David Ashley, MD, MBA

A Note from our President, David W. Ashley MD, MBA

Dear Members:

I’d like to introduce myself. I’m Dr. David Ashley and I’ve been your Chapter President for almost three months now. I live in North Kingstown and work in East Greenwich at University Family Medicine, with Karen Blackmer, MD, Pierre Manzo, MD, and Ellen Hight, MD, all RIAFP members. (full letter)

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The Medicare reform illusion

By Michael O. Leavitt
Washington Post
Friday, August 27, 2010

Despite the report from Medicare’s trustees this month that the hospital insurance trust fund will not be depleted until 2029, 12 years later than was predicted just last year, Medicare is no better off than it was a year ago.

The administration credits Medicare’s seemingly healthier financial outlook to changes made by the new health-care law. In fact, the legislation has weakened the program. Worse, its changes create the perception of progress, making it more difficult to pursue the reforms that would put Medicare on sound financial footing so future generations of seniors will benefit.

The problem begins with double counting. The Congressional Budget Office estimates that the health law will reduce Medicare spending by about $450 billion over 10 years. But all of those savings, plus massive tax increases, are used in the new law to pay for an expansion of Medicaid and a new entitlement program to subsidize insurance premiums for low-income households.

The Medicare cuts can be used to improve the government’s capacity to finance benefits in the future or to pay for another entitlement. But they can’t be used for both — a point the CBO and Medicare’s actuaries made in their cost estimates. On paper, the Medicare trust fund appears to have additional reserves because of government accounting peculiarities. But Congress has already committed those funds elsewhere. (click for full article)

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August 25, 2010

Bucking The Trend: Primary Care Doc Practices Solo.

Conventional wisdom is that the age-old model of a single doctor serving patients out of a small office is rapidly going extinct. Doctors need to evolve or die. That means fancy new computerized medical systems and bigger groups to handle the overhead.

But Cathy Crute wants to get one thing straight from the get-go: She is not a dinosaur.

“No, no. I think patients love a small practice,” she says from her rather Spartan office. “My receptionist can recognize a lot of patients’ voices over the phone. They know who they’re talking to every time. They don’t have to go through a whole chain of command.”

And the patients in the waiting room of her Portland, Maine, office seem to agree with that assessment. (Full Story)