Posts Tagged ‘University of Chicago’

Dr. David Donnersberger on Solving the Primary Care Crisis

Wednesday, November 3rd, 2010

Is concierge medicine the answer to healthcare?  Listen to Dr. David Donnersberger’s podcast.  Physicians who practice concierge medicine are reimbursed for spending significant time with their patients, knowing them extremely well and following them closely through every hospitalization.  This is the opinion of Dr. David Donnersberger, an internal-medicine specialist in private practice in Winnetka, IL, who is affiliated with the University of Chicago’s Pritzker School of Medicine.  In a recent interview for the Alter+Care Inspire Podcasts, Dr. Donnersberger described boutique or concierge VIP medicine as a return to a personal approach to healthcare where the physician knows the patient, their social situation and their health history.

In concierge practices, patients pay a flat annual fee and receive an expanded suite of services that includes the ability to call the physician on his cell phone at any time, obtain same-day appointments and – most importantly – receive personal care from the primary-care doctor when hospitalized.  Dr. Donnersberger notes that the current reimbursement system pays more to the radiologist and the radiology department for a chest X-ray than for an hour-long conversation and annual physical exam of the patient in the doctor’s office.  He believes that more information can be gleaned from that extensive conversation and physical exam, and serves as the starting point for years of personalized healthcare.

Practitioners of concierge medicine tend to have smaller practices than other physicians.  While a typical primary-care physician may have 2,000 to 2,500 patients, Dr. Donnersberger and his three partners have a smaller load of between 1,200 and 1,500 individuals.  Dr. Donnersberger’s practice is a hybrid – one which accepts patients who pay the upfront flat fee as well as others who rely on their healthcare insurance for reimbursement.  Concierge medicine’s most powerful tool is its ability to control costs.  Knowledge of a patient’s medical history can save money because the physician is keenly aware of pre-existing conditions that become crucial whenever that individual is hospitalized. This in-depth knowledge also saves the healthcare system thousands of dollars of workups that otherwise would have to be performed.

 
icon for podpress  Dr. David Donnersberger on Solving the Primary Care Crisis: Play Now | Play in Popup | Download

“Positive Deviants” Will Revitalize the Healthcare System

Tuesday, June 30th, 2009

The solution to America’s healthcare crisis might just lie in deviant thinking.  This is the message of Dr. Atul Gawande, this year’s commencement speaker at the University of Chicago’s Pritzker School of Medicine.  Gawande is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, an associate director of their Center for Surgery and Public Health, an associate professor at the Harvard School of Public Health and at Harvard Medical School.

050102_Gawande_Atul_3.jpgHis concept of positive deviants identifies those communities and physicians who discover innovative ways to reduce costs and improve care  to deliver better outcomes.

Gawande cites a nutritionist who spent his career attempting to reduce hunger in Vietnamese villages.  This man asked villagers to identify which families had the best-nourished children to determine a “positive deviance” from the norm.  The answer was that those children’s mothers did not act in accordance with accepted village wisdom had the best outcomes.  Rather, they fed their children even when they had diarrhea; fed them several small meals daily rather than one or two large ones; and fed their children foods that others considered low class but were nutritious such as sweet potato greens.

In the American healthcare system, the positive deviants resist the tendency to view patients primarily as revenue streams – but as human beings.  Rather, these physicians deliver high-value healthcare without focusing too strongly on their practices’ bottom lines; they neither over-treat nor under-treat their patients with extraneous but profitable tests and procedures.

To quote Gawande, “Look for those in your community who are making healthcare better, safer and less costly.  Pay attention to them.  Learn how they do it.  And join with them.”

Recession Makes Access to Quality Healthcare Less Accessible for the Poor

Tuesday, June 2nd, 2009

Thousands of poor women on Chicago’s South Side have lost what may have been their single lifeline to decent healthcare with the University of Chicago’s recent announcement that it is closing its storefront Women’s Medical Center on 47th Street near Woodlawn Avenue. This move is the latest in a pullback by the University of Chicago on some of the healthcare services it delivers to the city’s poor and indigent.47001667

According to University of Chicago Medical Center executives, the clinic’s June closing is a victim of the deep recession that has forced the hospital to cut $100 million from its budget.  The Women’s Medical Center, which treated women whose only healthcare insurance is Medicaid, consistently lost money.  The tax-exempt hospital insists that it isn’t hurting the poor, saying that most of the clinic’s patients will be sent to other neighborhood clinics.  The move will let the hospital focus on the more complex illnesses of the patients who utilized the clinic.

“We can’t do everything for everyone in the community,” says John Easton, the medical center’s spokesman.  “Our goal is to use our scarce resources to provide complex care and let our partners in the community provide primary care, which they do very well.”

The clinic’s closure is a highly controversial move.  As a non-profit hospital, the Medical Center is perceived as having a responsibility to give back to its community in exchange for the enormous tax breaks it receives.  It’s a tremendous loss for the women who visited the clinic to keep up with their annual pap smears and mammograms.