Frank Cacace MD FACP Profile picture
Apr 27 7 tweets 3 min read Twitter logo Read on Twitter
Hey #medtwitter #meded

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

#primarycare docs/teams can be penalized, 😡->
4/

In case you hadn’t heard, dear CMS/employers/service lines, #primarycare pipeline/durability is in critical shape

How about someone distinguish themselves and break the mold

Let’s go for alternative more meaningful patient and community centered metrics

Imagine these->
5/

%patients w diabetes who feel they live better w their disease as result of office teamwork

% visits involving inter professional like pharmacy, BH, CSW

Continuity in eyes of PCP

Continuity in eyes of patient

Validated #wellness scores of doctors in practice

->
6/

CBO relationships / talks given in community by practice team members

# visits to UC / ER / year

RVUs not just in clinical work, but also in teaching/rsch/community

Metrics in #primarycare that reflect wellness of patients, PCPs, team members &communities … ->
7/

would go a long way in alignment, happiness of good people doing good work, recruitment and retention of primary care interest and talent

How about we break the mold, dear employers, AMCs, CMS, M’care &M’caid plans

Everone - we need all the help we can get

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More from @GIMaPreceptor

Feb 27, 2022
#medtwitter #primarycare

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
2/
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

Imagine all the people
Breathing our free world

You may say Gods a dreamer
Read 4 tweets
Feb 7, 2022
#medtwitter #meded #primarycare @primarycarechat

Sorry going long, not sorry

1/?

Letterhead

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
Read 23 tweets
Feb 6, 2022
#medtwitter

1/3 Music 🎼 post Sunday morn

My Aunt Joanie loves her classical music, I got it from her

Yesterday on road 2wedding (see nice posts) played mellow rock 4the car, not like classical for her

I caught her index finger tapping to the beat of a few, sharing->
2/

First up, she tapped and the band well, won’t stop believing.. hee hee



Then a voice came up that I will confess as a teenager I crushed on. Aunt Joanie tapped slowly: what an interesting voice, singing about Sara



->
3/

Then to top it off - Aunt Joanie has always been faithful to Sunday RC mass. Saw Grandma Rita counting her rosaries … well, this one came on

Me: the church didn’t love this one

She tapped away, reminded of Joel lyrics re Catholic girls

Her: Hmm

Me: well, .. ->
Read 5 tweets
Oct 25, 2020
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 ->
2/

The ‘it didn’t have to be this way’ - must remind the public, the on the fence voter, of the following:

Pandemic preparedness structures were pared down &not present 2help initial strategy

‘Leadership’ must b holistic/humble - it sits back &listens deeply to expertise ->
3/ if ‘leadership’ respected lifelong career pandemic preparedness experts, we would have:

accepted WHO tests for #COVID19 to apply at the outset

commissioned efforts 2create a new test 2multiple entities 4redundancy as an insurance policy, ie .... ->
Read 11 tweets
Oct 25, 2020
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 ->
Read 15 tweets
May 25, 2020
1/ Had a really interesting day on #medtwitter today, re: #advocacy #activism #primarycare courtesy of @MParshleyMD @sagar_ankita @EricLast3 @gabrieldane @meggerber @mmteacherdoc @sulane7 @SusanHingle @dhpomerantz @UREssien

... and of course that made me think #baseballcards ->
2/ I was reminded that one hobby I have to relax me when pandemics, hubris, RVUs and #disparities are driving me bonkers 😜 = old ⚾️ cards.

On my recent B day my nieces/nephew bought me a pack of 2020 (?lost season) cards. Decided to open them ->
3/ they are new, shiny, the photography is awesome. Look at that Bryce Harper! The Laureano catch!

Rizzo for the Cubbies. Alfonzo of my Mets. -> getting back to the #advocacy in the environs of our institutions, promise ... Image
Read 10 tweets

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