Long before the new health reform law passed, Bryan Mills, CEO of Community Health Network, declared the hospital chain would turn itself into an accountable care organization by integrating with physicians.
Now that such an idea is codified in law, it’s only fueling Mills’ mission.
Community Health now has about 550 physicians, either on its payroll or committed through integration contracts, who have some of their pay hinge on measures of quality and communication.
Community had a head start on other local hospital systems because it kept the primary-care physician practices it acquired in the 1990s, when the managed care concept (a forerunner of accountable care) was all the rage. Today, those practices employ 200 physicians.
Eight days after her son was born and was still being cared for in the neonatal intensive care unit, Vera Delgado went home briefly to take a shower and change her clothes.
Now, Delgado is suing the hospital, not for a medical mistake, but for assault and battery on her newborn. She is asking for $1 million for the "deformity" the circumcision caused.
"This is not medical malpractice," said her lawyer, Spencer Aronfeld. "We are suing for battery, an unauthorized assault on this baby. They took a knife to him without his parent's permission."
"The baby was in neonatal intensive care with complications from a birth-related infection," said her lawyer. "They took the baby out and amputated healthy tissue from the penis in an irreversible procedure."
The battle of the emergency room billboards is being waged on our roadways.
"Why Wait LongER?" asks a billboard on northbound Interstate 95 near 45th Street. It lists live emergency room wait times for Columbia Hospital, JFK Medical Center and Palms West Hospital. You also can use your cellphone to text "ER" to 23000 and receive a text with the wait times for the hospitals.
Nearby is a "More than Just Fast ER" sign advertising St. Mary's Medical Center. Southbound, there are three more billboards - for St. Mary's, Columbia and Good Samaritan Medical Center - all within in a 5-mile stretch.
At as much as $10,000 per month per billboard, these ads are a big investment.
Why the ER advertising? On the surface, the idea doesn't make sense. Selecting an emergency room isn't like choosing a supermarket or department store. In some cases, it's not a choice. People who have a heart attack, stroke or other similar emergency usually don't get to decide where paramedics take them.
Marketers from Avera Health in Sioux Falls, SD, must be collectively putting their palms to foreheads over this one. The hospital erected a billboard showing a woman in a traffic accident as part of its campaign to encourage accident preparedness. The problem is that the billboard included a smoke machine, which was intended to make it look as if the busted-up car was fuming. Unfortunately, multiple commuters called 911 because they believed the sign was on fire. The hospital has since turned the smoke machine off after learning it violated a city ordinance.
Last week, Dr. Martin Samuels received a dinner invitation in the mail: He was invited to The Palm steakhouse to hear a Columbia University specialist discuss novel treatments for multiple sclerosis — and to earn continuing medical education credits.
But Samuels will not be attending. The class, he said, is not education, but subtle marketing by Teva Neuroscience, a pharmaceutical maker that sells a leading multiple sclerosis drug and, according to the fine print, is paying for the evening.
It is just this type of program that led Samuels, a Harvard Medical School neurologist, to start a new company that he says will provide continuing medical education to doctors across the country — without funding from the pharmaceutical industry.
“Doctors have lost confidence in [continuing medical education] and the public has lost confidence,’’ said Samuels, who sees patients at Brigham and Women’s Hospital, where he heads the neurology division. “The feeling is that everything is tainted. We simply must have a new way of doing this.’’ The company’s formation will be announced today.
The venture is the latest development in an escalating national debate over the system for educating physicians. States require physicians to take continuing education courses to retain their medical licenses, but doctors often pay little or nothing for the instruction because many of the companies that offer it are partly funded by makers of drugs and medical devices. Samuels himself worked part time for such a company until last year, when he said he decided that commercial support created an unacceptable conflict.
In a turn-around from previous studies, a research team is reporting that Miami area patients are using less, not more, of one medical service than the national average: primary care physicians.
After years of reports from the Dartmouth Atlas research group finding that Miami-Dade seniors see more specialists, get more tests and spend more time in intensive care than people in virtually every other part of the country, the researchers reported last week that the area's seniors are considerably less likely to see primary care doctors.
For Steve Ullmann, a health policy expert at the University of Miami, the recent finding reinforces what he already believed, that ``primary care keeps costs down.''
The data also confirms the beliefs of the policymakers who crafted the Obama healthcare reform act, which promotes primary care as a way of reducing America's healthcare costs, which are the highest in the world.
The Dartmouth report shows 64.9 percent of seniors in the Miami region had at least one visit a year to a primary care doctor from 2003 through 2007, compared to nationwide figure of 77.6. In every other Florida metropolitan market, seniors are more likely to get primary care than in Miami-Dade. In Broward, 75.5 percent have at least one visit a year. In Pensacola, Fort Myers and Sarasota, it's over 80 percent.