One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate enormous amounts of time, at great personal sacrifice, to represent the interests of our members and their patients. One of the things that I like least is when an ACP member (or non-member physician) caustically dismisses their efforts, usually because they disagree with some aspects of ACP policy. It ...

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I’m sure Ezekiel Emanuel hates being referred to as Rahm Emanuel’s brother, so I won’t describe him as such. After working as one of Obama’s main health care advisors, he’s now at U-Penn in a job spanning medicine, economics, and ethics. He’s also been writing engaging essays in JAMA about health care reform and economic change, that give us an augur into where health care reform might lead us. Here, ...

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There's a great deal of planning and testing of new models of care and delivery to respond to healthcare's ever increasing costs. We've all heard about Accountable Care Organizations (ACO) and medical homes. The common concern is that they become a repeat of HMOs with the accompanying misaligned incentives undermining their effectiveness. An exciting new medical home model is rapidly expanding that avoids the dreaded "gatekeeper" that was the undoing of ...

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Everyone in our industry -- policymakers, clinicians, healthcare facility administrators, public and private payers, technicians, pharmacists -- shares concerns about the state of healthcare in the U.S., each of us from a slightly different viewpoint. The thread that joins us all is that one day each of us will be a patient. As its title suggests, patients are central to almost every provision of the Patient Protection and Affordable Care Act (Act), ...

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Jack and John are identical twins, but have varying interests in life. One day Jack, 43-years old, decides he has had enough of these headaches and calls his family doctor and asks what he should do. He is told that his doctor can see him in 4 days and to take some over the counter ibuprofren. And to definitely go to the ER if the headaches worsen. John, who has also ...

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President Barrack Obama delivered a 6,944 word State of the Union address to the American people. Of the speech, less than .01% was devoted to healthcare, which is remarkable considering the major changes in healthcare that are on the horizon if Obamacare survives a challenge in an upcoming U.S. Supreme Court case. During the speech, there were only three sentences that mentioned healthcare. The first was this: “I will not ...

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It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that shocked our nation with its revelation that 98,000 people died yearly in hospitals due to doctors' errors. For decades, and through one administration after another, the lack of safety in our healthcare system has gone un-addressed, placing us at greater and greater risk. Hospitals have disappeared, ...

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A social media movement is happening before our eyes with action starting to take shape.  The #occupyhealthcare movement has begun within to the blogosphere and through various areas of social media by storm. What does the #occupyhealthcare movement mean to me?  My main focus in advocacy for family medicine is the production of an adequate primary care workforce distributed adequately to best serve our country.  Those close to me also ...

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The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering the health of populations, and reducing the per capita costs of health care. This struck me as odd when I first read it.  Why should the stated aim of any system become to decrease the costs associated with that system? Which led to the next logical questions: What should be the stated aim of ...

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The storyline is familiar. An organization is challenged to achieve better results without spending more money.  An executive is committed to obtaining these better outcomes and recognizes that more financial resources aren’t forthcoming .  Faced with the option of near-certain failure if he continues to work within the historic operating framework, he decides that a different approach is necessary.  With the help of a young and visionary analyst, they decide ...

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