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Physician says it’s past time to jettison MOC

Paul S. Teirstein, M.D.,  taking aim at the American Board of Internal Medicine (ABIM), argues in the New England Journal of Medicine that ”Maintenance of Certification”  (MOC) requirements are bad for both physicians and patients because, he asserts, they waste time and money on ABIM mandates that primarily benefit the ABIM as a business.

He writes: “Although the ABIM argues that there is evidence supporting the value of MOC, high-quality data supporting the efficacy of the program will be very hard, if not impossible, to obtain.”
And he complains that the ABIM has become a big business from fees used, for among other things, to compensate highly paid board members and its chief executive.
“We all support lifelong learning, but an excellent alternative to MOC already exists: continuing medical education (CME).”
“My main recommendation would be to allow 25 annual hours of CME to be substituted for the current MOC requirements that need to be met every 2 years.””Doing so would eliminate, or make optional, the {ABIM} busywork modules that have little practical value, including all medical knowledge, practice-improvement, and patient-safety modules.”

 


Feds sue rich Fla. cardiologist over lucrative tests

heart

The Feds have joined  two lawsuits that allege that Florida’s Asad Qamar, M.D., who was Medicare’s highest-paid cardiologist in 2012, taking in $18 million in reimbursements  that year, got patients to have unnecessary invasive heart testing to boost his income.

Modern Healthcare reports that in one of the lawsuits Dr.  Qamar and his group ”routinely waived patients’ Medicare copayments and deductible payments so that, the suit says, ‘patients had no reason to turn down services and would oblige Dr. Qamar’s improper recommendation that they consent to all manner of procedures for which there was no medically indicated need.’ according to the lawsuit. Qamar and the institute would then bill the government for the full cost of the treatment.”

A lawyer for the cardiologist said:

“Dr. Qamar practices under the highest medical and ethical standards. Any claims to the contrary are unsubstantiated and the doctor will defend himself vigorously against these baseless allegations.”

It’s interesting that so many of  alleged overbilling involve Florida physicians, but then, it does have so many people on Medicare.


Jonathan Merril, M.D., joins Cambridge Management Group

Jonathan Merril, M.D., has joined Cambridge Management Group  (cmg625.com) as a senior adviser.

Dr. Merril has devoted his career to improving provider and patient education through technology. He is currently developing a “chronic care university’’ at Partners HealthCare. The new “university’’ is an online service for patients and primary-care providers meant to improve the lives of people with chronic conditions, with the first program to be focused on multiple sclerosis.

Cambridge Management Group (cmg625.com) has increasingly worked with providers to improve care and control costs associated with patients with chronic conditions as their numbers increase with the aging of the population. Dr. Merril and his colleagues at Cambridge Management Group recognize the growing need to manage chronic diseases with innovation in diagnostics and therapeutics.

He uses mobile and simulation technology and healthcare-education expertise to work with businesses, government and non-profit organizations to create novel opportunities to enhance care.

He is also the chief executive of Astute Technology, which streams large medical conferences, including those of the American Heart Association, the American Society for Clinical Oncology and many other organizations. Dr. Merril holds many patents in the digital capture of such gatherings.

Dr. Merril has used the Internet and App technology to build some of the most widely used online (including mobile) learning resources for physicians and patients. These systems power the Partners Healthcare Office of Continuing Professional Development and some key activities (including board reviews) of various other large non-profit healthcare organizations.

He is an expert in building and integrating platforms for continuing education, maintenance of licensure and promoting best practices for hospitals and professional societies.

Dr. Merril received his M.D. degree from The George Washington University School of Medicine and Health Sciences. He did his internship in internal medicine and then completed a fellowship in medical informatics in a joint program of George Washington and Massachusetts General Hospital. Jonathan Merril is married and has three children.


The punishment of a bioethicist

 

Healthcare Renewal’s Roy Poses, M.D., and  the Minneapolis Star Tribune look  at the controversial case of Carl Elliott, M.D., a psychiatrist and bioethicist at the University of Minnesota who challenged the University of Minnesota’s handling of the  death of a patient in a clinical trial run by the university.

 

 


PinnacleHealth’s program to get physicians to listen more

 

With  vivid examples, Nirmal Joshi, M.D., chief medical officer for Pinnacle Health System, based in Harrisburg, Pa., discusses in a New York Times piece the necessity of  intense, if sometimes brief, two-way communication between physicians and patients.

Dr. Joshi notes that  the Joint Commission  has found that ”communication failure (rather than a provider’s lack of technical skill) was at the root of over 70 percent of serious adverse health outcomes in hospitals.”

”{O}ne survey found, two out of every three patients are discharged from the hospital without even knowing their diagnosis. Another study discovered that in over 60 percent of cases, patients misunderstood directions after a visit to their doctor’s office. And on average, physicians wait just 18 seconds before interrupting patients’ narratives of their symptoms.”

Dr. J0shi describes started a program  that he and his colleagues started to improve doctors’ communication with their patients at Pinnacle.

They developed a physician-training program, which, he writes in The Times, ”involved mock patient interviews and assessment from {an} actor role-playing the patient. Over 250 physicians were trained using this technique. We also arranged for a ‘physician coach’ to sit in on real patient interviews and provide feedback.”

 And it helped a lot, as his op-ed explains.


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