Steven R. Peskin, MD, MBA, FACP

What do these characteristics bring to mind?

  • Flexible appointment scheduling
  • Advanced electronic communication
  • Care coordination
  • Counseling and education
  • Electronic prescribing
  • Electronic health record with patient portal

If you thought Level 3 Medical Home, you were correct. If you thought retainer (concierge) practice, you would also be correct. To me, it seems eminently rational for people who have sufficient discretionary income to choose to use it to obtain more rapid access to a personal physician of her/ his choosing through a retainer (concierge) practice.

Steven R. Peskin, MD, MBA, FACP

The drumbeat of EBM — Evidence Based Medicine — seems less vigorous in the wake of enthusiasm for new models of care — Medical Homes and Accountable Care Organizations — and reimbursement based on performance, outcomes, or episodes of care.

A good definition of EBM from Sackett, et. al:

Steven R. Peskin, MD, MBA, FACP

In my Saturday morning Torah study, we focused on Jacob’s “settling in” with his family. After years of struggle, Jacob becomes complacent, comfortable. We discussed whether Jacob’s complacency — his relative inaction — contributed to the animosity that led Joseph’s brothers to sell him into slavery and to report to their father that his then youngest son had been killed.

Steven R. Peskin, MD, MBA, FACP

Mark Herzlich, Boston College All American linebacker and now New York Giants rookie, believes that positive thinking played an important part in his successful battle "to beat bone cancer" and return to football. World-renowned cyclist and cancer advocate Lance Armstrong credits not only topnotch medical care but also positive thinking in his overcoming testicular cancer. Armstrong stated on CBS Sunday Morning, "You can't deny the fact that a person with a positive and optimistic attitude does a lot better." Like the vast majority of individuals polled on whether or not the positive thinking can influence cancer outcomes, I believed/wanted to believe that positive thinking would be correlated with better survival data. But the weight of evidence does not support the thesis that optimistic attitude trumps the Big C, or even influences oncology outcomes.

Steven R. Peskin, MD, MBA, FACP

Americans’ girth is growing at an alarming rate. Many are too sedentary, too stressed, suffering from insomnia, making bad food choices. The drumbeat of “We need a culture of health versus a sickness culture” is a refrain that we now often hear and that I have espoused. Yet we advance this form of health and wellness promotion in the same way that we attempt to drive, sell, and be authoritative — in an almost combative fashion that is the zeitgeist of 21st century America.

John Marcille
John Marcille

I was just looking at the website of Newtek Business Services (www.thesba.com/), which also goes by the name of The Small Business Authority. It sells financial and administrative services to small businesses. I found more evidence that the public doesn’t have a clue about what’s going on in health care. This is goofy stuff, folks, so I'll have some fun with it.

Steven R. Peskin, MD, MBA, FACP

"You Can't Outrun Your Past"........ The title of a slide in a grand rounds presentation by Dr. David Kountz, senior VP for medical and academic affairs at Jersey Shore Medical Center and professor of medicine, UMDNJ-Robert Wood Johnson Medical School. The subtext is that the impact of being black in our society confers incremental risk across a range of cardiovascular and cardiometabolic conditions irrespective of socioeconomic status. A 1997 journal article by Thomas, et al.

Steven R. Peskin, MD, MBA, FACP

A recent conversation reminded me of the forgotten population in health care — the non-utilizers. I was speaking with a physician leader in Lancaster, Pa., about his program that emulates the good work of Dr. Jeff Brenner and his team in Camden, N.J., that has targeted the 1 percent of patients responsible for 30 percent of the cost. In similar fashion, the program in Lancaster targets 10 percent of the population that account for 50 percent of the cost. Dr.

John Marcille

I was amused and somewhat unsettled when I heard of Kaggle, a company with a novel approach to data analysis. As I understand it, Kaggle is a middleman between companies that have large amounts of data and are looking for certain kinds of analysis and the people or companies that can provide that analysis. But with a twist.

Steven Peskin MDThree times during the past month a friend has asked for advice regarding his/her personal health care or that of a family member out of frustration and concern stemming from not receiving clear communication/information about the health problem(s). This scenario is all too common.

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