#MDchat transcript Healthcare Social Media Transcript From: Tue Oct 11 17 :56:00 PDT 2011 To: Tue Oct 11 19 :00:00 PDT 2011 change time periodNew! Explore ana lytics f or this time period: #MDchat analytics Explore the world of healthcare social media: Healthcare Conferences - Healthcare Tweet Chats - All Healthcare Hashtags Learn more about #MDchat at The Healthcare Hashtag ProjectRichmondDoc Mark, f amily doc in #RVA; most ly lurking tonigh t as I get r eady to he ad out on the road soon. #mdchat Tue Oct 11 18:01:13 PDT 2011MedPedsDoctor Alex Djuricich, Med-Peds doc i n Indianap olis, just gett ing to Tw since ea rly am. #mdchat Tue Oct 11 18:02:33 PDT 2011NateOsit Hi all! Nate he re, your fr iendly H ealth IT geek! T uning in tonight to chat with #MDchat and #mhsm Tue Oct 11 18:03:11 PDT 2011apjonas @MD_chat Hi, Phil and all. Pat Jonas, MD here, Holistic Family Physician in OH. Looking fwd to learning on #MDChat Tue Oct 11 18:03:56 PDT 2011MD_chat T1 OccupyHealth: How migh t Occ upyWallStreet impact discourse re: healthcare reform? What are you r hopes/concerns? #MDchat Tue Oct 11 18:05:03 PDT 2011EMIMDoc Hi! David Marcus, EM/IM in Queen s, NY. Will be on for a b it then will have to g o... #MDchat . Tue Oct 11 18:05:33 PDT 2011T1 We should be outraged at the condi tion of our heal thcare. We pay more for care
RichmondDoc per capita than anyone else; lacking results. #mdchatTue Oct 11 18:07:43 PDT 2011
ElinSilveous Hi everyone. Elin here, sitting in for awhile from Southern Oregon. #MDChat
Tue Oct 11 18:08:04 PDT 2011
RichmondDoc T1 We are first per capita in #healthcare costs, yet we are 37th in @WHONewsrankings of health outcomes. #mdchat
Tue Oct 11 18:08:09 PDT 2011
MedPedsDoctor Given that health care costs are the biggest impact on the GDP, discussions aboutwhat to do with HC are a BIG deal #mdchat
Tue Oct 11 18:08:14 PDT 2011
RichmondDoc T1 We are the worst among developed Western nations in the quality of the healthcarewe provide...despite the costs. #mdchat
Tue Oct 11 18:08:39 PDT 2011
EMIMDocAgree with all you guys are saying, but for some reason people become sheepisharound healthcare. There is no rage. #MDchatTue Oct 11 18:09:15 PDT 2011
RichmondDoc @MedPedsDoctor Ah...I am too optimistic, then. #mdchatTue Oct 11 18:09:53 PDT 2011
EMIMDoc @RichmondDoc I wish. I think the only way that will happen is if this movementdevelops into a mature, long term type of thing. #MDchat
Tue Oct 11 18:10:36 PDT 2011
JediPD Part of the cost differential between US & other Western countries is their SUBSIDIZEDpharma drugs. In US i t is 24c of each HC $ #mdchat
Tue Oct 11 18:11:14 PDT 2011
RichmondDoc @EMIMDoc Long term movement is indeed necessary...but every long termmovement has to start with a kernel of activism. #mdchat
Tue Oct 11 18:11:34 PDT 2011
ElinSilveous @RichmondDoc Many ARE outraged! Re Healthcare, GDP, CER... #MDChatTue Oct 11 18:11:46 PDT 2011
apjonas T1 Focus on insurance reform is over emphasized. Changing Health Care (2 words) ismore important ¬ well addressed. 2 much blurr #MDChat
Tue Oct 11 18:11:59 PDT 2011
MedPedsDoctor Great article on how docs can help control costs: http://t.co/WukKcvs5 #mdchat
Tue Oct 11 18:12:21 PDT 2011
