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Issue Date: October 2005

Is 5 Minutes per Patient a Sign of the Times?
All physicians are struggling to see enough patients every day to meet the demands of managed care and cover their costs. Some physicians are spending as little as five minutes with each patient. Among the many problems with such a frenetic pace is that physicians can be perceived as brusque, uncaring, or worse still, may miss a significant diagnosis. Also, of course, they may not be able to deliver adequate patient care. For these reasons, physicians are seeking ways to move patients through the office quickly while also improving the quality of care they deliver.

Comorbidities Complicate HF Care
Cardiologists will undoubtedly treat a growing number of elderly patients with heart failure as the U.S. population ages. As a result, cardiologists must be aware of how the most common comorbidities in this population affect heart failure treatment, experts say. “It is important for cardiologists to consider the comorbid conditions of their heart failure patients who are 75 years of age and older,” says Michael W. Rich, MD, a cardiologist and associate professor of medicine in the cardiovascular division of the Washington University School of Medicine in St. Louis. “Comorbidities have a significant impact on the clinical presentation and, in some cases, treatment of cardiovascular diseases in elderly people.”

Are Individual or Group Incentives Best?
Pay for performance (P4P) systems have introduced a fundamental change in the way physicians are rewarded and reimbursed. The advancement of P4P programs and increased interest and investment by the federal Centers for Medicare & Medicaid Services (CMS) in P4P, shows that P4P is not merely a trend, but an evolving system that has the potential to improve health care quality. As greater investment is made in these systems, it is increasingly important to examine the advantages and disadvantages of the way in which incentive payments are distributed to providers and the methods for effectively distributing the payments, particularly whether an incentive is paid to a group or to an individual provider.