Physicians News Health news for doctors and patients.
By Ted Epperly, M.D.
President
American Academy of Family Physicians
The American Academy of Family Physicians and its 94,600 members congratulate Congress and President Barack Obama for including provisions that will improve the quality and efficiency of health care for all Americans in the now-enacted American Recovery and Reinvestment Act of 2009.
The health care provisions in this law will save lives and money by ensuring continued access to health care for newly unemployed Americans, preserving the stability of Medicaid for low-income Americans, supporting health information technology infrastructure and implementation, investing in primary care medical education funding, and boosting research into the most effective clinical treatments.
The AAFP applauds the assurance that 6.5 million newly unemployed workers will have continued access to health care through COBRA premium assistance and that 20 million eligible, low-income Americans will continue to qualify for Medicaid coverage as a result of the increase in the Federal Medical Assistance Percentage.
Particularly important are provisions enabling physicians to implement electronic health records, which will increase efficiency, reduce errors and enhance coordination of care for their patients. The AAFP has long called for federal leadership in ensuring the privacy of patients health information and in supporting physician efforts to implement EHR systems. By establishing a structure for developing interoperability standards and ensuring the privacy of medical records, this law takes an important step in resolving the obstacles to universal adoption of health information technology.
Moreover, by providing up to $44,000 to individual physicians for buying, installing and upgrading health information technology, the American Recovery and Reinvestment Act helps overcome an often insurmountable challenge that physicians have faced. Fully implemented, electronic health records promise to save more than $12 billion over 10 years in the U.S. health care system. A national health information technology infrastructure and universal implementation of this technology are integral to reining in spiraling health care costs and improving quality of care.
In addition, this law invests in the future of America’s health care system by revitalizing support for health professions grants for family medicine under Title VII of the Public Health Service Act and for the National Health Services Corps which places providers in underserved communities. This will focus funding on primary care medical education, which is critical to solving the current primary care physician shortage. At the same time, it will help ensure that primary medical care is available to millions of Americans who have limited financial or geographic access to the health services they need. Research has proven that a primary care-based health system increases quality, improves patient outcomes and holds down costs.
As advocates for evidence-based medicine, the AAFP supported provisions that set aside $1.1 billion for comparative effectiveness research. This paves the way for an evidence-based health care system that enables physicians and patients to identify the treatments that best meet their health care needs.
Taken as a whole, the health-related provisions in the American Recovery and Reinvestment Act will preserve Americans’ access to health care despite economic hardship; invest in the future accessibility, efficiency and appropriateness of care; and ensure an adequate primary care physician workforce to meet patients needs.
The AAFP jumped straight under the covers with the Hillary Clinton-Ira Magaziner health care plan of the early 1990’s and now the organization is doing it again. Damn fiscal responsibility! To hell with common sense! Everyone seems to want to suckle at the mammary gland of the federal government while paying no mind to the strong socialist and fascist themes. Just what does money for EMR’s have to do with stabilizing the economy and creating jobs for lots of Americans? Now the AAFP proposes a plan with “patient centered medical homes” open to ALL “residents” regardless of legal status. Dr. Epperly is a very fine person and an excellent family physician. We trained in the same FP resident class in the Army. He also is from Idaho, is a retired US Army Colonel (is something wrong with this picture?), employed in academic and leadership medicine, and was personally singled out by President obama [sic] to speak on behalf of primary care doctors in the Wash, DC in May. I reminded him in a recent e-mail: “If you’re kissed by a rogue, count your teeth.” Being asked to speak to the President and to testify before Congress as AAFP President is heady stuff. While health care reform is needed, it is no time to act too swiftly to destroy American medicine, kill primary care and wind up with a huge financial disaster just because we’re in a time where spending gigantic amounts of money on government