MedPedsDoctor Mark: love your phrase: kernel of activism. Now THAT is how advocacy truly starts!#mdchatTue Oct 11 18:13:02 PDT 2011
RichmondDoc @ElinSilveous And we should *all* be outraged...but for now many of the costs areborne by employers--but this is changing. #mdchat
Tue Oct 11 18:13:05 PDT 2011
RichmondDoc @ElinSilveous There is more and more cost shifting onto patients/employees/families.There is a limit to what can be tolerated. #mdchat
Tue Oct 11 18:13:39 PDT 2011
JediPD Over there it is subsidized and Negotiated down by Foreign relations of each country.@RichmondDoc #mdchat
Tue Oct 11 18:13:42 PDT 2011
katellington T1 The relationship between heal th and life for 99%. Example, foreclosures aremaking people sick, literally. #OccupyHealth #MDChatTue Oct 11 18:13:44 PDT 2011
RichmondDoc @NateOsit @JediPD PhRMA has more lobbyists on Capitol Hi ll than there arelegislators. Deck is notably stacked. #mdchat
Tue Oct 11 18:14:20 PDT 2011
EMIMDoc @apjonas And also, health insurance does NOT equal health care. They are inbusiness to make money, provide certain benefits, etc. #MDchat
Tue Oct 11 18:14:20 PDT 2011
RichmondDoc @JediPD And as a result, patients pay far less for necessary medications... #mdchat
Tue Oct 11 18:14:36 PDT 2011
RichmondDoc @katellington Welcome. Join me on my soapbox. ;) #mdchat
Tue Oct 11 18:14:51 PDT 2011
ElinSilveous Understood RT @RichmondDoc: @ElinSilveous There is more and more cost shiftingonto patients/employees/families. There is a limit.. #mdchat
Tue Oct 11 18:15:17 PDT 2011
NateOsit @katellington Hi Kate! Thanks for coming! :) #MDchatTue Oct 11 18:15:23 PDT 2011
miller7 For those not familiar with 1st order change and 2nd order change (Bateson), most#healthcare change is 1st order #MDchat
Tue Oct 11 18:15:36 PDT 2011
apjonas @katellington Hi Kate, welcome! #MDChat
Tue Oct 11 18:15:48 PDT 2011
RichmondDoc T1 The road to lower costs will be tough. More preventive care, actually *valuing*health (not illness), more primary care... #mdchatTue Oct 11 18:16:04 PDT 2011
JediPD Medicare Part D cost $58 Billion over 5 years. CMS did not negotiate due to lobbying
yayayarndiva #occupyhealth caught my attention #mdchatTue Oct 11 18:16:22 PDT 2011
katellington Glad to connect and share @RichmondDoc @NateOsit @apjonas ....#MDChat
Tue Oct 11 18:16:42 PDT 2011
ElinSilveous @NateOsit @katellington Hi Nate. Hi Kate. #MDchat
Tue Oct 11 18:16:44 PDT 2011
EMIMDoc This looks to be a fascinating discussion, unfortunately, must leave Will try to follow.#MDchat
Tue Oct 11 18:16:50 PDT 2011
MedPedsDoctor Agree! MT @EMIMDoc: @apjonas And also, health insurance does NOT equal healthcare. #mdchat
Tue Oct 11 18:16:57 PDT 2011
yayayarndiva medical debt- make people sick- literally #mdchat
Tue Oct 11 18:17:05 PDT 2011
NateOsit @RichmondDoc I think the fundamental issue w/ hc in the U.S. is there are severallarge industry who profit from our suffering #MDchat
Tue Oct 11 18:17:08 PDT 2011
RichmondDoc @JediPD Yeah. Interesting that Rep. Billy Tozin got Part D passed w/ PhRMA benefits,
then was hired by PhRMA as exec d irector... #mdchatTue Oct 11 18:17:27 PDT 2011
MD_chat @EMIMDoc Ok, enjoy the rest of your night. #MDchat
Tue Oct 11 18:17:37 PDT 2011
