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Consistency of ties with physicians said to reduce their patients’ visits to ERs


Seniors who consistently see the same physicians in  outpatient settings are more likely to avoid  emergency-room visits, according to a study  by CMS and Dartmouth researchers and published in the Annals of Emergency Medicine.

The researchers measured continuity of care based on two risk scores and found that patients who saw the same physician consistently were 20 percent less likely to go to the ER.

Those who did go to the ED were slightly more likely to be admitted to the hospital. The study suggested that  patients with more continuity of care receive more appropriate ED referrals.

“Visits with the same physician or a small number of physicians fosters long-term relationships for Medicare patients, which is ultimately good for their health,” said David Nyweide, Ph.D., a researcher with CMS and lead author of the study,  said in an announcement from the American College of Emergency Physicians (ACEP).

FierceHealthcare noted that the  number of ER visits has grown considerably in the past several years, blamed partly on an increasing number of non-emergency patients showing up there.

“Previous studies have shown that improving continuity of care could save Medicare as much as $600 billion each year by reducing frequently overused medical procedures, and limiting the rate of mortality linked to cardiovascular events,” Fierce reported.

To read the study, please hit this link.

To read a Fierce overview of the study, please hit this link.

Rationale for regionalizing high-risk surgery



An operation in 1753, painted by Gaspare Traversi.

In this JAMA piece, Karan R. Chhabra and Justin B. Dimick argue that hospital networks and value-based payment comprise “fertile ground for regionalizing high-risk surgery.”

They describe “the shifts made by hospital networks toward a new type of surgical regionalization to improve surgical outcomes and overall clinical quality.”

“Recently, 3 major medical centers—Dartmouth, Johns Hopkins, and the University of Michigan—declared a ‘volume pledge’ that restricts performance of 10 selected procedures to surgeons and hospitals that meet volume criteria. This followed an announcement by US News & World Report of a new analysis demonstrating poorer outcomes at low-volume hospitals.  Both of these are derived from decades of research showing that high surgical volumes are associated with better outcomes, especially in high-risk procedures.


Marketing your hospital


A professor of management at Dartmouth looks at  what hospitals should think about when they market their institutions.

Pitfalls of naming medical schools after big donors


Pieces in Academic Medicine  and The New York Times note the increasing incidence of medical schools being renamed after big donors, such as Dartmouth naming its medical school after Theodor Geisel (aka ”Dr. Seuss, ” Class of 1929) in recognition of the big donations to Dartmouth by Mr. Geisel and his wife, Audrey. As the authors of the Academic Medicine piece note:

“The perspective considers how renaming may negatively affect brand recognition and the associated impact on students, residents, faculty, and alumni. Finally, it concludes with an analysis of taxpayer-funded organizations and the concern that educational renaming will lead to a slippery slope in which other public goods are effectively purchased by wealthy donors.”

Still, in the case of Dartmouth, it’s hard to see much bad PR coming from naming its medical school after a famed artist and children’s book author.

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