MedBlog Power 8
MedBlog Power 86/25/2008 - 7/2/2008
Next revision: 7/2/2008
(Key: Rank, Blog name, Last week's rank, Post of note)
1) Rural Doctoring (1), Cultivating Rural Doctors
2) Health Beat (2), Choosing Our Battles
30
June
Medicare cuts, Monday update
Medicare cuts, Monday updateCutting physician payments will escalate health care costs: "If you cut payment for services as a cost control (the 10% cut), you will get more volume by the survivors doing the expensive highly profitable procedures, AND you will get declining access from the already high volume, low profit centers (primary care). In other words, you will get less primary care (the cheap stuff) and you will get more expensive proceduralization by specialists."
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30
June
Today’s news today, doctors, Peel, and individual insurance
I just noticed that THCB today is all about last week and Sunday’s news—including Merrill Goozner and me jumping separately on the same magic quote in the NY Times CT piece. So how about three little pieces of news about stuff reported today.
First off, in a desperate attempt to keep the Republicans from losing all 33 Senate seats in November, CMS is freezing the cuts in Medicare fees which were due to go automatically into effect this week. Bob Laszewski has a just excellent explanation of how the Dems finally seem to have figured out how to play hardball with the Republicans andAHIP. Perhaps they’ve taken on Tom Delay as an advisor, now he’s not so busy. Meanwhile Bob thinks that the 7 missing Republican votes will return from July 4 and the Medicare Advantage and PFFS plans will get their comeuppance. Wall Street isn’t so sure, and those health plan stocks are trading higher today.
30
June
A classic from a cardiologist
The NY Times has a long piece on the fast spread of 64 slice CT scans and their using in cardiac imaging. This is all pretty much taken straight from Shannon Brownlee's fabulous book Overtreatedwhich has a whole chapter on the topic. But it's good to get the debate out there.
It appears that essentially there’s no real reason to use these scanners for the vast majority of patients. And in fact they’re use probably leads to more unnecessary angioplasties and stenting (which in itself doesn’t seem to reduce the number of heart attacks). But of course once a practice buys a 64 slice CT it’s an ATM machine sitting in the corner—not much good if you don’t use it, but very profitable if you do. Of course, the more conservative approach gets short shrift and those waiting for evidence to justify all this spending get ignored in the rush by both doctors, hospitals and manufacturers to get at the taxpayer’s coffers.
30
June
Run for the hills: the doctors are coming
What is the one thing no human being should want to be next week?
A Republican Senator at a Fourth of July Picnic.
In the most amazing turn of events I have seen in 20 years of following health care policy in Washington, the Democrats have the Republicans backed into an awful corner over the issue of the July 1st automatic 10.6% Medicare physician fee cut and corresponding private Medicare cuts to pay for nixing it. Also at stake is another 5% physician fee cut set for January 1, 2009.
30
June
NY Times examines CT scans and evidenced-based medicine
The front page of the New York Times Sunday morning had a don't miss article on the financial incentives behind using CT scans to look for heart disease. Medicare's decided in March to begin paying for the test despite no evidence that it saves lives (see this GoozNews post). The lobbying campaign by a newly created physicians guild that invests in CT scanning clinics is discussed in the last few paragraphs of the story. That campaign was aided by "entrepreneurial guidelines" touting the procedure, discussed in this GoozNews post.
30
June
MD Consult
MD Consult
I would like to welcome MD Consult as the newest sponsor at Kevin, M.D.
MD Consult brings the leading medical resources together into one integrated online service to help physicians efficiently find answers to pressing clinical questions and make better treatment decisions. The website is designed to meet the exacting needs of clinical practitioners, providing practical and time-saving features that allow users to quickly access precise information.
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30
June
Doctor fee stalemate exemplifies problems of universal health care
The thousands of physicians and millions of Medicare beneficiaries who think the government should provide “universal health care” insurance to all Americans are getting a good look at how ugly such a politically-driven scheme would be. Doctors would see their incomes fall, and patients would suffer big time.
Because Congress cannot agree on how to prevent a 10.6 percent cut in Medicare payments, doctors are threatening to drop their Medicare patients. And because the Democrats want to prevent the cut in Medicare payments to doctors by cutting payments to private insurers that cover millions of Medicare beneficiaries, insurers are threatening to drop out of that program and make those Medicare beneficiaries very unhappy.
30
June
Solana Medspas is out of business?
Seems that Solana Medspas site is down. I've received two emails this morning asking if they've gone out of business and this comment on a Solana discussion thread in the forums:
"Well it looks like Buckingham and company can't hurt anyone else. The website is down and they are nowhere to be found. Hey, Over It...the truth hurts. Are you sure you aren't a Solana Owner in denial or just covering your rear end? Between the University of Arizona charges, Brooks College 60 Minutes expose and firing, Health West fiasco and connections, continuing client failures, deadbeat dad website stating a failure to pay tens of thousands in child support to his ex-wife (which was the final straw on why we didn't contract with Solana), etc... Wake up everyone associated or affiliated with Buckingham. it is time you recognize him for who he is before he hurts more people."
29
June