apjonas T1 Canadians have shortage of cardiovascular surgeons. We have shortage ofprimary care. Our System makes more $ w/less primary care #MDChatTue Oct 11 18:18:05 PDT 2011
NateOsitIndeed. It can be an nightmarish cycle RT @yayayarndiva: medical debt- make peoplesick- literally #MDchat
Tue Oct 11 18:18:33 PDT 2011
JediPD Besides the clinical outcomes (specific to oncology) Europe include UK has a 8%survival for lung cancer vs 16% in the US. #mdchat
Tue Oct 11 18:18:54 PDT 2011
miller7 @apjonas And we are significantly better at workarounds ;) #MDchat
NateOsit @RichmondDoc Oh Mark... That would be preposterous! ;) #MDchat
Tue Oct 11 18:23:07 PDT 2011
JediPD I agree. Primary care in Neonate, Pediatrics and Adul ts must be addressed. #mdchat@RichmondDoc
Tue Oct 11 18:23:07 PDT 2011
DrJonathan @EllenRichter Great article! I think pts do absolutely own their lab results, but Drsshould suggest they interpret it together. #mdchat
Tue Oct 11 18:23:29 PDT 2011
yayayarndiva @miller7 show and tell just a part: also need engagement and the resources forchange- not a level playing field in the US #mdchat
Tue Oct 11 18:23:47 PDT 2011
RichmondDoc @JediPD But we fund high-cost, inpatient care long before we adequately fundprimary care... #mdchat
Tue Oct 11 18:23:53 PDT 2011
miller7 @yayayarndiva YES!! #MDchatTue Oct 11 18:24:19 PDT 2011
RichmondDoc @JediPD My recall: fastest increasing costs in Medicare are chemotherapy andadvanced imaging. Not primary care. #mdchat
Tue Oct 11 18:24:21 PDT 2011
NateOsit True. Why is that? RT @RichmondDoc: @JediPD But we fund high-cost, inpatient carelong before we adequately fund primary care... #MDchat
Tue Oct 11 18:24:29 PDT 2011
yayayarndiva @miller7 "Behavior" also very loaded- need proper cultural context- awareness ofresources #mdchat
Tue Oct 11 18:24:49 PDT 2011
JediPD Also, personal health is advanced by education and peer pressure. Not by mandates.In US screening is under pressure due to costs. #mdchat
Tue Oct 11 18:24:59 PDT 2011
kdhoffman2 Unfortunately the focus has been on individual change not social change-- #mdchat
Tue Oct 11 18:25:32 PDT 2011
MedPedsDoctor Ounce of prevention worth a pound of cure. Public health needs more funding: nothappening. Newest scans: gotta have it! Problem #mdchat
Tue Oct 11 18:26:10 PDT 2011
RichmondDoc T1 Other nations fund primary care (low cost, low-tech interventions) first andsubspecialty care later--lower cost, better outcomes #mdchat
Tue Oct 11 18:26:12 PDT 2011
katellington Right, systems and environments matter. @kdhoffman2: Unfortunately the focus hasbeen on individual change not social change-- #mdchat
JediPD Bingo. And also the hardware in ortho, cardio and electronic enhancements. Forgetfree scooters. @RichmondDoc #mdchat
Tue Oct 11 18:26:46 PDT 2011
RichmondDoc @MedPedsDoctor Even worse: 50% of local health departments cut programs in thelast year. Cutting safety net as need increases. #mdchat
Tue Oct 11 18:26:55 PDT 2011
MedPedsDoctor Mark, you are right. We ARE on the same page, just in different cities. #mdchat
Tue Oct 11 18:27:26 PDT 2011
yayayarndiva @katellington @kdhoffman- families, neighborhoods, communities matter- need tolook at human factor on many levels #mdchat
Tue Oct 11 18:27:41 PDT 2011
NateOsit @RichmondDoc It would be worth having the discussion again, IMHO. #OWS needs
