Medscape Medical News

Updated Influenza Vaccine Recommendations Issued

August 18, 2011 — Updated guidance for influenza vaccination in the United States for the upcoming 2011-2012 influenza season has been released by federal health officials with the Centers for Disease Control and Prevention (CDC).

“There are relatively few changes from 2010-2011 recommendations,” Carolyn Bridges, MD, associate director for adult immunization, Immunization Services Division, National Center for Immunization and Respiratory Disease, said during a telebriefing today.

As a result, the 2011-2012 recommendations from the Advisory Committee on Immunization Practices have been issued in a shortened format, Dr. Bridges noted.

The report was published online August 18 in the Morbidity and Mortality Weekly Report.

The 2010 recommendation for routine annual influenza vaccination for all persons aged 6 months or older in the United States has not changed.

“We continue to recommend that people age 6 months and older be vaccinated,” Dr. Bridges emphasized.

To allow time for production of protective antibody levels, “vaccination should optimally occur before onset of influenza activity in the community, and providers should offer vaccination as soon as vaccine is available,” the report reads. “Vaccination also should continue to be offered throughout the influenza season.” Continue reading →

Quality of care need time spend with patients, only works well in the pay for value not pay for volumn healthcare deliverry system.

Article From Medscape Business of Medicine

Rebuttal: Concierge Practice Is a Doctor’s Right

Leslie Kane, MA; Bernard Kaminetsky, MD

Editor’s Note:

Medscape’s recent video commentary by ethicist Arthur Caplan, PhD, “Concierge Practice: Unjust for Patients and Doctors Alike,” provoked a flood of heated responses. To present the contrasting point of view, Medscape interviewed Bernard Kaminetsky, MD, board certified in internal medicine and nephrology.

Dr. Kaminetsky is the Medical Director of MDVIP, a company with a national network of primary care physicians who provide personalized care, focusing on wellness and prevention, and use a concierge-type model. Dr. Kaminetsky was a founding partner in a primary care practice based in Boca Raton, Florida. In 2001, he transitioned his practice to the MDVIP model. He recently left his primary care practice to serve as the national representative for MDVIP. Dr. Kaminetsky has testified before the Joint Economic Committee of the US Congress on the importance of wellness and prevention. He is a graduate of Albert Einstein College of Medicine and a former assistant professor at New York University School of Medicine.

Medscape: In a concierge medical practice, doctors generally charge an annual access fee, have a smaller number of patients, and spend more time with each patient. Some have said that this is unjust or unfair, particularly given the shortage of primary care doctors. How would you respond to that?

Dr. Kaminetsky: Let’s look at it from the patient’s perspective: Is it fair for patients to have an experience — as is common in conventional practice — where visits are very short and doctors are essentially reactive to acute problems because they have very little time for prevention and wellness? And the doctor knowingly is neglecting his or her ability to spend the time necessary with the patient to actually prevent the heart disease or diabetes from forming because there simply isn’t time. Is that fair to patients? Continue reading →