Family physician, author, blogger, speaker, physician leader.

Tag Archive for Choosing Wisely

The Seven Pillars of High Performing Primary Care Practices – Part Two

In a previous post titled, “Is Making Primary Care More Professionally Satisfying as Simple as Lowering Panel Size” I observed that lowering panel size and implementation of an electronic medical record did not change how doctors worked. Those doctors who stayed late continued to stay late. Those who left earlier tended to continue to leave earlier. Within a health care organization often touted by many to be an example of how health care should be delivered in the country, this phenomenon existed. Why? Our doctors work in a very large multispecialty group practice. We use a common electronic medical record. Doctors in both primary care and specialty care can discuss cases, review information, and determine together with the patient the best course of action. Our primary care doctors have lower panel sizes than a decade earlier. This panel size is adjusted and normalized for patient age, medical problems, and other […] Read More »

The New Ontario Annual Physical Exam – Is It Choosing Wisely?

Is the Ontario Annual Physical Exam going the way of the dinosaur? That appears to be the case for healthy individuals between the ages of 18 to 64 in the Canadian province of Ontario. Effective in 2013, these patients no longer would have available an annual physical examination, but instead a “personalized health review”. The new personalized health review would only be available to those who were healthy and did not have medical diagnoses of cancer, diabetes, or others, in which those patients could still receive a more thorough examination. Other changes include not allowing routine chest x-rays prior to minor surgery and moving the screening rate for cervical cancer from one to every three years. The plan would save the government of Ontario about half a percent on payment to physicians as the reimbursement is less for these personalized health review. Should people in Ontario be worried that their […] Read More »