Physicians

The future of primary care can look downright frightening.

Georgia and the rest of the nation already have a general shortage of obstetricians, internists, pediatricians and family medicine doctors, especially in rural and urban areas. And things are getting worse. The Health Resources and Services Administration forecasts a shortage of 65,000 primary care physicians in the U.S. in 2020.

Meanwhile, most physicians coming out of medical school are gravitating toward specialty medicine instead of front-line care.

If the Affordable Care Act is upheld by the Supreme Court, the law will enable 30 million uninsured Americans to gain coverage. A common prediction is that many of those newly insured people will immediately seek the physician services they have long needed, swamping primary care practices.

Currently, on the other hand, many uninsured patients put off seeking care until ‘‘the pain is unbearable,’’ said Dr. David Satcher, director of the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta.

Satcher, a former U.S. surgeon general and CDC director, joined a panel that addressed the future of primary care last week in Atlanta at the Association of Health Care Journalists conference.

The experts’ presentations suggested there may be no single answer to the nation’s primary care problem, but rather a number of partial remedies that, taken together, may fill in some of these vexing gaps in our health care system. full story

As Kaiser Health News journalist Phil Galewitz studied data on the nation’s community health centers, the statistics compelled him to visit Georgia.

The overall national picture, published Wednesday in a KHN and USA Today story, is that hundreds of the nation’s nearly 1,200 federally funded community health centers fall short on major quality-of-care measures, according to the federal data analyzed by the news organizations.

The centers’ performance most often lagged behind national averages on helping diabetics keep their blood sugar under control and on screening women for cervical cancer, the article said.

But the statistics also showed that Georgia was the only state to rank near the bottom on four of the six quality measures reported by community health centers. The four measures are:

· Percentage of children who receive all seven federally recommended vaccines by age 2.

· Percentage of adults, ages 18 to 85, with hypertension who have their blood pressure under control.

· Percentage of low-birthweight babies.

· Percentage of women, ages 24 to 64, with at least one Pap test in the prior three years.

“It was a barometer that something was going on in Georgia,’’ Galewitz said Thursday in Atlanta, where he’s attending the Association of Health Care Journalists conference. full story

Georgia emergency physicians say a shortage of drugs to treat critically ill and injured people poses a ‘‘real danger to our patients today, without relief in sight.’’

The Georgia EMS Medical Directors Advisory Council, in a letter Tuesday to the state commissioner of Public Health, said EMS physicians are adjusting protocols because of the shortages, including restricting the use of scarce drugs ‘‘to only the most severely ill and injured.’’

The physicians said there has been reported use of expired medication when up-to-date medication was not available. “The risk of using properly stored expired medication is preferable to helplessly witnessing the death of an adult or a child,’’ said the letter written by Dr. Robert Cox, chairman of the council, to Dr. Brenda Fitzgerald, commissioner of Public Health. A copy of the letter was obtained by Georgia Health News.

The EMS physicians asked that consideration be given to using properly stored expired medications and allowing access to lifesaving drugs in the Strategic National Stockpile.

A spokesman for Public Health said Tuesday that the agency is aware of the shortages and is taking steps to deal with them.

The Georgia situation is part of a nationwide gap in availability of EMS medications. full story

The federal government announced Tuesday that 27 health collaboratives –- including two in Georgia — have been picked to participate in a new Medicare program that provides financial incentives for doctors and hospitals to form an “accountable care organization.”

The program is called the Shared Savings Program. If the organizations improve patient care and contain costs, they can share in the savings, getting paid more for keeping their patients healthy and out of the hospital.

Accountable care organizations, or ACOs, are a central feature of the federal health reform law of 2010, also known as the Affordable Care Act. Medical providers will be rewarded based on the quality of care they provide, not the volume of services they deliver, as under the traditional fee-for-service model.

The U.S. Supreme Court is considering a challenge to the health care law and is expected to rule in June whether the law and the programs it has created remain in effect.

A Kaiser Health News article points out that the announcement on ACOs was the government’s first major health law action since the court held arguments on the law two weeks ago.

The 27 new ACOs will serve an estimated 375,000 beneficiaries in 18 states. The Georgia collaborations are in Athens and Savannah. full story

Legendary Georgia pediatrician Dr. Leila Denmark died Sunday in Athens at age 114.

Denmark lived with her daughter, Mary Hutcherson, who told GHN last year that Denmark “has a lot of fans who keep up with her.’’

The pediatrician, who practiced until she was 103, was known far beyond Georgia’s borders long before her age became a newsworthy item. She was known for her energy, her advice to parents and her work in developing an important vaccine.

She was born Leila Daughtry in the tiny Bulloch County town of Portal in 1898. Thirty years later, she graduated from medical school at the Medical College of Georgia, married John Denmark and began practicing medicine in Atlanta.

Denmark became the first physician on staff at Henrietta Egleston Hospital, a children’s hospital on the Emory University campus.

She began volunteering at a free clinic operated at the Central Presbyterian Church across the street from the state Capitol. At the clinic in the 1930s, she helped develop a vaccine for whooping cough, a potentially deadly ailment.

Denmark eventually moved her practice from the Virginia-Highland area to Sandy Springs and then to the greater Alpharetta area in Forsyth County.

“I don’t make appointments,’’ she explained to the Atlanta Business Chronicle in 1998. “You never know when a child’s going to get sick.” full story