Comments for Physicians News http://www.physiciansnews.com Wed, 10 Mar 2010 21:43:49 -0500 http://wordpress.org/?v=2.8.4 hourly 1 Comment on What’s The Best EHR Technology For Your Practice? by eMedicalOffice http://www.physiciansnews.com/2010/03/08/what%e2%80%99s-the-best-ehr-technology-for-your-practice/comment-page-1/#comment-1310 eMedicalOffice Wed, 10 Mar 2010 21:43:49 +0000 http://www.physiciansnews.com/?p=3071#comment-1310 What I would like to know is - How is the Patient Confidentiality protected through centralizing the patient records? Does that mean that any doctor with access to EMR or EHR software will be able to look at any persons medical records? What if I don't want a family friend doctor to know what my health issues are ? Is there a plan for that ? Thanks What I would like to know is – How is the Patient Confidentiality protected through centralizing the patient records?

Does that mean that any doctor with access to EMR or EHR software will be able to look at any persons medical records?

What if I don’t want a family friend doctor to know what my health issues are ?

Is there a plan for that ?

Thanks

]]> Comment on Futures for Physicians: Does Reform Matter? by Allen Goldberg http://www.physiciansnews.com/2010/03/05/futures-for-physicians-does-reform-matter/comment-page-1/#comment-1308 Allen Goldberg Tue, 09 Mar 2010 18:47:12 +0000 http://www.physiciansnews.com/?p=3062#comment-1308 Even my "uncle Rube" could not come up with an innovative way to fix health care in America! Health care is local and must be transformed regionally by collective partnerships representing all stakeholders as eligantly stated by Dr. Bauer. Just reforming finance is NOT health care reform. Although universal access to all Americans is the goal, just adding funding to a broken system that is wasteful, inefficient, and ineffective (as briliantly explained in "Paradox and Imperatives in Health Care") represents adding fuel to an blazing fire out of control. My late father (NYFD Captain Sanford Goldberg) would not approve. Dr. Bauer is right on the mark. We need basic operational and structural reform taking into consideration the potential of changes in medical science and practice and advantage of digital technologies (telemedicine and eHealth) for new models of health care delivery. This does require physician leadership as well as input of health care consumers who have vital insights. Even my “uncle Rube” could not come up with an innovative way to fix health care in America! Health care is local and must be transformed regionally by collective partnerships representing all stakeholders as eligantly stated by Dr. Bauer. Just reforming finance is NOT health care reform. Although universal access to all Americans is the goal, just adding funding to a broken system that is wasteful, inefficient, and ineffective (as briliantly explained in “Paradox and Imperatives in Health Care”) represents adding fuel to an blazing fire out of control. My late father (NYFD Captain Sanford Goldberg) would not approve.

Dr. Bauer is right on the mark. We need basic operational and structural reform taking into consideration the potential of changes in medical science and practice and advantage of digital technologies (telemedicine and eHealth) for new models of health care delivery.
This does require physician leadership as well as input of health care consumers who have vital insights.

]]> Comment on What’s The Best EHR Technology For Your Practice? by John Johnson http://www.physiciansnews.com/2010/03/08/what%e2%80%99s-the-best-ehr-technology-for-your-practice/comment-page-1/#comment-1307 John Johnson Tue, 09 Mar 2010 15:03:55 +0000 http://www.physiciansnews.com/?p=3071#comment-1307 A few things were left out of the C/S model vs SaaS. First, as the EMR software gets enhanced through updates and version releases, it will also require hardware and software(O/S, db, etc.)upgrades and that capital expense(incl. labor) needs to be figures into the C/S cost structure. With a SaaS model, it is already included in the cost structure. Second, very few health care organizations invest in the redundancy of the on-site infrastructure so when a fan or power supply quits, the server is down. With a SaaS model, most data center operations have extensive redundancy so that uptime is around 99.99% all the time. Third, the telecommunications issues are the same for both C/S and SaaS. If you have multiple locations that need to access the PM/EMR, solid telecommunication lines are necessary from a reliable company. Fourth, typically the biggest headache for a health care practice is the IT labor that is responsible for the upgrades, maintenance, etc. All of that is already covered for the server and storage in the SaaS model. A few things were left out of the C/S model vs SaaS. First, as the EMR software gets enhanced through updates and version releases, it will also require hardware and software(O/S, db, etc.)upgrades and that capital expense(incl. labor) needs to be figures into the C/S cost structure. With a SaaS model, it is already included in the cost structure. Second, very few health care organizations invest in the redundancy of the on-site infrastructure so when a fan or power supply quits, the server is down. With a SaaS model, most data center operations have extensive redundancy so that uptime is around 99.99% all the time. Third, the telecommunications issues are the same for both C/S and SaaS. If you have multiple locations that need to access the PM/EMR, solid telecommunication lines are necessary from a reliable company. Fourth, typically the biggest headache for a health care practice is the IT labor that is responsible for the upgrades, maintenance, etc. All of that is already covered for the server and storage in the SaaS model.

