Paula Muto, MD

Apremilast Benefits and Risks in PsA Dr. Akhil Sood discusses abstracts 1466, 2583, 0598 and 2640 discussing the use of apremilast in PsA, presented at #ACR24. https://buff.ly/491Nc4b

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New urgent update from Medicare Codes G0463 and G2211 G0463 Represents hospital outpatient clinic visits for the assessment and management of patients. • Modifiers: • PO: For excepted off-campus provider-based departments. • PN: For non-excepted off-campus provider-based departments. • Usage Examples: • GI Clinic: Follow-up on GERD management. • Orthopedics: Evaluation of knee pain and treatment planning. • Podiatry: Diabetic foot ulcer care with procedures like debridement. • Vascular Surgery: Comprehensive vascular assessment for leg ulcers. Important Notes: G0463 is specific to hospital outpatient settings and does not apply to regular office E/M codes like 99202-99205 or 99211-99215. G2211 Designed for outpatient office visits to reflect visit complexity. No changes in its usage for outpatient settings. Cannot be paired with G0463. G2211 is intended for office visits only, while G0463 is strictly for hospital outpatient visits with the required PO/PN modifiers. #CMSGuidelines #HealthcareUpdates #MedicareBilling #BillingAccuracy #HealthcareProfessionals #RevenueCycleManagement #HealthAdmin #MedicalEducation #OutpatientCare

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Carilion's Neurosurgery Research Eric Marvin, DO, neurosurgeon, is working on research that could reduce side effects and surgical interventions for older adults with chronic subdural hematomas. When older adults experience a head injury—even a relatively minor one—blood can collect between the skull and the surface of the brain, where it can cause symptoms ranging from headache to paralysis or coma. Dr. Marvin’s research could potentially lead to the development of a sustained local drug delivery release system for treating this condition. This new treatment option could help patients avoid additional surgeries after an initial operation. There is also potential to reduce hospital stays and improve patient outcomes. Dr. Marvin in collaboration with third year neurosurgery resident, Kristine Ravina, MD are recipients of our Research Acceleration Program (RAP) award, a grant that funds our employees to start clinical, biomedical or behavioral research projects. Stay tuned here on LinkedIn for more RAP recipient highlights. Learn more about our RAP grant program https://lnkd.in/grsYdh5x

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Thoughts from the Wild Health Summits Burning GP Summit: Should there be a salaried GP model to provide for patients that aren't fit for fee-for-service? Repeatedly throughout the day, there are examples of the current funding models failing complex patients that don't fit into the fee-for-service paradigm. This has been a problem for years, and despite advocacy from lots of different groups, patients with complex health needs continue to be failed by the fee-for-service model. We are in a situation where GPs are subsidizing these patients' care with their own income, and their own families suffer a drop in financial wealth as a direct result of GP altruism. Are we now at the point where we should consider a truly publicly funded, universally accessible, primary care GP-led system? The single employer model could be a soft landing for this idea. In reality small GP clinics are continuing to fail in low socioeconomic areas due to the inability of patients to pay a gap alongside poor Medicare rebates, I'd argue the government should be stepping in to nationalize these clinics when requested by practice owners and GPs. I know there are a lot of younger GPs who would be quite happy to spend part of the week in a salaried role doing altruistic work and spending another part of the week in a different role l/clinic doing private fee-for-service work. Is it time for a discussion about what this looks like? We’ve already seen councils and other funding bodies stepping to rescue small rural clinics. Maybe it’s time for a national approach. Jeremy Knibbs Michelle O'Brien The Royal Australian College of General Practitioners (RACGP) Australian Medical Association

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New numbers published in AJR from a study by Harvey L. Neiman Health Policy Institute illustrate changes in radiology's traditional private-practice model. The number of radiologist-affiliated and radiologist-only practices has dropped, even as the total number of US radiologists has gone up. https://buff.ly/3wX90zD #radiology #radiologists #radiologistjobs

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Friends and family often ask me who the 'best' surgeon is for a specific problem. My advice is always to seek a surgeon who regularly performs the specific procedure you need—someone with experience and expertise in that area. While people often ask about factors like MD vs DO, academic vs private practice, international vs US grad, or for spine surgery whether a neurosurgeon or an orthopedic spine surgeon is the best choice, these details are less crucial to the success of your surgery than you might think. Ultimately, what matters most is that the surgeon has a genuine passion for solving your specific problem and is highly skilled in that area. Focus on finding someone who truly understands your needs and has the experience to deliver the best possible care. #scoliosis,#spinaldeformity

