Healthcare Reform continues to move forward, and America’s internists are stepping up to the plate, going to bat in Washington for both doctors and patients. Their demands are neither simple nor small, but are most definitely crucial to a healthier America.

Last week, members of the American College of Physician Services (ACP) attended the 2011 Leadership Day on Capitol Hill to lobby Congress for significant changes to America’s healthcare system. Their top priorities included:

• Eliminating the Medicare Sustainable Growth Rate (SGR) and transitioning to a better payment system,
• The preservation and protection of key discretionary Workforce programs,
• The creation of mandatory programs to strengthen access to primary care, improve quality and lower costs,
• And preserving, improving or revising key health reform policies.

In a pre-Leadership Day speech Nancy Nielsen, MACP, a senior advisor at the Center for Medicare & Medicaid Innovation (CMS) urged doctors to voice their opinions on reform.

According to Doctor Nielsen, “The important thing here is for you [physicians] to comment on this. Would you need an infusion of cash up front to do whatever it is you need to do? Or would it be more helpful to have it as a per beneficiary per month payment you can count on? You want to think about that and comment on it. You might have some other ideas about how the advance payment ought to be distributed.”

There are a variety of ways to make your voice heard even if your travels don’t take you all the way to DC. For example, the Legislative Affairs page of the ACP website includes a Legislative Action Center with letters doctors and students can address to their legislators and customize with their own anecdotes and experiences. The letters are expertly written, not at all pedantic and full of the passion internists have for their calling.

Here’s a sample from the current letter going out from internists across the nation urging Washington to help curb the impending shortage of doctors:

As an internist, I provide long-term, comprehensive care in both the office and the hospital, managing both common and complex illnesses of adolescents, adults, and the elderly. The U.S., however, is facing a growing shortage of internal medicine physician specialists, like me, and other primary care physician specialties.

I recognize that there are strong differences in Congress on the health reform law, yet I continue to hope that Congress will find common ground on providing all Americans with access to affordable health insurance coverage. Despite the deep disagreements on many issues, I hope that Congress can at least reach bipartisan agreement on these initiatives that contribute to better patient care and lower costs . . .

If you have not already participated in this letter writing campaign or a similar campaign with one of the many other healthcare member organizations, please don’t wait! The time to make your voice heard is NOW!

You’ve just sent another patient to a specialist and by this time tomorrow, you may not remember his name. In fact, you may not even see him again! Is this really what it’s all about?

Isn’t it nice when your patient is your patient? When you are fully involved with her care for the long term? When you can greet her like an old friend and chat about little league and the school play? Well, the medical community is slowly embracing an idea called the “patient-centered medical home” which would allow doctors and patients to enjoy this kind of relationship.

In an article in Consumer Reports, Dr. Ronald Epstein, Professor and Director of the Center for Communication and Disparities Research at the University of Rochester Medical Center, says the medical home is designed to give patients a doctor who knows them as a person and ensures their needs are met and placed front and center. This idea is not a pipe dream; a bill being considered in the state of Oregon would set aside $400,000 to establish a “patient centered medical home” research and training center at Oregon Health & Science University.

Dr. Mark Kleinman, Vice President and Associate Medical Director for Primary Care for Kaiser Permanente, was recently quoted in the Oregonian regarding medical homes, “We want people to develop a years-long, longitudinal relationship with a single primary care provider and their team.”

Kaiser Permanente is planning to convert all of its clinics in Oregon and southwest Washington to the medical home model over the next year. Medicare is expected to launch a pilot program devoted to the medical home in the next few years.

Allowing primary care doctors to take part in the majority of a patient’s health care reduces visits to more costly specialists. Additionally, a study by Group Health Cooperative out of Seattle claims patients involved with this model of care required 29 percent fewer emergency room visits and six percent less hospital stays. This same study showed a return on investment of $1.50 for every dollar spent.

