Patient-centered Medical Home Fails to Deliver Quality Improvement

In what is sure to be a setback to the PCMH movement, a new study showed that the PCMH model failed to deliver promised quality improvements.

One of the first, largest, and longest-running multipayer trials of patient-centered medical home medical practices in the United States was associated with limited improvements in quality and was not associated with reductions in use of hospital, emergency department, or ambulatory care services or total costs of care over three years, according to a study. The patient-centered medical home is a team-based model of primary care practice intended to improve the quality, efficiency, and patient experience of care. Professional associations, payers, policy makers, and other stakeholders have advocated for the patient-centered medical home model.”

http://www.sciencedaily.com/releases/2014/02/140225162702.htm

Robin Williams Tribute

The Primary Care Clinic at Stony Brook held a tribute lunch to Robin Williams on 8/12/2014. Robin Williams committed suicide on 8/11/2014 after a long battle with depression. He brought joy to millions through his acting, comedy, and generosity, and he was “one of a kind” as President Obama put it.

Remember that depression can strike anyone. Someone may be depressed and yet never show it or talk about it. They can seem to have everything, and yet feel they have nothing.

“Richard Cory” by Edwin Arlington Robinson

Whenever Richard Cory went down town,
We people on the pavement looked at him:
He was a gentleman from sole to crown,
Clean favored, and imperially slim.

And he was always quietly arrayed,
And he was always human when he talked;
But still he fluttered pulses when he said,
‘Good-morning,’ and he glittered when he walked.

And he was rich – yes, richer than a king –
And admirably schooled in every grace:
In fine, we thought that he was everything
To make us wish that we were in his place.

So on we worked, and waited for the light,
And went without the meat, and cursed the bread;
And Richard Cory, one calm summer night,
Went home and put a bullet through his head.

2014-08-12

Robin Williams Tribute

Approaching the End

While doctors primarily pursue medicine with the intention of healing people and curing disease, little do they realize how much death and dying becomes part of the conversation with patients and families. Throughout my internship year in internal medicine, I was faced with many discussions regarding palliative care. Discussing the end of life is not an easy task at any stage of a physician’s career, from seasoned physicians to novice interns

Check out the full article:

Journal of Medical Education Perspectives
Vol 3, No 1 (2014)
Table of
Contents
http://www.jmeps.com/issue/view/1084

Brooklyn Half Marathon Medical Team Volunteering

Hey guys,

Stony Brook Medicine will be participating in the Brooklyn Half Marathon on May 17, 2014 as medical volunteers. Let me know if you are interested in volunteering as a medical personnel.

Email Christine.garcia@stonybrookmedicine.edu

Also, keep a look out for more details for the NYC Marathon in November 2014!

For more information on the Brooklyn Half Marathon: http://www.nyrr.org/races-and-events/2014/brooklyn-half

Global Supply of Health Professionals

Global Supply of Health Professionals

The world’s need for and supply of health professionals is in flux. The latest article in the Global Health Series reviews the supply of and demand for physicians and nurses around the world. An interactive graphic shows the density of health workers in each country.

There is a global crisis of severe shortages and marked maldistribution of health professionals that is exacerbated by three great global transitions — demographic changes, epidemiologic shifts, and redistribution of the disability burden.

Shared from the New England Journal of Medicine

Dietary Supplements Blamed for Sharp Rise in Drug-Related Liver Injuries

“Dietary supplements account for nearly 20 percent of drug-related liver injuries that turn up in hospitals, up from 7 percent a decade ago, according to an analysis by a national network of liver specialists. The research included only the most severe cases of liver damage referred to a representative group of hospitals around the country, and the investigators said they were undercounting the actual number of cases.

While many patients recover once they stop taking the supplements and receive treatment, a few require liver transplants or die because of liver failure. Naïve teenagers are not the only consumers at risk, the researchers said. Many are middle-aged women who turn to dietary supplements that promise to burn fat or speed up weight loss.”

Read the NY Times article here

JNC-8 HTN guidelines finally released!

For more information, please see the following link.

Top 10 reasons I use Twitter in Healthcare

I’ve been on Twitter for almost a couple of years now and when I talk to people about it, I still get a healthy dose of skepticism.

So I’ve put together a top ten list of why as a physician and medical educator, I use Twitter.

10: Connecting with Leaders

To be lead, you must know what your leaders are thinking. Twitter has made leaders accessible. Now, instead of spending time looking for their opinions or hoping to catch a handshake or meeting at a conference, they send their thoughts directly to me, in small increments of 140 characters, everyday!

9: Connecting with Followers

As physicians, you are a leader. Whether it ‘s in your office, your patient panel, your learners, your colleagues, your academic society, you have the opportunity (and responsibility? ) to lead and lead effectively. Twitter allows you to share your thoughts in small increments, reach a vast audience with minimal effort. Quoting #10, “To be lead, you must know what your leaders are thinking.”

