Tuesday, May 12, 2009

Flap's Dentistry Blog Links May 12, 2009


Many middle aged men are pumping their system with the human growth hormone to keep 'ageing' at bay. Government guidelines state it should only be prescribed to kids with growth disorders and adults with severe hormone deficiencies. However, an investigation has revealed that many anti-ageing clinics in Australia are flouting regulations by prescribing to people as young as 35 who want to look good, stay fit and boost their sex lives. Most are men who use human growth hormone (HGH) to improve fitness and energy levels, but leading specialists claim it can have serious side effects.

Health care reform that focuses on fixing health insurance without dealing with the chronic and growing shortage of primary care physicians is likely to encounter “Massachusetts style growing pains” unless nurse practitioners are fully involved in health care reform, according to University of Miami President and former Secretary of the U.S. Department of Health and Human Services (HHS) Secretary Donna E. Shalala, Pennsylvania Governor Edward G. Rendell, and other experts brought together today by the American Academy of Nursing (AAN) and its “Raise the Voice” (RTV) campaign. Shalala, Rendell and the others agreed that “Nurse-Managed Health Centers” – an innovative delivery model for primary and preventive care, especially for low-income and vulnerable populations – will be a vital ingredient in any plan to increase the capacity of the nation’s health care delivery system. The good news is that these nurse practitioner-led facilities are a “solution in plain sight” that already has..

Paying physicians via capitation was soundly rejected by patients when it was tried in the HMO era a decade ago. Massachusetts is trying again. According to a state commission, they recommend "replacing fee-for-service with a system that would use a single payment to cover most of a person’s care for an entire year." The last time this was tried, patients rebelled as it was perceived that there was a financial incentive for doctors and insurers to deny care. And they were right. Bluntly put, it's the only way to control health care spending.

Rohack said that following evidence-based guidelines, such as those created by medical specialty societies, could be a way to reduce those variations. But some docs may worry that they could be sued for skipping a test — even if the guidelines recommend against the test. Giving some liability protection to doctors who follow the guidelines might change that, Rohack argued, helping to reduce the number of tests and slow the growth of health costs. Here’s how he put it in our phone conversation: If we as the profession come up with evidence-based ways to provide care, and as a result of that can reduce unnecessary tests or unnecessary procedures, then the physician and the patient should feel comfortable that if the physician has followed the guideline, the physician is not later going to be sued.

Dentists in Gainesville have noticed unusual effects from the economic recession. More patients have been visiting with problems from grinding and clenching teeth in recent months. Darylin Kestner, business manager for Gainesville Family Dentistry, said more patients have been opting for cheaper procedures. In February, Kestner began to notice patients deciding only to receive a filling instead of a crown if the tooth is broken or has decayed. A crown can cost almost $1,000, and insurance usually covers only 50 percent. However, if the tooth isn't necessary for basic chewing functions, she said some patients have even expressed the desire to have the tooth taken out instead. More patients also have decided not to follow through on gum-disease treatment, which can cost from $250 to $1,000, she said.

No comments:

Post a Comment