In an effort to get wider audience I have transitioned to a stand-alone blog from my original blog at http://www.imswf.com. What follows is the original material from my very first blog, the “Bulletin Board” at my first website.
Americans turning to emergency departments for care – 9/30/10
This article speaks to the shortage of primary care doctors and lack of incentives for doctors to extend office hours.
The new healthcare experiment – 9/27/10
Here is preview of the Federal governments vision of the new health care system. Massachusetts is the model the Federal Government is looking to for its health care program. Massachusetts has announced it is hoping to stop the financial hemorrhaging from their “forced insurance” model by paying the providers and hospitals globally- read about it.
Local internist publishes diet/weight loss book – 8/23/10
Our esteemed colleague and fellow internist, Richard Torricelli, M.D., has recently published an excellent book. We are very proud of his achievement. We recommend you consider reading The Amino Slimming Effect. Medical Watch discusses how Metabolic testing is used to lose weight – 8/23/10 Recently Medical Watch discussed using metabolic testing to assist in weight management. Internal Medicine of Southwest Florida has been providing this service since 2008. To read further about the Metabolic testing service click here.
Read the government’s description of the Affordable Health Care Act – 8/23/10
There continues to be a lot of articles in the press, as well as opinions pieces, regarding the Affordable Health Care Act legislation (healthcare reform legislation). We recommend you follow this link to the government’s website explaining numerous aspects of the law. Bid to block state health care is off ballot – 07/30/10 News-Press Article: For now, the amendment that would have blocked any planned Florida version of President Barrack Obama’s federal health care legislation is off the November ballot. Amendment co-sponsor Sen. Carey Baker, R-Eustis, said Thursday its Republican backers will seek an appeal. And Dr. Ray Kordonowy, an internist and board member of the Independent Physicians of Lee County, applauds the appeal. While the group has no official position, Kordonowy echoes that of the Louisiana State Medical Society: Health care reform as passed federally is a bad deal. “A law or rule should not compel anyone to buy health insurance,” Kordonowy said. “I’m in favor of a more open market. The insurance method of paying for health care is inefficient.”
At present, the US spends some $210 billion a year on claims processing – 06/17/10
AMA Morning Rounds (press summary) reports referencing the following article. Dr. Kordonowy comments, “To give this sum of money perspective – the government is planning to cut approximately the same amount from Medicare’s budget as part of the new health care legislation. Our President is escrowing 20 billion dollars from British Petroleum to fund the oil spill disaster to “cover our losses”. We spend 10 times that annually just doing the paperwork to pay your doctor! Where is the outrage?!? Can we not see the forest for the trees? We should be paying for services directly and cut the 3rd party payer bureaucracy out of the process. Health care is expensive indeed, too bad so much of the money doesn’t actually go to providing care.” 21% and increasing Medicare payment cut goes through. Payment from Medicare to physicians suspended by law for 10 business days effective June 1 – 06/03/10 Congress failed to address the flawed SGR formula and future payment for Medicare physicians’ services (for the THIRD TIME THIS YEAR). Independent Physicians of Lee County, IPALC, posted a notice in the News-Press concerning these cuts. Please Contact Your Representativesand ask them to replace the SGR formula with a truly feasible payment structure. Allowing balanced billing to occur would be the easiest way to fix the problem.
21% Medicare payment cut goes through, only to be temporarily fixed – 03/01/10
Please urge your Congressional Representatives to repeal the flawed Sustainable Growth Rate (SGR), and provide adequate funding for Medicare so that we are able to continue to be able to provide the best quality health care available for our patients.
Dr. Raymond Kordonowy Voices His Thoughts on the Health Care Debate – 12/13/09
Web Site Readers – The following is an e-mail trail relating to an opinion piece I attempted to get into the News-Press in Fort Myers. This was my second attempt to send it to Mr. Plazas but it never was placed in the Opinion section of the news-paper: “Today (December 12th, 2009), I edited the October opinion to include my comments about General Surgery reimbursement and the recent idea I have about a Health Care Trust model as another possible model to capitalize health care. As stated in more detail in the opinion piece, a main issue of the health care crises is how we as Americans presently capitalized health care through an insurance model and how that has over time turned into a private business monopoly which has indeed made health care unaffordable for the majority of Americans. I remain deeply critical of our government’s desire to create a government monopoly to replace the current corporate monopoly. The opinion piece is my attempt to offer some different ideas/models to make the cost of health care cheaper, more efficient and properly balanced, and most effectively delivered. I did not go into how to take care of the truly impoverished and I think most American citizens agree, we have a social obligation to not allow people to “fall through the cracks”. By allowing a more efficiently and more properly aligned health care market, I am confident we would have both the human capital as well as financial capital to solve that part of the problem, likely though true (subsidized if impoverished) catastrophic insurance options (real insurance) or perhaps through a totally different/unique approach to hospitals than the present system is following. – Raymond Kordonowy M.D.”
New Patient Registration and Service Request available online – 12/9/09
Internal Medicine of Southwest Florida makes health care more user friendly and accessible by launching an online Service Request Form for current patients as well as a New Patient Registration Form. A newly revised Vitamins page offers patients unprecedented access to in-depth information concerning PureCaps Supplements, a line offered at Internal Medicine of Southwest Florida.
