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Nitin Damle

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Study: Longer PCP hours = fewer ER visits


A British study suggests that keeping primary-care practices open for more hours, particularly on nights and weekends, cuts visits to hospital emergency departments for non-life threatening illnesses and injuries, reports Medical Economics.

Researchers at the University of Manchester, in  England, determined that practices that extended their hours beyond the British standard of 8:30 a.m. to 6:30 p.m. had a 26.4 percent reduction in patients seeking local emergency department visits for minor problems.

“The difference amounted to 10,933 fewer ER visits in a year. For every three additional primary-care slots booked, one visit to the ER was avoided.” said Medical Economics in summarizing the study.

But are longer hours practical for most primary-care practices? Nitin Damle, M.D.,  president of the American College of Physicians and an internist in Rhode Island, told Medical Economics that they are.

“We have had after-hours and Saturday morning hours for 15 years,” he says. “We find it helpful to patients, and it seems to decrease ER use modestly along with providing continuity of care.”

To read the Medical Economics piece, please hit this link.

Is value-based care good for physicians?


An article in Medscape takes on these questions:

Value-based care is clearly positive for private- and public-sector insurers  in that it can lower costs, but does it overall benefit physicians and/or patients? Should doctors be embracing value-based approaches instead of holding back?

The answer is far from clear.

“Some aspects of value-based medicine could make physicians better clinicians, ” Nitin Damle, M.D., managing partner of an eight-physician practice in Wakefield, Rhode Island, and president-elect of the American College of Physicians, told the publication.

His practice has qualified as a level 3 medical home and uses patient registries that track key clinical measures and show each patient’s need for lab and preventive services. ‘The most value is going to come from patient registries. For example, a registry can objectively measure good diabetes control and identify gaps in care, such as monitoring patients’ warfarin use.”‘

But Dr. Damle adds, “It remains unclear whether value-based payment results in better patient outcomes.”

And other observers have noted how long it could  take before physicians making long-term improvements in their patients’ health would get rewarded for it.



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