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Joseph Burns

Texas Clinic’s Patient-Centered Medical Home Exceeds Expectations
Feeling overworked and under compensated, many physicians in primary care are dissatisfied with medicine. The hours are long, the number of patients is high, and the paperwork is burdensome. As a solution to these problems policymakers have proposed the patient-centered medical home (PCMH), a practice model that stresses coordination of care, the use of electronic medical record (EMR) systems, and improved access to care. As the name implies, the patient-centered approach is appealing to physicians seeking more time with patients and more job satisfaction.

Introducing a New Column— Medical Makeover: Group Edition
In this issue we introduce a new department, Practice Makeover, for both group practices and solo practitioners. For this inaugural column, we interviewed Betsy Nicoletti, a physician consultant in Springfield, Vt. Nicoletti explains how one of her clients, an eight-member physician practice in rural New Hampshire, struggled to collect enough money each month to meet its financial obligations.

Report Offers Snapshot of U.S. Physician Practices
Last year, 44% of physicians reported receiving some form of performance-adjusted compensation, according to a report by the Center for Studying Health System Change (HSC) in Washington, D.C. Productivity factors and overall practice financial performance were the most common financial incentives affecting their compensation, and, about 61% of physicians reported that these factors were moderately or very important in determining their compensation, said the report, A Snapshot of U.S. Physicians: Key Findings From the 2008 Health Tracking Physician Survey.

Government Offers Support for E-Prescribing
This editorial discusses Medicare's endorsement of an initiative to promote electronic drug prescribing and the potential benefits of widespread e-prescribing.

OIG Warns Boutique Practices on Fees
This article discusses how the Office of the Inspector General intends to crack down on physicians who charge Medicare patients fees for services already covered by Medicare.

Act May Help Rural Doctors Succeed
This article discusses how the Medicare Prescription Drug Improvement and Modernization Act may spur an increase in health savings accounts. It also discusses the current role of primary care, which some experts say needs to be given more relevance in the health care system in order to improve quality of care.

Report Offers Lessons in Technology
This article discusses a report on the strategies that hospitals and health systems have used to foster wider use of information systems among physicians.

Standards Needed to Reduce Errors
This article discusses the recomendations in the Institute of Medicine's report, Patient Safety: Achieving a New Standard of Care, including the IOM's recommendation that the health care system adopt methods to prevent injuries before they occur, rather than reporting them after they have happened.

IOM Calls for Universal Coverage
This article discusses the Institute of Medicine's report Insuring America's Health: Principles and Recommendations. The report says that all proposals for extending health care should be judged by five principles: health care coverage should be universal, continuous, affordable for individuals and families, affordable and sustainable for society, and enhance health and well-being by promoting access to high-quality care.

EMRs Offer Lessons for Groups
This article discusses the findings of a recent report on the experiences of small physician practices as they adopted and adapted to electronic medical records systems.

IOM Wants Changes in Nursing Levels
This article discusses a report issued by the Institute of Medicine in which IOM suggests changes in how health care organizations can improve the working environment for nurses, and thereby improve patient care.

Act Will Foster Pay for Performance
This article discusses the Medicare Prescription Drug Improvement and Modernization Act and how physicians stand to benefit from some of its provisions.

Reports Raise Concerns About Physician-Owned Specialty Hospitals
This article discusses two reports that focus on physician-owned specialty hospitals and the economic and quality impact of these facilities on the health care system.

California Slow to Adopt New Plans
This article discusses the status of consumer-directed health care in California, based on a report by the California HealthCare Foundation. The report says that California has been slow to adopt consumer-directed plans and that many insurers view these plans either as a threat or an opportunity.

Making the Link Between Health and Productivity
This editorial outlines the topics covered in this issue of Health Care Quality Special Reports; that is, how employees' health affects their productivity while they are at work, as well as how their absence from work due to health-related causes affects their employers' overall costs.

Has a Consumer-Directed Health Care System Arrived?
This editorial discusses the overall impact consumers are likely to have on the health care system and the manner in which physicians will respond to consumer demands.

AHCs Need to Retool, Report Says
This article discusses a report published by the Commonwealth Fund on academic health centers. Specifically, the report looks at the challenges facing AHCs and steps they can take to meet those challenges.

Medicare Quality Improves, Says CMS
This article discusses the results of a study by the Centers for Medicare & Medicaid Services that show improvements in several areas related to inpatient and outpatient care. However, the report also points out that the gap between care delivered and the care that could be delivered remains wide.

Government Promotes Quality Improvement
This editorial discusses a report by the Institute of Medicine that lists 20 priority areas to be addressed in efforts to improve the delivery of health care. Focusing on the areas listed in the report, as well as on illness prevention and disease management, could help patients with certain conditions and help control health care costs, experts say.

California Starts Retreat From HMOs
This article discusses the results of a survey conducted by the Center for the Health Professions at the University of California that found an increasing reluctance of physicians in California to treat patients with HMO coverage. Physicians in California, long regarded as a bellwether for managed care, seem to be now going in a different direction.