Family Practitioner Awarded Family Physician of the Year

Family medicine has always been at the heart of medicine. If you ask a patient they willl usually say 'Our family doctor is .....  It bespeaks much of the complexity of credentials, board certification and the rest of it. Most patients are not that aware of what all those diplomas are on the wall. And with  the general training all young physicians obtain, and are licensed as MDs in all states, not as a specialist most MDs are capable of handling routine complaints and treat simple disorders. If they can't then they should not be practicing medicine (in my opinion)

My perspective may be a bit skewed by the fact that I did general medicine after internship in t he Navy and practiced family medicine for three years afterward.  When I had a major heart surgery, I relinquished my scalpel for several years, returning to family medicine with a colleage who  used to refer to me.

This announcement caught my eye and is well worth recognition.
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At just 11 years old, Karen Smith, M.D., went on the trip of a lifetime.

Smith's mother wanted to visit Walt Disney World with her children. In 1972, the family made the trip to Orlando, Fla., and it's where a young Smith learned the power of imagination, belief and creativity. Walt Disney's famous saying, "If you can dream it, you can do it," resonated with her.

Smith's mother died from sarcoidosis not long after the trip, but the memories they created inspired her daughter to pursue a career of medical service.

"It's amazing what a mother can instill in her children," Smith told AAFP News. "Those memories are in us, and those memories are what have allowed me to do what I've done … with the grace of God."

For her efforts, Smith has been named the Academy's 2017 Family Physician of the Year. The award recognizes a family physician who stands out among his or her colleagues for providing compassionate and comprehensive care, enhancing the quality of the community, and acting as a credible role model. Today, 43 years after her first trip to Orlando, Smith has returned to the city to accept this award during the AAFP Family Medicine Experience.

Another example of the unsung, underpaid, overwhelmed primary care internists, pediatricians and family medicine physicians...In today's world primary care providers take a residency as long as most other specialtlies.  

STORY HIGHLIGHTS

• Karen Smith, M.D., of Raeford, N.C., has been named the 2017 Family Physician of the Year.
• The award recognizes a family physician who stands out among his or her colleagues for providing compassionate and comprehensive care, enhancing the quality of the community, and acting as a credible role model. 
• After more than two decades in rural practice, Smith says she still is driven by the power of touch -- physical, emotional and spiritual.

Compassion, Imagination and Belief Inspired 2017 FPOY

How those pharmacy coupons may increase your health care costs

How drug coupons 'undermine' payers' efforts to limit healthcare costs

Consumer drug vouchers for pricey pharmaceuticals--like Mylan’s EpiPen--may lead to market failures that dissolve the incentive for powerful pharmaceutical firms to reduce prescription drug prices, hurting payers' cost-control efforts.

Here are five ways, according to a article published in the Annals of Internal Medicine, that vouchers to help offset the cost of drugs like EpiPens interrupts the proper functioning of the market--and subsequently contributes to higher future healthcare costs:

• Co-pay assistance placates “public outcry.” Public pressure, such as articles about the high cost of EpiPens, seemed to be correlated with a “reduction in the magnitude” of price hikes by Mylan, the authors note. Appeasing consumer anger can circumvent such processes, and therefore lessen pressure on companies like Mylan to reduce prices.  
• The vouchers subvert insurers' strategies to limit healthcare utilization for low-premium, high-deductible enrollees. Low-premium, high out-of-pocket expense health insurance plans shift the burden of healthcare utilization onto consumers, nudging them to use fewer healthcare services--which lower total healthcare expenditures. The co-pay assistance programs “undermine” this effort, pressuring insurers to increase premiums across the board, the authors say.
• They create an artificial price distortion. High prices are supposed to encourage consumer shrewdness in the marketplace, according to the authors, which theoretically should “include scrutiny” of product price and quality. The researchers thus conclude copay coupons “keep patients from acting as consumers,” reducing the incentive for consumers to factor price into their decisions and further decreasing the incentive for pharmaceutical firms to lower their prices.
• The tactic handcuffs insurers’ leverage during negotiation with drug companies. Insurers that reach price concession agreements with drug producers reflect this in their formulary tiers with lower out-of-pocket costs--and vice versa for manufacturers that insist on high prices. Pharmaceutical companies like Mylan, which offered patients $300 coupons, are able to sidestep this mechanism by keeping out-of-pocket expenses lower for consumers when insurers aim to keep them high.
• Co-pay assistance programs don’t live up to their promises.Pharmaceutical companies don’t provide financial assistance to all filled prescriptions, only for patients who haven’t hit their deductible to have their insurer prescription benefit kick in. Insurers can’t ascertain payments made by patients versus those covered by the co-pay coupons, ultimately helping patients hit out-of-pocket maximums quicker. For specialty drugs that can cost up to $10,000 per month, insurers can be left to foot the bill much earlier in the year.

