This link has been bookmarked by 5 people . It was first bookmarked on 23 Jun 2009, by T. Rex Bean.
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07 Oct 11
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revenue-driven medicine
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whether you decide to take phone calls from patients and instead bring them to your office because you're paid for office visits but not phone calls
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to provide the best possible care requires using resources in a way that keeps you viable but improves the quality of care
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to reduce waste and improve quality means organizing ourselves in ways that would sacrifice revenues
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stretched the economy and our budget much thinner with the damage from health care costs
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On the medical side, there is a much greater sense of dissatisfaction in our work lives. We're working incredibly hard to make the system work for our patients. But it doesn't work very well for them or us. Some of that is the march of science. The increase in coordination and complexity makes it impossible to do this stuff out of your office. We're not in a system that's well equipped to make this a satisfying way to spend your time.
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25 Jun 09
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That brings up another point. Putting aside the difference between El Paso and McAllen, both are going to have higher costs because their people are poorer. This gets to the whole question of social determinants of health: the fact that you're sicker if you have less income, or education. Do we give that enough attention?
I think the really interesting thing is that even beyond the baseline amount of poorer health associated with lower incomes, there's this whole body of powerful literature showing that levels of inequality are even more highly correlated with poor health.
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there's something protective about rural areas, where there's less inequality, so if you take rural areas and urban areas with similar levels of poverty, the rural areas will be healthier. And people say these areas are more socially cohesive and that's what does it. But how does that make cancer rates lower?
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My hypothesis is that communities have local anchor institutions that foster values and norms that make the medical system successful. My sense is that in McAllen it was about a few institutions striking out in different ways that set the norm for what others did.
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24 Jun 09
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23 Jun 09
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