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- Page navigation anchor for Incentivizing Total Healthcare?Incentivizing Total Healthcare?Show More
I found Hunt, Kreiner, and Brody's article extremely illuminating, timely, and critically important (as well as the comments/discussion to the piece). It seems their research and response point to a pharmaceutical nexus of sorts that is operating in and through the bodies of patients: pharma marketing, incentivization of medical care, and poly pharmacy. Outside of mental health treatments, there is probably no greater ar...
Competing Interests: None declared. - Page navigation anchor for Re: Changing Face of Chronic Illness ManagementRe: Changing Face of Chronic Illness ManagementShow More
In this interesting paper is a reference to one of the interviewees: "As one family physician said: I was being a little bit lackadaisical with the A1c goal as 7.0[%] or less. I wouldn't really like to admit it, but the insurance companies making a financial carrot is probably one impetus for really cracking down on my diabetics to get them 7.0[%] or less. 7.1[%] don't cut it...anymore. It has to be 7.0[%] or less." This...
Competing Interests: None declared. - Page navigation anchor for Re: Physician habitsRe: Physician habitsShow More
The transcribed conversations reported by Hunt, Kreiner, & Brody (2012) give evidence that physicians in a variety of clinical settings are following very similar personal scripts. Scripts are habitual ways of thinking and interacting with patients around a medical problem (R. M. Hamm, 2003). Though perhaps no longer conscious, they are flexible, developed first during a physician's education but shaped during practic...
Competing Interests: None declared. - Page navigation anchor for Re: Underlying InfluencesRe: Underlying InfluencesShow More
Hunt, Kreiner, and Brody noted that "the clinical consultations we observed focused heavily on choosing and adjusting medications, to the near exclusion of other considerations, such as diet and lifestyle" (p. 455). But there is such good evidence that counseling patients to change diet and exercise behavior is effective in reducing cardiovascular risk (Fisher et al., 2011; Hankinson et al., 2010; Lin, O'Connor, Whitlock...
Competing Interests: None declared. - Page navigation anchor for Improving prescription practices through drug safety dataImproving prescription practices through drug safety dataShow More
Hunt, Kreiner, & Brody's carefully researched and forthrightly written article may signal the state of affairs pertaining to a significant segment of the diabetes/metabolic syndrome patient population. The authors identify the potential harms of the recent expansion of and pressure to comply with early and intensive pharmacological algorithms for the management of type 2 diabetes.
There is a considerable and...
Competing Interests: None declared. - Page navigation anchor for Well DoneWell DoneShow More
As a medical director developing a new national health plan with Ascension Health I am appreciative of information regarding the possible negative effects of pay-for-performance programs. It supports my position that we need to incentivize interventions that include education, counseling and judicious use of medications. Focusing physicians on a number rather than individual well-being may be dangerous to the individua...
Competing Interests: None declared.