targets if they want to #occupyhealthcare #MDchatTue Oct 11 18:27:55 PDT 2011
RichmondDoc @JediPD Right. How many stents/pacemakers/IEDs have been implantedinappropriately and against best evidence? Many = much $. #mdchat
Tue Oct 11 18:27:56 PDT 2011
RichmondDoc T1 I know this group knows this, but http://t.co/JW1azKZg is a great overview of socialdeterminants of health. #mdchat
Tue Oct 11 18:28:40 PDT 2011
RichmondDoc @MedPedsDoctor How many readmissions could have been prevented by paying anurse to visit pts in home and help after discharge? #mdchatTue Oct 11 18:29:44 PDT 2011
katellington T1 We can hope for the reality of basic primary care as a national concern with fullattention across sectors. #OccupyHealth #MDchat
Tue Oct 11 18:29:58 PDT 2011
apjonas @MedPedsDoctor And profit to hosp and docs til new Medicare rules. Follow the $$,find the problems. #MDChat
Tue Oct 11 18:30:05 PDT 2011
NateOsit @RichmondDoc hehe, no rush. Maybe another day? Revive #FMRevolution chat? ;)#MDchat
Tue Oct 11 18:30:15 PDT 2011
MedPedsDoctor @RichmondDoc Agree. That would be a great program IMHO to support which wouldimprove outcomes. Studies show it. #mdchat
Tue Oct 11 18:30:44 PDT 2011
NateOsit Common solution! RT @apjonas: @MedPedsDoctor And profit to hosp and docs tilnew Medicare rules. Follow the $$, find the problems. #MDchat
JediPD readmissions in 30 days for elderly is a problem not because of desire but for multiplecomorbidities that confound #mdchat @MedPedsDoctor
Tue Oct 11 18:30:52 PDT 2011
yayayarndiva @NateOsit include al l primary care- pediatrics, internal medicine and family medicine#mdchatTue Oct 11 18:31:04 PDT 2011
RichmondDoc Old quote: every system is perfectly designed to provide the results that it is getting.We know our results. Change the system. #mdchat
Tue Oct 11 18:31:53 PDT 2011
RichmondDoc T1 #OccupyHealthcare matters because the answers to these issues are large-scale,political and public health answers. #mdchat
Tue Oct 11 18:32:20 PDT 2011
miller7 @RichmondDoc Similarly, what gets measured gets done... #MDchatTue Oct 11 18:32:32 PDT 2011
katellington T1 Primary care for all should be a baseline for cost-containment, prevention andhealth care accessibility. #occupyhealth #MDChat cc@PNHPTue Oct 11 18:32:41 PDT 2011
ElinSilveous T1: #OccupyHealth should include a dialogue about quali ty of life versus length of life& consumer/patient expectations #MDChat
Tue Oct 11 18:32:44 PDT 2011
apjonas T1 Private networks, community & web based wi ll innovate to bypass fecal vortex ofusual suspects taking $$ from HC #MDChat
Tue Oct 11 18:32:52 PDT 2011
RichmondDoc T1 #OccupyHealthcare is more than a one-on-one doctor/patient encounter. That is atits heart, but community focus is needed. #mdchat
Tue Oct 11 18:33:01 PDT 2011
yayayarndiva @miller7 or what gets measured gets funded:) #mdchat
Tue Oct 11 18:33:03 PDT 2011
RichmondDoc T1 Physicians should be activists. We should be calling for reform, pointing out flaws,partnering w/ patients to #OccupyHealthcare #mdchat
Tue Oct 11 18:33:27 PDT 2011
miller7 @yayayarndiva Spoken like a reformed researcher ;) #MDchat
Tue Oct 11 18:33:28 PDT 2011
kdhoffman2 Medicaid is also a major issue. In situations of long term care, it is what pays foreverything. Not enough $$ for real care. #mdchat
