Basic Health Access

The list of distractions from True Reform are impressive. For decades True Reform has been specifically avoided as primary care worsens within practices and from outside. The demise is most specifically about the financial design. Unless there is a focus on True Reform, there is little hope for Basic Health Access. This may not make as much sense to those outside of family medicine. Family physicians not familiar with AAFP may also be clueless. If you think that you can fix primary care with more technology, more rearrangements, more types of health professional graduates, or more expansions of training - think again. None of these have any hope of working without financial design changes - major changes. The following are various concepts that dominate the discussions at AAFP and primary care meetings and media releases of associations and foundations and institutions. Members, staff, media releases, programs, and personnel have been reviewed.  There is little about...

With additional decades, with time away from academic influences, with time away from conferences, and with more interactions with practice and practicing physicians - it is possible to see with a different perspective. The leaders and staff shaped by the above may be quite limited in their critical abilities. The newest and most innovative approaches are given free reign. Meanwhile back in the real world of practice, there are consequences. Conferences to address burnout - this is the nominee for the first Focus on Fixing the Financial post. Conferences on burnout appear to be a good thing For associations to appear that they are addressing member needs, especially those failing to address the financial design or the innovations, regulations, and digitalizations that make practice worse For association leaders to raise up their flags to also appear to focus on important areas For association finances For advertisers associated with association conferences For advert...

The Value Based Movement lacks Value. It is important to understand how AAFP, Commonwealth, and others have arrived at their misguided focus about what is value.You will hear the various promotions constantly in journals, policy papers, and in the media. The following are more critical evaluations via Jha, Soumerai, Sullivan, CBO, Annals of IM, and others with my comments, critique, and assumptions regarding the real influences on outcomes. I still have hope for associations and foundations, but they need new leadership and a return to missions such as health access – real health access.Their staff need to be re-educated regarding the true value of family physicians and others serving in teams on the front lines despite that greater challenges of the value-based focus. Value, P4P, Performance Based Evidence Is Lacking Annals of IM 1/17 in a comprehensive review did not indicate value for performance based incentives. Only process was improved.   It is hard to stop a...

What does it mean when someone says you re killin me Smalls? Line from the movie "The Sandlot,"  meant  to show extreme frustration towards someone's ineptitude or clueless-ness, sometimes both.  You ' re killing me ,  Smalls definition  by Urban Dictionary. Nov 27, 2014   Urban Dictionary Those that design health care are indeed killing us small practices, small hospitals, and small health care - and we let them do it. The health care financial design is toxic to small practices. Only those with extremes of ineptitude or clueless-ness could do so. Or perhaps they are so dominated by those larger, more organized, and most powerful that they cannot see the damage being done. More confirmation of small health value and neglect AAFP has no excuse. Half of members are in small practices and have consistently been paid the least for family practice and are paid 15% less where they practice and suffer the most cost of delive...