By Evan Falchuk
Here are eleven things that are absolutely going to happen** in 2011.
They are in no particular order….or are they?
Posts Tagged ‘Doctor Patient Relationship’
11 Predictions for 2011
Tuesday, December 14th, 2010
Things You Should Read
Sunday, November 21st, 2010By Evan Falchuk
Here’s my weekly look at things I’ve read that maybe you haven’t.
1. Health Insurance, Hospital Industries: Don’t Repeal Reform Law. Hospitals and health insurers aren’t keen on seeing the health care reform law changed very much. It’s probably got something to do with the fact that hospitals are going to get lots of new money from millions of newly insured Americans. And that health insurers like the idea that they will end up like utility companies- with secure market shares and predictable profits. Large employers – least affected by the law – also seem to want to avoid opening this can of worms.
2. Will Government Web Site Make it Easier to Pick Doctors? I hope so. But, if it’s anything like the way healthcare.gov says it helps you pick hospitals, I am skeptical. At some point, consumers will figure out the serious limitations of these tools and get upset about how they are being handled. Ask the TSA what that’s like.
3. Medical Tourism: Not What You Think It Is. I don’t think there is much of a market for Americans to travel abroad for care, no matter how much cheaper it is. But there is a market for Americans to travel to other cities in the US for higher-quality, or lower cost care. I call it “domestic medical tourism,” and it is one of the emerging trends in U.S. benefits design.
4. Higher Deductible? You Probably Think Reform is Bad. Well, it’s a bit of an exaggeration, but a study showed that employees who were in higher deductible plans were more likely to be worried about the impact of health care reform. Does this mean that once you’re in a higher deductible plan you tend to like it better?
5. Never Hesitate to Get a Second Medical Opinion. File this one under “damn straight.”
6. Google’s Unintentional Weight Loss Program. A friend of mine recently wondered if the people in news stock footage of obese people ever recognize themselves. Well, when a very overweight man in the UK recognized himself on Google Street View, he was shocked by how he looked and decided to do something about it. He lost 100 pounds.
What I’m Reading
Saturday, November 13th, 2010By Evan Falchuk
Here are some interesting things you may have missed this week:
1. Can CAT Scans Prevent Lung Cancer? Smoke and Mirrors. The always-interesting Michael Kirsch, MD calls BS on the news that CT scans can prevent lung cancer. Read the whole thing.
2. Paging Dr. Luddite. Megan McCardle at The Atlantic is a terrific economics writer – but falls for some very strange ideas about why health care is so far behind in adoption of information technology:
Fighting disease is relatively simple. Fighting patients, doctors, and all the other stakeholders in the current system may be beyond the powers of even the most advanced computing system.
Really? There’s persistent magical thinking around health care IT. Yes, more technology will make things better, but it’s not the fundamental issue in health care. The problem is a continuing failure to recognize that fighting disease is incredibly hard. The most powerful tools available to do that are doctors’ insights, judgment and time, and patients’ engagement in that process. Ever-more clever ways of failing to take this into account are the real culprits here, not doctors and patients.
3. Businesses Not Going to Drop Health Plans Because of Reform. At the New Health Dialogue, they report on a study by the benefits consulting giant Mercer. They found that few, if any, employers plan on dropping their coverage in order to push their employees onto government-run exchanges in 2014. If the government’s success in attracting people to its new plan for people with pre-existing conditions is any preview of how well that will go, this shouldn’t be a surprise.
4. MetLife Stopping New Sales of LTC Coverage. Earlier this week I advised that buying long-term care coverage was a cornerstone of being a health care survivalist. This news underscores two points. First, that the coverage is too cheap right now so you should buy it before rates go up. Second, as the linked NYT blog post points out, not enough people understand how important it is to own this kind of coverage. Medicare isn’t going to cover you for long term care.
5. Knights of the Executive Roundtable. More on this later, but I had the privilege on being a member of this terrific panel in Las Vegas on Thursday. Risk and Insurance said it brought some “well-received frankness” into one of my favorite topics – how to produce good medical outcomes and how to measure them. If you know me, you know my answer: did the person get the right care?
How to Be a Healthcare Survivalist
Tuesday, November 9th, 2010By Evan Falchuk
There are plenty of “survivalists” out there who stock their basements with canned goods, getting ready for some unexpected (and unlikely) apocalypse.
Meanwhile there are things that are much more likely to happen to you, like getting sick, which many of us don’t prepare for at all.
So to help you get started, here are five important tips on how you can become a health care survivalist.
The Future of American Healthcare
Friday, October 29th, 2010By Evan Falchuk
You want to see a doctor?
You’re going to have to wait. And I don’t mean like an hour in the office.
I mean like 53 days.
Stop the Phony Quality Measures, Ctd
Friday, October 15th, 2010By Evan Falchuk
Who do you think is likely to be a better doctor:
A board certified graduate of one of the top medical schools in America, or a non-certified doctor trained in a foreign country?
If your answer is “I have absolutely no idea,” then you’re probably spending a lot of time looking at the “report cards” that pass for measures of health care quality. And you’re probably confused.
Cardiac Stents Don’t Work
Wednesday, September 8th, 2010By Evan Falchuk
I have a friend who had a blocked cardiac artery. A couple of years ago he had angioplasty on it, and his doctor inserted stents. The stents got rid of his chest pain and other symptoms, but didn’t do anything to get at the underlying cause of the blockage, which had to do with an unhappy combination of genetics and a – perfectly admirable – taste for rich, fatty foods.
Like steak. More on that in a moment.
Before having the procedure, his doctors spent a lot of time with him explaining what the surgery would and wouldn’t do. In particular, the doctors explained that the stents would do their job, but he had to do his. He needed to eat better, exercise more, and take his medications. He’s followed most of that advice, and is doing well.
Unfortunately, his experience is not typical. A recently-published study found that more than 80% of patients who had gotten angioplasty and stents thought they were, alone, a cure for their problems.
These patients are wrong – so how can it be that they are coming to this strange conclusion?
Starving Doctors
Wednesday, September 1st, 2010By Evan Falchuk
If you’re into health care consumerism, and you like, well, me, you will enjoy my guest blog post at CDHC Solutions Magazine.
CDHC Solutions focuses on consumer-driven health plans. Consumer-driven plans are a form of “high deductible” health coverage that is more popular than ever.
For whatever you want to say about these plans, one thing is clear: they don’t solve the fundamental problem of patients not having enough time with their doctors.
Here’s a taste of what I wrote:
Researchers have been trying to pinpoint the impact of this time starvation on the quality of medical care, and they’re finding disturbing results. A recent study in the Annals of Internal Medicine found that because of time pressures and related factors doctors deliver “error-free” care as rarely as 22% of the time. The researchers called this a “failure to individualize care,” which is a nice way of saying the doctors just weren’t paying enough attention to the needs of their patients.
Read the whole thing here.
It’s Your Medical Record, But….
Wednesday, July 28th, 2010By Evan Falchuk
You have a right to your medical record.
It’s true – the record of every test and procedure you’ve had done, any films or studies, your doctors notes. It’s all yours if you ask for it.
But it’s not that simple.
“I was shocked”
Tuesday, July 27th, 2010By Evan Falchuk
According to the Annals of Internal Medicine, doctors make the wrong medical decisions surprisingly often.
Using a “mystery patient” technique – in which actors pretended to be patients – researchers found that doctors made errors in complicated cases in 60% to 90% of cases. Sixty to ninety percent. In uncomplicated cases, they made errors in nearly 30% of cases.
As one study participant put it, “I was shocked.”
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