Shingles vaccine now available – 12/3/09
Internal Medicine of Southwest Florida now has Zostavax vaccines available to prevent Shingles. Click to learn more about the physician recommended vaccination.
IMSF joins MediBid – 11/28/09
Internal Medicine of Southwest Florida continues to improve patient access to healthcare by joining MediBid. Click to learn more about this novel market approach to healthcare.
IPALC publishes letter for patients concerning Medicare cuts – 3/07/09
An excerpt: “Please understand that this won’t just affect Medicare patients. Essentially all of the insurance companies now set their reimbursement rates in proportion to Medicare fees. A reimbursement reduction of 21% by Medicare will also result in a 21% reduction in nearly all insurance reimbursement.
Physician practices may cease taking new Medicare patients. Employees will have to be let go and our fragile local economy will be further harmed. Understanding that medical care is the number one income generator in Lee County when you combine the hospitals and private practices together, the results for this community may be devastating.” Read the letter here.
Tell us the insurance industry isn’t behaving like a monopoly – 3/06/09
Consumers should be asking the insurance industry “where’s the beef”? Providers and hospitals are receiving lower reimbursements and consumers are being asked to assume more out of pocket expenses, yet insurance rates are jumping 20-40%? Consumers need to consider – do I really want to purchase health insurance? Wouldn’t I be better off keeping my and my employer’s hard earned money in my own Health Savings Account and shop my health care? The insurance industry is reducing payment to providers and hospitals but the consumers are not seeing price reductions/savings from the insurance industries actions- something is very much amiss! This goes for Medicare Medigap plans as well. See Associated Press Article – Sebelius asks insurers to justify rate hikes
21% Medicare physician fee cuts will definitely be a deal changer for patient access – 3/06/09
If physicians don’t outright quit you can be assured our services will have to diminish even further. Such measures as : no more new Medicare patients, shorter visits, no phone assistance and much more fees for non covered services will likely result. Please read the link regarding recent quotes from Dr. Henricks in a recent news article. Please inform your federal legislators that the SGR formula is flawed. The easiest solution to the governments dilemma is to go back prior to 1994 and allow providers to bill above the Medicare fee schedule.
Medicare payment cuts go through – 3/01/2010
We have been educating and warning our patients that Medicare by law was facing this potential outcome- it has, in fact, happened. Congress might still be able to change this but as it stands, effective March 1 all physician evaluation and services codes (office visits) will pay 21%! less per visit across the board. This will have a huge impact on services provided and if not reversed, our patients can anticipate radical changes in our office policy. The physicians will be analyzing our business model and changes are likely to come quickly. Be prepared please and trust we will do what we can. Under this drastic pay cut changes will be necessary. See the following link (NPR Article) for some historical perspective that has led to this cut. Remember that with every government policy change regarding health care, unforeseen consequences occur.
In the News-IMSWF 12/6/2009 Review/Update-
The FDA’s Arthritis advisory committee has voted unanimously in favor of a possible new treatment for Dupuytren’s contractures. Dupuytren’s contractures result in limited motion of the fingers and is commonly referred to as “trigger finger”. The treatment is a biological treatment which results in the breakup of the contracture using an injection procedure to the involved tendon/contraction. The active ingredient is a collagenase (enzyme) from a bacterium named clostridium histolyticum. In double blinded, placebo controlled trials the patients treated with the active ingredient had significant (and dramatic) improvement in the range of motion of their joint (64% vs. 7% in placebo group). The manufacturer is Auxillum Pharmaceuticals Inc. They plan to market the product as Xiaflex if/when the FDA formally approves it.
A new class of drugs in the anticoagulation therapy class are getting a lot of attention. The implications are that we may soon have an alternative to Coumadin (warfarin) for some indications including atrial fibrillation (one of the most common reasons we use warfarin in Internal Medicine). The new drug class is called direct thrombin inhibitors and the most promising product presently appears to be dabigatran. This medication comes in a fixed dosage and does not require blood monitoring. It is not yet FDA approved and thus isn’t available for the market at this time. Frequent INR testing is now needed to monitor the efficacy and safety of warfarin therapy and is a significant drawback to this treatment. Another drug class known as factor Xa inhibitors could also find similar indications but have had trouble with liver toxicity in some of the initial drugs studied to date.
Spending on Alternative Medicine tops $33 billion as reported by Heidi Splete in Internal Medicine News. She refers readers to www.cdc.gov/NCHS/data/nhsr/nhsr018.pdf for the full report. This is newsworthy in my opinion as it provides evidence to me as a health care provider that the national statements being made by the public that it “can’t afford insurance” is disingenuous. It also is an indication that the public views traditional health services as lacking or that perhaps we can “cheat” the system by taking unproven supplements and use nebulous treatments such as acupuncture and homeopathic physician products to treat medical illnesses.
Statin use appears once again to be associated with less (yes, I said yes) incidence of dementia. Michele G Sullivan reports that a study sponsored by the Alzheimer’s Association indicated the incidence of dementia when analyzing for use and non use of statin therapy as approximately half as frequent in statin users over non users. The information came from a national Finnish study where a Dr. Alina Solomon and her colleagues extracted data from the national FINRISK study, a large population survey of cardiovascular risk factors among Finnish citizens. The data included 17,257 citizens from 1997-2002 and disease incidence was followed through 2007. Statins began to be used in Finland in 1995. The persons studied were 60 years or older in age in 1995.
