In addition to last weekend's "Patient Revolution" summit, the physicians also had a "revolution" like gathering from our friends at Primary Care Progress. They had a Primary Care Leadership summit that was tracked on twitter with the hashtag #pcpsummit.
I was not physically there, but I felt like I was while following the twitter stream. I've only been following the Primary Care Progress organization for the past couple of months, and I've enjoyed what I have read. Hopefully, there will be collaborative opportunities in the future.
Last weekend, patients and patient advocates gathered for a three day event entitled The Partnership With Patients Summit. The evening of Day One was The Walking Gallery (which I still have to see in person for myself one of these days). Day Two was a long day with a fabulous set of speakers (one of which I will highlight below) and ended with the always fun Ignite format of presentations. I didn't know why the hashtag for day two was #cinderblocks, but reading here, I learned why. Day three was Health Camp Kansas City.
One of the speakers on Day Two was a Family Doc who calls himself Dr. Neu and is @NeuCare on twitter. W Ryan Neuhofel, DO is from Lawrence, Kansas and his practice is called NeuCare Family Medicine. The tweets from his presentation are below. As discussed on a previous podcast, it looks like Dr. Neu also practices in the model of Direct Primary Care. We definitely need more and more trailblazers like this. I have never met this physician in person, but it would be interesting for me to interview this innovative Family Physician on the podcast (hint, hint).
At the top of this post, you'll see an interesting metric from the past weekend's meeting. If you wanted to learn how to do twitter at this meeting right, we'll this was the meeting to be at. The number that should stick out to you is Seven Million Impressions on social media. (What's an impression? Click here.)
One other thing I wanted to point out was that look who was number three in impressions (if you can't see the graphic, I was number three in impressions), and I wasn't even on site at the meeting. Now, I know that was because of the number of twitter followers I have. But still, think about the impact and internet reach your meeting could have, even by people who are not on site with you.
Oh, and by the way, guess actually how many people were on site for the meeting. How about this? Organizers tell me that there were about 70 people for about 7,000,000 impressions. Do the math people. We'll see if today's E-Patient Connections Conference (hashtag #epatcon) in Philadelphia can keep up - Hehe. Enjoy the tweets from Dr. Neu's presentation below. Have a great week!
At issue is the question about who should be the leader of the health care team - The Physician or the Independent Nurse Practitioner. There have been long form essays written about this report, and I will include links and quotes below from the five I think are interesting, and you can decide for yourself how you feel about this issue.
Granting independent practice to nurse practitioners would create two classes of care: one run by a physician-led team and one run by less-qualified health care professionals. Physicians are required to complete 16,000 more hours of training than nurse practitioners
At a time when the AAFP is advocating a team-based approach to health care to improve outcomes and lower costs, some nurse practitioners are eager to go it alone. Our report makes a strong statement that the patient-centered medical home model is designed to be run with a physician leading a team of health care professionals.
The American Academy of Nurse Practitioners strongly supports patient-centered and team-based care models. However, the AANP believes that AAFP's efforts to link these evolving models of care with the licensure of nurse practioner practice are misdirected and out of step with today's environment.
Making full use of the NP workforce is a critical piece of a multi-pronged solution to address the urgent need for health care access in our nation. The ongoing attempts by the AAFP to limit the ability of NPs to practice to the full extent of their education and training only serves to increase the already overwhelming hardships placed on millions of Americans who are struggling to gain access to high quality health care.
Frankly, I find this statement condescending and disheartening. First of all, the statement over simplifies a much more complicated issue. Yes, I believe in removing barriers to nurse practitioner scope of practice. One practical reason for this is that when nurse practitioners are authorized to diagnose and prescribe, they can bill more comprehensively for services. If nurse practitioners cannot bill for services, they aren't useful additions to the health care team.
The way the AAFP has presented their argument leaves me throughly disheartened... With one statement, the specialty that made me believe in the future of healthcare has made me feel like a second class citizen... Believe it or not, that attitude doesn't make me want to collaborate.