miller7 T1 #Occupyhealthcare matters because the community (all of us) should be wantingmore than what we are getting from healthcare #MDchat
Tue Oct 11 18:34:06 PDT 2011
yayayarndiva @miller7 busted:) #mdchat
Tue Oct 11 18:34:07 PDT 2011
MedPedsDoctor Agree with the primary care comments, but remember, there are other primary carefields besides Fam Med. #medpeds #med #pediatrics #mdchat
Tue Oct 11 18:34:07 PDT 2011
RichmondDoc T1 Physicians are called to improve the health in their patients, and should extend thatto the community. Raise your voices! #mdchat
Tue Oct 11 18:34:39 PDT 2011
NateOsit Agree, healthcare problems are systemic. They cut to the core of social problems inthe US. I think #OWS can help address! #MDchat
Tue Oct 11 18:34:59 PDT 2011
JediPD Cost in HC has many heads. Pharma, Hospital, Over usage of ERs, duplication oftest/procedures. Yet focus is on docs as usual #mdchat
Tue Oct 11 18:34:59 PDT 2011
RichmondDoc @MedPedsDoctor (I speak of what I know...no offense intended in any way) #mdchat
Tue Oct 11 18:35:00 PDT 2011
yayayarndiva Preaching to the choir- methinks those participating in #mdchat are activists #mdchat
Tue Oct 11 18:35:05 PDT 2011
NateOsit :) RT @yayayarndiva: Preaching to the choir- methinks those participating in #mdchatare activists #MDchat
Tue Oct 11 18:35:33 PDT 2011
RichmondDoc @apjonas *Established docs* may be too content w/ jobs. Tap into the energy andcommitment in students/residents. #mdchat
Tue Oct 11 18:35:39 PDT 2011
apjonas @RichmondDoc Good point of differentiation, Onward! #MDChatTue Oct 11 18:36:19 PDT 2011
RichmondDoc @JediPD No doubt that cost pressures come from multiple areas...but docs write Rx,order studies, send for consults. #mdchat
Tue Oct 11 18:36:19 PDT 2011
miller7 @yayayarndiva Since we are the choir, here is one take at an old tunehttp://t.co/zn8zybCc #Occupyhealthcare #MDchat
yayayarndiva @apjonas There are many "discontented" docs- for many medicine was a smallpractice- now jobs in larger systems #mdchat
Tue Oct 11 18:36:31 PDT 2011
ElinSilveous Absolutely! RT @BHGContent4Dr: RT @RichmondDoc: T1 Physicians should beactivists. We should be call ing... #OccupyHealthcare #mdchat
Tue Oct 11 18:36:36 PDT 2011
RichmondDoc @JediPD We *do not* carry all of the responsibility, but we *do* carry a certain share.#mdchat
Tue Oct 11 18:36:45 PDT 2011
MedPedsDoctor Current gener of trainees want work-life balance, and r being trained in advocacy.Community/Advocacy required in peds training #mdchat
Tue Oct 11 18:37:01 PDT 2011
MD_chat Uh oh: I just spotted the Fail Whale for a moment. #MDchat
Tue Oct 11 18:37:47 PDT 2011
JediPD True RT @RichmondDoc: @JediPD No doubt cost pressures come from multipleareas. docs write Rx, order studies, send for consults. #mdchat”
Tue Oct 11 18:37:56 PDT 2011
RichmondDoc @MedPedsDoctor When I work w/ students, I discuss and I (hope to) model howphysicians must be part of the discussion. #mdchat
Tue Oct 11 18:38:05 PDT 2011
ElinSilveous #OccupyHealthcare should also call for health to be addressed in all pol icies(transportation, energy, environment, food, etc.) #MDChat
Tue Oct 11 18:38:16 PDT 2011
miller7 @MD_chat Sorry, that was my fault. #MDchat
Tue Oct 11 18:38:41 PDT 2011
