In Vermont, Where Almost Everyone Has Insurance, Many Can’t Find or Afford Care
Insurance issues, shrinking care facilities, centralization, and an aging population—Vermont is a microcosm of the problems facing healthcare. While the article focuses on specific issues in Vermont, they are not much different from those in other areas. Vermont has state regulation of hospital and insurance prices and a strong investment in care provision, but it also has a patchwork of out-of-network providers, clinics, and small hospitals.
In Vermont, Where Almost Everyone Has Insurance, Many Can’t Find or Afford Care - KFF Health News
Physician Survey Shows Medicine’s Toll on Personal Relationships
Unsurprisingly, the impact of physician careers and the demands of those careers present a lot of challenges to personal relationships. Especially the areas with shift work and high overtime requirements. This AMA article summarizes some of the findings from a report published in Mayo Clinic Proceedings recently (study linked in article).
Emergency medicine physicians win the price, with 93% reporting significant impact on personal relationships, whether married or single. Next highest, interestingly, was physical medicine and rehab.
Physician Survey Shows Medicine’s Toll on Personal Relationships - AMA
Medicare Telehealth Flexibilities Should Be Here to Stay | Kaiser Permanente
Telehealth came through big during COVID, and matured a lot. Several of the restrictions that were removed in 2020 for Medicare are set to expire at the end of 2024. Everyone has known this for months, and there’s been lots of talk, papers, and legislation, but nothing has been done yet. Some of that flexibility has allowed some questionable things. Direct-to-consumer pharmaceutical sales by manufacturers through telehealth prescriptions and pill mills are getting a lot of Senate scrutiny right now.
But there’s not a quick answer without addressing more fundamental things about marketing, advertising, and care provision overall. From big systems (here, Kaiser) to private practices, telehealth has been a boon to Medicare and other participants, and there’s 45 days to do something - whether its booting the decision down the road or trying address more holistic regulation.
Medicare Telehealth Flexibilities Should Be Here to Stay - Kaiser Permanente
QUIZ QUESTION
80-year-old man with a history of diabetes mellitus
An 80 year old man with a history of diabetes mellitus presents with acute pain, cyanosis and decreased temperature of the right lower extremity. Distal pulses are not obtainable via palpation or doppler. You suspect acute arterial occlusion (see figure).
Based on this assumption, which of the following statements is true?
- Warming of the extremity is expected to improve cyanosis in this case.
- The patient’s cyanosis is secondary to postobstructive vasodilation and venous stasis.
- Supplemental oxygen is not expected to improve cyanosis in this case.
- This degree of cyanosis is a clue to decreased arterial oxygen saturation being present in addition to the peripheral occlusion.
- Systemic vasodilators such as calcium channel blockers may improve this patient’s cyanosis.
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