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Novant Health, which owns Forsyth Medical Center and other hospitals, is talking with Greensboro Cardiology Associates about a possible sale, the practice's administrator says. I am not an expert on business deals of this type (I'm not an expert on business deals in general), so I throw this to you: What questions should I be asking?
I've just stumbled across a blog that might possibly be of help to health-care professionals trying to address how much time their patients wait. It's called "Wait Time & Delayed Care." Not being a health-care professional myself, I have no idea whether it would be truly helpful or not, but I pass it along for whatever it might be worth. Maybe patients can find something useful there, as well.
The Health Beat Blog says it bluntly: Medical practitioners are often slow to adopt well-researched, proven mental health interventions -- because they're rarely profitable.
... you'd think that health care practitioners would make it a priority to provide effective mental health treatment. But a 2005 study from the National Institutes of Mental Health (NIMH) and Harvard found that only one-third of mental health therapies received by patients meet minimal standards for adequacy as established in national guidelines. That means that when we know what works -- and even draw up guidelines to define best practices -- relatively few providers follow the rules. Why is it so hard to translate knowledge into practice?Three academics -- Robert Drake, M.D. and Jonathan Skinner, Ph.D from Dartmouth Medical School, along with Goldman -- wrote an issue brief for the conference that looked at his very question. Their conclusion? It's all about the money.
According to the authors, most effective mental health treatment regimes are not purely medication-based but also involve psychosocial intervention -- that is, a program of cognitive and behavioral measures such as patient education, psychotherapy, and peer support. ...
Given [cognitive behavioral therapy]'s focus on self-esteem, perspective, and encouragement, it might come off as somewhat touchy-feely to the outside observer -- but in fact it's proven to be quite effective. ...
Why can't psychosocial treatments seem to catch a break? "Unlike new medications, where the marketing of new practices is supported and encouraged by patents," notes Drake et al. in their issue brief, "psychosocial treatments are not patented and therefore lack the economic incentives to promote them widely. Because it is difficult to market, doctors are less exposed to best practice strategies and consumers are often unaware of other strategies for treatment."
Speaking about this issue in person during a panel at the conference, Drake didn't mince words, noting that "no one makes a profit off psychosocial interventions, so they are used less often." Moreover, a treatment like CBT is not quick and easy: it's sequential, collaborative, and personalized. In short, it's messy, labor intensive -- and thus hard to sell.
Is there a way these "best practices" can be applied more widely when market forces appear to be arrayed in opposition? Or is this a problem the market cannot fix? I'm not much of an economist, so anyone who has some insights, please speak up.
Massive judgments in medical-malpractice cases are soaring, leading to a shortage of physicians and creating a need for "tort reform" in which damages are capped. Right?
Not so much, says Maggie Mahar, referring to a study in the New England Journal of Medicine. Among its findings, Mahar says:
Mahar also refers to some other sources to suggest that if there's a crisis in medical-malpractice lawsuits, it's not what we think it is. She suggests that the medical malpractice "crisis" is being played up so it can be used as a sort of stalking horse for people who want to eliminate all personal-injury lawsuits.
One of the key factors contributing to the success of the Veterans Administration health-care system has been a computerized health-records system that VA workers developed themselves and continue to improve. In an era of skyrocketing health-costs, the system, called VistA, has actually helped reduce the VA's health-care costs, as well as improving the accuracy of prescriptions to the point at which it almost literally can't get any better.
If you worked in the government, wouldn't you want to expand this system and make even more and better use of it? One would think. But, as Maggie Mahar reports at the Century Foundation's Health Beat Blog, one would be wrong. The Department of Defense, which must coordinate care for military folks with the VA, has gotten its own, proprietary (read: expensive and less flexible) system from a big military contractor rather than just adopting VistA. What's more, although there are good reasons not to -- and although VistA is actually being adopted in the private sector now -- the VA itself may be moving away from VistA.
Mahar provides some good links, some credible analysis, a warning about what's happening and a pledge to keep following the issue. Go read her.
Some people who created special effects for such movies as "The Matrix" and "Eraser" have turned their talents to creating artificial organs for doctors to train with. No, really.
Via the Wall Street Journal comes news of a Credit Suisse report noting that as corporations become more aware of the financial implications of fast-growing obesity, investing in companies that, one way or another, fight obesity might be good for your own personal business. In fact, the report authors have created an unofficial stock index called the "Healthier Living 15," whose products and services range from fitness centers to a device used in bariatric surgery.
Given the financial, medical and lifespan implications of obesity, I'll pass on the "growth-industry" puns here. But is this kind of investment morally OK? For that matter, is it good business?