Washington, Please don’t bail out the health care industry

From the Health Care Blog:

A health care Marshall Plan — $50 Billion stimulus to get electronic health records (EHRs) in every doctor’s hands or $50,000 to each physician -– what an incredible marketing job.

Detroit, are you listening? Stop whining to Congress that you need a bailout. Tell them you want to be the new alternative energy Manhattan Project, get the money, and then keep building SUVs and flying around in corporate jets.

To Congress, Daschle, and Obama, please don’t do this. Our industry, health care, combines the worst of the Big Three automakers with the worst of the hubris, dishonesty, and failure of the public trust of Wall Street. Please do not bail us out.

Free-standing ERs promise good medicine plus customer service

From the Kansas City Star:

At most of America’s 4,500 or so hospital emergency rooms, the old ways still rule. But a new type of emergency facility is emerging across the country, one that isn’t at a hospital at all and whose claim to fame is customer service.

Often situated in the fast-growing suburbs, these “freestanding” emergency rooms trumpet shorter wait times and a more pleasant environment and, at their best, bring much-needed emergency diagnostic and clinical expertise to underserved areas.

Typically staffed by board-certified emergency physicians, they’re equipped to evaluate, stabilize, diagnose and treat patients with conditions as varied and serious as broken bones and severe burns. They currently operate in only about 16 states, so they’re not commonplace yet. But their numbers are growing fast. Between 2005 and 2006 alone, the total grew more than 20 percent, to 179, according to the American Hospital Association.

USA Today Editorial on Malpractice

From USA Today:

Health care costs are out of control, as we heard constantly during the presidential campaign. Yet that doesn’t stop sensible physicians from shunning the sickest patients or ordering needless hospitalizations, drugs, tests and invasive procedures.

Against their better judgment, physicians practice “defensive medicine” — actions designed to protect themselves from lawsuits rather than serve patients’ best interests.

Why? The threat of being sued is pervasive, and doctors simply don’t trust the legal system. One in seven obstetricians/gynecologists has stopped delivering babies, and three-quarters have been sued at least once, according to a 2003 study. Years of staggering malpractice premium increases have forced many to alter their practices or quit treating patients.

The decline of family practice residency training programs

From Kevin MD:

It’s well known that fewer medical students are opting to become family physicians.

This is having a deleterious effect on training programs, where slots are going unfilled. It costs approximately $100,000 to train a single doctor, and hospitals are operating family practice residencies at a loss.

Two programs in Arizona are eliminating such primary care training positions, citing cost and declining student interest.

As “doctors are more likely to launch their careers near where they complete their medical training,” this further depletes the region of much-needed new primary care blood.