Posted in Access to healthcare, advance-pricing, Consumer-Driven Health Care, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Health Insurance, Healthcare financing, Independent Physicians, Medical Costs, Medical Practice Models, out-of-pocket costs, Patient Choice, Patient Compliance, Patient Safety, Patient-centered Care, Policy Issues, primary care, The Quadruple Aim, Third-Party Free Practices, Uncategorized, Wait times to see a doctor

More Patients Turning to ‘Direct Primary Care’ | Medscape

Christine Lehmann, MA

February 11, 2020

Having quick access to a primary care doctor 24/7 is very appealing to Mick Lowderman, 56, who is married with two children, ages 10 and 8. He pays a monthly membership fee to AtlasMD, a direct primary care practice in Wichita, KS.

Primary care is built on the long-term relationship between clinicians and patients. A 10- to 15-minute patient visit doesn’t support that relationship, Sullivan says.

When Kevin Boyd, 64, fell on his stairs in Wichita and broke three ribs, he didn’t go the emergency room. Instead, he called Umbehr, who told him to come to his office. He referred Boyd nearby for an X-ray and dispensed pain medications at his office. The total cost was $70.

In contrast, the first time Boyd fell and broke his ribs, he had Blue Cross Blue Shield and drove himself to the ER, where he saw the ER doctor, a radiologist for an MRI, and got shots for his pain. The total bill was $14,000, and he paid $2,600.

“I don’t put off care the way I used to because of the money I save,” says Boyd, who joined AtlasMD in 2015.
For his monthly membership fee of $75, Boyd gets several benefits, including unlimited 24/7 access to Umbehr by text, email, or phone, extended same- or next-day office visits, and free diagnostic tests and office procedures, such as EKGs, DEXA scans, and body fat analysis. If Boyd gets really sick and needs a house call, or if he needs a phone consult when traveling, those are also included in the fee.
Posted in Access to healthcare, big government, Canadian Health System, Crony Capitalism, Dependency, Doctor shortage, Economic Issues, Government Regulations, Government Spending, Healthcare financing, Liberty, Medical Costs, Medical Practice Models, Medicare, Organizational structure, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Protocols, Quality, Uncategorized, Wait times to see a doctor

Dr. Whatley: Single-payer healthcare – the good, the bad and the nutty – THE DIRECT PRIMARY CARE JOURNAL

Dr. Shawn Whatley

 

Shawn Whatley is past-president of the Ontario Medical Association. He has worked in emergency medicine, as a coroner, in a vein clinic, and as a surgical assistant. He also held a leadership role at a large suburban hospital. He now practises family medicine in rural Ontario. Visit his blog at shawnwhatley.com.in rural Ontario. Visit his blog at shawnwhatley.com.

The Nutty

  • Hospitals lose money for seeing more patients; doctors earn more for seeing more patients
  • Unlimited sick days for some nurses
  • March madness: hospitals spend like crazy before year-end or lose funding for next year
  • Pharmacists paid more for same service than MDs (e.g. flu shot)
  • Black market in radiology and lab licenses
  • NPs and midwives earn more per patient than MDs
  • Labs have fixed budgets: more tests means less profit per test

Bigger Issues

Single payer healthcare also raises other, more challenging problems:

Those who know cannot speak. The system suppresses dissent. People cannot speak up, because they have nowhere else to work. Professionals working in hospitals or academia must stay quiet. Single-payer systems give tremendous power to administrators who run the monopoly. It enriches and expands government. Price controls appear to limit costs, but profits are found in other ways. For example, price controls force doctors to shorten visits, unbundle care, up-code, or stop providing a service. Centrally planned single-payer systems function on Hayek’s Fatal Conceit, the assumption that planning is possible:

The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.

Local knowledge is impossible to capture or to use in managing the system. Single-payer systems incentivize collusion with government to exclude competition. It creates a psychological change in Canadians. Whereas choice empowers patients, single-payer fosters dependency on the system. It creates increased demand for fixed price services but decreased availability of those services. Single-payer assumes that bigger is always better. But bigger often becomes too big to manage. A CEO of A.T.&T. once said, “A.T.&T. is so big that, if you gave it a kick in the behind today, it would be two years before the head said ‘ouch.’”

https://directprimarycare.com/2019/01/31/dr-whatley-single-payer-healthcare-the-good-the-bad-and-the-nutty/

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Independent Physicians, Medicaid, Medical Costs, Medical Practice Models, Medicare, Organizational structure, Patient Choice, Policy Issues, Quality, Reforming Medicaid, Reforming Medicare, Subsidies, Uncategorized, Wait times to see a doctor

Most Americans Want Government-Run Health Care Until They Find Out the Government Will Run Health Care – Hit & Run : Reason.com

“While 55 percent of Americans say they want a single-payer/Medicaid-for-all plan, those in favor tend to change their minds when they hear that it means giving the government more control over health care, or that Americans would have to pay more in taxes.

That tracks with other polling on the issue. A May poll from the nonpartisan Public Policy Institute of California found support for single-payer state healthcare at 65 percent statewide, but that number dropped to 42 percent when respondents were told at least $50 billion in new taxes would be required to pay for it. That’s a pretty optimistic view of the taxes that would be required to pay for single-payer in California; the actual cost would be well over $100 billion annually.