Medicare Part D spending on EpiPens grew more than 1,150 percent over a seven-year period from 2007 to 2014 while the number of beneficiaries receiving the treatment increased a disproportionate 164 percent. The ensuing public frustration resulted in CEO Heather Bresch to testifying at a Senate hearing to defend the 400 to 500 percent price hikes.

Most health cost containment programs just shift the burden or cost to another segment of the health industry.  There is one big pot, which we must all share. And the partcipants do not play fair.

Thanks to Fierce Health Care Payer for most of this article.

Anthem, Cigna Have Accused Each Other of Merger Breach - WSJ

The ink has barely made it to the paper, and Anthem and Cigna have gotten cold feet regarding their proposed merger.

The blowback from the public and the DOJ, FTC are working, even without a formal filing or restraining order. In order to save face....blame each other. It's a no lose situation for counsel for either company.  What the heck, those guys are on multi-mllion dollar retainers either way...A nice cash flow for the junior non  partner attorneys for the big law firms in the health and insurance niche.  They most likely reasoned it would cost more money to litigate than to simply carry on as they are now. (that is how obscene the amount of money is at stake and how much money these companies have under their mattresses. How long is the American public going to put up with these rules that bankers and insurance companies write for themselves ? Are we a ship of fools ? Yes

Sometimes it makes me wish I had gone to law school...no HMOs no ObamaCare, no EMRs Meaningful use, MACRA, MIPS, Accountable Care Organization, getting paid for volume, not outcomes....etc. Now that I am retired (I am young only 73 and my life expectancy is still pretty good according to the latest stats. I could retrain here at my local Western law school and make some really big bucks !

Doctors don't seem to have time anymore for Wednesday (or is it Thursday) afternoon golf..but since I am retired I do. Even though I don't play golf I am willing to give up my afternoon nap time to study for my new profession.

Anthem, Cigna Have Accused Each Other of Merger Breach - WSJ

The Top Gun of Health Train Express Blogs for 2016 (so far)

Our readership fluctuates quite a bit, averaging a paltry 200-300 users/day. Most of the readership is from the U.S. and the U.K.

This year we had several posts that went well above 1000 readers/day.  Like most internet publications readership depends heavily upon Google searchs.  Readership continues for days, weeks months and even years.  We network our contributions on facebook, twitter Newsana, Digg, Redditr and a list of email subscribers. We have an RSS  feed as well.

Top Gun Posts:

11 TOP PATIENT QUESTIONS ABOUT TELEHEALTH Affordable Care Act causing more mega=-mergers Sleep is not an Option Revised Food and Drug Labels New Hope for Stroke Patients The Senior Learning Network The Five Percent in Health Curing Cancer MentalHealth, Behavioral Health, and Neuroscience. Patients Cannot Always Access Complete Medical Records There were many others receiving between 750 and 950 readers/day.  Our readership continues to grow consistently...thanks for  your interest.

