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Badly designed electronic records can be hazardous to your health

It isn’t easy to ruffle my friend of 30 years, one of the best gastroenterologists in Boston, a town known for top-notch medicine. But he was ruffled when he told the story of giving a patient anesthesia and performing a medically unnecessary procedure—only he hadn’t known it was unnecessary because the patient’s electronic health record, or EHR, didn’t function as promised.

If you’ve heard of EHRs, you know that many doctors consider them a pain in the neck. Not much is said, however, about the harm EHRs can cause to patients. There’s a reason for that: Gag clauses prevent EHR users from talking publicly about their specific problems.

At its core, the electronic health record is a great idea. The technology is intended to replace paper records in the interest of efficiency, quality and safety. For millennia, physicians have written notes to record what we see, think and do in the care of our patients. Those notes began to develop into primitive electronic medical records as early as the 1970s, but things changed dramatically during the Great Recession.

Read more on WSJ

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Health Sharing and the Politics of Health Care

Join Host Mike Koriwchak, M.D. in this week’s Doctor’s Lounge as we travel back to DPC 2018 and explore the best interviews recorded live at the annual conference.

This week Mike interviews Dale Bellis of Liberty HealthShare and Dr. Elaina George, author, speaker, columnist, podcaster, and board certified Otolaryngologist.

BBellisio: Dale Bellis is currently the Executive Director of Liberty HealthShare. He led the reorganization plan two years ago that launched Liberty HealthShare under the terms of the Affordable Care Act for healthcare sharing ministries. Liberty HealthShare dates its origins to the mid-1980s. Mr. Bellis began his work in healthcare as an Executive Administrator with the First cost-sharing group ever begun in modern times. When he started in 1988 there were 1000 families participating. When he left in 2001 there were 25,000 families sharing medical bills. He was instrumental in passing legislation in 11 states exempting cost sharing from insurance regulations.

George, M.D.Bio: Dr Elaina George is a Board Certified Otolaryngologist. Her interest in the politics of healthcare and the reform effort have led her to become both a powerful voice for the practicing physician, an advocate for the patient, and a healthcare policy analyst specializing in healthcare consumer driven solutions. She graduated from Princeton University with a degree in Biology.

She received her Masters degree in Medical Microbiology from Long Island University, and received her medical degree from Mount Sinai School of Medicine in New York. Dr George completed her residency at Manhattan, Eye Ear & Throat Hospital. Her training included general surgery at Lenox Hill Hospital, pediatric ENT at The NY-Presbyterian Hospital, and head and neck oncology at Memorial Sloan-Kettering Cancer Center.

She has published in several scientific journals and presented her research at national meetings. As a solo practitioner in private practice who is also a small business owner, she has a unique perspective on the problems of health care delivery, the true costs of healthcare and viable solutions. Dr George is a recipient of the Patients’ Choice Award in 2008 and 2009. She was honored with membership in The Leading Physicians of the World and Who’s Who Top Doctors Honors Edition.

She is a member of the National Physicians Council on Healthcare Policy and is a contributor to a wide variety of websites including BigGovernment.com, Newmediajournal.us, and Amy Ridenour’s National Center Blog. Dr George has been a recurring guest discussing a wide range of medical topics from Your World with Neil Cavuto, Financial Survival Network With Kerry Lutz and Newsmax, to appearances on Frances & Friends to discuss the consequences of healthcare reform with a world wide audience of over 500 million people. She has also been a medical expert on a range of shows including The Bill Cunningham Show, Lions of Liberty, The Barry Farber Show, and The Kev Baker Show. Dr George hosts her own show, Medicine On Call, a weekly talk show that explores health issues and the politics of medicine on Americas Web Radio and Liberty Talk.fm Radio. She is the author of Big Medicine: The cost of Corporate Control And How Doctors And Patients Working Together Can Rebuild A Better System – A book which explores how the US healthcare system has evolved and explains how patients and doctors can create a healthcare system that is based on the principles of price transparency with the power of the doctor patient relationship.

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Direct primary care empowers doctors, patients

Scores of doctors are taking a page from Netflix’s playbook and getting into the subscription business.

They’ve adopted a business model called “direct primary care,” whereby patients pay a periodic fee for access to primary care physicians. Since 2014, the number of direct primary care practices in America has grown more than six times over.

Doctors appreciate its simplicity; no longer do they have to fight with insurance companies over payment or getting a particular treatment approved. Patients, meanwhile, love its flexibility – they have essentially unlimited access to their doctors, sometimes for less than they’d spend with conventional insurance.

Direct primary care could inject some sanity into our health care system by relying on the same market forces that have resulted in higher-quality products at lower cost everywhere else in our economy.

 

Read more over on The Buffalo News

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DPC Physician meets with Senators and Congressman on HR6199

Dr. James Pinckney II, ABFM of Diamond Physicians met with eight senators and two congressmen last week in an effort to reintroduce the Direct Primary Care Bill HR6199.

To further demonstrate the effectiveness of direct primary care, Michael Schneider, CEO of A-1 Locksmith DFW, accompanied the team. Together, they presented how a small blue-collar business was able to save 25% on their health benefits as a company while improving the care and health of their employees.

As this process progresses, it’s becoming increasingly likely that direct primary care membership will become a qualified medical expense under 213-D via executive order. This would allow for the bill to bypass congressional approval.

Upon passage, the bill would allow consumers to use HSA cards to pay for direct primary care membership.

