By Patrick Howington
phowington@courier-journal.com
The Courier-Journal

University of Louisville faculty doctors may build an outpatient medical center in fast-growing eastern Jefferson County, establishing an outpost miles from the downtown academic medical center.

If the project proceeds, it would join a list of other medical centers planned out east by Baptist Hospital East, Norton Healthcare, and Jewish Hospital & St. Mary’s HealthCare.

In letters filed with a state agency Monday, the university’s Medical School Practice Association said it is considering establishing an outpatient surgical center, an ambulatory care center offering diagnostic services, or both, in eastern Jefferson County “near I-265.”

The project is not a certainty, however, said Dr. Larry Cook, U of L executive vice president for health affairs and a member of the association’s board. (more…)

By Rob Stein
Washington Post Staff Writer

Sandwiched between a swimming pool store and a spice shop on Lee Highway in Fairfax, the Tepeyac Family Center looks like any other suburban doctor’s office. But it isn’t.

The practice combines “the best of modern medicine with the healing presence of Jesus Christ,” a brochure at the reception desk announces. An image of the Madonna greets every patient. Doctors, nurses and staff members gather to pray each day before the first appointments.

The center is one of a small but growing number of practices around the country that tailor the care they provide to the religious beliefs of their doctors, shunning birth-control and morning-after pills, IUDs and other contraceptive devices, sterilizations, and abortions, as well as in vitro fertilization. Instead, doctors offer “natural family planning” — teaching couples to monitor a woman’s temperature and other bodily signals to time intercourse.

Proponents say the practices allow doctors to avoid conflicts with patients who want services the practitioners find objectionable, as well as to provide care that conforms with many patients’ own values. The approach, they say, provides an alternative to mainstream medicine’s reliance on drugs and devices that, they argue, carry side effects and negatively affect couples’ relationships.

“I want to practice my faith,” said John T. Bruchalski, the obstetrician-gynecologist who started Tepeyac. “I’m not interested in pushing it on other people. But this allows me to practice medicine without having to do something that I wouldn’t see as positive or healthy.”

Critics, however, worry that the practices are segregating medicine along religious lines and may be providing inadequate care by failing to fully inform patients about their options. The critics are especially alarmed about the consequences in poor or rural areas with few alternatives.

“Welcome to the era of balkanized medicine,” said R. Alta Charo, a bioethicist at the University of Wisconsin at Madison. “We’ve had this for years with religious hospitals. What’s happening now is it’s drifting down to the level of individual practitioners and small group practices. It essentially creates a parallel world of medicine.”

The American College of Obstetricians and Gynecologists has no formal position on such practices, but its officials say the approach can offer a way for religious doctors to work and serve religious patients as long as they are upfront about their limitations.

“If women know before selecting them, then it’s quite a legitimate thing to do and might meet the needs of many women and doctors,” said Anita L. Nelson of the University of California at Los Angeles, speaking for the organization. “But if you hang out your shingle that says ‘All-purpose OB-GYN’ and don’t offer certain services, that’s false advertising.” (more…)

By JEFF DONN, Associated Press Writer
yahoo.com

Despite exploding costs, most Americans got sizable life-extending bang for their medical bucks over recent decades, says one of the most sweeping studies ever of health-care value.

That might come as a surprise to anyone who has ever shuddered over a medical bill, and the report itself raises doubts over how quickly costs have escalated.

However, the study calculated that Americans of all ages spent an average of $19,900 on medical care for each extra year of life expectancy gained over the last four decades of the 20th century. And that cost is worth it, the study authors say.

“On average, the return is very high,” concludes study leader David Cutler, a Harvard University health economist. “But it’s getting worse for … in particular, the elderly.”

The federally funded study by researchers at Harvard and the University of Michigan was being published Thursday in the New England Journal of Medicine. (more…)

by Amy Fletcher
Denver Business Journal
http://www.bizjournals.com

Medical malpractice reform has been the source of heated debate, but there’s little data about the impact of frivolous lawsuits on health care costs — though they’re frequently cited as a major cause of health care cost inflation.

The powerful American Medical Association, which represents doctors, cites statistics indicating the fear of malpractice claims has caused nearly 80 percent of doctors to order tests they otherwise wouldn’t have.

But the Congressional Budget Office (CBO), the General Accounting Office and the Kaiser Family Foundation say there is little evidence to support that claim.

“Defensive medicine may be motivated less by liability concerns than by the income it generates for physicians or by the positive, albeit small, benefits to patients,” the CBO said in a 2004 briefing.

“On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.”

But the topic is popular with doctors and politicians. President George W. Bush and Colorado Republican gubernatorial candidate Bob Beauprez tout the need for malpractice reform.

When recently asked what’s driving health care costs, Beauprez said medical malpractice costs, adding that when 80 percent of doctors say they are practicing defensive medicine, “something is wrong.”

However, when it comes to limiting doctors’ liability in malpractice cases, Colorado is considered a leader among those who favor tort reform. Colorado’s noneconomic loss cap is $300,000, and economic damages are limited at $1 million. (more…)

http://www.healthleadersmedia.com

When Tampa Bay Women’s Care was formed in 1998, the physician-owned and operated OB/GYN specialty practice merged 14 groups into one. Full of expectation but skeptical of how the organization would ultimately take shape, the new partners wanted a lot of input in decisions early on. “We started off with committees for almost everything,” says Robert W. Yelverton, M.D., charter president and CEO.

As the growing pains subsided and the Tampa, Fla.-based practice matured, the 66-physician group created a more defined leadership structure. Yelverton, a 33-year OB/GYN veteran, hung up his white coat 2 1/2 years ago to become the group’s full-time CEO and medical director. He now leads the administrative staff out of a central business office and answers directly to the 16-member board.

The group is divided into 14 divisions based on the original groups’ locations, and each division selects one board member for every three full-time physicians. This structure, Yelverton says, allows each of the offices, regardless of size, to have input. As trust in the leadership has grown, the burdensome committees created at the practice’s inception have been mostly disbanded in favor of the more streamlined decision-making process. (more…)