Medicine
- Find New Family Medicine Leaders?
Message to Family Medicine: Return Leaders to Family Medicine Focus Annals of Family Medicine published an article about the Primary Care Medical Home that was not flattering. In many ways Annals has been cutting edge with regard to basic health care...
- How The Disease Focused Abuse Health Access
Names and Naming Must Be More ImportantUnited States leaders have developed the nasty habit of calling things what they are not. No Child Left Behind reflects a process of American education that leaves most behind. American primary care training...
- Exploring The Health Consequences Of Disease Focus
Cost Cutting ConsequencesThe past 30 years have been cost cutting designs in the US. Past leaders have shaped health care focused ever more on disease, subspecialty, and academic interests. A previous Congress reacted with an attempt to cut costs, but...
- Myth For The Cure: Essential For Disease Focus
Do no harm has lost its charm - when dollars are involved. Do no harm is difficult when the focus is eliminating disease. Nearly all of the disease-focused treatments cause harm and some cause substantial harm to people, to groups, or to entire nations....
- One Million Hearts Saved Or 160 Million Lives Improved
Where Should Our Leaders and Our Designs Take Us as a Nation? Million Hearts is another attempt to turn risk factors into saved lives - specifically reductions in heart attacks and strokes. The targets are once again human behavior changes (patient...
Medicine
What Is Killing US Is Not Four Deadly Diseases
The Myth for the Cure and others in the Disease Focused Crowd Are Now Selling Four Diseases to the United States and to the World Health Organization.
What is killing the United States is not hundreds of heart diseases or thousands of cancers or lung diseases all lumped together. These are great strategies to market well or to fund raise more efficiently or to siphon off ever more health spending as as simplistic 4 diseases. This also makes it seem that we only have 4 disease to cure. We have made slow progress on a few diseases - period. Our major advances have been in clean water and food and immunizations and basic health habits - areas that we have been forgetting as primary in importance. Microbes still teach us these areas and the futility of technology, but we fail to listen.
Disease is just the end stage. We all will die. We can choose how we die. More importantly, if we allow our designs for health and health care to be controlled by those focused on disease and delaying death, we will actually impair the lives of more and more people and those youngest.
After 100 years of marketing disease, we are beginning to understand that disease focus can actually kill more people. We have known for decades what really kills the United States in economy, people, income, jobs, and productivity.
Greed
No explanation is needed here, we know it, we tolerate it, and it kills us as a people and a nation. We fail particularly when Greed wins over Need.
Too Much Stress
When stressed too much we eat too much, smoke too much, drink too much, and do all the behaviors that cost our nation year after year and generation to generation – and our design insures more left behind and fewer at the top. We also pack people into the unhealthiest places that divide most into rich and poor in income as well as in health. We design this and greed exploits this. Divided states and populations have the most costly and worst health outcomes – enough said.
Ignoring the Needs of Children
This is my number one disease choice. As a nation we spend far too little time and effort and resources on the first months and years of life. This results in children who are defeated in education, jobs, health decisions, and citizenship from the start. Spending upon disease in the last months and years of life can be seen as compromising the youngest from their start. Votes by Congress such as Part D Medicare clearly will take trillions out of current and future budgets to care for those oldest who can contribute least to the future of our nation. This was voted to Medicare recipients that already had health care coverage and already had coverage for drugs. It was a specific package to get votes from the elderly and an affront to the next three generations to come that cannot vote yet and will be ever less able to meet the needs of the nation. Other state and federal and insurance designs also steal the future from our children.
Failing to Support our Human Infrastructure
Those on the front lines are our Human Infrastructure – teachers, nurses, police and other public servants, primary care, public health, military, and more. They are far more likely to arise from the 65% left behind. They also represent America to our children by their jobs and their interactions.
Disease focus is set to move US past 20% of the annual Gross Domestic Product, but this is apparently not enough. Our health professionals are selected and trained and paid specifically to address disease with their teaching, research, and work effort. Not surprisingly Greed, Stress, child failures, and lack of human infrastructure support facilitate disease focus and disease spending to ever greater heights.
So next time that you hear about Four Diseases, recognize the marketing of disease and the compromise of health. When you hear Race for the Cure, remember Myth for the Cure and $400,000 or greater salaries for those leading the charge. When you see salaries of $400,000 and up for subspecialty physicians or 20% of the top 1% as physicians, you will understand the focus on disease rather than health. When you understand primary care penalized and non-primary care rewarded you will understand why only 25% of nurse practitioner graduates and 25% of physician assistants and 25% of medical school graduates remain in primary care for careers and decades of shortages of primary care for over half of US.
What are the antidotes to Greed, Stress, Arrogance, and Ignorance? Sacrifice, Service, Togetherness, and Belonging
All are about Connectedness.
Myth for the Cure
Social Conditions as a Cause of Disease
One Million Hearts or 160 Million People
Failure of Disease Management to Save - a caution for PCMH as well
Thanks to all 12,000 who have visited Basic Health Access in 2011.
Robert C. Bowman, M.D. Basic Health Access Web Basic Health Access Blog
SMART Basic Health Access World of Rural Medical Education
Basic Health Access Blogspot 2011 - Summaries and Links for 2011
Dr. Bowman is the North American Co-Editor of Rural and Remote Health and a Professor in Family Medicine at A T Still University School of Osteopathic Medicine. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association, he was the long term chair of the STFM Group on Rural Health, he is the founding director of Priority Infrastructure at http://www.infrastructureamerica.org/ and he is the author of the World of Rural Medical Education, and Physician Workforce Studies
Meeting Primary Care Needs in the Last Half of the 21st Century - Really!.
