Basic Health Access

“In health care, as elsewhere, information is power: not only the power to heal, but also the power to improve quality, efficiency, reliability, safety, and value.” David Blumenthal MD This stunning quote is another example of solutions that will "come from above." Such a perspective is quite the opposite from a focus on the top priority of the challenging labors at the local and individual level where health care and other needs are most complex. Adding more and more to administrative cost is a major reason for higher health care costs. As noted in small practices, something about the small practice results in quality improvement. A greater emphasis upon local and individual would have to be considered high on the list of reasons why. Experienced clinicians directly connected to their patients would consider that  Bodies have the capacity to heal themselves. Clinicians cannot heal but they can help the body to heal Health information technology has little capaci...

Academics love innovation, new grants, and change. A weakness of academic focus is doing what works -  practical and relevant. Academics often have to be forced to do the practical and relevant. Such is the case with RPAP. The Rural Physician Associates Program has been practical and relevant for 40 years and has facilitated increased primary care and rural services where needed since the first 3rd year medical student began. RPAP is well known to the people at HRSA. During this past two years at least three times I have reminded them about RPAP as a very inexpensive way to increase health services for those in most need - in rural underserved areas. Given the serious problem facing HRSA with designs that would increase primary care demand in the face of failing primary care supply, worse in underserved areas, one would think HRSA would do more. HRSA has been busy elsewhere on reports and programs that are not SMART - specific, measurable, achievable, realistic, and timely...