8: Networking

The importance of professional networking cannot be understated. Twitter easily connects people with similar interests. In less than 2 years, I have been able to access a vast network of people interested in things that are important to me such as Primary Care, Medical Education, Social Media, Evidence Based Medicine and Healthcare Technology. In the past, networking for me occurred in spurts, at pre-determined locations over a finite period of time. With Twitter, networking happens 24/7, with little effort no matter where you are (and in your pajamas, while watching tv!).

7: It makes me an active learner.

All through my education I took notes. Writing things down helped solidify that piece of knowledge. A notebook was also useful for exams, reviewing and reinforcing information. Now instead of a notebook, I have a tablet and instead of a piece of paper, I use twitter. The 140 character limitations forces me to be succinct which makes my virtual notebook very easy to review.

6: I can educate the world

This is a grandiose statement, but Twitter makes it real. As a Medical Educator, I take pride in being able to influence the learners in my immediate proximity. With Twitter I can take all those notes  (See reason #7) and broadcast it to learners in other cities, states, countries and continents! Currently I’m using the the hashtag #sbmgr to broadcast what we’re learning in our Internal Medicine Grand Rounds every Wednesday 8:30 to 9:30 AM.

5: I can attend multiple conferences simultaneously, year round.

Until human cloning technology advances, Twitter is the best way to be at multiple places at once.  I wish I could attend every medical conference out there. But thanks to people who prescribe to reason #7, I can virtually attend other conferences through my smart phone, all throughout the year. There are thousands of people out there like myself, live tweeting from conferences. This year, I personally attended ACP and APDIM live tweeting from both. But in addition, while being back home, I followed the tweets from Kidney Week and Chest in the past couple of months.

4: It’s a forum for debate

Healthy debate is part of our lives as physicians. New guidelines and treatments are always coming up, and Twitter I get immediate access to viewpoints from a wide variety of people. I often get immediate feedback on my own opinions.

3: My mom taught me to share

We are all online, all the time. As a physician, I’m always finding a great journal article, an interesting blog,  or an important news article. Before twitter, I had no mechanism to share that, besides e-mailing to a small set of people or writing it down somewhere and hope that I have an opportunity to suggest it to people. Now, every website has a Twitter link. You see something cool, you can share it with a large audience with just a few clicks.

2: The world at any given moment

Whenever I have a free moment, Twitter  is my go to activity. In 2 minutes, I can scroll through a myriad of messages and get a burst of information from a network of my choosing.  So it’s whether pumping gas, waiting for an elevator, a 15 minute lunch, a commercial break during the football game, Twitter helps me use these small snippets of time, constructively.

1: It broadens my mind

In patient care we are emphasizing a team-based approach that values the roles of every individual in a healthcare team. The same can be said for my continuing medical education. I think I have something to learn, from everyone. As a result I follow folks in Internal Medicine, sub-specialties, family medicine, psychiatry, surgery and so on. I follow nurses, physical therapists, social workers and patient advocates. I follow patients (not my own) sharing the story of their medical conditions. I am learning something from everyone from the palm of my hand.

If this doesn’t get you interested in Twitter, here’s a a blog post from someone who’s listed 140 Health Care uses for Twitter

http://philbaumann.com/140-health-care-uses-for-twitter/

In addition, here’s another post to help you make the leap.

Top Twitter Myths and Tips

This is written by Dr. Vineet Arora who is Director of GME Clinical Learning Environment Innovation and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago.

 

Shabbir Hossain MD
Assistant Professor of Clinical Medicine
Co-Director Combined Medicine Pediatrics Residency Program
Division of Primary Care & Geriatrics
Department of Internal Medicine
Stony Brook School of Medicine

Heart Groups, CDC Issue New Algorithm for Hypertension Control

A science advisory from the American Heart Association, American College of Cardiology, and CDC — designed as a “call to action for broad-based efforts to improve hypertension awareness, treatment, and the proportion of patients treated and controlled” — includes a new, simple algorithm for controlling hypertension in adults.

The algorithm emphasizes the importance of lifestyle modification as first-line therapy for all patients with stage 1 or 2 hypertension. In addition, a thiazide may initially be considered in certain stage 1 patients (e.g., those with heart failure or diabetes), while two drugs (e.g., a thiazide plus ACE inhibitor) are preferred for stage 2 patients.

The algorithm can be found on page 14 of the free PDF linked below.

– See more at Journal Watch

http://www.sbuim.com/blog/wp-content/uploads/2013/11/Hypertension-2013.pdf

Download this file

What is the Patient Protection Affordable Care Act?

Everyone’s taking about it,

But as physicians, do we REALLY know what it is?

Can you explain it to your patients?

Can you explain it to your interns or medical students?

It’s one of the major healthcare policy decisions to happen in a generation, and it’s important as physicians, we all at least understand the basics.

Here’s a link to the Khan Academy video that breaks it down. It’s not an opinion piece for or against it. It just describes what it currently is.

Khan Academy PPACA

 

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