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Combating the CON 2019

Certificate of Need Laws STILL Restricting Expansion of Access to Care

CON (Certificate of Need) laws still are enforced in states across the land.  Dr. Hal Scherz caused a stir with his commentary in the Georgia Health News as he exposed the folly of requiring a state certificate to build new health care facilities.

The CON is on and Dr. Scherz explores the problem on our next Doctor’s Lounge Radio Show.

Read his Commentary –
In his recent State of the Union address, President Trump pointed out that although progress is being made on a variety of health care issues, health care costs are just too expensive for the average American.

One reason is this: Hospitals are the most expensive delivery point in the health care system, and ironically, an increasing amount of medical care is being directed there. Complicating this issue is that no one can be sure how much a hospital will charge.

Two patients can receive identical services and leave the hospital with vastly different bills. Furthermore, because of bizarre payments by insurance companies, care in the hospital can cost five to 10 times more than care by the same doctor in an outpatient setting not owned by the hospital.

Due to high deductibles and co-pays, patients now…

Read the commentary in Georgia Health News HERE

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CON laws help hospitals, but they hurt patients

In his recent State of the Union address, President Trump pointed out that although progress is being made on a variety of health care issues, health care costs are just too expensive for the average American.

One reason is this: Hospitals are the most expensive delivery point in the health care system, and ironically, an increasing amount of medical care is being directed there. Complicating this issue is that no one can be sure how much a hospital will charge.

Two patients can receive identical services and leave the hospital with vastly different bills. Furthermore, because of bizarre payments by insurance companies, care in the hospital can cost five to 10 times more than care by the same doctor in an outpatient setting not owned by the hospital.

Read the full article at Georgia Health News.

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Blockchain, Resurrection, and DPC

Host Michael Koriwchak, M.D. continues his series recorded live at Direct Primary Care 2018 in Orlando, FL.
Interview highlights this episode include

  • Leah Houston, M.D. of HPEC.io – live stream sponsor of the conference.
  • We’ll hear the testimony of physicians who revived their will to practice medicine through DPC.
  • Listen in as D4PC Foundation President Lee Gross reflects on the event first hand.
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Physician-dispensed generics proposal pitched to Senate panel

What if doctors could not only prescribe drugs to their patients but also dispense them–no writing a prescription and sending it off the pharmacy? Not only would it be more convenient, it could be cheaper—a lot cheaper.

That’s the premise of a proposal put before the Senate health committee this week. Dr. Josh Umbehr, cofounder of Kansas-based Atlas MD, one such company providing generics directly to patients says it’s much cheaper than alternatives. In fact, Umbehr tells Modern Healthcare, “I’m cheaper than 340B.”

Umbehr related to the committee and chair Lamar Alexander, R-TN, that his practice, which he terms a “blue-collar concierge” direct primary care model that takes monthly membership fees from patients instead of accepting Medicare, Medicaid and private insurance, has a cabinet stocking about $50,000 in medications. The markup on those 200 different medications? About 10 percent. And since he gets extremely low prices on generics, his patients save money.

 

Read the full article at BenefitsPro.

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Measles Epidemic in USA

Trends Behind the Cause Explored

Step into the Doctor’s Lounge with Dr. Chip Harbaugh, the founder of Kids Health First, the largest Independent Physician Association in Atlanta with over 220 physicians.

Dr. Chip Harbaugh will discuss the measles epidemic in the USA and the trend to avoid childhood vaccinations.

Dr. Harbaugh brings a lifetime of front lines experience in pediatric care in everything from medical missions to pivotal rolls in the American Academy of Pediatrics.

Bio: (read full CV here)Dr.  Chip Harbaugh grew up in Atlanta in the Druid Hills area.He and his wife, Dana, live in the Johns Creek area and enjoy spending time with their five children and four dogs.

Dr. Harbaugh enjoys engaging patients to help the parents in the early years understand the joys as well as the concerns of parenthood. He likes teaching about development as well as disease process so the parents can fully understand their child. As children grow from infants, to toddlers and then Middle School and even High School, they will need a guiding hand in both educational and social issues. Our job as pediatricians is to make sure that each child achieves to be the best person they can be as an adult. Children are the future of our families and our society.

Recently, he served as CEO and Chairman of the Board of Kids Health First Pediatric Alliance. It is a metropolitan Atlanta Independent Physician Association (IPA), which is physician-owned and driven by 37 private pediatric practices and 210 pediatricians covering 750,000 patients. Dr. Harbaugh founded the organization in 1996 and has served as its leader until recently.

With a special interest in medical quality improvement and advocating for patients, physicians and dentists, Dr. Harbaugh has held numerous other positions outside of his clinical practice. He has served on the American Academy of Pediatrics’ COPAM (Committee on Practice and Ambulatory Medicine) and was recently appointed to the American Academy of Pediatrics’ National Conference and Exhibition Planning Committee Group.  He was also elected to the Executive Committee of the Section on Administration, Practice Management for the national AAP and serves on the organization’s Steering Committee on Quality Improvement, Child Healthcare Financing Committee and Accountable Care Organization Committee.

The Centers for Disease Control and Prevention (CDC) – appointed Dr. Harbaugh to their Clinical Laboratory Improvement Advisory Committee (CLIAC) in 2007 to help with the interface of public healthcare and the physician and dental community. In addition, Dr. Harbaugh represents the American Academy of Pediatrics on United Healthcare’s Physician Advisory Board with the goal of bridging the gap between physicians and payors to improve quality while decreasing healthcare costs.

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