New Report Outlines Success of PCMH Model in Variety of Public, Private Demonstrations -- AAFP News Now -- American Academy of Family Physicians

New Report Outlines Success of PCMH Model in Variety of Public, Private Demonstrations -- AAFP News Now -- American Academy of Family Physicians

Young Doctors in Love … With Primary Care!

Print | Comments (2)Posted by John McDonough  September 12, 2012 09:12 PM

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I get asked what's best about teaching at the Harvard School of Public Health. Here's an example.
Last spring, three of my public health students, all medical students getting their masters in public health (MPH) degree before finishing their final year of medical school, sent me a draft of an article they had written. The article detailed their excitement at the prospect of specializing in primary care, not traditional primary care, but the new primary care now being developed in innovative medical homes and accountable care organizations across the U.S.
I was surprised and thought their proposed article was fantastic and important, a rationale for why primary care may just be the most exciting place to be in medicine in the near future. I gave them some ideas on how to improve it, and urged them to think big, say, theNew England Journal of Medicine, one of the most prestigious medical journals in the world. And now...

In the September 6 issue, NEJM published the essay by my three students: Kathleen A. Barnes from Boston, Jason C. Kroening-Roche from Portland Oregon, and Branden W. Comfort from Kansas. The essay is titled: The Developing Vision of Primary Care, and here is a brief excerpt about the new role of primary care physicians:

"Physicians' jobs would change as well, as they took on new roles and shed some old ones. No longer would the physician run from room to room, pushed by the clock and the paycheck. Reimbursed through global payments linking hospitals to primary care practices, the physician, too, would have a financial incentive to keep patients healthy and to prioritize services with that goal in mind. The physician would now see fewer patients in the office, leaving time for responding to questions e-mailed by patients the previous night and for calling those who would otherwise be headed to the emergency department. Clinic visits would ideally be nearly twice as long as they are now, since physicians would focus on patients with complex conditions and would have time to address care coordination, answer patients' questions fully, and understand their personal health goals in order to guide treatment. Timely follow-up after hospital discharge would be a high priority, and some visit slots would be reserved for that purpose. Savings from reduced hospitalizations could be reinvested in these high-value primary care services."

There is a revolution brewing in medical care and in primary care especially. It's exciting to see our young and new physicians embracing it.

Long live the Entrepeneur! -Ed

Surgeon Turns to iPod Tool To Improve Knee Replacement Surgeries

An Illinois orthopedic surgeon has started using iPod-based technology to improve the accuracy of knee replacement surgeries, the Chicago Sun-Times reports.

Departure From Traditional Surgeries

Traditional knee-replacement surgeries involve running a metal rod through the patient's tibia to align and secure an artificial knee.

George Branovacki -- an orthopedic surgeon at Christ Medical Center in Oak Lawn, Ill. -- said he "takes the rod out of the equation" by using his iPod's Dash navigational software to more precisely measure and place artificial knees. Although the iPod-based technology received FDA approval in 2011, its manufacturer says Christ Medical Center currently is the only U.S. hospital to use it.

How It Works

During an operation, the iPod is placed in a frame with a pistol-like handle. It takes measurements on the patient and wirelessly relays the data to an infrared camera a few feet away.

The camera is connected to a computer that calculates where the surgeon should make an incision, and then the computer relays that information to the iPod's screen to show Branovacki whether he is on target.

According to Branovacki, the device's "GPS-like navigation" helps prevent small misalignments, which can have a large effect on a patient's mobility and pain, as well as on the life of the implant. Those misalignments are significantly more likely when a physician must move his or her focus back and forth between the patient and a computer, he said (Nolan, Chicago Sun-Times, 9/10).