Mark Zuckerberg, Priscilla Chan unveil $3 billion effort to cure disease

Mark Zuckerberg and spouse have joined the list of other philanthropists such as William and Melinda Gates,  Paul Allen, Sean Parker, Mayor Michael Bloomberg, and the Koch brothers are donating billions of dollars to many scientific and health related research efforts.

Sean Parker, the cofounder of Napster, has committed $250 million to develop new cancer treatments. Former New York City Mayor Michael Bloomberg is leading a coalition of philanthropists putting up $100 million for a separate cancer initiative. And philanthropist and entrepreneur Paul Allen committed $100 million in March to an initiative that backs risky, cutting-edge science that more conventional funders might avoid.

Paul Allen created the Paul G. Allen Family Foundation  launched in 2010, funds scientists who take “out-of-the-box approaches at the very edges of knowledge,” as Allen put it. The program’s 2015 awards for Alzheimer’s research, for instance, largely passed over scientists who focus on the leading (and, so far, leading-to-nothing-useful-to-patients) hypothesis that the disease can be treated by eliminating amyloid plaques.

Billionaire businessmen Charles and David Koch have also given tens of millions to cancer research.

And Bill Gates funds public health projects around the world, including malaria and polio prevention efforts, through his charitable foundation.

Mark Zuckerberg, Priscilla Chan unveil $3 billion effort to cure disease

UnitedHealth survey: More shop around for healthcare, but insurance literacy falls short

While more American consumers are taking advantage of tech tools to comparison shop for healthcare, they still lack basic knowledge about health insurance and dread selecting a health benefits plan.

This one of the major failures of the American Health System.  Interestingly it is also a major failure in the American Tax System.  Two items so important to every citizen cause great angst and frustration for all.

A new survey from UnitedHealth details those and other findings, offering both positive signs for consumer engagement and areas that suggest health insurers have more work to do as they look to improve their members' experience.

Indeed, “this survey underscores why UnitedHealthcare is working to simplify the healthcare experience for people and help them take full advantage of their healthcare benefits,” Rebecca Madsen, UnitedHealthcare chief consumer officer, said in an announcement.

Here’s a look at some of the survey’s key findings:

Highlights:

• Nearly a third of respondents have used the internet or mobile apps during the last year to compare the cost of medical services, which is more than double the rate in 2012. The uptick was most significant among young people.
• Among all comparison shoppers, 81 percent described the process of using online or mobile resources as “very” or “somewhat” helpful.
• Fifty-six percent of survey respondents who are employed full time said they would be interested in using a wearable fitness tracker as part of a workplace wellness program.
• Thirty-seven percent of respondents said they were “very" or “somewhat" likely to use telemedicine to access healthcare services.
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Lowlights:

• Only 7 percent of respondents could successfully define all four basic health insurance concepts: plan premium, deductible, co-insurance and out-of-pocket maximum. Consumers had the most trouble defining co-insurance and out-of-pocket maximum.
• Many survey respondents underestimated the actual cost of specific healthcare services. For a knee replacement procedure, for example, 63 percent estimated the cost to be lower than the national average of $35,000, and only 11 percent answered correctly.
• The task of selecting a health plan is not one that consumers relish, as 25 percent would rather file their annual income taxes. And 28 percent said having to review their health benefits during open enrollment would be worse than the hassle of losing their mobile phone.
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In addition, despite the increased uptake of tech tools by consumers, 78 percent of respondents preferred speaking with a customer service representative to resolve an issue or ask a question--the clear winner over email, online chat or mobile app. When customers do speak to a representative, 30 percent ranked the person’s knowledge as the most important factor of the experience.

The system must be deconstructed to one in which the number of choices is much less, more intuitive and less subject to making critical errors in selecting coverage.

Fierce HealthCare

Forbes column: CBO Blesses Violation of Separation of Powers - gmlevinmd@gmail.com - Gmail

Forbes column: CBO Blesses Violation of Separation of Powers - gmlevinmd@gmail.com - Gmail