I have been posting audio from some recent conferences (ASBH, ATS, ICCEC) on my website here and here. I have now started loading some videos. I divided a recent one hour presentation into six YouTube video posts.
Friday, January 7, 2011
Thursday, January 6, 2011
Repeal of the Patient Self Determination Act
With all the talk both about repealing healthcare reform legislation (or at least cutting off its funding) and about the backlash to Medicare coverage of voluntary advance care planning, it would not surprise me to see a bill aimed at repealing the Patient Self Determination Act.
After all, the PSDA actually requires hospitals and other facilities to inquire about and engage in education concerning advance care planning. If the states want to promote or require advance care planning, that is one thing. But if the federal government wants to be agnostic and treat advance care planning like abortion and assisted suicide (not allowing federal funds), then why not at least be consistent? Repeal all the federal law that promotes advance care planning. The PSDA has been pretty unsuccessful in any case.
After all, the PSDA actually requires hospitals and other facilities to inquire about and engage in education concerning advance care planning. If the states want to promote or require advance care planning, that is one thing. But if the federal government wants to be agnostic and treat advance care planning like abortion and assisted suicide (not allowing federal funds), then why not at least be consistent? Repeal all the federal law that promotes advance care planning. The PSDA has been pretty unsuccessful in any case.
Wednesday, January 5, 2011
Death Panels Win Again - CMS to Reduce Advance Care Planning Coverage
Physicians have always been permitted to engage in advance care planning with their Medicare patients. Indeed, they have been, and will continue to be able to, get reimbursed for such discussion (under several office visit CPT codes). And ACP is still covered under the initial "Welcome to Medicare" visit. But otherwise the reimbursement level is too low to incentivize this wanted and needed planning.
Higher reimbursement was specifically covered under an early version of PPACA. It was then specifically covered under Medicare regulations. But now, the New York Times reports that coverage has been removed from the regulations too.
Higher reimbursement was specifically covered under an early version of PPACA. It was then specifically covered under Medicare regulations. But now, the New York Times reports that coverage has been removed from the regulations too.
Tuesday, January 4, 2011
"Help, They Want Everything" - Futility at the American Geriatrics Society
At the annual meeting of the American Geriatrics Society in Washington DC in May 2011:
HELP, THEY WANT EVERYTHING!
Developed by the Ethics Committee and sponsored by the Ethnogeriatrics Committee.
Moderator: Elizabeth K. Vig, MD, MPH
Learning Objectives: (1) identify factors that contribute to patients and their family members requesting 'everything' be done; (2) review and practice strategies for communicating with patients and families who want 'everything'; and (3) reflect on how beliefs and values may influence how clinicians respond to certain cases.
Developed by the Ethics Committee and sponsored by the Ethnogeriatrics Committee.
Moderator: Elizabeth K. Vig, MD, MPH
Learning Objectives: (1) identify factors that contribute to patients and their family members requesting 'everything' be done; (2) review and practice strategies for communicating with patients and families who want 'everything'; and (3) reflect on how beliefs and values may influence how clinicians respond to certain cases.
Reasons for Wanting 'Everything'
Elizabeth K. Vig, MD, MPH
Case Discussion - Disagreement among Family Members
Karen S. Feldt, PhD, ARNP, GNP
Case Discussion - Ethnic/Cultural Influences
Fred Kobylarz, MD, MPH and Ramona Rhodes, MD, MPH
Case Discussion - Futility
Sandra Sanchez-Reilly, MD, AGSF
Case Discussion - Family Wants 'Everything' Done while They Wait for a Miracle
Joseph W. Shega, MD
Case Discussion - Disagreement between Family Members
Caroline A. Vitale, MD
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