Journal of general internal medicine
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Abstract
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Multicenter Study
Performance of Internists and Medicine Specialists in Medicare Quality Metrics: Variation by Specialty and Other Physician Characteristics.
Abstract
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Abstract
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Multicenter Study
The Effects of a Primary Care Transformation Initiative on Primary Care Physician Burnout and Workplace Experience.
Physician burnout is associated with deleterious effects for physicians and their patients and might be exacerbated by practice transformation. ⋯ Despite requiring substantial practice transformation, CPC did not affect physician experience. Research should track effects of other transformation initiatives on physicians and test new ways to address burnout.
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The "VA Mission Act of 2018" will expand the current "Choice Program" legislation of 2014, which has enabled outsourcing of VA care to private physicians. As the ranks of Veteran patients swell, Congress intended that the Mission Act will help relieve the VHA's significant access problems. We contend that this new legislation will have negative consequences for veterans by diverting support from our VA system of 1300 hospitals and clinics. ⋯ In support of this proposal, we describe (1) features of the "VA Mission Act" relevant to outsourcing, (2) the challenges of the present "Choice Program" and likely future obstacles with the new legislation, and (3) the advantages of expanding CHC VA outsourced primary care. This policy would focus more on providing specialized care for veterans in the VA system, while coordinating with CHCs for the necessary expanded outsourced, holistic primary care. We conclude that failure to develop an incremental, cost-effective alternative as described herein represents a potential threat to adequate future support of our VA hospital system, and thus outstanding care for our veterans.