Kevin Grumbach, M.D., Chair of the Department of Family and Community Medicine at UC San Francisco, said this new model of health care allows a patient’s doctor to be their advocate, rather than a gatekeeper that restricts access to services. Grumbach, as quoted in Consumer Reports, said medical homes lower costs by reducing wasteful and duplicative services. He goes on to say that in our nation’s “large health-care delivery system . . . People are looking for someone they can recognize, who can lead them through the journey.”

Keep an eye on this emerging trend that may vastly improve your practice and your doctor-patient relationships!

The job-related headlines have provided an ongoing emotional roller coaster the past few years swinging wildly from pessimistic news of doom and gloom to optimistic reports of economic recovery. This week I read about something positive and real that encouraged me – a system in healthcare technology that is creating new jobs and will continue to do so in the coming years. These are Health Information Exchanges (HIEs), also referred to as Health Information Technology (HIT) (and a bevy of other monikers with accompanying acronyms).

HIEs have been around, on a small scale, for at least a decade, allowing the exchange of medical records between formerly unconnected electronic systems. The systems will decrease administrative costs for providers while improving the quality of healthcare for patients.

While there are some networks in various States, there are currently no state or federal regulations governing the exchange of medical records. However, there are several organizations working towards a nationwide, regulated network.

This will create more jobs as the system matures. On the bureaucratic level, there will be people in state and federal government responsible for creating and monitoring these networks. There will be the techies creating the software (there’s already several companies out there, but as we know with technology, there’s always room for competition and room for improvement). There will be the sales force and the tech support staff installing, training and helping providers maintain the systems. And finally, there will be the end users themselves, possibly an entire job in itself once these systems become fully integrated into the healthcare system.

How can you jump on this burgeoning bandwagon? Should you hop on board? Whether you’re looking for work or already employed the answer is YES. This is a system that you should definitely keep your eye on as it continues to grow and change, whether you’re in management, tech support, patient services or even employed as a nurse or physician.

Here are a few of the ways that you could use your healthcare experience to assist the transition to HIE’s:

1. Serve on a regulatory committee providing your healthcare expertise.
2. Become a point person who provides test runs of one of the new systems that eventually gets installed in your hospital.
3. Combine your healthcare experience with your love of technology to write software or consult for an HIE.
4. Take classes in software development if this field interests you.

Follow the HIE news at the Nationwide Health Information Network Watch.

Well the new Healthcare Reform Bill has been pushed into “almost-law” today and it seems to me that there has rarely been such a great controversy-even amongst the health care community.

One doctor interviewed in CNN this AM says that their fees will have to go down, salaries will be reduced and less people will enter the health care field as a career. Another doctor stated that we already deal with a high percentage of uninsured folks and as a result, we all pay. “It is better to pay for it within an organized system such as this as opposed to the unorganized system we have been dealing with,” he says.

According to the Christian Science Monitor, several states are already filing lawsuits against the reform. These states include Florida, South Carolina, Alabama, Nebraska, Texas, Oklahoma, Pennsylvania, Washington, Utah, North Dakota, and South Dakota. John McCain has gone on record saying that he is “repulsed by the euphoria and that Americans will challenge the bill.”

Could it be that those without health insurance are choosing to see only parts of the bill? That we as Americans, so anxious for an insurance fix, and so hopeful that Obama can indeed provide what he promised that many of us have accepted the bill lock, stock and barrel without getting the details?

What about the right to life issue? The Pro-Life Democrats are saying that with the executive order, absolutely no federal funds can be used for abortion. They knew that they could not get a law passed but the executive order was the next best thing and they are “pleased with the results”. At the same time, the Pro-Life Republicans are stating emphatically that federal dollars WILL go towards abortion and that this is the biggest change benefitting abortion in the past 30 years. Their beef is that the health insurance companies will cover abortions and then be credited by the government which will of course come from our pockets-even from the pockets of those who believe that abortion is murder.

I suspect that if doctor’s fees are getting reduced, that it will also affect other health care careers due to the trickle-down effect. What do you think? Will nurses, lab technicians, etc also be affected? And if so, how will this affect you?