Will medical centers be able to change leadership structure to conform to the PPACA “ObamaCare”?

In full screen

June 30, 2012, by Steven Greer, MD

The Supreme Court ruled that the PPACA “ObamaCare” law was constitutional in most aspects. With the law proceeding forward, provisions within it to change the leadership structure of medical centers will have to be adopted by academic medical centers accustomed for decades to being reimbursed under the fee-for-service hierarchical divisional leadership style.

The Cleveland Clinic (CCF) is one of the few medical centers to organize leadership by “institutes” comprised of different medical and surgical subspecialties with the faculty paid a flat salary. The Accountable Care Organizations (ACO’s) created by the PPACA are an attempt to nudge the American healthcare system more toward the CCF and away from the fee-for-service systems that reward volume over outcome.

To understand the basics of the different leadership structures of medical centers, we interviewed Dr. John Kastor of the University of Maryland. He has published extensively on the topics of leadership in medicine.

Clifford Mitchell, MD: Detecting nuclear fallout from Japan and elsewhere

Interviewed by Steven Greer, MD

Clifford Mitchell, MD of the State of Maryland health department discusses how they measure nuclear fallout, as well as how the federal government has an independent system run by the EPA.

- Which isotopes are the most dangerous?

- How are they detected?

- Are levels significant in US samples?

 

Arif Hussain, MD: Targeted drugs for renal cell cancer

The disease category of renal cancer had few advances in chemotherapy for decades, but within the last five years, more than six drugs have been approved around the world to treat renal call cancer. Most recently, Votrient was approved for GlaxoSmithKline, adding to the list of Sutent, Nexavar, Avastin, Torisel, and more. Some of these drugs are very important to the revenue of the drug and biotech companies (e.g. ONXX, GSK, NVS, PFE, Roche).

To help understand where all of these drugs fit in with the treatment algorithms now, we interviewed Arif Hussain, MD of the University of Maryland, a renal cell cancer expert, to give an overview.