Are you sure you want government-run health care? Many Americans don’t seem to understand the question. But once they do, the answer is “no.” “

Posted in Access to healthcare, British National Health Service, Cartoons, Economic Issues, government incompetence, Government Regulations, Government Spending, Healthcare financing, Organizational structure, Policy Issues, Uncategorized, Wait times to see a doctor

The U.K.’s Government-Run Healthcare System Is Working Wonderfully…for Bureaucrats | International Liberty

Hundreds of NHS managers have amassed million-pound pension pots while presiding over the worst financial crisis in the history of the health service… As patients face crippling delays for treatment, A&E closures and overcrowded wards, bureaucrats have quietly been building up huge taxpayer-funded pensions. They will be handed tax-free six-figure lump sums on retirement, and annual payouts from the age of 60 of at least £55,000 – guaranteed for life.

Nearly 300 directors on NHS trust boards have accrued pension pots valued at £1million or more; At least 36 are sitting on pots in excess of £1.5million – with three topping a staggering £2 million; The NHS pays a staggering 14.3 per cent on top of employees’ salary towards their pension – almost five times the average of 3 per cent paid in the private sector…

Back in 2013, I got very upset when I learned that senior bureaucrats at the IRS awarded themselves big bonuses, notwithstanding the fact that the agency was deeply tarnished by scandal because of …

Source: The U.K.’s Government-Run Healthcare System Is Working Wonderfully…for Bureaucrats | International Liberty

Posted in Access to healthcare, Doctor shortage, Medical Costs, Medical Practice Models, outcomes, Patient Choice, Patient Safety, Policy Issues, primary care, Quality, Uncategorized, Unsettled Science, Wait times to see a doctor

A Primary Care Panel Size of 2500 Is neither Accurate nor Reasonable

Primary care panel sizes are an important component of primary care practices. Determining the appropriate panel size has implications for patient access, physician workload, and care comprehensiveness and will have an impact on quality of care. An often quoted standard panel size is 2500. However, this number seems to arise in the literature anecdotally, without a basis in research. Subsequently, multiple studies observed that a panel size of 2500 is not feasible because of time constraints and results in incomplete preventive care and health care screening services. In this article we review the origins of a panel size of 2500, review the subsequent work examining this number and effectively debunking it as a feasible panel size, and discuss the importance of primary care physicians setting an appropriate panel size.

Recent studies of various practice settings in the United States and abroad found current panel sizes ranging from 1200 to 1900 patients per physician. For example, Kaiser Permanente reported a mean per-physician panel size of 1751 patients, and Group Health Cooperative of Puget Sound reported a panel size of 1490 patients per physician.18 The US Department of Veterans Affairs reported a mean panel size of 1266 patients per full-time equivalent physician.1

Source: A Primary Care Panel Size of 2500 Is neither Accurate nor Reasonable

Posted in Access to healthcare, Deductibles, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor shortage, Economic Issues, Health Insurance, Healthcare financing, Independent Physicians, Medical Costs, medical inflation, Medical Practice Models, Patient Choice, Policy Issues, primary care, Quality, Third-Party Free Practices, third-party payments, Uncategorized, Uninsured, Wait times to see a doctor

Debunking Media-Supported Myths about DPC: A Conversation with Dr. Brian Forrest — Hint Health

Dr. Brian Forrest. PHOTOGRAPHS BY DEREK ANDERSON After growing frustrated with the patient volume and time requirements of managed care, Dr. Brian Forrest started his own practice with a unique model of care. Its flat-rate fee and longer office visits have proven popular with patients.
Dr. Brian Forrest

As a seasoned advocate and DPC practitioner, Dr. Brian Forrest knows all to well the problems that misinformation can create for a movement built almost entirely on word of mouth. In the second installment of our ongoing series, Dr. Forrest provides a healthy dose of reality and debunks the nine most dangerous myths about DPC.

Source: Debunking Media-Supported Myths about DPC: A Conversation with Dr. Brian Forrest — Hint Health

Posted in Access to healthcare, Consumer-Driven Health Care, Direct-Pay Practice Models, Education, Evidence-based Medicine, Medical Practice Models, Patient Choice, Patient Compliance, Patient Safety, Patient-centered Care, primary care, Protocols, Quality, Uncategorized, Wait times to see a doctor

Most of the care you’re receiving isn’t patient-centered. Here’s why.

By Rob Lamberts, MD | Physician  | DPC Journal/CMT Contributor -- http://more-distractible.org/
Rob Lamberts, MD

There is no excuse for the lousy service people get from our system.

Source: Most of the care you’re receiving isn’t patient-centered. Here’s why.

Posted in Access to healthcare, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relations, Economic Issues, Independent Physicians, Medical Costs, Medical Practice Models, Patient Choice, Patient-centered Care, Policy Issues, Prevention, primary care, Quality, The Quadruple Aim, The Triple Aim, Uncategorized, Wait times to see a doctor

The Solution to Making Our Healthcare System Affordable May Be a Lesson From Our Past | Jeffrey Gold | LinkedIn

Jeff Gold
Dr. Jeff Gold

For a state that prides itself on providing superior healthcare services for its citizens, Massachusetts is emerging as the state that no other state wants to emulate. No matter how much policymakers

Source: The Solution to Making Our Healthcare System Affordable May Be a Lesson From Our Past | Jeffrey Gold | LinkedIn