programs is really in style. Does anyone with half of a doctor’s brain want to work as a drone in a government-harassed clinic working for administrative dweebs whose only real concern is passing their next government audit? And think about it – the Joint Commission that has inflicted so much expense for too little benefit for hospitals can soon expand and make its way into our outpatient exam rooms and maybe even our homes. This isn’t really about patient care and quality medicine. History (don’t forget its lessons from Nazi Germany and Stalinist Russia) tells us this is about absolute power and control. I sometimes dread what it will be like having to work as a family physician in such a system. Worse yet, what it might become to be a patient in such a system. Let’s asked our neighbors in Canada and in Europe. One advantage of weakening our system with increasing quotas, long waiting lists and rationing of care is fewer non-residents may be attracted to come to America for medical care because our care will suck just as much as theirs. I appreciate the comments of others on this page. -T. Utt, MD, Family Physician, Lakewood, WA
While the good doctor has some very good ideas in an article in the Idaho Statesman, these comments make me wonder what he is thinking about. A small amount of money for health care included in a huge pork barrel spending bill, mostly aimed at helping the low income, union members and government employees, is not what this country needed. Since the unemployment rate keeps going up, you would think it became evident to Obama an his crew that raising taxes will makes things worse, not better. Oh well, we can all now start getting reading to stand in line for our appointments and having medical procedures delayed for as long as possible due to shortages in everything in medicine. Welcome to the “change” we were all waiting for. Oh, and by the way, the troops are still in Iraq, and casualties are mounting in Afghanistan, but no matter, they are on Obama’s watch now, and nobody seems to care, especially the main stream media who elected Obama.
Not surprised at all. Organized Family Practice was so thrilled to be the “gatekeeper” back in the 1990’s. Never saw a group so thrilled to be patsies.
Here’s the AAFP with Obama:
http://www.youtube.com/watch?v=IdHHbi_RE20
http://www.youtube.com/watch?v=Oj-OAJtiwJ8
I too am saddened by the short sighted and ill informed AAFP’s response to the HIT portion of the stimulus bill. Dr. Epperly, it is unfathomable that this bill has attached set of “carrots and sticks” to promote c-EHR systems that the vast majority of physicians don’t want and can’t afford. Primary care physicians that actually work “in the trenches” unlike yourself are suffering from years of pay cuts. Many doctors will be forced to retire or simply go bankrupt.
These systems are still in the stage where they are difficult to use, are not interoperable, are expensive to both purchase and maintain, and have not been shown in any large prospective study to increase quality, decrease errors, and decrease costs. In fact, there are many studies that show the opposite- download my 2 slideshows located here- http://msofficeemrproject.com/Page3.htm (“HIT in the USA Under President Obama” and “What is Wrong With HIT in the USA?”).
All of this is push is generated by politics at its worse and by lobbyists that through the donation of vast amounts of money have bought political favors from technology-dumb politicians. Allscripts’ CEO Glen Tullman is now Obama’s “HIT adviser” donated $144300 in the 2 years prior to Obama’s election. Now you have the new health czar Nancy-Ann DeParle who is a Cerner board member since 2001. She was paid $195K in stock and cash and held around $1 million of CERN shares at the end of 2007. She donated $44000 to Democrats in the 2 years prior to Obama’s election.
The adoption of c-EHR systems cannot be pushed. The current stimulus bill will only hasten the physician exodus from Medicare at a time when there is a pending shortage of providers to handle the onslaught of elderly and possibly universal healthcare in the near future.
Al
Actually there is a resonably priced EMR—SUPRA, combines,nn billing and prescription writing, connects to Quest and Labcorp and support is reliable and responsive to each physician’s need. Check it out at
http://www.supraemr.com
I am saddened by the AAFP response to the stimulus package passage. The provision of funds for EHR acquisition is perhaps attractive at first glance, but the overall package is pork-laden wasteful borrowing against the future of our children future stability of our country. EHRs will not become wildly popular due to $44K for individual doctors. They will have the same problems that they always have had, which are the reasons that their adoption rate is so low. It has to be fast, simple to use, intuitive, robust and bug free, and interoperable. The holy grail of these qualities will not be brought closer to reality by using our children’s money to buy inadequate products now.