]]> Comment on What’s The Best EHR Technology For Your Practice? by Jeremy Engdahl-Johnson http://www.physiciansnews.com/2010/03/08/what%e2%80%99s-the-best-ehr-technology-for-your-practice/comment-page-1/#comment-1303 Jeremy Engdahl-Johnson Mon, 08 Mar 2010 16:12:05 +0000 http://www.physiciansnews.com/?p=3071#comment-1303 Federal funding may be encouraging a move toward EHR, but there's more to it than just installing systems. How can healthcare data pooling lead to a better system? Federal funding may be encouraging a move toward EHR, but there’s more to it than just installing systems. How can healthcare data pooling lead to a better system?

]]> Comment on How the Healthcare Reform Bill May Affect the Docs by Robert L. FNP http://www.physiciansnews.com/2009/08/03/how-the-healthcare-reform-bill-may-affect-the-docs/comment-page-1/#comment-1298 Robert L. FNP Sat, 06 Mar 2010 22:42:47 +0000 http://www.physiciansnews.com/?p=2512#comment-1298 I find it amusing that some docs have an issue when the term "Primary Care Provider" is used instead of "Physician". As an NP it never was my intent to replace a doctor. I was trained in primary care and feel that within that realm of medicine I function very well. The fact is that most docs do not go into the area of Family Med/primary care due to various reasons (pay, patient load, etc...). NP's ( and PA's) have stepped into that gap and provided quality primary care with good rates of patient satisfaction. There are many studies that document this. In the future I think we will continue to see the movement of NP's and PA's performing primary care and physicians going into specialties. I just wish we could do away with the bickering that goes on between the AMA and Nursing Organizations. We are all after the same thing, providing care to improve the quality of a patient's life. Also, I despise the term "mid-level". What the heck am I "mid-level" to? It is a very degrading term. I find it amusing that some docs have an issue when the term “Primary Care Provider” is used instead of “Physician”. As an NP it never was my intent to replace a doctor. I was trained in primary care and feel that within that realm of medicine I function very well. The fact is that most docs do not go into the area of Family Med/primary care due to various reasons (pay, patient load, etc…). NP’s ( and PA’s) have stepped into that gap and provided quality primary care with good rates of patient satisfaction. There are many studies that document this. In the future I think we will continue to see the movement of NP’s and PA’s performing primary care and physicians going into specialties. I just wish we could do away with the bickering that goes on between the AMA and Nursing Organizations. We are all after the same thing, providing care to improve the quality of a patient’s life. Also, I despise the term “mid-level”. What the heck am I “mid-level” to? It is a very degrading term.

]]> Comment on New Prostate Cancer Screening Guidelines: Let the Patient Decide by Paul http://www.physiciansnews.com/2010/03/04/new-prostate-cancer-screening-guidelines-let-the-patient-decide/comment-page-1/#comment-1297 Paul Sat, 06 Mar 2010 05:06:22 +0000 http://www.physiciansnews.com/?p=3057#comment-1297 First off, prostate cancer is a terrible disease and I commend urologists in their fight and plight against this scourge. That said, the PSA test is not a specific test, it is not a sensitive test. Screening tests are generally given to populations that are mainly without disease, so when there is an error it often falls in the majority group, ie the people without disease, i.e. a false positive result. If there is a positive finding the follow-up test, prostate biopsy is both expensive and poses a not insignificant risk to the patient. If the result was not a false positive their is then no good way to stratify which are the very slow growing prostate cancers which might be addressed with "watchful waiting" versus the more malignant and aggressive types. Finally if one chooses to intervene there is no home run treatment in fact its hard to say whether the treatments are often really of much benefit at all in terms of over all mortality while they carry a significant risk of long term complications. Evidently, two recent studies have now also supported that PSA screening is not of benefit and may actually be harming patients from the unnecessary procedures secondary to false positives. So likely the PSA test isn't worth it, which then brings up a related question which may sound flippant but I think is entirely reasonable. Unless you have Dr. Goldfinger, the dreaded finger wave is a worse test than even PSA as a screening test. Is their any rationale reason for a digital rectal exam as a routine urologic screening? First off, prostate cancer is a terrible disease and I commend urologists in their fight and plight against this scourge. That said, the PSA test is not a specific test, it is not a sensitive test. Screening tests are generally given to populations that are mainly without disease, so when there is an error it often falls in the majority group, ie the people without disease, i.e. a false positive result. If there is a positive finding the follow-up test, prostate biopsy is both expensive and poses a not insignificant risk to the patient. If the result was not a false positive their is then no good way to stratify which are the very slow growing prostate cancers which might be addressed with “watchful waiting” versus the more malignant and aggressive types. Finally if one chooses to intervene there is no home run treatment in fact its hard to say whether the treatments are often really of much benefit at all in terms of over all mortality while they carry a significant risk of long term complications. Evidently, two recent studies have now also supported that PSA screening is not of benefit and may actually be harming patients from the unnecessary procedures secondary to false positives.

