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Doc Gurley



Posts from an Insane Healthcare System



Last Build Date: Wed, 15 Apr 2015 17:47:11 +0000

 



Doccupy, EHRs and the Affordable Care Act

Thu, 20 Feb 2014 22:25:18 +0000

Source: Doccupy, EHRs and the Affordable Care Act

EHR Interface Design = a giant MESS (Photo credit: juhansonin)

It’s rare for doctors to turn out en masse for a public protest. But that’s what happened at “Doccupy” in Contra Costa County California in 2012. A group of safety net physicians testified before county supervisors — in what they only half-jokingly called “Doccupy” [...]




Medical Homes Part III: The True Cost

Sun, 16 Feb 2014 17:16:04 +0000

Source: Medical Homes Part III: The True Cost

Implenting Patient Centered Medical Home (Photo credit: Army Medicine)

As the Patient Centered Medical Homes (PCMHs) train charges forward along with implementation of the Affordable Care Act, dollars are taken directly out of our health care system to certify providers in a method with no proven benefit (see Medical Homes Part II: The Depressing [...]




Medical Homes Part II: The Depressing Data

Fri, 07 Feb 2014 02:07:04 +0000

Source: Medical Homes Part II: The Depressing Data

Community Based Medical Home (Photo credit: Army Medicine)

When looking to examine Patient Centered Medical Home data (click here for my overview of PCMHs), there’s no better place to start than the 26-month evaluation of the multi-site National Demonstration Project. Begun in 2006, with results published in 2010, this federally funded project included an [...]




The Gurley Rule of Bureaucracy: The complexity of a bureaucracy is inversely proportionate to the clarity of the idea behind it.

Fri, 07 Feb 2014 02:02:21 +0000

Source: The Gurley Rule of Bureaucracy: The complexity of a bureaucracy is inversely proportionate to the clarity of the idea behind it.

Following on from the first post about Medical Homes and the bureaucracy that was involved in creating and driving the concept, here are some thoughts on medical bureacracy.

Good Bureaucracy: If you’re in health care and you amputate the wrong limb, that is bad.

1) While not as simple to avoid as initially believed, there [...]




Medical Homes Part 1: The Reality vs. The Hype

Sun, 02 Feb 2014 01:23:49 +0000

Source: Medical Homes Part 1: The Reality vs. The Hype

English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

Patient-Centered Primary Care Medical Homes (PCMHs) are all the rage. A frequently-touted part of the Affordable Care Act (ACA), they have received literally hundreds of millions of dollars in federal incentive and demonstration-project funding. They’ve been [...]




Investigating drug rehab, overdose death prevention in your community

Tue, 30 Jul 2013 19:10:55 +0000

Source: Investigating drug rehab, overdose death prevention in your community

Image of Cory Monteith by vagueonthehow via Flickr

Hollywood stars, like Glee’s Cory Monteith, aren’t the only Americans struggling with addiction that kills. Monteith, who died of a heroin and alcohol overdose earlier this month, exemplifies the public health tragedy that is opioid overdose deaths in America. The fact is, there is no [...]




Booby Traps Part 3: Staying Focused and Honoring Your Decision

Fri, 14 Jun 2013 18:44:48 +0000

Source: Booby Traps Part 3: Staying Focused and Honoring Your Decision

The more complex and high stakes a health care decision is – like with genetic testing and mastectomies (see Booby Traps Part 1 and Part 2

An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue in the surrounding yellow fatty tissue. (Photo credit: Wikipedia)

[...]




Booby Traps Pt. 2: Human nature and the health care system

Thu, 30 May 2013 20:12:45 +0000

Source: Booby Traps Pt. 2: Human nature and the health care system

English: Naval Medical Clinic Pearl Harbor, Hawaii (Oct. 25, 2002) — Hospital Corpsman 2nd Class Dana L. Ford, a mammogram technician, aids a patient in completing her annual mammogram evaluation. Breast cancer is the leading form of cancer found in women. Naval Medical Clinic Pearl Harbor conducts approximately 2,300 mammograms annually. U.S. Navy photo [...]




Booby Traps: Pitfalls along the path of genetic testing and mastectomies

Thu, 16 May 2013 12:31:30 +0000

Source: Booby Traps: Pitfalls along the path of genetic testing and mastectomies

Right breast cancer (Photo credit: Wikipedia)

The first time I wrestled with the issue of whether to get my breasts cut off, I was in my early forties. Partners in life, my breasts had done right by me. They delighted me in all their underwhelming adolescent glory. Then they’d been a source of panting, [...]




Social Media and the Patient Community Explosion

Sat, 13 Apr 2013 02:33:43 +0000

Source: Social Media and the Patient Community Explosion

There’s a great post over at Diabetes Mine about the explosion in patient interaction and patient communities around social media. It’s well worth a read so you should head on over and take a look. Here’s an excerpt.

Everyone wants to know what the patient community is thinking these days. The explosion of social media [...]