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Dear fellow family medicine doctors: If you want to know how statins really affect your patients you have to learn to read between the lines. I just had to take a test on a statin research paper to keep my board certification. The paper is called “Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease” [link below] and it’s a great example of the kind of unethical data presentation I see all too often. The study compares the effects of two levels of statin drug dosages. One called “high intensity” meaning patients got maximum doses of their statin (20 of Crestor or 40 of lovastatin), and one called “treat to target” meaning people were given the amount of statin required to get their LDL between 50 and 70 mg/dl. People in the treat-to-target group generally took lower doses of statins and their LDL levels were a little higher. People in the high-intensity group generally took higher doses and had slightly lower LDL levels. What did that slight difference in LDL do to their health? The people with lower LDL levels (in the “high intensity” statin group) did worse. They died significantly more often than the people with higher LDL levels in the less aggressive treatment group. This difference had a p-value of <0.001 meaning it was statistically significant. This suggests having a lower LDL is WORSE than having a higher LDL. It also suggests more drug equals more death. So how do they report this finding that goes counter to everything we hear about how dangerous cholesterol is and how safe statin drugs are? The study authors don’t tell you what I just told you. They don’t want you to know the truth. So they use doublespeak. They say the “treating to target strategy is “noninferior” to treating with “high intensity” statin doses.” They spin a negative into a neutral. That’s fraud. But unless you have your cynical hat on, you will be fooled. This is just one example of how doctors get fooled. I’ve covered others in previous posts, most notably here: However, a much bigger fraud centers on the very notion that saturated fat is bad for us. I just spent 4 years writing a book called Dark Calories, which I hope will open eyes to how a medical organization pulled off the deadliest deception ever perpetrated on humanity. JAMA article here: https://lnkd.in/eE7Wz7mP To learn about Dark Calories visit https://lnkd.in/eRnWG-q7 #cholesterol #preventativemedicine #familymedicine #hearthealth #statins Ken Berry, MD Jeffry Gerber, MD, FAAFP The Florida Academy of Family Physicians (FAFP) Laurence Bauer Joseph Scherger

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Very important points about hospital consolidation. ⏺ Has led to the majority of physicians now being employed by a system. ⏺ A hospital system may have different priorities than physicians (in private practice). ⏺A system in which physicians have very little leverage to negotiate or change factors important to patients and clinical care. The real reason highlighted around 2 minutes 50 seconds. Short interview with beneficial insight. ⏺Physicians have joined unions not for wage negotiation but to focus on changes that affect clinical care. We as physicians do not have a unified voice. We have not organized ourselves well to create a unified voice. I am not sure that a union is the right path, but uniting to have a common voice, leverage, and negotiation power is needed. At 9 minutes Kevin Schulman highlights how this could be done without creation of a union (we need a system clinical strategy, not a market strategy) based on thoughts by @atul gawande. #UsingWhatWeHaveBetter https://lnkd.in/g5YTjFbD

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The track record of innovative telehealth programs requiring major changes is poor due to lack of adoption and sustainability. Long term sustainability and spread can be attained by evaluating the 7 areas identified below. Lets continue the conversation in the comments section

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Rural health. Is the one we’re we need to see improvement not in care, but in operational efficiency. So nice to see implementation of AI methodologies. I have been a bit of a sceptic, AI tool tries to save physican and care provider time, but than they are over burdened with administrative tasks. So glad to see AI Grand Rounds giving a realistic picture of what is happening by in the field and not just hype. If we want real victories, we need to tackle at multiple levels, AI is absolutely a yes these days, but organizations should adapt and want to make provider lives better. AI Grand Rounds Dallas AI #RuralHealth #healthequity

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For hospitals to function successfully, 'Physician run' model needs to be revisited. For example, an army may have MBA's perform some administrative/non-martial tasks, but wouldn't countenance those 'civilians' lead the war or decide strategy. Vatican may hire a bunch of bankers to help manage their wealth, but those bankers don't become bishops or pope (except for the Medicis!). Nor, decide how to do religion. Imagine if they did! Congregation would be 'customers/clients'; there would be various kinds of confessions and priests would have a set time in which to complete and concurrently enter them into electronic records. The afterlife would depend upon what premium one paid, though results not guaranteed :) I attempted to make this same point in an article for kevinmd.com.https://https://lnkd.in/guHzFq7X Somehow, we need to take our profession back.

