Re: FW: AAFPs Take on the NDP -- guess what, pts HATE IT

[Guest guest]

RE PCMH = decreased pt satisfaction.

OK, I get it...

1) Decreased pt satisfaction.

2) Keep working on it, because "if you build it" they'll PAY YOU LATER??????????????

Sorry, and my AAFP dues went to this.

OK, how about my "off the cuff" analysis:

1) The GOAL (unstated) of PCMH is to document what we do, while dramatically changing how we do it.

2) We don't get paid enough (no real increase at least in Medicare pay for 10 years!) so we need to spend more moneys to show how we don't succeed.

3) The final goal, unintended of course, of microdocumenting what we cannot do well due to computerization with beta systems is to conglomerate all of us to work for hospitals, and we all know how efficiently they do the job, don't we??

How about we:

1) Do what we do to keep pts alive.

2) Take home messages of minor changes from systems like the Muscular Dystrophy groups (someone showed this info at a Pennsylvania AFP conference in March 2010 -- curiously, Pa is one of the states that does NOT support the PCMH project as it is, fancy that!!) to institute BEST PRACTICES to individual docs to IMPROVE PROCESSES instead of scrapping all we do now for an UNPROVEN SYSTEM.

3) Pay us more for well care which we're doing now (the local BCBS does this actually, with payment to me about $100/pt annually).

I'll just watch and gradually computerize more and more, as my pt base of adults with acute and chronic care issues grows.

To say I'm disappointed in the AAFP is NOT correct. To say that I'm disappointed that they don't want to acknowledge that bigger and more restrictive administrative processes do NOT bring more benefits to OUR PTS and OURSELVES is correct.

Nope, not cancelling my AAFP dues, but I'm watching closely.

My vote is to CLOSE DOWN PCMH as stands, fund TransforMED as a consultancy to assist in appropriate and useful technology support.

And to LOBY MORE FOR WELL CARE ADDITIONAL PAYMENTS TO PRIMARY CARE SO WE CAN DO WHAT WE DO BEST!!!

My PERSONAL opinion, signed,

Levin MD

Solo since 2004

Residency trained grad 1988

Western PA

User of SOAPware since 1997User of Appointmentquest.com for online appointment scheduling since May 2007User of RelayHealth for secure email with patients since June 2007Technology and Practice Management consultancyContributing Volunteer Editorial staff of Family Practice Management at AAFP

dr-levin@...

AAFPs Take on the NDP

Here is the official word from the AAFP on the National Demonstration Project from Transformed: http://www.aafp.org/online/en/home/publications/news/news-now/practice-management/20100607tmedndpfindings.html

It is ironic that the answer to the dilemma of decreased patient satisfaction is to continue to push the concept forward (well, that is not very “patient centered” is it?). Also, even with the marginal results, minimal improvement in outcomes for the actively managed groups over the passively managed groups, and decreased patient satisfaction, there is still an advertisement at the bottom for Transformed services. Even the title is a nice spin—of course practices need support to change, but the 18 actively supported groups in the Transformed NDP fared no better than the passively supported groups so I am not certain there is proof that their support makes a difference. Finally, in terms of the cost issue, the NDC cost $8 million to work with 36 practices for 2 years. That equates to $222,222/practice/year. Remember that only 18 were actively managed so that means the equivalent of probably $400,000/actively managed practice/year—and the result was worse patient satisfaction. How much money would it take to transform a practice????? Stay tuned for more…