Enjoy our most current issue of the most popular medical e-newsletter on the internet.
Blogs and Thoughts for June 7th to June 13th, 2018
Here is what we had this past week:
- Your AMA …Cover for the MOC by Pat Conrad MD
- How Hospitals Think They Can Fix Burnout
- Cigna Making Your Life Easier
- The Health Insurer Rate Hike Tracker
- Bourdain, Suicide and Sadness
- Friday Funny: Test
- Quote of the Week: Adam Gropman
1. Your AMA …Cover for the MOC by Pat Conrad MD
June 13, 2018
Anyone wishing to cure an overabundant zest for living need only spend a few minutes reading AMA House of Delegates committee resolutions. The formal tone attempting to dress up a truckload of self-important swirl not nearly dignified enough to be called bullshit is…Contemptible? Loathsome? It sure is boring.
Remember when the AMA came out against MOC in 2016? Of course you don’t, because in the end they predictably backed off and went back “for more study,” the politician’s way of saying he ‘wants to spend more time with the family” right after his latest DUI.
The AMA has worked diligently AGAINST the interests of patients and physicians for decades, and like the ABMS, has made a boatload of money in the process. Yes I know, the ABMS doesn’t really answer to the AMA, but the latter is a powerful voice for all physicians, and could help us in this fight against the Maintenance of Certification gangsters. Wouldn’t they want to?
This week the Vichy sellouts of “The House of Medicine” met at their AMA ego orgy in Chicago. Could this really be the year when they finally came out and opposed the MOC extortion racket?
Madam Speaker, your Reference Committee recommends that Resolution 316 be referred.
HOD ACTION: Resolution 316 referred.
Resolution 316 asks that our AMA call for an end to the mandatory American Board of Medical Specialties “Part 4 Improvement in Medical Practice” maintenance of certification requirement. Your Reference Committee heard mixed testimony regarding the Part 4 requirement for American Board of Medical Specialties (ABMS) maintenance of certification (MOC). There was testimony concerning the relevance, burden, and cost of the MOC Part 4 process in addition to the other requirements physicians are required to fulfill for meaningful use, MACRA, etc. However, it was also noted that the broadening range of acceptable activities that meet the Improvement in Medical Practice (MOC Part 4) component has made this activity acceptable for other national value-based reporting requirements and continuing certification programs. It was also noted that the boards are implementing a number of activities related to registries, systems-based practice, and practice audits to show improvement in practice. The ABMS Multi-Specialty Portfolio Program offers health care organizations a way to support physician involvement in their institution’s quality and performance improvement initiatives by offering credit for the Improvement in Medical Practice component of the ABMS Program for MOC. Due to the Council on Medical Education’s ongoing work with the ABMS and the ABMS member boards to improve this process, your Reference Committee felt that this issue should be referred for further study. Therefore, your Reference Committee recommends that Resolution 316 be referred.”
If you couldn’t read the preceding statement without looking for the whiskey or a rusty knife, here are the low points:
- The AMA will not oppose MOC
- The “mixed” testimony included pro-MOC agents that (easily) seduce the AMA traitors with language regarding “value-based reporting requirements”, “systems-based practices”, and “audits to show improvement in practice.” The AMA is using the phony, unproven quality-value based lingo to push their tacit support of the ABMS thieves.
- And for some moral veneer and a wink, this report cheers the ABMS’ support of forcing physicians into “quality” initiatives forced on them by non-physicians.
- “Since the Council on Medical Education is already working with the ABMS to screw all physicians for a fee, we don’t think the AMA should interfere.”
The AMA delegates, as a body, are traitors to anything decent in medicine. Most of this already knew that, and now we have their support for the MOC in black and white.
2. How Hospitals Think They Can Fix Burnout
June 12, 2018
I know that many of you cannot read this article in the Wall Street Journal but I still think there is a need to highlight what was said in it. The online version is called:
Hospitals Address Widespread Doctor Burnout
To address an epidemic of physician stress that some say puts patients at risk of medical errors, hospitals are making changes
Okay, where do I begin? First, I need to take a deep breath. Look at the sub headline. Patients at risk? Medical errors? Umm, what about doctors killing themselves or quitting? To be fair, at least this issue is being talked about. Let’s move on.
The article highlights how some hospitals are creating a new position called “Chief Wellness Officer”. What’s your thoughts when you first hear that? I hate that more administrators are created but I do like that someone is going to bat for the doctors. Anyway, the doctor doing this job was interviewed and said this:
“Telling doctors to eat granola, do yoga and be more resilient isn’t going to address this problem,” says Tait Shanafelt, who was appointed chief wellness officer of Stanford Medicine a year ago.
Ok, he gets a pass on this because I think he is right. The rest of the article talks about things I have been saying FOREVER:
- One priority is reducing clerical duties. A leading cause of physician distress is electronic record-keeping, which requires doctors to do clerical and billing work, and cuts into time with patients. It has also increased “Pajama Time,” the hours doctors devote at home to electronic charting that wasn’t finished during the day.
- A related problem is managing electronic in-baskets filled with patient demands. “A typical physician nowadays gets bombarded with tasks.”
But the recommendations given were questionable:
- He envisions a team approach where doctors focus on clinical care and leave some tasks to others. By shaving administrative minutes here and there, Dr. Ripp aims to reduce nightly electronic work by an hour.
