Author Archives: Denise Fulton

Medicare Takes on Fraud: The Policy & Practice Podcast

Hey, loyal listeners! Your Policy & Practice Podcast this week features Dr. Don Berwick talking about the beefed up fraud-fighting tools provided by the Affordable Care Act. Instead of reacting to fraudulent efforts, the new tools will help his agency prevent fraud, according to the good doctor.  Listen to his comments here:

Also, in this installment: The election and a looming SGR cut have doctors concerned as well. Do you think Congress will do anything to prevent your Medicare pay from being cut on Dec. 1? Add your thoughts to the comments section.

—Denise Fulton (@denisefulton on Twitter)

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Filed under Family Medicine, Health Policy, health reform, IMNG, Internal Medicine, Pediatrics, Podcast

Dr. Berwick Speaks: The Policy & Practice Podcast

New CMS Administrator Dr. Don Berwick gave his first major speech recently, reaching out to health insurers to enlist their help  in implementing health reform. He got an affirmation, but only time will tell if these two parties—often at odds over how to provide and pay for health care—can reach common ground.

Dr. Donald M. Berwick

Also in this week’s podcast: The primary election season is over; will the general election be a referendum on the Affordable Care Act? And, new Census numbers show that some 51 million U.S. residents are now uninsured.

Want to hear more? Take a listen to the Policy & Practice Podcast.

—Denise Fulton (@denisefulton on Twitter)

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Filed under Health Policy, health reform, IMNG, Podcast

More Money and More Doctors: The Policy & Practice Podcast

As the health reform law begins to impact doctors and patients across the country, a couple things are becoming clear.

Courtesy flickr user Darren Hester (CC)

First, components of the health reform law are causing health spending to go up over the next decade, not down as many advocates projected, according to new projections from the Centers for Medicare and Medicaid Services.

Second, health reform will provide coverage to millions more U.S. residents over the next decade and someone will need to take care of them. Researchers at Dartmouth University say more providers is not necessarily the answer — it’s more subtle than that.

Want to learn more? Take a listen to our Policy & Practice podcast for this week. Then, let us know what you think.

—Denise Fulton (@denisefulton on Twitter)

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Filed under Family Medicine, Health Policy, health reform, IMNG, Internal Medicine, Podcast, Practice Trends, Primary care

The Labor Day Edition: The Policy & Practice Podcast

As U.S. workers came back from a brief Labor Day holiday, new federal health reform benefits are in the spotlight.

Morgantown, WV

Health reform benefits seek to help small businesses. Image courtesy flickr user jmd41280 (CC)

Two Affordable Care Act programs seek to help employers cover more of their workers — one seeks to encourage small businesses to continue to cover their workers, while the other helps companies to continue insurance benefits for early retirees.

And as summer turns to fall, so the nation’s attention turns to the upcoming midterm election in November. How will candidates’ support of health reform affect voters’ choices?

The Policy & Practice Podcast has more on these important issues. Take a listen and let us know what you think:

—Denise Fulton (@denisefulton on Twitter)

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Filed under Health Policy, health reform, IMNG, Podcast

Give Me a (Medical) Home: The Policy & Practice Podcast

While doctors are still peeved that there’s been no action to avoid the deep cuts in Medicare pay necessitated by the Sustainable Growth Rate formula, or SGR, the Obama administration has delivered some good news regarding a test of the Advanced Primary Care Practice concept, better known as the medical home.

For more on those stories, listen to this week’s Policy & Practice Podcast.

Not up to speed on the medical home? My colleague Mary Ellen Schneider can help you with that. As the medical home beat reporter for Elsevier Global Medical News—Notes From the Road’s sister news outlet—she’s covered the topic from most angles.

Image courtesy flickr user J. Steven Conn (CC)

Today, she wrote about an extensive test of the concept sponsored by the American Academy of Family Physicians; last week, she took a look at how specialists might lead the medical home for some of their patients.

See how much you can learn by reading Notes From the Road?

—Denise Fulton (@denisefulton on Twitter)
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Filed under Family Medicine, Health Policy, health reform, IMNG, Internal Medicine, Podcast, Practice Trends, Primary care, Rheumatology

One of These Things Is Not Like the Others

Courtesy flickr user pasma (CC)

One of these things is not like the others,
One of these things just doesn’t belong,
Can you tell which thing is not like the others
By the time I finish my song?
(Words and Music by Joe Raposo and Jon Stone, Sesame Street)

The current public health message to patients is to look for the ABCD’s of melanoma. But how many people do you think can actually remember what that mnemonic stands for?

The ugly duckling sign of melanoma was first described in 1998 by Dr. Jean-Jacques Grob of the University of Marsielle in Provence, France. It holds that nevi on a given individual tend to resemble each other, said Dr. Ashfaq A. Marghoob, at today’s meeting at the annual Hawaii Dermatology Seminar sponsored by Skin Disease Education Foundation. Most individuals harbor nevi that resemble each other like brothers. And when a lesion breaks that common mold, it becomes an ugly duckling…

This post first appeared in our sister blog, The Mole: the Skin & Allergy News blog. To read the whole post by managing editor Amy Pfeiffer, go here.


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Filed under Dermatology, Family Medicine, IMNG, Internal Medicine, Oncology

Straighten Out Your 3-Iron With CPAP

Courtesy flickr user anthony_goto (CC)

Finally, a way to motive patients to use the CPAP machine you’ve prescribed for them.

According to Dr. Marc L. Benton, golfers with obstructive sleep apnea can expect to knock strokes off their game by adhering to nighttime treatment with continuous positive airway pressure. What’s more, the better the player, the bigger the improvement in golf handicap resulting from sticking with CPAP.

Compliance with CPAP is notoriously poor, notes Dr. Benton, a sleep disorders and pulmonary medicine specialist in Madison, N.J. Many patients, put off by CPAP’s noise, inconvenience, and expense, remain unswayed by their physician’s warnings of the serious medical risks they face in foregoing treatment.

Not avid golfers, however. Dr. Benton has shown in a small prospective study that golfers with OSA are are willing–indeed, eager–to embrace the therapy. He calls the prospect of playing a better game a powerful and previously untapped motivator to seek out and adhere to treatment.

“The adherence in this study was absolutely through the roof,” Dr. Benton observed in presenting his study findings at the annual meeting of the American College of Chest Physicians, held in San Diego.

“More so than almost any other sport, golf has a strong intellectual component, with on-course strategizing, focus, and endurance being integral components to achieving good play,” he noted. “Through treatment with nasal positive airway pressure [NPAP] we can improve many cognitive metrics, including attention span, memory, decision-making abilities, and frustration management, which may in turn positively affect a person’s golf game.”

His study included 12 golfers with moderate-to-severe OSA and 12 controls matched by age and golf handicap. None of the golfers with OSA had previously been interested in treatment, but the glowing vision of a lower handicap lured them into study participation.

After 3-5 months of NPAP their handicap dropped from an average of 12.4 to 11.0. All of them felt better able to perform on the links. The control subjects had no change in handicap.

The outcomes were particularly striking among the 5 golfers with OSA who were already very good at the game as defined by a baseline handicap below 12. Their average handicap dropped from 9.2 to 6.3, and they were ecstatic about it. “Most of these better golfers were in their late 50s and early 60s, a time of life when the handicap index is typically going in the other direction due to issues related to the aging process,” Dr. Benton noted.

He estimated that 1-3 million American golfers have OSA. In most cases the disorder is undiagnosed and/or untreated.

—Bruce Jancin

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Filed under Family Medicine, IMNG, Internal Medicine, Pulmonary Diseases and Sleep Medicine, Sports Medicine