monday, 16 May 2016 00:00

According to a new statewide survey by the Massachusetts Coalition for Serious Illness Care and published on PR Newswire May 12, 2016:
Eighty-five percent of Massachusetts residents believe that physicians and their patients should talk about end-of-life care - but only 15 percent have actually had such conversations...
Strikingly, even those respondents facing serious illness are reluctant to plan ahead with their care team. Only 25 percent of respondents facing such afflictions reported talking with their physician about end-of-life care...

"These findings are a wake-up call for all of us, clinicians and patients alike," said Atul Gawande, MD, MPH, Co-chair of the Coalition, Executive Director of Ariadne Labs, a joint center of Brigham and Women's Hospital andHarvard T.H. Chan School of Public Health, and author of the New York Times bestseller, Being Mortal: Medicine and What Matters in the End...
"This is about how you want to live, not just about how you want to die," Gawande said. "When clinicians don't talk to people about their priorities for serious illness care, care can become misaligned with what matters to them. And the result is suffering."

Read more in the current issue of Week in Review>>

Last Updated on Sunday, 05 June 2016 09:25
Population Health Model Poses Challenge to Private Practice Print E-mail
Written by Nicole Lewis | Medical Economics   
Thursday, 12 May 2016 00:00

As the push to implement population health initiatives gets underway, Lonnie Joe, MD, is still mulling over whether his private practice can survive the changes he'll have to make to participate in this emerging model of care.

Like many private practice physicians, Joe, an internist who has been practicing for almost three decades, is trying to tailor his four-year-old group practice in Detroit, Michigan, to meet the defined goals of population health: identifying groups of patients with specific medical conditions such as diabetes, hypertension, or cancer, and implementing a variety of health management approaches to improve these patients' outcomes...

Such an endeavor requires additional staff, better patient engagement and more technology to support population health initiatives.

"Implementing a long-term population health strategy at private practice physicians' offices requires a team-based model of care with skilled personnel and infrastructure, all of which requires adequate financial support," says Nitin Damle, MD, FACP, president-elect of the American College of Physicians.

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Last Updated on Tuesday, 31 May 2016 12:04
Re-Thinking Your Practice in the Age of Telemedicine Print E-mail
Written by Accountable Care Options, LLC   
Thursday, 12 May 2016 00:00
Are you ready for telemedicine? It’s coming. And it may or may not be a threat to your practice.

The Next-Generation Accountable Care Organization Model incorporates telemedicine, though waivers are being issued for this year. Physicians are expected to evaluate patients through the telephone or via the Web in face-to-face chats. There’s a big push for this service in rural areas of the country.

Here’s how it might work: An insurer emails a patient a link to an app. Once installed, the individual has a video appointment over the Internet with a physician about a minor health problem. The doctor can electronically send a prescription to a pharmacy.

This service is not for life-threatening conditions or complicated disease states -- yet. Some dermatologists are taking high-quality digital images from mobile devices and using them to evaluate patients for cancer. Remote monitoring of a chronic condition is not widespread now, but it will be as more diagnostic equipment becomes Web-enabled.

Having an office visit at anytime from anywhere may be fantastic for patients, but for some physicians that's kind of scary. They’re going to have to start competing with other medical practices, be nimble enough to have their doors open at convenient times and compete with inexpensive healthcare providers.

FaceTime is HIPAA-compliant, but it can be challenging for physicians to incorporate it into their practices. How do you remain marketable and competitive? Do you want to offer telemedicine? If you don't, somebody else will.

Telemedicine is being marketed to physicians who don't want the typical schedule. They may be retired physicians and want to work a couple of hours for extra income or seek a schedule that frees them from being tied to a facility. They represent competition for a traditional physician practice with an office, nurses, equipment and other overhead.

For retirees, adjusting their schedule to doctors’ office hours is not difficult. But for working people, it’s a big deal, especially when they’re pressed for time and technology has created expectations of immediate gratification. They want a doctor on demand.

Physicians have to decide how to allocate their time and use their staff members to their highest degree of certification. Some patient-care tasks can be delegated so that everyone uses his or her time wisely.

And while doctors probably don’t want to hear this, they’ll have to think about overhauling of the business model of healthcare. They can either adopt telemedicine and succeed, or try and fight it. And let's face it, those who fight it are not going to get very far.
5 Innovators in Women's Health Print E-mail
Written by SFBJ   
Thursday, 12 May 2016 00:00

Betsey Guzior, reporting for the SFBJ yesterday, states:

It's National Women's Health Week, used to highlight the unique needs and challenges women face in wellness, managing chronic conditions and recognizing and preventing diseases.
Here are five women who are making a difference in women's health issues:
Dr. Nieca Goldberg, medical director of the Joan H. Tisch Center for Women's Health at the NYU Langone Medical Center

Sohila Zadran
, founder of Igantia Therapeutics in San Francisco

Dr. Shelley Hwang
and Dr. Laura Esserman, oncologists

Dr. Michelle Dipp, CEO, Ovascience

Learn what they are doing and why it's important HERE>>

Last Updated on Tuesday, 17 May 2016 17:21
Should the FDA Approve Experimental Treatment for Severe Diseases? Print E-mail
Written by MD Whistleblower   
Monday, 09 May 2016 00:00

I've never had the pain and agony of having a kid who is truly sick. Broken bones and minor surgeries don't count. Even one of my kid's bouts with malaria doesn't rate, as this illness was easily cured.
Parents of kids with chronic illnesses would sacrifice anything to help their kids get better or to suffer less. In the news recently is a conflict between families of kids with Duchenne muscular dystrophy and the Food and Drug Administration (FDA). A very small study of an experimental drug called eteplirsensuggested some benefit. Understandably, the families want the FDA to grant approval so that their kids and others could have access to this drug that will fight a dreadful disease that is fatal. Families argue that these kids have nothing to lose and can't wait another 5 years waiting for more definite evidence of efficacy to emerge.
The FDA is legally required to approve drugs that are safe and effective. Obviously, the definitions of safe and effective are subjective, but the agency requires that a reasonable threshold be crossed for both of these parameters. Gray areas create agonizing conundrums for agency officials and patient advocates.

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