Why has AAFP taken a public stance against nurse practitioners extending primary care services, but ignored specialists usurping a significant portion of primary care business? An August 2012 study found tht 41% of primary care office visits were provided by specialists.
Primary care is in decline because it has been compromised by a health care industry that wants direct patient access to lucrative downstream services. But primary care's leadership also has complicity, because it has failed to compellingly convey primary care's value and allowed others to define it.
Our medical home team has a team leader. At any time, it can be a nurse, a physician, or whoever is available to take charge and make sure our patients are cared for. That's the point.
Whether or not it needs to be a physician or nurse practitioner - the evidence is definitely lacking. However, when looking at the IOM report for nursing and the AAFP report for the future of primary care, the only thing that really sticks out to me is the idea we should be working together in collaboration. The national organizations can spin their reports and backlashes however they would like. Unfortunately, this is what media will do for a news story.
Who is the leader in the Patient-Centered Medical Home? The answer is easy - Our Patients. And they deserve the right for increased access to a team of providers - physicians, nurse practitioners, not practicing independently - who all need to be leaders for the patient's ability to achieve a healthier life.
As of the publishing of this post, there are 19 comments right here. And, it is the comments to this article that are most interesting. Opinions are on both sides of this one - supporting the AAFP paper, and against the views in the paper. There have already been several essays written on both points of view on this AAFP paper. I'll address those in a future blog post.
You can listen to the show in its entirety below in the player. You can also download the entire audio podcast for Family Medicine Rocks Episode 278 right here. I also encourage you to follow me on twitter, check out the facebook page for this show (and "like" it), and to check out my you tube page with a new TV interview from this past week. Enjoy!
This post as well as the video below is intended for attendees for the 2012 Family Medicine Education Consortium meeting in Cleveland, Ohio. If you're reading this, you're considering helping out to video document the meeting. Thanks so much for your consideration!
There are tons of complicated articles out there to help you record great vids. But, if you're using a flip video camera or your smartphone, there are two simple steps that you have to remember when you are recording video interviews at meetings:
1) Adequate Lighting: The most common error that is made is a dark picture because of not enough light. Try to make sure that there is almost a light focused on the subject. You'll see in this video interview that I recorded at the 2010 FMEC meeting - that there was not enough light. In another example from a 2012 meeting, you'll see in this video, the lights initially off, and then magically turn on during the interview. Kinda funny.
2) Little Background Noise: It's very convenient to catch someone just after a session ends, and before they leave the room. The 2nd most common error is not knowing just how much background noise will interfere with the interview. In this first example, here is an interview of me last year that was recorded on a smartphone. You'll hear that breakfast has been going on with the background noise. Would've been easier (but less convenient) to go out into the hall. In the 2nd example, I conduct an interview "behind the scenes" at a meeting in an empty room, with only some music in the background. It's kind of a spoof video, so enjoy that.
There are a lot of other tips that I could give you, but I wanted to keep it simple, Also check out my "tips video" below, and I hope to see you in Cleveland for the FMEC meeting!
Thanks again to Rob Lamberts, MD for being my guest on Family Medicine Rocks Episode 277. He is leaving his current traditional medical practice model for something called "Direct Care" medicine which is a subscription model in which patients pay a monthly fee. Dr. Rob states that his patients will have better access to him in this model, which includes electronic communication like e-mail.
In the midst of our conversation, he describes how he came to this decision. He's frustrated (like many of us primary care physicians) with the current health care system, and he felt that he could not transform his practice from within. So, he decided to start his new practice from scratch.
At the end of the interview, we reminisced about when we first started blogging about 5 years ago. My, how times have changed in the healthcare social media space. In the video above, Dr. Rob gave some reflective comments to close the show.
You can listen to the show in the player below. You can also download Family Medicine Rocks Episode 277 here or below. Welcome to those of you who are new to this site. I invite you to check you the podcast site (which includes our iTunes link), the facebook page for this website, my youtube page, my twitter feed, and my linked in page. Enjoy!
