Policy

Solving the low-acuity emergency department problem

Dillon Mercado

Policy

February 9, 2022

Before I worked as a medical scribe, I didn’t realize how many mildly ill people visited the emergency department (ED). In my first few weeks, though, I learned that patients with minor complaints, such as sprains, cavities, rashes, and common cold symptoms, actually present to the ED quite often – often enough that the hospital where I worked had to dedicate an entire 12-bed wing to them. In most EDs, …

How strong policies can improve guardianship

Alyson O’Daniel, PhD

Policy

February 9, 2022

Millions of Americans each week watch as fictional television matriarch Rebecca Pearson, in the NBC-TV series, “This Is Us,” struggles with frustrations of early-onset Alzheimer’s disease and fear of an unknown health future. In the coming decades, millions more will experience this in real life.

Guardianship — or the care and legal control over another person’s life —may become one of the biggest issues of the next three …

Why and how to get a second opinion [PODCAST]

The Podcast by KevinMD

Policy

February 6, 2022

“In the end, the patient-physician relationship is crucial to overall decision-making for any plan of care, treatment, or surgery. There are many variations in the reviewed studies in health care literature as to the cost-effectiveness of second opinions in medicine. These studies could be easily misconstrued that there are …

Why the health care industry must prioritize health equity

George T. Mathew, MD, MBA

Policy

January 31, 2022

There are few silver linings related to the COVID-19 pandemic, but one that stands out is the growing recognition that health equity must be an essential guiding principle for health care organizations going forward.

The broader health care system suffered greatly due to the coronavirus outbreak that has infected tens of millions and killed hundreds of thousands nationwide, but vulnerable patient populations and marginalized communities were far more susceptible to long-term …

Is EMTALA really protecting patients during COVID?

Trent Dietsche

Policy

January 28, 2022

I am a physician at a critical access hospital. I manage both the ER and inpatient service and am the only physician in the hospital. This is the reality for many rural hospitals across the country. With no urgent care in town, and with primary care offices few and far between, these hospitals see everything.

We see patients with ailments from a minor finger laceration to those with septic shock from …

The social imperative of health

Steven Merahn, MD

Policy

January 25, 2022

As a nation, we have committed to a social imperative for education — an aspirational vision, based on its broad social benefit, for universal literacy and numeracy of our citizens — as manifested in our systems of mandatory K-12 education.

While this vision remains a work-in-progress — there are significant inequities and differences of opinion as to the process and content of education — the shared value of, and responsibility for, …

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The social imperative of health

Why travel bans in response to Omicron are harmful

Michelle Verghese

Policy

January 23, 2022

In late November, the state of the COVID-19 pandemic shifted once more when South African scientists reported the discovery of a new SARS-CoV-2 variant named Omicron. When panic surrounding Omicron’s emergence set in, numerous countries instituted travel bans on South Africa and neighboring nations.

As a medical student, I have begun to examine COVID-19 epidemiology and policy decisions more closely. Given that Omicron is already circulating globally and …

The real value of high-value care

Julia Canick and Walter Lee, MD, MHS

Policy

January 18, 2022

When newly admitted medical students enroll in their respective programs, they participate in the cherished White Coat Ceremony, in which they eagerly vow to stop at nothing to help patients—to go above and beyond to provide the highest quality care to any and every individual who needs it. Though this aspiration is not overtly naïve, it is, perhaps, exceedingly optimistic. As training progresses, many students come to realize that the …

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The real value of high-value care

This physician is running for U.S. Senate. Here is his health plan outline.

Kevin M. Baumlin, MD

Policy

January 17, 2022

Martin Luther King once said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Sadly, this remains true today. Instead of simply providing the care one needs, access to care varies based on wealth, status, and the type of insurance product a person has.

I have been working as an emergency physician, health services researcher, and leader in health care for over 30 years. …

Legal challenge from Disability Rights Texas may have repercussions in schools across the country

Eva Kittay, PhD

Policy

January 16, 2022

Parents of disabled children together with Disability Rights Texas won a ruling in November that could have ramifications well beyond the state of Texas. In July, Texas Governor Abbot issued an executive order, GA-38, that prohibited schools from instituting a mask mandate. He insisted that whether a child should be compelled to wear a mask should be up to a child’s parents.

