tag:blogger.com,1999:blog-3226163574202790522.post4350017061913279992..comments2023-06-22T07:17:08.797-07:00Comments on Salus University - President Mittelman's Blog: Improved Healthcare for 2014 Michael H. Mittelman, OD, MPH, FAAO, FACHEhttp://www.blogger.com/profile/11139400882312570759noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-3226163574202790522.post-13851262177264413092014-05-17T09:13:15.612-07:002014-05-17T09:13:15.612-07:00Great point L! Not too long ago I was in a coffee ...Great point L! Not too long ago I was in a coffee shop and here came a lady with a young daughter who in my opinion was over weight for her age, ironically though, the mother stood there and asked her to order WHATEVER she wanted!! If parents learn to train their children from young age to eat healthy and exercise (play more outdoor games than couch games), I believe we will raise a healthier future generation. The only bigger issue would be trying to give more complex and maybe medical help for the older over weight individuals!Anonymoushttps://www.blogger.com/profile/12171417829787097056noreply@blogger.comtag:blogger.com,1999:blog-3226163574202790522.post-10771301838068225212014-01-19T09:12:30.988-08:002014-01-19T09:12:30.988-08:00I think you're spot on. The training models o...I think you're spot on. The training models of the past for physicians have certainly contributed to today's primary care physician shortage. Compounding this has been the reimbursement rates for primary care services; something that has lagged significantly behind those of the specialty services, thus acting as a type of disincentive or providers to move in the primary care direction. Employing physician extenders such as Physician Assistants and Nurse Practitioners will help to mitigate the shortage of primary care physicians that's projected to extend beyond 2025 but the key to success will be instilling the culture of wellness and prevention to American society. This will take a generation, or more. In the meantime, it's going to be essential to develop healthcare delivery mechanisms provide easy access and incentivize health, prevention and wellness. I believe it's our responsibility as public health professionals working within a major health science professions university to develop models that faciltiate this and more. Thus, the impetus to establish a Patient Centered Medical Home located in the center of an underserved, yet robust section of our city. The Patient Protection and Affordable Care Act focuses on children's vision needs in addition to attempting to capture those 40 milliion uninsured in our country. We need to capitalize on all the potential good this brings and leverage it towards establishing the model that can work.Michael H. Mittelman, OD, MPH, FAAO, FACHEhttps://www.blogger.com/profile/11139400882312570759noreply@blogger.comtag:blogger.com,1999:blog-3226163574202790522.post-20034044804354645822014-01-18T07:08:26.545-08:002014-01-18T07:08:26.545-08:00The primary challenge, in my view, on this topic i...The primary challenge, in my view, on this topic is cultural mentality. Many of those individuals who will be needing long term care for multi-system problems do not have an appreciation for the value of prevention. Further, our health care system does not have an emphasis on prevention. In the 1980's our national health priority was the training of sub-special providers. The result of that emphasis has lead to a provider community that cannot meet the health care needs of our current society-particularly the rapidly growing population of "Boomer Elderly."<br />The Affordable Health Care Act (AHCA), in my view, is an attempt to balance these inequities. We have a test population of 40M people who had no health care coverage-now they can. It is a reflection of the population health emphasis to note that- not ALL of these people are lining up for health care, or even agree with the concept. Only those who currently have health care issues understand the value of the AHCA, and the healthy individuals see it as an infringement on their constitutional rights, and are fighting its implementation. Large health insurance organizations need FULL participation, and healthy, younger people, enrolling in these plans so that they can balance profits. If they do not get people who are healthy participating, they will probably make adjustments by increasing rates or delaying provider reimbursement (this has been dramatically increased since 2011).<br />I agree that the emphasis should be on prevention, and that the current disciplines and programs at Salus are in a unique position to participate and contribute to this evolving process. Skilled care facilities are also a wonderful test bed for interdisciplinary cooperation in patient care. In Delaware we implemented such a model that involved optometry, physicians, OT, PT, nursing and pharmacy-the patient centered model was tested for 9 years. We learned a very important lesson from this demonstration-administration must have a vested interest in its success, and this typically involved legislated (and enforced) mandates.<br />What a WONDERFUL public health question-thank you!WMonacohttps://www.blogger.com/profile/13548562307969144761noreply@blogger.comtag:blogger.com,1999:blog-3226163574202790522.post-75597563320089384752014-01-16T07:03:02.645-08:002014-01-16T07:03:02.645-08:00Sounds like Patient Centered Medical Home (PCMH) m...Sounds like Patient Centered Medical Home (PCMH) model! Good luck with this endeavour! Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3226163574202790522.post-44644298087750447062014-01-15T14:20:30.931-08:002014-01-15T14:20:30.931-08:00Great points! Management of obesity must include ...Great points! Management of obesity must include an interdisciplinary approach to include behavioral health, nutrition and primary health care specialists. Additionally, family members must be brought into the loop so afflicted people have the appropriate support mechanisms at home. Additionally, there are socioeconomic factors that we cannot ignore such as having access to the healthcare and counseling mentioned previously, and the ability to purchase healthy foods in local neighborhoods. As you allude, this is an extremely complex issue the will require a multifaceted approach both from the medical as well as social aspects. Behaviors need to change but along with that we need to ensure people have access to adequate medical and concealing services. Michael H. Mittelman, OD, MPH, FAAO, FACHEhttps://www.blogger.com/profile/11139400882312570759noreply@blogger.comtag:blogger.com,1999:blog-3226163574202790522.post-36505951356847378942014-01-15T07:57:39.777-08:002014-01-15T07:57:39.777-08:00What is being said it's true, but who likes th...What is being said it's true, but who likes the truth?<br />...Getting a fine for bad behavior always helps, nobody likes to pay out-of-pocket! This could be a way...<br />Would people who lack DISCIPLINE & ACTION and loose control over their bodies, like to be ordered (told) what to do? Some of us who have family members in the fat/obese situation, know there is little to do when body takes control over the mind. Perhaps mental counselors/ specialists need to employ conversations, dialogues & patience (not prescribing drugs) in their therapies as a way to pursue change in patients' behavior.<br />Greed may also play a factor: why go for a smaller plate, when bigger & more (for the same price) is better? <br />May be all in our brains, if we can train the mind...Anonymousnoreply@blogger.com