The kind of thing we have done instinctively in our workplaces for two decades — sending a quick email instead of setting up a meeting — has until recently eluded many doctors.
Electronic consultations, or eConsults (sometimes called eReferrals), are a growing way for primary care doctors and specialists to communicate with each other securely. They can help patients avoid additional visits to specialists and free up capacity in crowded health systems, reducing waiting times for others.
Studies have found that a large proportion of referrals to specialists — upward of 40 percent in some cases — are not needed.
Getting the right medical advice without another visit to a specialist might be especially helpful for patients on Medicaid or without insurance. One national study found that nearly one-third of specialists are unwilling to make appointments with new Medicaid patients. Delays in getting the right advice from a specialist can cause harm. For patients who would have to travel far to see specialists — those in rural areas, for example — eConsults can save considerable time, expense and headaches.
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https://www.nytimes.com/2019/03/18/upshot/when-email-comes-to-the-doctors-office-wait-times-decrease.html?
Friday, March 22, 2019
Sunday, March 17, 2019
Did Your Doctor Disappear Without a Word? A Noncompete Clause Could Be the Reason - The New York Times
When Don Cue developed a bladder infection last fall, he called his longtime urologist's office for a urine culture and antibiotics. It was a familiar routine for the two-time prostate cancer survivor; infections were not uncommon since he began using a catheter that connects to his bladder through an incision in his abdomen.
When Mr. Cue called this time, a receptionist told him that his physician, Dr. Mark Kellerman, no longer worked at the Iowa Clinic in Des Moines, a large multi-specialty group. She refused to divulge where he had gone.
"As a patient, 'scared' is too strong a word, but my feeling is, 'What do I do now?'" said Mr. Cue, 58.
Flummoxed, he solved his immediate problem by taking leftover antibiotics he had in his medicine cabinet.
It was only later that he learned his doctor had been fired by the Iowa Clinic and planned to start a urology practice with clinic colleagues. And, under the terms of their contract with their former employer, the doctors were banned for a year from practicing within 35 miles of the clinic, and from recruiting former patients to follow them.
Contracts with so-called restrictive covenants are now common in medicine, although some states limit their use. Noncompete clauses — common in many commercial sectors — aim to stop physicians and other health care professionals from taking patients with them if they move to a competing practice nearby or start their own. But what may be good for business can be bad for patient care — and certainly disquieting for those whose doctors seem to simply disappear.
More ...
https://www.nytimes.com/2019/03/15/business/physician-non-compete-clause.html
When Mr. Cue called this time, a receptionist told him that his physician, Dr. Mark Kellerman, no longer worked at the Iowa Clinic in Des Moines, a large multi-specialty group. She refused to divulge where he had gone.
"As a patient, 'scared' is too strong a word, but my feeling is, 'What do I do now?'" said Mr. Cue, 58.
Flummoxed, he solved his immediate problem by taking leftover antibiotics he had in his medicine cabinet.
It was only later that he learned his doctor had been fired by the Iowa Clinic and planned to start a urology practice with clinic colleagues. And, under the terms of their contract with their former employer, the doctors were banned for a year from practicing within 35 miles of the clinic, and from recruiting former patients to follow them.
Contracts with so-called restrictive covenants are now common in medicine, although some states limit their use. Noncompete clauses — common in many commercial sectors — aim to stop physicians and other health care professionals from taking patients with them if they move to a competing practice nearby or start their own. But what may be good for business can be bad for patient care — and certainly disquieting for those whose doctors seem to simply disappear.
More ...
https://www.nytimes.com/2019/03/15/business/physician-non-compete-clause.html
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