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It is all transpiring under the radar. No one seems to care. Few are fighting it, even fewer are reporting on it. And yet the implications of what Congress is poised to do will have profound reprucussions for doctors, patients, and the entire Medicare system. See a new article in Kaiser Health news in which I am interviewed: CLICK HERE for the article. When the Affordable Care Act (ACA) passed 6 years ago, one of its goals was to increase the number of primary care physicians. Multiple studies have demonstrated the value of primary care in providing quality and cost effective care; in areas of the country with more primary care doctors, patients do better at a lower cost. Without a dou
Finally the SPRINT numbers have been published, and the results are both unimpressive and of questionable significance. In a highly selected and very small (2500 people over age 70) group of patients with heart disease, there was a reduction in death of 3.5/1000/year in the tightly controlled hypertensive group compared to the less controlled group. See BRCT on the left. CLICK HERE to see BRCTs of SPRINT endpoints and others. The SPRINT numbers are in direct contradiction to several other studies that show increased mortality with aggressive blood pressure reduction. A 2013 VA study of 650,000 veterans with chronic renal disease not on dialysis, those with systolic blood pressure under
Coronary Artery Calcification can be scored by a CT scan (CAC score) and may help determine who may or may not be at risk of having a hard cardiac event (heart attack or sudden cardiac death) in the next year. In fact, as the BRCT shows, of people who have a negative CAC score, only one out of 1000 of them will have a cardiac event in a year, meaning that 999 of them do not have to worry. That is pretty reassuring! Many patients, and their doctors, are interested in determining if they are at risk for heart attack or sudden cardiac death. We know from ample studies that random EKG’s and stress tests are not helpful in this regard. 70-80% of heart attacks occur in blood vessels that are n
Erik Rifkin and I published an op-ed in the Baltimore Sun on November 2 (CLICK HERE FOR LINK) discussing the use of BRCTs in the media. The article's link is at: http://www.baltimoresun.com/news/opinion/oped/bs-ed-media-patients-20151101-story.html To learn more about BRCTs and how we think that this concept can lead to impactful changes in Medicare reform, check out website at www.doc-patient-talk.com. Also, see our video: We believe that accurate and easily understandable health care reporting is crucial to facilitating shared decision making between doctor and patient, to reducing over-treatment and over-testing, and to increasing the quality of health care delivery at a lower cost. Ul
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