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3 myths about a single-payer system and why it’s doomed to fail

Health Policy

March 27, 2017

It sounds great, almost too good to be true: Coverage for all with lower costs, a broad choice of providers, and minimal paperwork.

The problem is that it won’t work.

For more than half a century, advocates for a government-run, single-payer approach to health care coverage have touted its potential. With debate over the Affordable Care Act heating up by the day, progressives, both at the state and federal levels are now …

Meet the doctor who started a physician advocacy group

Kim Jackson, MD

Physician

March 27, 2017

This week is Physicians Week, and this is one in a series of interviews with members of the physician community that are bringing a variety of ideas and networks together in order to improve the relationships between physicians and between physicians and their patients.

Dr. Kim Jackson founded a large network of physicians and future physicians that started as a group on Facebook. As patients lamented increasing costs in health coverage …

My cold hands met their match

Andrea Eisenberg, MD

Physician

March 27, 2017

Despite living in Michigan for over 30 years, my cold hands disclose my Southern California origin. As a physician, these cold hands have touched many lives. For my pregnant patients, they usually sigh with relief as I touch their bellies, the coolness of my hands offering them respite from the inferno growing inside them. They smile when I tell them I can feel their baby squirming and how it is …

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My cold hands met their match

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Watch who you call “paternalistic”: A physician takes exception to the New York Times

Karen S. Sibert, MD

Physician

March 27, 2017

My husband and I, both anesthesiologists, enjoy our Sunday mornings together — coffee, the New York Times, a leisurely breakfast. No rush to arrive in the operating room before many people are even awake.

Today, though, seeing reporter Jan Hoffman’s front-page article in the Times — “Staying Awake for Your Surgery?” — was enough to take the sparkle out of the sugar. Her article on how much better …

Digital tools should not adversely affect the doctor-patient relationship

Joseph Kvedar, MD

Health Technology

March 27, 2017

I did a second stint on a talk radio a few weeks ago which I really enjoyed. The callers represent a genuine, down-to-earth view of the reality of connected health adoption. The first time around, most callers were cautionary, raising concerns about data security and wondering about physician endorsement. This time the theme that spontaneously emerged was one of people telling stories from the heart, about loved ones who have …

The problem with price transparency

Niran S. Al-Agba, MD

Physician

March 26, 2017

Transparency — including price, quality, and effectiveness of medical services– is a vital component to lowering costs and improving outcomes. However, it is imperative transparency go hand-in-hand with financial incentives for patients and consumers; otherwise, the quest will be in vain. The single best way of reducing costs while not worsening health outcomes is to redistribute resources from less cost-effective health services to more cost-effective ones. Americans are extremely uncomfortable …

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The problem with price transparency

How politicians mislead their constituents on health care

Charles Ornstein

Health Policy

March 26, 2017

When Louisiana resident Andrea Mongler wrote to her senator, Bill Cassidy, in support of the Affordable Care Act, she wasn’t surprised to get an email back detailing the law’s faults. Cassidy, a Republican who is also a physician, has been a vocal critic.

“Obamacare” he wrote in January, “does not lower costs or improve quality, but rather it raises taxes and allows a presidentially handpicked ‘Health Landing Pages Choices Commissioner’ to determine …

The one person that sustains this emergency physician

Edwin Leap, MD

Physician

March 26, 2017

When I go to work, I take a lot of things with me. Everyone has their ritual, right? I take my backpack with my computer inside. I take my phone. I take charging cords, the true modern lifeline. I take lunch. I carry a pen, flashlight and pocket knife.

On a more abstract level, I take the wonderful education I received as a medical student and resident, coupled with my years …

Solving the telephone problem in primary care

Fred N. Pelzman, MD

Physician

March 26, 2017

The phones, the phones, the phones.

Every time we look, everywhere we look, getting the phone answered seems to be a problem we just can’t lick, a continual thorn in the side of our practice, something that’s hindering all the other efforts we try to make things better, to get ourselves to the best care environment for our patients, our staff, and our providers.

Without …

How to fix the NHS. And what the United States can learn from it.

Suneel Dhand, MD

Health Policy

March 25, 2017

I grew up in the United Kingdom and have friends and family who rely on the National Health Service. I’ve written previously how I believe that, despite the idea of a completely free at the point of use health care system sounding very noble — and there are certainly many great things about the NHS — it’s not a model that has been copied in any other country.

