Categories

Above the Fold

Hello Health open for business

Hello Health, the clinic that Jay Parkinson has been promoting for a while, is open for business. If all the patients are as happy as the first patient, success is assured!

The deal is that they’ve gone with mid-range concierge fee ($35 a month—around the cost of a low cost cell phone plan or high-end Netflix?) for patients to get access/membership and then have fixed charges thereafter. That amount is about three times what I pay for very basic low-end concierge services (basically email) at Tom Lee’s Metropolitan Medical Group in San Francisco, but way less than the typical $150–200 a month fee for high-end concierge practices.Hellohealth

What remains to me the tricky factor in their vision is how they’ll make this work with the bureaucracy & accounting behind high deductible plans (without taking on a ton of staff). But however that piece works out, someone needs to shake up primary care. Jay and his 2 colleagues are young entrepreneurial docs giving it a shake.

Health 2.0 had a film crew there with David Kibbe acting as roving reporter at the launch party. Much more on both these topics to come, but remember that Hello Health is also working with MyCa on a very interesting new interface to the EMR and much more.

Yes, you’ll see much more about the Health 2.0 Across America video starring David Kibbe and the MyCa interface at the Health 2.0 Conference.

A few socialist musings for Monday

I just watched the closing ceremony of the Olympics, and the word is that state sponsorship of little known or cared about sports like swimming, gymnastics and cycling gets more medals and so should be encouraged. Bob Costas told me that China spent $40 billion on the games, even if London is going to spend less than half that. So it got me thinking about socialism.

Kevin Pho, blogger of KevinMD fame, and usually reliably anti-government in his views, asks for more socialism, at least directed in the direction of him and his fellow MDs. In this USA Today op-ed he suggests rightly that cutting doctors fees in itself saves little in health costs..

Continue reading…

Medical debt is increasing even for the insured

Four in 10 Americans had trouble paying for medical care in 2007, according to the Commonwealth Fund’s latest study on medical debt.

The study, "Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families," looks at 2007 data on consumers’ and health costs.

Costproblems_2The Fund’s researchers examine 4 areas of cost-related access problems when it comes to health care for Americans age 19-64:

  • Those who did not fill a prescription (31%)
  • People not seeing a specialist when needed (20%)
  • Those skipping a medical test, treatment or follow up (25%)
  • Adults with a medical problem, but not seeing a doctor or clinic (31%).

Overall, 45 percent of American adults age 19-64 had at least one of these cost-access problems. This includes 29 percent of people who were insured all year.

Continue reading…

The first one’s always free….but will you buy a kid a bike?

Many times because I’m an independent consultant, blogger or general self-appointed health care know-it-all people want to talk to me. And I’m always happy to talk. Sometimes these conversations turn into business for me or THCB or Health 2.0, but sometimes they don’t. What I tell anyone who wants my time is that the "first one is always free."

Saigon

Meanwhile, as part of her return from a back injury my wife Amanda has bought a bike and is training for a triathlon later this Fall. It’s also renewal time for our favorite cause the Saigon Childrens Charity. Much of its resources are spent buying rice for poor families so that they don’t need to send kids out to work, and so the kid can go to school instead. With the price of rice doubling this year, things are getting tougher for the charity and the kids.

Continue reading…

Who’d be a pollster, eh

HSC says that the number of Americans going online for healthcare goes way up:

In 2007, 56 percent of American adults—more than 122 million people—sought information about a personal health concern from a source other than their doctor, up from 38 percent, or 72 million people, in 2001, according to a national study released today by the Center for Studying Health System Change (HSC).

Harris Interactive says it’s gone down ;

Ten years ago, in 1998, the Harris Poll began measuring the number of people going online for health care information. At that time we reported that 54 million people had done so at least once. Since then the number of those people, whom we labeled “cyberchondriacs,” have increased almost every year, reaching 110 million in 2002, and 160 million in 2007.

This year, the Harris Poll finds only 150 million who claim to have gone online to obtain health care information. Of course, 150 million is still a huge number and includes 66 percent of all adults and 81 percent of those who are online.

Extra points if you can spot the flaw in my reasoning. (Yes, it’s easy but I’ve been up late watching the Olympics….even though I said I wouldn’t)

Merck’s Marketing for HPV Vaccine Trumps Science

I first wrote about Gardasil on The American Prospect online in the summer of 2006, just weeks before the Merck vaccine designed to protect against cervical cancer went to market.

There, I noted that “the hullabaloo began in June when the FDA approved Gardasil, a vaccine widely described as ‘100 percent effective’ in preventing cervical cancer, a disease that kills some 233,000 women worldwide each year. The drumbeat grew louder last month when a federal panel recommended that all American girls and women ages 11 to 26 should be inoculated. And now there is talk that states may mandate the vaccine for all school-age children.

“But before prescribing for the entire population,” I suggested, “it’s worth asking a few questions: Why does the vaccine cost $360 for a three-shot regimen? How much do we know about the new product? And is this a cost-effective use of health-care dollars?”

Continue reading…

On Rural Doctoring: The Generalist’s Mind

This is the second part of a series that first appeared on the blog Rural Doctoring,
where Theresa Chan writes about her experience working as a family
physician and hospitalist in a rural community in Northern California. Chan
moved from San Francisco to try out rural life.

When I think of rural doctors, I think of family practice. Part of this is training bias, because I am a family doctor, but this bias is supported by surveys which demonstrate that a significant number of rural communities would be medically underserved if it were not for the presence of family physicians.

In this post series, I will emphasize the family practice model of medical training as an approach to preparation for rural practice. I do not mean to imply that other primary care specialties–such as internal medicine, pediatrics or OB/GYN–have no place in rural communities. Quite the opposite, in fact. My job in rural California would be much more difficult if I did not have the support of the other primary care specialties. I hope this post series will be useful to medical students and residents who are training in those specialties as well, even if the content tends to veer towards family practice. I will argue that it is the generalist’s mind, rather than the specialty, which will suit a doctor for rural practice.

Continue reading…

Reports on Gardasil study offer varying interprations

Merck’s HPV vaccine, Gardasil, has received significant press in recent days, following a cost-effectiveness study published in the current issue of the New England Journal of Medicine.

Depending on where Americans get their news, they received different summaries and interpretations of the study. No wonder consumers are confused. Here are four examples:

Continue reading…

Chastened and More Sober, Harry and Louise Return

On Tuesday, Ron Pollack of Families USA led a call with bloggers — unfortunately, I couldn’t be on it — to discuss  Harry and Louise Return — the new health reform campaign sponsored by five prominent organizations: the American Cancer Society’s Cancer Action Network (ASC CAN), the American Hospital Association (AHA), the Catholic Health Association (ACHA), Families USA and the National Federation of Independent Business (NFIB).

Continue reading…

assetto corsa mods