Kevin Graham

Family Medicine. Palliative Care

[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

[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.

[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.

[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.

[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.

[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.

[Julia Malott @AlottaMalotta]

My latest in @nationalpost, reflecting on the failures of @ONThealth my family experienced during my daughter's need for critical care.

https://t.co/XBRgGSVOoS

@StMarysGenHosp @grhospitalkw @SylviaJonesMPP

[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.

[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??

[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.

[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.

[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.

[Kevin Graham @KCGraham6]

@DrKathleenRoss1 @CMA_Docs @AlikaMD @DoctorsOfBC @OntariosDoctors @CFPC_e This literally could become policy overnight and would have immediate and significant impact on freeing up time in primary care.

[Kevin Graham @KCGraham6]

@DrKathleenRoss1 @CMA_Docs @AlikaMD @DoctorsOfBC @OntariosDoctors @CFPC_e Is it really that complex? There are many components of administrative burden that are easily solvable. A few simple rule changes would free up so much time in primary care.

[Kevin Graham @KCGraham6]

@DrKathleenRoss1 @CMA_Docs @AlikaMD @DoctorsOfBC @OntariosDoctors @CFPC_e 1) No further sick notes for illness less than 3 days
2) No further notes for purpose of obtaining an insurance benefit (massage, physio, orthotics etc)
3) All insurance company forms and reports must be paid for directly by the insurance company. No exceptions.

[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?

[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.

[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.

[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.