As someone …

How peer-to-peer review helps hospitals

Peter Pronovost, MD, PhD

Physician

March 25, 2017

The moment that an accreditation team shows up unannounced can spike the pulse of even the most seasoned hospital executive. The next several days will amount to one big exam for the safety and quality of care, as surveyors meet with executives, managers and care teams, and watch first-hand as care is delivered. Make the wrong move or give a wrong answer, have them see rust on a ceiling sprinkler, …

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How peer-to-peer review helps hospitals

How a mathematician developed an algorithm to help treat diabetes

Dimitris Bertsimas, PhD

Conditions and Diseases

March 25, 2017

When people ask me why I, an applied mathematician, study diabetes, I tell them that I am motivated for both scientific and human reasons.

Type 2 diabetes runs in my family. My grandfather died of complications related to the condition. My mother was diagnosed with the disease when I was 10 years old, and my Aunt Zacharoula suffered from it. I myself am pre-diabetic.

As …

Is nonoperative treatment of appendicitis in children safe?

Skeptical Scalpel, MD

Conditions and Diseases

March 25, 2017

After writing my 21st post about appendicitis back in November, I swore I would not write about it again for the foreseeable future.

Well, the future is now because investigators from the United Kingdom and Canada just published a meta-analysis including ten papers and 413 children about the efficacy and safety of nonoperative treatment for appendicitis in children.

They concluded that nonoperative management is effective in 96 percent …

The new generation of physicians will reconcile the patient-provider relationship

Nisarg A. Patel

Medical Education

March 25, 2017

There’s absolutely no good reason why Sally should have been in the hospital. Not a day over 60, she had come to the emergency department for severe gastrointestinal pain and was then moved to a bed on the 10th floor of one of the hospital’s two towers.

I met Sally (not her real name) during my first year …

MKSAP: 81-year-old man after a percutaneous coronary intervention

mksap

Conditions and Diseases

March 25, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

An 81-year-old man is evaluated in the office 3 days following a percutaneous coronary intervention with placement of a bare metal stent in the left anterior descending artery for angina refractory to maximal medical therapy. He indicates that he feels well except for palpitations that were not present before the procedure. Medical history …

Why the American Health Care Act must be stopped. Now.

Bob Doherty

Health Policy

March 24, 2017

When I tweeted this on Monday morning about the House GOP bill to “repeal and replace” the Affordable Care Act, I had no idea that it would result in me appearing on MSNBC’s Last Word with Lawrence O’Donnell or that it and my other tweets would be referenced by NBC News, a New York Times editorial, or for that matter, a retweet from singer-songwriter John Legend!

I mention …

The American Health Care Act isn’t perfect. It’s pragmatic.

Niran S. Al-Agba, MD

Health Policy

March 24, 2017

The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed, “We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients, and they’re equal that we prioritize the commercial insured patients enough so … We can …

Physicians must speak out on heath reform to make a difference for patients

Ardis D. Hoven, MD

Health Policy

March 24, 2017

Uncertainty surrounding health system reform and the future of the Affordable Care Act has left many physicians with questions about how current proposals will affect them and their patients. Stakes could not be greater for patients who may again face the stark, life-or-death choices arising from the possible loss of health insurance. As a longtime member of the American Medical Association’s Board of Trustees and a former president of the …

Help me help you: I’m not a politician. I’m just a doctor.

Michelle Au, MD, MPH

Health Policy

March 24, 2017

At this point, much has been made of the health care bill the Republican administration has put forth to replace the ACA. We’ve heard the details of the bill, we’ve seen the numbers. We know that the U.S. Congressional Budget Office has forecast that 24 million more people will be uninsured by 2026 if House Representatives replace the ACA with the current bill proposed by the Trump administration. We know …

A tribute to the pharmacist

Taison Bell, MD

Physician

March 24, 2017

Dear pharmacist,

You just paged me and, I must admit, I’m not feeling excited to call back. I estimate that I probably get paged, called, texted or stopped in person by you exactly X·102 per day, where “X” is the number of days I’ve been on service. Despite all of the interactions over the years, I have never stopped to really consider our relationship. Here are a few of our most …

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A tribute to the pharmacist

Real physician voices, twice a week

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