Our pal Kevin MD presented in Washington, DC this morning at the eDTC Revolution 2012 Conference. From looking at their website, looks like it was primarily a pharma crowd. I presented at an industry conference in San Francisco and let me tell you, it was a little bit of a tough crowd. Those pharma people really want and need access to physicians/providers.
Below are the tweets (via storify) from his talk via the hashtag to the conference #eDTC2012. I don't know if he is making his slides available, but you'll get a good idea of his talk from the tweets. Enjoy and have a great weekend everybody!
On his new website, Doctor Rob announces that he is leaving is primary care group to create a solo practice using a model of care called "Direct Care." This has also been called "Direct Primary Care" or "Direct Medicine." This quote is from his website.
Direct care has several things that define it as such
Insurance is not accepted
Patients pay a monthly subscription fee for access
Office visits are free or very low cost
Patients have much more access to their doctor via phone, internet, or immediate appointment availability
The number of patients is kept relatively small
During tonight's program, I'll be asking him the process by which he made this decision to start his own solo practice. In addition, you may have read about this different model of practice that is starting to pop up out there in America. I am in what is considered a traditional patient practice model right now, and I have many questions about the logistics of how something like this would work.
Doctor Rob was my first guest on the old Doctor Anonymous Show podcast. Just for fun, I have included the audio player for Show Number 5 below which took place five years ago this month. Doctor Rob was calling in from a medical conference, and I mainly asked him about blogging back then. This five year old show is a great looking glass into where medical social media was back then. Download Show Number 5 here.
So, I hope you can listen to our conversation tonight, Thursday, September 13, 2012 at 8pm Eastern Time on Blogtalkradio for Family Medicine Rocks Episode 277. As always, if you cannot listen live, you can download the archived podcast later and listen anytime. Hope you can join us!
This post is inspired by the facebook update by my long time social media friend Dr Gwenn. And, I know that this post is going to sound like I'm an "old guy" of social media ("Hey kids, get off of my lawn" LOL). I started blogging six years ago, and, at that time, the community was very small - especially the medical social media community.
But, as the natural evolution of media goes, as things get more "mainstream" (however you define that), more and more commercialization comes about (defined by Dr. Gwenn above as corporate robots). With that comes discussions about topics like this: "Scheduled tweets: Yes or No."
So, do I long of those "old" days (just a few years ago) of medical social media? Of course. It's getting more and more difficult to navigate through the fluff to get to the quality content. It's even gotten to the point where there have been apps and sites created to help us sort through the information overload.
This entire whiny post can be encapsulated in the video below from one of my fave cartoons of all time: A Charilie Brown Christmas when Charlie Brown says, "My own dog gone commercial. I can't stand it." Yup, that sums it up. And, yeah, I'm talking to you. Get off my lawn you kids LOL
In the twitter medicine world, @BurbDoc is one of the most intriguing, yet polarizing individuals out there. I really should not be posting this essay because of the e-mails that I received today about my previous post. A lot of people out there viciously defend what @BurbDoc does, which I find very interesting.
What really was interesting to me was the tweet about "gallows humor" and venting. For those who don't know, I was anonymous once out here on the internet as @DoctorAnonymous. So, I definitely understand and lived that point of view.
Shifting to today's @BurbDoc tweets, they are below courtesy of storify. Even though it was on twitter, the tweets was essentially a long blog post - 140 characters at a time. I saw this unfold in real time today. And, if you don't know anything about "Meaningful Use," the one thing that you are able to gather is that it is a bunch of "clicks."
So, do I think @BurbDoc is all bad - Well no. Do I think that @BurbDoc is all good - Well no. (I welcome all the hate mail that you're going to send me - HA!). I do think that @BurbDoc is a real doctor (not a fake), on the west coast of the US (guess), who is finding a unique way of self-expression. Once you cut through the cussing and the thick sarcasm, there is painful truth there about our broken health care system. Am I wrong? Let me know :)