So likely the PSA test isn’t worth it, which then brings up a related question which may sound flippant but I think is entirely reasonable. Unless you have Dr. Goldfinger, the dreaded finger wave is a worse test than even PSA as a screening test. Is their any rationale reason for a digital rectal exam as a routine urologic screening?

]]> Comment on Futures for Physicians: Does Reform Matter? by Jeremy Engdahl-Johnson http://www.physiciansnews.com/2010/03/05/futures-for-physicians-does-reform-matter/comment-page-1/#comment-1296 Jeremy Engdahl-Johnson Fri, 05 Mar 2010 16:41:33 +0000 http://www.physiciansnews.com/?p=3062#comment-1296 Many seem to agree on the need to find a better approach than fee-for-service reimbursement. If accountable care organizations can adopt the risk-management know-how of health plans and integrate patient care using technology and best clinical practice, they may be part of the solution. Many seem to agree on the need to find a better approach than fee-for-service reimbursement. If accountable care organizations can adopt the risk-management know-how of health plans and integrate patient care using technology and best clinical practice, they may be part of the solution.

]]> Comment on AMA: Physicians Outraged At Steep Medicare Cut (UPDATE) by Dr. S (Family Medicine / Plano TX) http://www.physiciansnews.com/2010/03/01/ama-physicians-outraged-at-today%e2%80%99s-steep-medicare-cut/comment-page-1/#comment-1293 Dr. S (Family Medicine / Plano TX) Wed, 03 Mar 2010 03:56:34 +0000 http://www.physiciansnews.com/?p=3047#comment-1293 Dr. Ziev is wrong. Our three doctor Family Medicine practice has opted-out of Medicare. Many doctors in our I.P.A. are doing the same (and others did it long ago). Quite frankly, you'd have to be one f***ing crazy doctor to continue participating at this point. Our Medicare patients continue to see us on a cash-basis. They appreciate the generous time and attention that we give them, and are charged very fair rates. I didn't become a Family Doctor to get rich, but I certainly didn't become one to get poor. 21% my ass... Dr. Ziev is wrong.
Our three doctor Family Medicine practice has opted-out of Medicare.

Many doctors in our I.P.A. are doing the same (and others did it long ago).

Quite frankly, you’d have to be one f***ing crazy doctor to continue participating at this point.

Our Medicare patients continue to see us on a cash-basis. They appreciate the generous time and attention that we give them, and are charged very fair rates.

I didn’t become a Family Doctor to get rich, but I certainly didn’t become one to get poor. 21% my ass…

]]> Comment on AMA: Physicians Outraged At Steep Medicare Cut (UPDATE) by admin http://www.physiciansnews.com/2010/03/01/ama-physicians-outraged-at-today%e2%80%99s-steep-medicare-cut/comment-page-1/#comment-1291 admin Tue, 02 Mar 2010 21:19:01 +0000 http://www.physiciansnews.com/?p=3047#comment-1291 From Dr. Ziev: I have been following this story. The AMA and AOA have sent notices to physicians telling them how to withdraw from participation in Medicare. It will be interesting to see how the doctors respond to the 21% cut. My personal belief is that they will do nothing but complain. They will probably continue to participate. They never learn. From Dr. Ziev:

I have been following this story. The AMA and AOA have sent notices to physicians
telling them how to withdraw from participation in Medicare. It will be interesting
to see how the doctors respond to the 21% cut. My personal belief is that they will
do nothing but complain. They will probably continue to participate. They never
learn.

]]> Comment on Live From DC….It’s The Health Reform Summit by Jeremy Engdahl-Johnson http://www.physiciansnews.com/2010/02/26/live-from-dc-its-the-health-reform-summit/comment-page-1/#comment-1289 Jeremy Engdahl-Johnson Mon, 01 Mar 2010 00:45:55 +0000 http://www.physiciansnews.com/?p=3043#comment-1289 Today's medical professional liability system is too adversarial and too expensive. There are alternatives. Jeremy Healthcare Town Hall Today’s medical professional liability system is too adversarial and too expensive. There are alternatives.

Jeremy
Healthcare Town Hall

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