America Is Stealing the World’s Doctors
By MATT McALLESTER
It was not an unusual death. Kunj Desai, a young doctor in training at University Teaching Hospital in Lusaka, Zambia, had seen many that were not so different and were equally needless. Still, this was the one that altered all his plans. “A guy came in, and he had a stab wound,” Desai recalled, “and his intestines got injured.” The operation was delayed, and the wound became infected. “Whatever he was eating would come out of his belly,” Desai said. A carefully managed diet would have helped the man heal, but there were no dietitians at the hospital nor any IV drips of liquid nutrients with which to feed him. “He withered away to probably about 100 pounds when he died.”
The man was in his 30s, and his wife and children would have to fend for themselves. It was 2004, and Desai had worked at the chronically understaffed and underfinanced hospital for a year and a half. The hospital blood bank was often out of blood, and the lab was unreliable. The patients were often so poor that Desai would pay for private lab tests out of his own pocket. Desai came home in tears one day after being unable to save a premature baby boy. When the man with the stab wound died, the accumulation of preventable deaths — at what was, he kept reminding himself, the best public hospital in the country — finally became too heavy to bear.
Computer problem extended MaineCare payments to ineligible recipients; budget figures in doubt
Posted March 06, 2012, at 7:42 p.m.
AUGUSTA, Maine – A computer problem that allowed at least 19,000 Mainers who were not eligible for Medicaid to receive benefits has thrown state budget assumptions into doubt and may extend the current legislative session while the situation is addressed, state officials said Tuesday.
“We had people who were no longer eligible for MaineCare that were continuing to be covered,” Health and Human Services Commissioner Mary Mayhew said. “We are doing an analysis to find what the financial implications are.”
Mayhew and Gov. Paul LePage met with legislative leaders and members of the Appropriations Committee on Tuesday afternoon to inform them of the problem with the billing for MaineCare, the state’s name for Medicaid.
Mayhew said staff at the Department of Health and Human Services were aware of a problem with the bill-paying computer system since 2010 but it was not brought to the attention of her and other agency leaders until January. She did not know how long the ineligible people received the benefits.
Digital Records May Not Cut Health Costs, Study Cautions
By Steve Lohr
The New York Times, March 5, 2012
Computerized patient records are unlikely to cut health care costs and may actually encourage doctors to order expensive tests more often, a study published on Monday concludes.
Modern electronic health records are meant to give doctors an integrated view of a patient’s care, including medical history, treatments, medications and past tests.
Industry experts have said that electronic health records could generate huge savings — as much as $80 billion a year, according to a RAND Corporation estimate. The promise of cost savings has been a major justification for billions of dollars in federal spending to encourage doctors to embrace digital health records.
But research published Monday in the journal Health Affairs found that doctors using computers to track tests, like X-rays and magnetic resonance imaging, ordered far more tests than doctors relying on paper records.
http://www.pnhp.org/print/news/2012/march/digital-records-may-not-cut-health-costs-study-cautions
The New York Times, March 5, 2012
Computerized patient records are unlikely to cut health care costs and may actually encourage doctors to order expensive tests more often, a study published on Monday concludes.
Modern electronic health records are meant to give doctors an integrated view of a patient’s care, including medical history, treatments, medications and past tests.
Industry experts have said that electronic health records could generate huge savings — as much as $80 billion a year, according to a RAND Corporation estimate. The promise of cost savings has been a major justification for billions of dollars in federal spending to encourage doctors to embrace digital health records.
But research published Monday in the journal Health Affairs found that doctors using computers to track tests, like X-rays and magnetic resonance imaging, ordered far more tests than doctors relying on paper records.
http://www.pnhp.org/print/news/2012/march/digital-records-may-not-cut-health-costs-study-cautions
The silent decline of primary health care
By Margaret Newton, M.D.
Brattleboro Reformer, Feb. 23, 2012
Book review: "Breaking Point: How the Primary Care Crisis Endangers the Lives of Americans," by John Geyman
Dr. John Geyman was a rural family doctor before joining the University of Washington School of Medicine. He eventually chaired its department of family medicine and is now professor emeritus. He has written extensively about America’s urgent need for health care reform. He was president of Physicians for a National Health Program from 2005 to 2007 and is a member of the national Institute of Medicine.
Dr. Geyman began practicing medicine when family doctors knew their patients well and were trusted and overworked community servants. He is a leader in educational and other nonprofit groups that seek solutions to America’s costly and fragmented health care. He has a solid understanding of its conflicting ingredients and politics.
http://www.pnhp.org/print/news/2012/february/the-silent-decline-of-primary-health-care
Brattleboro Reformer, Feb. 23, 2012
Book review: "Breaking Point: How the Primary Care Crisis Endangers the Lives of Americans," by John Geyman
Dr. John Geyman was a rural family doctor before joining the University of Washington School of Medicine. He eventually chaired its department of family medicine and is now professor emeritus. He has written extensively about America’s urgent need for health care reform. He was president of Physicians for a National Health Program from 2005 to 2007 and is a member of the national Institute of Medicine.
Dr. Geyman began practicing medicine when family doctors knew their patients well and were trusted and overworked community servants. He is a leader in educational and other nonprofit groups that seek solutions to America’s costly and fragmented health care. He has a solid understanding of its conflicting ingredients and politics.
http://www.pnhp.org/print/news/2012/february/the-silent-decline-of-primary-health-care
When Doctors Don’t Tell the Truth
By PAULINE W. CHEN, M.D.Thomas Barwick/Getty ImagesDoes your doctor always tell the full truth?
Every spring, a former patient and his elderly parents would drive two hours to the hospital carrying chocolates for the staff — an epicurean celebration of the man’s successful liver transplant a few years earlier. The patient, tall, in his 30s and with sandy-brown hair, handed out the boxes, and his parents, their parched-earth faces beaming with joy, shook everyone’s hands.
But each time the parents came over to me, there seemed to be a moment of hesitation.
On the night of their son’s transplant, I was the doctor who relayed the grim details of their son’s state. As he lay in the intensive care unit waiting for the organ, I described to them his deep coma, his complete dependence on a breathing machine, his blood, which had become as thin as water, and his need for such high doses of an intravenous infusion to support his blood pressure that if we couldn’t do the operation soon, it would be impossible to move him even the few hundred feet to the operating room for a lifesaving transplant.
Because I believed that it was my duty as their son’s doctor to be truthful, I told them that their only child might die.
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