- Hiring staff to sit in on appointments and take notes is cost-effective, he says, because it frees up doctors to see more patients.
The answer, in my humble opinion, is not hiring more people but destroying the system that created these tasks in the first place. Direct primary care is one way but I understand that this may not work for specialists. We cannot keep trying to follow the demands of third parties and think we can win at this game. That is a dog trying to catch his tail. This system needs to be blown up. The bandaid approach won’t work.
My favorite part of this article, and I am not being sarcastic, was this:
As an example of frayed bonds, Dr. Shanafelt points out that hospitals’ physician lounges, where doctors could meet, unwind and discuss cases, have largely vanished. While two new Stanford hospitals have them, Dr. Shanafelt, associate dean at the Stanford School of Medicine, would like gathering places for doctors throughout his institution and at other hospitals as a low-cost effort “to help drive community.”
I love the idea of a Doctor’s Lounge again!! Love it. But who would be allowed in? Doctor of what? DNP? Ph.D? There is no way this would hold. I could see this politically correct culture of ours watering that down so much that ANYONE would be allowed in and then doctors wouldn’t show up anymore. And then the administration would close it. Oh yeah, that is how they got rid of them in the first place.
What is your thoughts on all this? I would love to hear it.
3. Cigna Making Your Life Easier
June 11, 2018
This was emailed to me:
I don’t know if you saw the email Cigna distributed this week.
They started strong:
“We’re committed to making it easier for you to do business with us.”
And then immediately disappointed:
“Our new Precertification web page is one of the many ways…”
It’s almost like a giant insurance company has no idea what a physician’s office does all day.
Thought you might be interested in this bit of hypocrisy.
Editor’s Note: Just another day in the life of a doctor.
4. The Health Insurer Rate Hike Tracker
June 10, 2018
Did you hear the news?
Before you start blaming the right or the left, I just want you to know that it doesn’t matter. I believe I am the ONLY written/blogger that follows this. I mentioned this farce last year. The idiotic article above says:
Many insurers cite two key drivers of the increases: Congress’ elimination of the penalty for the individual mandate — which requires nearly all Americans to have coverage or pay up –and the Trump administration’s expected expansion of two types of health plans that don’t have to adhere to Obamacare’s regulations.
We need to stop letting the media hypnotize us. As I have been tracking this for almost a decade, here is what the media says every year:
- Health insurers seek big premium increases (2017)
- HEALTH INSURERS SEEK BIG INCREASES IN THEIR PREMIUMS …(2016)
- More Health-Care Insurers Seek Big Premium Increases – WSJ (2015)
- Health Insurers Threaten To Increase Premiums, Even As Profits Soar (2013)
- Health insurance costs rise again | Star Tribune (2012)
- Health Insurers Seek Higher Premiums – The New York Times (2011)
- Health insurers seek rate hikes, citing new reform law – The Denver Post (2010)
I put the year these articles were published in parenthesis but just know that they’re forecasting or warning about the rates for the following year. So, I have them all in order. Can you see any commonalities?
Yup. THERE THE SAME!
It’s the insurers who continue to make more and more money yet somehow get away with passing any expenses onto us. They “feed” the press whatever the want and these idiots buy it. They cry poor mouth but their stocks and profits keep going up and the media is too busy with personal grudges to report what is really going on.
So, I’ll report it. The truth is that EVERY YEAR we will have the same headline as shown above. This is not new. How about for ONCE it says Health insurance to lower premiums next year?
What a joke.
5. Bourdain, Suicide and Sadness
June 9, 2018
I was really sad when I heard the news about Anthony Bourdain. It is the same way I felt when I heard about Robin Williams. I never heard of Kate Spade before so it didn’t hit me as hard. Why am I so sad? Obviously, I am bothered that their recent suicides left young kids without a parent forever. That being said, I didn’t know these people personally.
Bourdain had the job EVERY guy wanted. Travel. Eat. Make money. He was also cool even if you didn’t agree with some of the things he said.
My friend said this to me:
“And he was a recovered heroin addict who’d known some dark times, though all that supposedly was behind him. Spade had been dealing with demons for five years, according to her sister and her husband. But Bourdain? Whatever it was, it’ll probably emerge in the next few days or weeks. Seems like no amount of self-awareness is enough to protect some people from making that choice.”
I guess. There’s also the fact that suicide has gone up 30% since 2018 (WSJ article on 6/8/18) and there is a massive epidemic of white, middle aged men offing themselves.
Maybe Kate Spade’s death gave Bourdain social proof to do it (he probably knew her)?
So why am I so bothered by this? Maybe it’s because I know people in my life who are at risk and I worry about them? Maybe because we always worry about ourselves and our own thoughts. I really don’t know.
But in the end, I am just sad.
6. Friday Funny: Test
June 8, 2018
I find this funny.
7. Quote of the Week: Adam Gropman
June 7, 2018
“Here’s some advice: At a job interview, tell them you’re willing to give 110 percent. Unless the job is a statistician.”
Comedian Adam Gropman
UNTIL NEXT TIME, KEEP SMILING, KEEP LAUGHING AND KEEP OUT OF REHAB!
Douglas Farrago MDTweet