Dear #healthcare employers, academic medical centers/institutional structures
#primarycare is the foundation of care in a large system. It is not treated as such
Metrics rating us and attracting scrutiny include
1/? -> …
2/
% A1C > 9
blood pressure <140/90 at last touch across board,
w/o regard to age/context
% mammo (w many outside your system and clicks to result burdensome)
% colon screening
% flu or pnvx
% PHQ screened
average # patients seen / exam room / day
90% RVU target->
3/
These metrics are from CMS menus, or from finance, etc
EMRs don’t always generate panel wide data well, don’t always define or find panels well. #primarycare metric measurement workarounds then have to be created repeatedly
1/4 I like to share my 🎹 on here, trying to brush up mid career for peace/decompression, #wellness. Wrote some lyrics to Imagine and put it out, thought I’d share lyrics &video (see attached at end):
Imagine there’s no covid
And all it forced to see
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No white and brown between us
Within reach equity
Imagine all the people
Livin’ for that day
Imagine there’s no despots
And all disparity
Nothin to kill or suppress for
No tribes or chambers be
Imagine all the people
Livin’ lives safely
You may say God’s a dreamer
3/
But dreams need to take some hold
She hopes some day you’ll heed Her
And we will then be as one
Imagine there’s no covid
I wonder if you can
No need for hater leaders
All worldly life adored
From: All primary care docs (community, employed in large network, academic medical centers)
To: #healthcare system writ large, administrators/financial lever pullers
2/
Primary care docs are in a precariously fatigued way
We deliver longitudinal relational care, which is foundational to the whole person rewarding work we need to be professionally happy, and to the revenue and reputational growth you need to maintain community market
3/
Primary care docs fulfill an indispensable role not just in the local setting, but we provide what all the country and our society desperately needs - coordination and high value care in a system that overspends and doesn’t provide universal access nor competitive outcomes
1/ Debating whether to dignify this ... but here goes
I think most of us endangered docs/nurses/respiratory therapists/social workers/hospital chaplains are also frustrated re clarity of the campaign &publicly voiced narrative re this administration’s &our nation’s response ->
1/ This past Thurs, I was honored to ‘emcee’ a grand rounds @HofNorthwellDOM, presenting the Candee Award for Education Excellence in Medicine 2our beloved Ron Rosen of @NorthwellDGIM
Ron is a 50 yr general internist who has taught no less than 40 yrs worth of learners -> 🧵
2/ Ron had so much to tell us about his aunt and uncle, who were early family medicine practitioners in the Bronx/Manhattan. Ambulance drivers would take them to a patient’s home. A beautiful sepia tone showing his aunt going to a call, and another of his uncle in the office
3/ We heard about Dr. Rosen’s medical school yrs @nymedcollege in the early 60s &how he knew the civil rights movement, the movement for reproductive rights, the attempts to mitigate poverty and the birth of Medicaid and Medicare would affect all his future pts &his work ->