RichmondDoc T1 I highlight to students the failings in our system, and ways they can be addressed,and encourage them to be vocal/active. #mdchat
Tue Oct 11 18:38:47 PDT 2011
MedPedsDoctor Mark, that is wonderful. This generation seems more engaged in advocacy interest
than, say, mine 15 yrs ago #mdchatTue Oct 11 18:38:48 PDT 2011
katellington T1 Primary care for all should be a baseline for cost-containment, prevention andhealth care accessibility. #occupyhealth #MDChat cc @PNHP
Tue Oct 11 18:39:09 PDT 2011
miller7 MT @ElinSilveous: #OccupyHealthcare should also call for #health to be addressed inall policies (transportation, energy, etc.) #MDchat
RichmondDoc @MedPedsDoctor I think they truly are. I think the millenia l generation enteringmedicine is more energized/active than we were. #mdchat
Tue Oct 11 18:39:36 PDT 2011
ElinSilveous Oops. T1: #OccupyHealth should also call for health to be addressed in all pol icies(transportation, energy, environment, food...) #MDChat
Tue Oct 11 18:40:09 PDT 2011
2healthguru @ElinSilveous #occupyhealthcare I love it. Sign me up! #mdchatTue Oct 11 18:40:31 PDT 2011
DebErupts Agree! RT @miller7 RT @ElinSilveous: #OccupyHealthcare should also call for#health to be addressed in all policies #MDchatTue Oct 11 18:40:35 PDT 2011
RichmondDoc T1 Until voters make their politicians understand that business as usual = bankruptcy,then little will change. #OccupyHealthcare #mdchat
Tue Oct 11 18:41:03 PDT 2011
yayayarndiva #Occupyhealthcare how about cost savings rather than cost containment #mdchatTue Oct 11 18:41:37 PDT 2011
RichmondDoc T1 So we should make our voices heard: value people over $, value health overcorporate profits. #OccupyHealthcare #mdchat
Tue Oct 11 18:41:45 PDT 2011
JediPD Simple solution for preventing duplication of tests: A $10 USB keychain stick loadedwith their med test info presented @ doc visit #mdchatTue Oct 11 18:41:52 PDT 2011
yayayarndiva .@NateOsit Go to a general assembly at an #OWS site- you will find that #health and#healthcare are already part of the dialogue #mdchat
Tue Oct 11 18:42:55 PDT 2011
ElinSilveous TY RT @DebErupts Agree! RT @miller7 RT @ElinSilveous: #OccupyHealthcareshould also call for #health to be addressed in all policies #MDchat
Tue Oct 11 18:43:01 PDT 2011
RichmondDoc T1 As clinicians, we should stop ordering tests that have no value.http://t.co/oMVGMZ97 #mdchatTue Oct 11 18:43:34 PDT 2011
MedPedsDoctor Maybe another savings: decrease complexity of health care system. When no onereally understands costs of hospitalization: problem! #mdchat
apjonas @BernieMD31 A wild one, tonight. Welcome #MDChat
Tue Oct 11 18:44:19 PDT 2011
RichmondDoc (Here is the citation to the Top 5 Good Stewardship from @NPALive:http://t.co/uoZNr0OD) #mdchat
Tue Oct 11 18:44:32 PDT 2011
miller7 @RichmondDoc This raises another issue - are providers aware of how much tests
and such cost? We try to teach this. #MDChatTue Oct 11 18:44:46 PDT 2011
RichmondDoc @MedPedsDoctor And we can continue to find valid, safe, effective ways to provideout-of-hospital care. #mdchat
Tue Oct 11 18:44:55 PDT 2011
ElinSilveous @yayayarndiva #OccupyHealthcare, Medicare, SS were addressed at local#OccupyAshland #MDChat
Tue Oct 11 18:45:08 PDT 2011
