“In Fact, It Doesn’t Matter How Many Americans Obtain Insurance under the ACA. Most Will Have Difficulty Finding a Physician.”

The City Journal article noted ”… having health insurance is not the same thing as getting good health care, or any health care. Many Americans could lose their employer-provided insurance if firms decide that paying the ACA penalty—and maybe giving small raises to their employees—is cheaper than offering health insurance as a benefit of employment or reduce workers’ hours (the ACA does not mandate coverage for part-time employees).”

Read more

Beware of Shifting Options within Medicare Plans

The New York Times reported: “The Medicare open enrollment season, which runs from Oct. 15 through Dec. 7, gives individuals a chance to rethink it all and reassess whether their plan still fits their needs.”

“Elizabeth Cooper, a 68-year-old former elementary schoolteacher, weighs her options each year. She has already tried a couple of plans, including one through Medicare Advantage, which lured her in because it had no monthly premium. But the plan required her to shoulder a significant share of her medical costs.”

Read more

How Hospitals Should Prepare For A Potential Ebola Patient

The Huffington Post reported “Back in August, it only took Mount Sinai Hospital workers in New York seven minutes to isolate and start treating a man who they suspected of having Ebola. Other U.S. hospitals have also speedily screened and tested suspected Ebola patients, all without incident.

The contrast between those other hospitals’ responses and the actions of workers at Texas Health Presbyterian Hospital Dallas, who recently mistook a Liberian man’s symptoms for a common illness and didn’t properly communicate his travel history to other colleagues, can be explained with training and drills, explained Dr. Brian Koll, the executive director of infection prevention for Mount Sinai Health System.

Read more

“I’m Here, Doc, to Make Sure I Don’t Have Anything Serious. I’m Not Sure My Regular Doctor Was Listening to Everything I Was Trying to Tell Him.”

The New York Times article included the following vignette:

“According to the nurse’s note, the patient had received a clean bill of health from his regular doctor only a few days before, so I was surprised to see his request for a second opinion. He stared intently at my name badge as I walked into the room, then nodded his head at each syllable of my name as I introduced myself.

Read more

“…Many Decisions about Discussing Errors with Patients … Involve Situations in Which Other Clinicians Were Primarily Responsible for the Error.”

Have you ever wondered what your physician should say to you if a medical error by another physician is identified?

A New England Journal of Medicine article focused on this question.

“Although a consensus has been reached regarding the ethical duty to communicate openly with patients who have been harmed by medical errors physicians struggle to fulfill this responsibility …”

Read more

“…Variation … is What Plagues Healthcare”

An article in Beckers Hospital Review focused on clinical care variation -

“Back when he was a resident, (he) saw two physicians perform separate colonoscopies, in which they discovered polyps in their respective patients. Each, however, went about removing the polyp in a different way — one via endoscopic surgery, another through open surgery. Despite having the resources and expertise to perform the procedure endoscopically, the physician who decided on surgery said his reason was a simple one: “That’s how I like to do it.”"

Read more

“The Sudden Termination of a Close Doctor-Patient Relationship Is a Wrenching Scenario …”

A major source of emotional and spiritual suffering among patients who are nearing the end of life is the abandonment they feel when they stop being cared for by a physician to whom they have become attached.

The New York Times article noted “’I can tell you, it happens all the time and it breaks the heart of patients and families and oncologists,’ said Dr. Diane Meier, director of the Center to Advance Palliative Care at Mount Sinai’s Icahn School of Medicine in New York City.”

Read more

“How Healthcare Is Changing—for the Better”

There are many innovative practices being used to make sure patients are not unnecessarily readmitted to the hospital.

A U.S News article describes a discharge regimen used by the Cleveland Clinic.

“When Richard Jones of Niles, Ohio, 70, was discharged in May, he was sent home with a digital scale to flag any weight fluctuations (a possible sign of fluid buildup), a blood pressure cuff, and other monitoring equipment tied into the hospital system. He was also assigned a telemonitoring support team of nurses, social workers, nutritionists, therapists, and doctors who would check his vital signs daily, remotely or in person, for up to 40 days. In phone and house calls, the team coordinated follow-up doctor visits and counseled the lifelong cheeseburger-and-fries fan on worrisome symptoms to watch for and how to make lifestyle changes stick.”

Read more

“… Comparing the Quality and Outcomes of Care at Competing Cancer Centers”

“Cancer!” Should you rush to a “major” cancer center?

The Modern Healthcare article noted “When it comes to cancer care, there is a huge disconnect between the possibilities of modern medicine and its day-to-day practice. As last fall’s troubling report from the Institute of Medicine noted, variation in oncology practice is wide; collection of quality and outcomes data is poor; and progress in learning what works best for any particular cancer remains slow and halting.”

Read more