Primary care: life in the pressure cooker.

Primary care practices are under constant pressure of increased demand for their services, even as their numbers decrease. They are often scheduled to see too many patients in a day. Government and other third-party payors continue to reimburse them at a comparatively low level, despite evidence that more PCPs in an area improves care. Groups that want to stay in practice need to run their practice like a business.

Coming to a theater near you: Recovery Audit Contract Initiative.

This article describes the expansion of a Medicare demonstration project called the Recovery Audit Contractor Initiative. The goal of this initiative is to identify overpayments by Medicare intermediaries and payors, and return the money to the Medicare program. The initial demonstration project, in Florida, California, and New York, recovered significant monies for Medicare. Medicare hires private contractors that select claims to review based on data analysis. The contractors are paid on a percentage-of-collections basis. Congress has mandated that the program be expanded to all states by 2010.

Let physicians be physicians.

On a recent visit to his physician, a friend reported that the physician spent 95% of the visit hunched over a laptop computer, leaving it only for a quick listen to his heart and lungs. The remarkable thing is, in medical circles the story is unremarkable. Many consider it the norm now. Who thought it was a good idea to turn physicians into typists? Does it make sense that the most highly educated person in the building is doing data entry? How is patient care improved if the physician is hunched over a laptop computer in the exam room?