Clinician Specific Medical Education
SMART – Specific, Measurable, Achievable, Realistic, Timely
Hard to keep up with the disease focused coming from so many directions in so many diseases.
Thought I was updated, but one more about billions that will be wasted on Lung Cancer Screening not to mention the harm done directly and indirectly with more disease creation.http://www.medscape.com/viewarticle/752955 if you have Medscape or immediate promotion by http://www.news-medical.net/news/20111029/LCA-hails-NCCN-for-lung-cancer-screening-guidelines.aspx Watch how rapidly this is spread.
Worth reflection for this day and time in history:
Commonwealth Wants SGR Repeal, RCB wants health leaders to discover that health focus is not about disease and designs for health care should not have disease focus.
The Daily Yonder shared my concerns today regarding 11/2/11 as worst day for primary care in the past 4000 days. Like Soylent Green, Primary Care is People – People delivering the care to people – when the design supports people to deliver the care that they need when they need it and where they need it.
After 100 years of disease focus, the nation is finally becoming aware of the consequences of disease focus - failed health designs. These designs result in ever more spent for ever fewer people for even fewer years of their lives with care delivered in ever fewer locations. This is also ever more health spending for fewer locations.
The excesses have resulted in steady compromises of basic health services for nearly all Americans needed nearly all of the years of their lives in nearly all locations.
Primary care was supposed to be the centerpiece of President Obama's health care reform bill — the way the country was to reduce the amount it spends on medicine. So why is his administration allowing cuts of primary care that will kill off more primary care?
The excesses have resulted in steady compromises of basic health services for nearly all Americans needed nearly all of the years of their lives in nearly all locations.
Primary care was supposed to be the centerpiece of President Obama's health care reform bill — the way the country was to reduce the amount it spends on medicine. So why is his administration allowing cuts of primary care that will kill off more primary care?
This Will Be Brief As Will Primary Care Blog just previous
Or past blogs months ago warning about the changes to come
It is my hope that Commonwealth, Major Journals, government leaders, and other health care leaders begin to understand that innovation and reorganization is exactly the wrong approach at the current time. Research is also not needed. What is needed is people that commit to delivering primary care for entire careers with the nation committed to supporting them. By the way this is what nurses, teachers, soldiers, and public servants need and we have made progress only in much better support of our soldiers (compared to recent decades)
It is my hope that Commonwealth, Major Journals, government leaders, and other health care leaders begin to understand that innovation and reorganization is exactly the wrong approach at the current time. Research is also not needed. What is needed is people that commit to delivering primary care for entire careers with the nation committed to supporting them. By the way this is what nurses, teachers, soldiers, and public servants need and we have made progress only in much better support of our soldiers (compared to recent decades)
The United States cannot recover primary care by technology, innovation, or reorganization. The best it can do for innovation is what it has ignored for 40 years - put tens of thousands of RN, MD, DO, NP, and PA out in the health access field year after year – before training, during training, and after training, and for entire careers.
RPAP Is SMART and Has Been for Forty Years
With regard to the current flash in the pan popularity of many folks running for positions or power or leadership - As noted in the American President, Michael J. Fox's character noted
“People want leadership, Mr. President, and in the absence of genuine leadership, they'll listen to anyone who steps up to the microphone. They want leadership. They're so thirsty for it they'll crawl through the desert toward a mirage, and when they discover there's no water, they'll drink the sand.”
“People want leadership, Mr. President, and in the absence of genuine leadership, they'll listen to anyone who steps up to the microphone. They want leadership. They're so thirsty for it they'll crawl through the desert toward a mirage, and when they discover there's no water, they'll drink the sand.”
Do not drink the sand. Practice thoughtful reflection and avoid the mirage. Desperation never works well for democracy and also manages to defeat capitalism by allowing greed to reign over long term investments that are better for the nation and the companies. Desperation works well for those that sit in wait of desperate opportunities and are first in line although last in need.
We are all as grains of sand in the grant scheme of things, but connected together we can be more.
- Find New Family Medicine Leaders?
Message to Family Medicine: Return Leaders to Family Medicine Focus Annals of Family Medicine published an article about the Primary Care Medical Home that was not flattering. In many ways Annals has been cutting edge with regard to basic health care...
- How The Disease Focused Abuse Health Access
Names and Naming Must Be More ImportantUnited States leaders have developed the nasty habit of calling things what they are not. No Child Left Behind reflects a process of American education that leaves most behind. American primary care training...
- Exploring The Health Consequences Of Disease Focus
Cost Cutting ConsequencesThe past 30 years have been cost cutting designs in the US. Past leaders have shaped health care focused ever more on disease, subspecialty, and academic interests. A previous Congress reacted with an attempt to cut costs, but...
- Myth For The Cure: Essential For Disease Focus
Do no harm has lost its charm - when dollars are involved. Do no harm is difficult when the focus is eliminating disease. Nearly all of the disease-focused treatments cause harm and some cause substantial harm to people, to groups, or to entire nations....
- One Million Hearts Saved Or 160 Million Lives Improved
Where Should Our Leaders and Our Designs Take Us as a Nation? Million Hearts is another attempt to turn risk factors into saved lives - specifically reductions in heart attacks and strokes. The targets are once again human behavior changes (patient...