Ted Eytan, MD

e-Health. Patient empowerment. Washington, DC.

Archive for October 10th, 2008

Photo Friday: Diverse communities …

October 10th, 2008 | Popularity: 21%

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support the health of everyone….

…are strong,

fun to live in….

…and beautiful.

From the top:

(support the health of everyone) AIDS Walk Washington 2008, sponsored by Whitman-Walker Clinic (that’s the US Treasury Department in the background of Pennsylvania Avenue). I supported the Kaiser Permanente Mid-Atlantic Region team.; (are strong) Fiesta DC 2008, Mount-Pleasant, Washington, DC (60,000 attendees); (are fun to live in) Adams-Morgan Day, Adams-Morgan Neighborhood, Washington, DC; (are beautiful) Fiesta DC 2008, Mount-Pleasant Neighborhood, Washington, DC.

People in intolerant places are less happy and less fulfilled than those in tolerant and open-minded ones.
Business organizations that embrace diversity have more customers and greater profitability.
Health and health care is improved when we embrace the differences of the people we are serving and serving with.

A patient once said to me, “We don’t tolerate diversity where I work. We LIVE diversity.” This Photo Friday is a reminder to live diversity, wherever you are.

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Tags: DC diversity Photos

What we can do to help primary care: Comments from Christine Cassel, MD MACP

October 10th, 2008 | Popularity: 22%

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Christine Cassel, MD, MACP (click to enlarge)

This post is part 2 of my experience recently in Englewood, Colorado, at Kaiser Permanente’s first gathering of its primary care leadership across the nation.

On day two of our discussion, we changed our focus to the specific work being done within the Kaiser Permanente system to support primary care, to the external environment and ways we could support it.

As part of that conversation, Christine Cassel, MD, MACP, President of the American Board of Internal Medicine, came to talk to us about her experience and offer guidance. I was fortunate to meet both Christine and Richard Baron, MD, who presided over a dedicated forum on patient-centered care in California earlier this year. Organizations like the ABIM are spending the time to find the best opportunities to improve the patient experience and support them. Both Christine and Richard wrote a commentary recently in JAMA entitled: 21st-Century Primary Care: New Physician Roles Need New Payment Models

I wrote down three main messages from Christine’s talk to us (my paraphrase), which were:

Make this (primary care) a satisfying profession
Make the workload manageable
Create a team culture of mutual respect (with specialty care colleagues)

I really identified with the last point because I think Permanente Medical groups are among several (see: The Council of Accountable Physician Practices) that can contribute to knowledge around successful partnerships between primary care and specialty care physicians. I’ve seen and participated in these partnerships in past work – and I know there are many opportunities, perhaps more than is conventionally believed, to work together.

Following Christine’s comments, there was a review of multiple other innovative practices throughout the Kaiser Permanente system that touched on the 3 points above. It’s important to remember that these are practices that have fully functioning electronic health records and personal health records, coast to coast (and Hawaii). The innovations I saw are ones that extend this functionality to change the way medicine is practiced. I am hopeful that these practices can be shared (and critiqued) widely, as possible solutions for primary care everywhere.

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Tags: ABIM Colorado Kaiser Permanente primary care The Permanente Federation

Throwing Out the Rules of Work | workforce.com

October 10th, 2008 | Popularity: 13%

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Throwing Out the Rules of Work | workforce.com – More press for Results Only Work Environment (ROWE) at BestBuy:

“You start looking at everything and saying, ‘Is this really going to help get me to my desired outcome?’ ” Ressler says. “Pretty soon you’ve cut out 10 of those unnecessary things that used to fill up your week, and you’re getting a lot more done.”

Best Buy is so enamored of ROWE that it is in the process of marketing the system to other companies, and is even considering trying a modified version in its retail stores. There are skeptics who wonder whether ROWE will work outside of a relatively homogenous corporate campus.

It’s a 6 month process, and the steps are detailed in the article. What works in retail or in the professional environment of BestBuy’s corporate campus should work in health care, especially in professions where workload management by the clock makes less sense. Agree?

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Tags: bestbuy rowe

“I want to make primary care doctors rich” – the potential of genetic science to reshape medical care

October 10th, 2008 | Popularity: 16%

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The statement in the title of the post was made in jest by Navigenics Co-Founder and Chief Scientific Officer Dietrich Stephan, Ph.D. to me recently. Dietrich was in DC, along with colleague Phil Marshall, MD sharing views on the future of medicine and health at the renown Lauriol Plaza in my neighborhood. In the context of our conversation, Dietrich was speaking to the current imbalance in our health system that prioritizes procedures and specialty care over primary care in our resource allocation.

The statement made an impact on me because it triggered visions of a different world, where medical students might choose primary care and community as the lucrative specialty instead of the ones they choose today with this idea in mind.

With that as a starting point (instead of “we want to make primary care less disenfranchised”) Dietrich laid out a vision for primary care providers as stewards of genetic science, leveraged to help patients stay healthy, whether by suggesting lifestyle modification, alternate therapies for common conditions, or mitigating risks later in life. Right now, our instruments are very blunt when it comes to predicting risk even for things where we have lots of data, like heart disease.

What would it be like for primary care providers to work with patients to plan a healthy life by wielding the best genetic science, and how would society value that relative to procedures? The path of primary care might change, from managing and directing goals and processes in the management of chronic illness to a new role of predictive science and planning, for a person, a family, a community.

I went to medical school hoping to become a family physician and left medical school hoping to become one, because I was most interested in what I would do as a physician. Even though I was a molecular biology major in college, I haven’t really considered how genetics would integrate into medical practice. Now I am. See what you think, comments welcome.

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Tags: DC genetic science primary care