Extra Extra Read All About It

Today’s online edition of the New England Journal of Medicine has two articles, one by Katherine Sebelius regarding the recent health reform legislation in the United States, and another article  by Nick Black, M.D. on the United Kingdom’s proposed  changes to the NHS. The appearance of these two articles with almost inexplicable timing  reveals how two different systems see themselves as failures and are seeking to correct it by going in opposite directions.  It begs the question, “Who is ahead in creating a ‘more perfect world?”...

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So goes California…so goes the Nation

or why we need less government. The remainder of this post has been removed at the request of the copyright holder. Modern Medicine holds the rights to the content, and we are negotiating with them to license some portions of their material for this blog. Sorry....

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Power to the People !!???

What people you may ask?  Ask and ye shall be told !! Modern Medicine announced today the 100 MOST POWERFUL PEOPLE IN MEDICINE. So, who makes  this momentous decision?? Is it more important than the ‘Golden Llama Award’?? (of which I unashamedly boast that I earned some time ago) A little bit of research reveals that these mighty Centurions are chosen in this manner.  Is it any wonder why most physicians are enraged and stand gawking with disbelief? Dr Wes, in his blog today points out how the rules don’t count for those who make the rules Should Dr. Emanuel not have noted his relationship as White House advisor for health care policy and his relationship with his brother, White House Chief of Staff Rahm Emanuel? And...

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Health Reform in the NHS vs.. The U.S.

             Surprise!! The U.K.s NHS system is running away from itself as fast as Obama and Berwick are running toward an obsolete model. From the  BBC News Online  today, Hospitals are to be set free from central control   “Unison has launched legal action against the government's plans for a major shake-up of the NHS system in England. The UK's largest public service union claims ministers failed to ask the public if it wanted such fundamental changes in the first place. The proposals in the health White Paper would hand the responsibility for most health services to GPs. A consultation on how the changes would be implemented ends on 5 October 2010. A Department...

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Innovation

It goes something like this: Bill Gates: img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('86382d47-fd8c-44af-8b35-b133561fa4ae'); downlevelDiv.innerHTML = "";" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5IQtxAzNRe37e5b6b4aJxOXarM3qP0X4p5b6rp-Dtz-qzdBpVCRq0tlMC9YB5sJjz40wKwNB5pw4KpwZVIaKALw_twpzb_7tzXTbYnDVNibIy8UhV_e8MxaAPN1IaqMgnjK8EgYWYx3s/?imgmax=800" style="border-style: none">   So, the underlying question is what will Obamacare do for innovation in health care.   Perhaps it will drive further innovation to radically change our paradigm for delivering healthcare and improving wellness. Did congress set off the spark for innovation? Will innovators enter medical...

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Diabetes and it’s Complications

Normally I post articles on health reform, and information technology. However today I was in the process of preparing examination questions for board preparation for the American Board of Ophthalmoloogy, and came upon this poignant observation by a medical resident. It also points out the importance of tight glycemic control for diabetic patients. Insight Elizabeth B. Gay, MD Charlottesville, Virginia eg3d@hscmail.mcc.virginia.edu JAMA. 2010;303(3):205. The right eye bleeds on a Wednesday morning. I am walking to clinic, heading up the hill on 97th Street. For a moment, I imagine the dark spot is some trick of light and shadow. But it grows before me, spreading outward from its center, forming a web across my vision. I...

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Some Inspirational Art

I was about to fold my tent this evening after a long day of writing, however as I was finishing my evening rounds on blog lines, my favorite RSS aggregator, I came upon this…. I need to share what I consider an outstanding post by Regina Holliday and here almost biblical art work that reminds me of the last supper, Moses receiving the ten commandments. the parting of the red sea, and the last supper.   SHARE THIS WITH ME,  and thank you Regina….what a wonderful way to turn off the day. GML...

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The Meaningful Use May Mean

This morning I had a chance to sit in on a conference hosted by Centricity, to discuss meaningful use as a criteria for selecting your next EMR or upgrading your present EMR. Both physician providers represent fairly large user groups who already have implemented GE Centricity, an enterprise sized EMR solution. The complete slide deck of the presentation will be available in the next several days. Several of the presenters are physicians  MDs.  Med Star Health is a present  user of their EMR solution.  Peter Basch M.D., an internist and member of this large group  reviewed the tenets of HITECH and its financial incentives for adopters, and penalties for non adopters.  Groups in underserved areas will receive...