Judge Lee Yeakel declared that the Governor’s order Read more…

Legal challenge from Disability Rights Texas may have repercussions in schools across the country

A new boon for Big Data and patient care

Michael R. McGuire

Policy

January 13, 2022

Big Data in medicine is the data analysis of large amounts of patient medical information to improve medical care. Analysis of data may be used to pick the best intervention for a patient based upon care outcomes of similar patients or to evaluate physicians.

The primary source of patient medical information is patient medical records, where a medical record reports what happens during an encounter, where an encounter …

Skin-in-the-game doesn’t have to be scary

Ronald Dixon, MD

Finance

January 6, 2022

When I entered the field of medicine, the goal was clear; to make patients “better.” Through my hospital-based training and practice as an internal medicine physician, I developed a strong interest in illness prevention — how can we keep patients from coming here in the first place? The answer became crystal clear. What wasn’t clear was how to focus on preventative care in the current structure of the U.S. health …

6 major disadvantages of insurance involvement in primary care

Troy A. Burns, MD

Policy

January 5, 2022

An excerpt from Medical Answers Now!: How Direct Primary Care Guarantees Fast Access to Your Doctor.

Virtually everyone understands the importance of major medical insurance as it relates to unexpected high-dollar care for severe injuries and significant medical conditions, but the value equation for health insurance is quite different when applied to coverage for primary care services.

The full potential cost for …

It is time to make the unvaccinated pay their fair share

Hayward Zwerling, MD

Policy

January 4, 2022

Massachusetts is again experiencing a COVID-19 surge and our hospitals are overwhelmed, mostly with unvaccinated patients.

As a practicing physician who takes care of many high-risk diabetic patients, I ask all my patients about their COVID-19 vaccination status. I explain to my unvaccinated patients that the benefits of vaccination far exceed the risk, both at the individual and societal levels.

Unfortunately, this conversation only convinces a minority of the unvaccinated to get …

CPT coding changes: 5 proven methods of how to do more with less

James Maskell

Policy

December 31, 2021

It’s well known that coding changes drive provider behavior, and billing behavior drives provider decisions.

For the last 30 years, little has changed in health insurance billing, which is why the standard of care within the payer system has remained, well, standard.

Then the pandemic hit, and suddenly everything was turned on its head. Patient demands increased sharply, office visits became impossible or prohibited across most of the country, and with telemedicine, …

Health care guest workers could make “home, sweet home” a reality for America’s seniors

Brian Bartoz

Policy

December 31, 2021

“If you want to be happy in a million ways, for the holidays, you can’t beat home, sweet home.” The late Perry Como’s observations reflect a bittersweet truth about an unattainable goal — not just during the holiday season, but each day of the year — for the 1.4 million Americans age 65 and over who reside in long-term care facilities. Older Americans who might prefer to age in place …

The U.S. doesn’t have enough faculty to train the next generation of nurses

Rayna M. Letourneau, PhD, RN

Policy

December 29, 2021

Despite a national nursing shortage in the United States, over 80,000 qualified applications were not accepted at U.S. nursing schools in 2020, according to the American Association of Colleges of Nursing.

This was due primarily to a shortage of nursing professors and a limited number of clinical placements where nursing students get practical job training. Additional constraints include a …

Why health care delivery is an exceptionally different industry: Why does it matter?

Joe Mandato and Ryan Van Wert, MD

Policy

December 27, 2021

Third in a series. Please read part 1 and part 2.

We expect that most readers have noticed the differences in health care delivery compared to other industries that we discussed in part 1 and part 2. Those differences relate to board governance, health care leadership, infrastructure, and operations. Readers probably also noticed that these differences …

High deductible health insurance is bankrupting Americans

Ben Aiken, MD

Policy

December 24, 2021

Two decades ago, high deductible health plans barely existed. Today, more than half of the U.S. workforce is on one, which are plans with deductibles greater than $1300 per individual or $2,600 for a family.

It’s a growing, undiscussed problem for public health. Most doctors have had patients refuse treatment due to out-of-pocket costs caused by their high deductible health plan. All the while medical debt continues to …

The goal of health care is in peril

Vincent Roddy, MD

Policy

December 23, 2021

Introduction and background

As an emergency department medical director and physician, a busy emergency department can be a thing of beauty to me. We work hard to set up systems that will provide the care our patients need. Despite our best efforts, almost daily, variables occur that throw the system into chaos and lead to inefficiency. The COVID-19 pandemic unveiled and exacerbated many challenges that affect our ability to provide the …

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The goal of health care is in peril

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