• Reflex: September 13, 2011

    A report from the Josiah Macy Jr. Foundation says that the nation’s system for training physicians is in dramatic need of a complete overhaul to adequately provide future patient care, reports Cheryl Clark. “The panel, consisting of physicians and surgeons as well as medical school deans and faculty members, said the nation will be short more than 100,000 doctors by the middle of the next decade, in part because of the current system’s entrenched ways of educating and assuring the quality of the physician workforce.” Aaron’s comment: I couldn’t agree more. Listen to our podcast from last week for a fuller understanding of what it takes to be a doctor today.

    CMS introduces new rules that benefit high quality Medicare Advantage plans, reports Modern Healthcare“Plans rated with five stars [for quality] may market and enroll new beneficiaries throughout the year, beginning on Jan. 1, 2012, and not just during the traditional fall enrollment period.” Austin’s comment: The ability to enroll beneficiaries throughout the year is a substantial advantage. A similar rule once benefited Medicare’s private fee for service plans. What quality ratings mean for Medicare Advantage plans have been an evolving story. (H/t: Igor Volsky.)

    What happened to “first do no harm”? In a must-read piece at Kaiser Health News, Sandra Boodman reports on the “overtesting of older patients [… and] the widespread practice of routine screening for cancer and other ailments of people in their 70s, 80s and even 90s.” Critics say that in many cases the risks outweigh the benefits. Austin’s comment: I’m very upset by some of the content of this piece. I will write something longer about it, though possibly not until next week.

    The debt deal’s automatic Medicare cuts would save $123 billion over ten years, reports Sam Baker. The amount of cuts that can take place in Medicare under the terms of the Budget Control Act of 2011 are limited by a cap of the degree to which specific parts of Medicare can be cut in any year under the the automatic cut (sequester) provisions of the law. Don’s comment: around 70% of the nearly $24 Trillion in mandatory spending scheduled to be spent from 2013-2021 is exempt from the mandatory cut provisions of the Budget Control Act. CBO estimates that the total deficit reduction attained will be around $1.1 Trillion if no legislation is passed and the automatic cuts take full effect. (h/t wonkbook)

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    • The Macy Foundation report depresses me. I suspect this means that we will need to start a residency in my specialty, anesthesia, at our hospital. Our new medical school is officially under way. This requires a lot of time out of the OR and I have no idea how we will pay for it. OTOH, as of yesterday, I am now officially a professor so I expect a little more respect when I comment. 🙂 (Ok, assistant professor.)

      Steve