kdhoffman2 Better care requires more time #mdchat
Tue Oct 11 18:45:28 PDT 2011
MedPedsDoctor Double retreet here: RT RT @RichmondDoc: And we can continue to find valid, safe,effective ways to provide out-of-hospital care. #mdchat
Tue Oct 11 18:45:36 PDT 2011
yayayarndiva @NateOsit Go there to dialogue rather than to teach:) #mdchat
Tue Oct 11 18:45:50 PDT 2011
MedPedsDoctor sorry: retreet should be retweet. Wonder how that slip will be interpreted! #mdchat
Tue Oct 11 18:46:11 PDT 2011
miller7 @apjonas You are on fire tonight. Love it. #MDChat
Tue Oct 11 18:46:43 PDT 2011
yayayarndiva @apjonas @miller Oh a puh-leese many in primary care understand the costs ofthings- especially working w underserved communities #mdchat
Tue Oct 11 18:47:08 PDT 2011
ElinSilveous #OccupyHealthcare must also address consumer/patient expectations. Sometimes,doing nothing is the best medicine. #MDChat
Tue Oct 11 18:47:25 PDT 2011
MedPedsDoctor @apjonas I agree in general, but the literature Mark mentioned earlier is appl icable toFam Med and all primary care special ties #mdchat
Tue Oct 11 18:47:49 PDT 2011
yayayarndiva @apjonas @miller and becoming more real for many specialities as patients loseinsurance coverage and have to make cash choices #mdchat
BernieMD31 @miller7 @apjonas Good thing I work in a hospital that is run by us family docs andfamily med residents. Huge difference! #mdchat
Tue Oct 11 18:48:11 PDT 2011
yayayarndiva @ElinSilveous not so much about doing "nothing"- rather not writing a prescription 4every visit:) Dialogue, education is valuable #mdchat
Tue Oct 11 18:48:41 PDT 2011
yayayarndiva @kdhoffman2 but remember many docs do "uncompensated" time- and haveoverhead and family bills to cover #mdchat
Tue Oct 11 18:49:09 PDT 2011
BernieMD31 @RichmondDoc Anytime I order meds on our military system, the cost for each popsup. Makes you think about it before ordering #mdchat
Tue Oct 11 18:49:37 PDT 2011
yayayarndiva @RichmondDoc work in a FQHC for a while- you will learn about costs, rationing andcompromise #mdchat
Tue Oct 11 18:49:44 PDT 2011
RichmondDoc @kdhoffman2 If I spend 45 mins w/ a patient (in a 15 min slot), there is a cascade ofunintended consequences. #mdchat
Tue Oct 11 18:49:55 PDT 2011
ElinSilveous Excellent point mRT @yayayarndiva: @ElinSilveous ... not writing a prescription 4every visit:) Dialogue, education is valuable #mdchat
Tue Oct 11 18:50:07 PDT 2011
yayayarndiva @apjonas there is also defensive medicine, CYA tests, fear of being sued #mdchatTue Oct 11 18:50:09 PDT 2011
yayayarndiva @RichmondDoc so you know exactly what I mean:) #mdchat
Tue Oct 11 18:50:47 PDT 2011
miller7 @MedPedsDoctor Yes! Continuity (relationship) and comprehensiveness - essentialingredients for great #primarycare #MDChat
Tue Oct 11 18:51:11 PDT 2011
RichmondDoc @yayayarndiva So, you run the risk of going a very long time ordering high-cost, low-value tests before realizing the system costs. #mdchat
Tue Oct 11 18:51:19 PDT 2011
yayayarndiva @RichmondDoc very few folks "well insured"- those copays add up for even middleclass patients #mdchat
Tue Oct 11 18:51:38 PDT 2011
RichmondDoc @yayayarndiva Yes, I know exactly what you mean. So we should be teachingstudents re: unnecessary costs and unneeded tests/care. #mdchat
