Kevin Graham

1.2K posts

Kevin Graham

Kevin Graham

@KCGraham6

Family Medicine. Palliative Care

Oshawa, Ontario Bergabung Eylül 2014
366 Mengikuti396 Pengikut
Kevin Graham
Kevin Graham@KCGraham6·
@OntariosDoctors @CMA_Docs The solution is simple. If the requesting party was mandated to pay directly for these forms on a per page basis, the majority would shrink significantly or disappear entirely. This is entirely a problem of not assigning the costs to the entity creating the forms . Easy fix
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Ontario Medical Association
Ontario Medical Association@OntariosDoctors·
Canada’s doctors are wasting millions of hours on unnecessary paperwork. A new @CMA_Docs report conducted with the CFIB has found red tape is leaving doctors with significantly less time to spend with patients. Here’s how bad it’s gotten: #tncms-source=login" target="_blank" rel="nofollow noopener">thestar.com/news/canada/st…
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Kevin Graham
Kevin Graham@KCGraham6·
@jossreimer The answer has been known for a long time. If the requesting party (employee, insurance company etc) was mandated to pay directly at a per page rate this would all stop overnight.
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Dr. Joss Reimer
Dr. Joss Reimer@jossreimer·
Canada needs more family doctors. Unfortunately, administrative burden is a huge deterrent against medical students entering family medicine. Let’s help physicians get back to seeing more patients, and doing less paperwork. thestar.com/opinion/contri…
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Kevin Graham
Kevin Graham@KCGraham6·
@mkcavy From my perspective in Primary Care, MedsCheck post hospital discharge is high yield, I think scheduled checks with CKD would also be high yield. Unfortunately I can confirm the absolute onslaught of low yield checks the last few years.
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Mike Cavanagh
Mike Cavanagh@mkcavy·
Who wants to know what work goes in to, what I consider, a good, quality #MedsChecks? Almost like an AMA session. Ask away, and I’ll share how we perform them at our group of pharmacies.
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Kevin Graham
Kevin Graham@KCGraham6·
@mkcavy Great example of appropriate use of a MedsCheck. It’s unfortunate those providing appropriate care for patients are caught up in this issue of clearly inappropriate use of this program by some pharmacies.
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Kevin Graham
Kevin Graham@KCGraham6·
Good thread on proper use of MedsCheck program, the program working the way it is intended to….
Mike Cavanagh@mkcavy

@KCGraham6 I’ll provide you with one recent example. Discharge patient. This is important because evidence shows a MedsCheck done post-discharge reduces the risk of 30-day rehospitalization. If anything, these are completely under utilized in our system.

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Kevin Graham me-retweet
Mike Cavanagh
Mike Cavanagh@mkcavy·
@KCGraham6 I’ll provide you with one recent example. Discharge patient. This is important because evidence shows a MedsCheck done post-discharge reduces the risk of 30-day rehospitalization. If anything, these are completely under utilized in our system.
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Kevin Graham
Kevin Graham@KCGraham6·
@Kapur_AK @alandrummond2 @tedhsu It makes sense if it was framed as an estimate of patient encounters per year. Works out to about 10 patient enounters per work day per NP. Wording is clumsy if this is what it is.
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Dr. Atul Kapur
Dr. Atul Kapur@Kapur_AK·
@alandrummond2 @tedhsu And you just believe any number put in front of you? I'm not looking for detailed analysis, just a half-second of thought. That's 87% of Ontario's total population - cared for by only 4952 NPs?!?! So if we only hired 729 more, then every Ontarian would be covered?!
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alan drummond
alan drummond@alandrummond2·
Thanks for the response but I seriously doubt that 13.6 million Ontarians are getting care from Nurse Practitioners. Five million Ontarians go to the ER every year and ER waiting rooms are filled with folks who would love to be receiving care from anybody.
Ted Hsu@tedhsu

@alandrummond2 My office met with the @NPAOntario on this week and these numbers came directly from them.