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Social Networking Update

  It’s time for Health Train Express  to do some CME in social networking and all the new words, and eponyms that develop with a new subspecialty in medicine. How does social networking impact on medicine and your practice?  Well, it is a huge new aspect which all providers need to watch closely. It is no longer a ‘geek thing”  or just  a place where Betty Boop posts some nudie pictures that predatory “perps” lurk and wait.  There is or should be no ‘prejudice’ or strange looks from our colleagues at those of us who know about and use ‘social media’ in the course of our day. It has become a new highway of information, rivaling Google and perhaps surpassing it’s formidable market presence.  In fact I...

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Meaningful Use or Meaningless Data

  The climb (path) to Meaningful Use   Today  MARGALIT GUR-AIRE waxed mightily in his writing on the Health Care Blog.  I like MARGALIT GUR-AIRE , a brilliant medical writer, who far exceeds my minimalistic attempts to display my inadequacies in the written word.   Meaningful or meaningless data?  It remains to be seen about the benefits of all this data. First of all the 'system' is currently 'non existent" except for relatively small silo's of information limited to established larger health institutions and/or medical clinics  that have integrated EHRs Much of the stimulus funding for EMR by HITECH has been driven by empty promises for the potential of a unified data sharing system. The system...

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Another Cool Thing

I love time savers. As a physician, like all of you I am pressed for time. Anything that shortens my tasks without sacrificing quality is a ‘meaningful use” nominee. Having said that I have just discovered the utility of ‘tiny url’. This little doo-hickey is a downloadable add in for either Firefox (my preferred browser) and Internet Explorer. With one tiny click on your toolbar, a copy and a paste you are off and running. I see great potential for it’s use in EMR applications. Another tiny tidbit for today.  Their domain name is in the Cocos Islands. (is this another offshore financial opportunity?) (Australian territory) Technorati Tags: tiny url,health train,meaningful use,cocos...

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Another CMS Eponym

What is a “ ZPIC”  ?  (see below)     WASHINGTON (AP) - They don't seem that interested in hot pursuit. It took private sleuths hired by Medicare an average of six months last year to refer fraud cases to law enforcement. Have you looked in your post office lately? Perhaps your photo will be up there, soon.   According to congressional investigators, the exact average was 178 days. By that time, many cases go cold, making it difficult to catch perpetrators, much less recover money for taxpayers. A recent inspector general report also raised questions about the contractors, who play an important role in Medicare's overall effort to combat fraud. click on the image Groucho, Harpo and Zeppo.  Question...

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We’re Back !!!

  As I promised the technical glitches have been fixed. I reposted several previous posts to be sure it is working. Have a nice weekend….   thank you Microsoft...

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The Clothesline

I don't know about you, but I and most physicians are fed up with being hung out to 'dry'. Same old, same old. Doctors with Medicare patients will start seeing a 21 percent pay cut this week after Congress failed to defer the cuts by two more years. This Story appears today in the Washington Post. The Senate had until June 1 to avert the cuts. It is not expected to vote by Tuesday, when the Center for Medicare and Medicaid Services' temporary hold on Medicare claims expires. Some members of the American Medical Association signed white lab coats instead of a petition to voice their displeasure on Sunday at the group's annual meetings in Chicago. The coats will be delivered to lawmakers in Washington on Friday, a spokeswoman said....

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Vending Machine Medicine

I was reading Distractible MD this morning and came across this photo that Rob Lambert posted. I could not resist passing this along to my readers.  It says a lot about what has and is happening to our domain as physicians.  I wonder if it talks too....

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The Yo-Yo Effect

The past several months reveal how disconnected the plan for health care reform has evolved. There was little transparency regarding the evolution of the bill, except for political posturing. The present administration has no experience in business leadership, nor basic economic theory. The fact that the flawed SGR formula, hastily conceived in the early 1990s, was not addressed in the health reform bill attests to the simple fact that cost is a major factor in the legislation. Universal care was never a top priority except to assuage the proletariat.  SGR was and is held out as a bargaining chip and as a diversion for most  physicians. The effects of the SGR impact very severely on ophthalmologists, urologists, geriatricians,...

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Non Publishing Notice

I have just discovered my daily blog has not published for the past week.  I am working on finding the cause and solution.. I will be back...

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