Resources for Physicians

KHN: New Guidelines Boost Diabetes Screening For Overweight Adults

heidi Active Senior Living, Resources for Physicians Comments Off on KHN: New Guidelines Boost Diabetes Screening For Overweight Adults
Patients with higher-than-normal blood sugar may now get nutrition and exercise counseling without paying out of pocket.

Patients with higher-than-normal blood sugar may now get nutrition and exercise counseling without paying out of pocket.

More people who are overweight or obese may get screened for diabetes under new guidelines released this week by a panel of prevention experts, according to Kaiser Health News. Those whose blood sugar is higher than normal now can be referred to nutrition and exercise counseling without paying anything out of pocket for it.

“Obesity and overweight have been risk factors all along for diabetes,” says Dr. Wanda Filer, president of the American Academy of Family Physicians. “But we haven’t had guidelines that actually said, ‘Screen those folks.’”

Under the health law, insurers have to cover preventive services that receive a grade of A or B from the U.S. Preventive Services Task Force, an independent panel of experts, without charging patients. Read more


The Washington Post: A Different Kind of Care Package

heidi Resources for Physicians Comments Off on The Washington Post: A Different Kind of Care Package
Doctors in training visit patients in their homes to learn about the intractable factors that can shape a person's health, such as where they live, what they eat, and what social supports they have.

Doctors in training visit patients in their homes to learn about the intractable factors that can shape a person’s health, such as where they live, what they eat, and what social supports they have.

U.S. health care is in a revolution that is starting to shake up one of the most conservative parts of medicine: its antiquated model for training doctors.

Once paid a la carte for the procedures and services they perform, physicians are beginning to be reimbursed for keeping their patients healthy. Doctors trained in the science of medicine, the diagnosis and treatment of the sick person in front of them, are increasingly responsible for helping to keep their patients out of the hospital, reports The Washington Post (Johnson, 10/8).

The American Medical Association is worried enough about the problem that it has been giving out millions of dollars to prod new kinds of teaching, in the hope that doctors’ training can adapt as quickly as the system they will soon join, according to the article.

Here is an excerpt:

[A tectonic shift can’t hang on the success of a handful of bold start-ups, and in 2013, the American Medical Association gave $11 million in grants to medical schools making changes that would narrow the gap between how physicians are trained and how medicine is practiced. This year, the AMA decided to extend the program to hand out an additional $1.5 million.

Penn State was one of the grant recipients and last year rolled out the patient navigator program. First-year students pair up and make home visits, where they are faced with problems that can be far more difficult than figuring out which tests to give and what to prescribe. Students learn about the intractable factors that can shape a person’s health — where he lives, what he eats, what social supports he has — essentially, his life.]

Read entire article.


Report: Everyone Will Experience at Least One Diagnostic Error

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In addition to errors of medical treatment, more focus needs to be on diagnostic errors.

In addition to errors of medical treatment, more focus needs to be on diagnostic errors.

The Institute of Medicine published a new report in which it observes that nearly everyone will experience at least one diagnostic error in their lifetimes.

[Read Leslie Michelson’s Checklist for Avoiding Diagnostic Errors-The KHN Conversation.]

According to findings: Getting the right diagnosis is a key aspect of health care — it provides an explanation of a patient’s health problem and informs subsequent health care decisions. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err is Human: Building a Safer Health System (2000) and Crossing the Quality Chasm: A New Health System for the 21st Century (2001) finds that diagnosis — and, in particular, the occurrence of diagnostic errors — has been largely unappreciated in efforts to improve the quality and safety of health care. The result of this inattention is significant: the committee concluded that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.

Read Getting the Diagnosis Wrong by Danielle Ofri, published in The New York Times. In her column she reports that it is estimated doctors get the diagnosis wrong in one out of 10 to one out of 20 cases. She writes: “Up until now, the focus of the patient safety movement has been on errors of medical treatment — incorrect medications or dosages, postoperative complications, hospital-acquired infections. But diagnostic errors — incorrect or delayed diagnoses — may be more common and potentially more deadly. The Institute of Medicine has taken up the subject, and its new report offers the chilling observation that nearly everyone will experience at least one diagnostic error in their lifetimes.”

Read Leslie Michelson’s Checklist For Avoiding Diagnostic Errors-The KHN Conversation.