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Kevin Graham
Kevin Graham@KCGraham6·
@doreen_rabi It’s almost funny. “Family physician graduates are intimidated by the complexity of family practice”….so they do hospitalist or ER instead……wait a minute …what??
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Doreen Rabi, M.D.
Doreen Rabi, M.D.@doreen_rabi·
@KCGraham6 Thank you, well said. I also agree it's not the complexity itself- its the lack of system support to deal with it coupled w/ increasing admin burden related to care coordination.
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Kevin Graham
Kevin Graham@KCGraham6·
@doreen_rabi I know literally dozens of family medicine trained physicians in focused practice. I have never heard the reason being complexity / needs more training . Never. Common reasons : lack of support, administrative burden, cost to run a practice, unable to disconnect.
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Doreen Rabi, M.D.
Doreen Rabi, M.D.@doreen_rabi·
2. I need to look into the data, but anecdotally, ppl chose to focus practice for a number of reasons. Increasing complexity is one, but to say an additional year will fix that is naive. Medicine will continue to evolve- increasing complexity will not go away. 4/
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Kevin Graham
Kevin Graham@KCGraham6·
Personally I have not seen any evidence of this. Physicians I know who narrowed scope did it entirely based on lack of support for comprehensive practice and the administrative burden. Don’t know a single person who narrowed due to perceived “under training”
The College of Family Physicians of Canada@CFPC_e

4/ The current curriculum needs changes to better support trainees today. As it stands, many are choosing to narrow their scope because of the gaps and need for support in transition into comprehensive practice.

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Kevin Graham
Kevin Graham@KCGraham6·
@petrosoniak Additionally family med is inherently community based meaning family physician is covering overhead for their practice, at a time of inflation without corresponding increase in payment. Not to mention during maternity leave physicians are literally paying money to not practice.
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Andrew Petrosoniak
Andrew Petrosoniak@petrosoniak·
To discount the importance of the financial incentives (or lack of thereof) related to the family doctor crisis is flawed at best and to me seems disrespectful of the quality of care so many are providing. End.
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Andrew Petrosoniak
Andrew Petrosoniak@petrosoniak·
Very disappointing to hear @docdanielle avoid the elephant in the room. Family physicians are straight up underpaid. Its not easy to discuss when we're talking about 6 figure incomes but when there's a choice as a med student between higher & lower paying jobs.. 1/
UofT Family Medicine@UofTFamilyMed

How do we fix the family doctor shortage? We attract more medical students into family medicine. How do we attract more medical students? We fix the system they will graduate into. DFCM Chair @docdanielle talks to @YourMorning. youtube.com/watch?v=imW_aN…

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Kevin Graham
Kevin Graham@KCGraham6·
@mathisonej I still don’t understand what makes a hospital a Catholic hospital. Who owns the land? Who owns the building and all the infrastructure?
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Eric Mathison
Eric Mathison@mathisonej·
Faith-based healthcare organizations that receive public funding shouldn't be able to refuse services. Forced transfers, treatment delays, and discrimination are some of the effects of the current system. [Paywalled] theglobeandmail.com/canada/british…
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Kevin Graham
Kevin Graham@KCGraham6·
@NightShiftMD Family physicians are spending hours per day on administrative tasks. We have this capacity. We simply choose to continually squander it.
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Dr. Brian Goldman
Dr. Brian Goldman@NightShiftMD·
If they’re really going to transform health care, premiers must present a united front. “…boost the number of Canadian adults with a primary caregiver from 78 to a least 85 % within five years.” Doubtful. theglobeandmail.com/opinion/articl…
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Kevin Graham
Kevin Graham@KCGraham6·
Agree. But it bothers me to think of the unspoken part of this. Nurses have their wages suppressed by the public monopoly of health care, so we can only keep them by offering them no other option. Fundamentally unfair to nurses in the system.
Raghu Venugopal MD@raghu_venugopal

Nurses and doctors follow the money. So do you. So does everyone. If you think ER staff in the public system - facing what they face - won't leave in a second for a private clinic, daytime, better paid job - then you're living in a different universe. Ontario's Bill 60.

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Kevin Graham
Kevin Graham@KCGraham6·
@RoxanaDaneshjou Appears there is only financial incentive for insurance company to continue with these policies. If current system is continued you at least want to add a financial disincentive. Claims initially denied later accepted must be paid in full plus penalty fee to compensate time.
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Roxana Daneshjou MD/PhD
Roxana Daneshjou MD/PhD@RoxanaDaneshjou·
Recently I had a prior authorization denied immediately because I should be using medication X instead of Y. The patient is allergic to X, and we had documented that. But now it makes sense… these insurance companies don’t even read what we write: propublica.org/article/cigna-…
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Jelajahi

@OntariosDoctors @CMA_Docs @jossreimer @mkcavy @nationalpost @ONThealth @StMarysGenHosp @grhospitalkw