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Beyond Binary Choices: Embrace the Professional Micro-Corporation in Healthcare Physicians face a binary choice between hospital employment and private practice. However, the rise of single-member professional micro-corporations offers a third path. This model provides autonomy, flexibility, and minimal overhead, enabling virtual healthcare services and location independence. Explore diverse job opportunities, including telemedicine, consulting, and direct care models, to optimize your career and personal life. #HealthcareEntrepreneurship #PhysicianCareers #MedicalPractice #MicroCorporation #Telemedicine #WorkLifeBalance

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Q: Do you know who is successful in treating Hepatitis C? A: Egypt and our VA system! "The initiative, which was included in President Biden’s latest budget proposal, calls for about $5 billion to establish a five-year “subscription” contract. The federal government would pay a flat fee and, in return, receive drugs for every patient it enrolled for treatment." Colleen Grogan from the University of Chicago contends that public dollars pay for more than 60% of U.S. national health care expenditures (Grow and Hide, September 2023). 18% of GDP is spent on U.S. health care compared to 10% in peer nations — We are not receiving value in U.S. health care. What is the opportunity cost to our society by delivering care in this manner? Colleen Grogan #health #healthcare #managedcare #affordablecareact #healthpolicy #healthcarereform #medicareforall

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This is a great article focusing on the distinction of machine learning ON healthcare data from machine learning FOR healthcare. It is well worth the read.

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Great meeting today and more work planned over the coming weeks to bring some interesting research insights as to what makes PNS effective and how we can design future systems that are consistently effective for our patients in order to drive greater payor coverage and improve patient access. Looking forward to crafting a really interesting presentation for this interactive presentation at NANS and cuing up Dr. Evan Peskin to share data on functional outcomes with PNS #innovation #PNS #neuromodulation #research #patientoutcomes #understandhowitworks #NANS

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How our team at Research'Kraft is helping a #US-based Gastroenterology research group with their #probiotic product #development for #dental use. 1] We conducted extensive #literaturereviews to identify research gaps and existing knowledge. Some of the questions answered include: **How are different oral bacteria linked to conditions like cavities and periodontitis? **What are effective probiotic strains for oral health? **How can we measure a probiotic's effectiveness? **Which strains are most effective against cariogenic bacteria? **Do combined strains have a greater effect than individual strains? **Can other materials boost probiotic effectiveness? 2] We provided valuable insights from our #patient experiences and personal experience as a #periodontist.  3] Also connected our client with a few #laboratory in #India as they requested. 4] We are currently working on a compelling #grant proposal to secure #funding for their product. 5] We will also be providing support with #publication writing. Ready to leverage our expertise for your next project? Let's connect! ----------------------------------------------------------------------------- Hi, I am Betsy. A research consultant and dental specialist. We at Research'Kraft Consulting can help you with your projects related to research, consultation, scientific writing, publication writing, literature review, editing, and data analysis. Feel free to connect through DM or email to [email protected] or visit our website www.researchkraft.in #dentistry #oralhealth #publichealth #research #science #consultation #scientificwriting #communication #business #linkedin #clinicalresearch #medicalwriting #journal #dataanalysis

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It’s Sepsis Awareness Month! Are you looking for peer inspiration to get started on improving Sepsis practices? Check out our 2023 Sepsis Honor Roll hospital journey posterboards, compiled in this Excellence in Practice Hospital Journey virtual booklet. https://hubs.ly/Q02MWxGn0 #SepsisAwarenessMonth

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Had a fascinating one hour interview with Omar M. Khateeb on his show State of MedTech today. We discussed a wide range of topics focusing on how clinical and entrepreneurial efforts can be combined to solve health challenges Topics ranged from: Intelligent Implants, Ltd. and how connected implants will help people. Use of AI in Neurosurgery and Spine Surgery Surgeons roles as founders, investors and advisors to Medtech companies. NeuroBell Protecting the team in the OR Texray and my favorite topic how we are helping people after a spinal cord injury The Miami Project to Cure Paralysis Neuralink Highridge Medical Medtronic Globus Medical Spineart Orthofix #medtech #medicaldevices #medicine #digitalhealth #medicalsales #bci #neurosurgery #braincomputerinterface #spinalcordinjury

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