“Active Shooter in Squirrel Hill.” This was the subject line of an email I received on the morning of the Tree of Life synagogue shooting. It was from my children’s school, which is located less than a mile from the scene of the shooting. “I am working … to put in place a plan for helping our students understand this situation in age-appropriate ways,” the school’s principal went on to …
Don’t wait to take action on gun control
In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective, there are only four countries with a GDP more than the amount spent on health care in the United …
Medicine: noble profession or big business?
Anyone following the debate around gun regulation knows it is a hotly charged issue. On November 7th, doctors got dragged front and center after the NRA issued the statement: “Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.” …
Physicians should never leave the lane of gun violence
We’re very fortunate in anesthesiology. We’re seldom the physicians who have to face families with the terrible news that a patient has died from a gunshot wound.
But all too often we’re right there in the operating room for the frantic attempts to repair the bullet hole in the heart before it stops beating, or the blast wound to the shattered liver before the patient bleeds to death.
Despite all the skills …
Gun control is our lane: Physician opinions on guns matter
In Dr. Suneel Dhand’s article, “We can do a better job with hospital discharge paperwork,” he advocates for physicians to do a better job at creating discharge instructions that are more appealing and easier for patients to understand. After all, coherent patient instructions are a crucial part in ensuring that patients are able to adhere to our recommendations, including taking appropriate medications, following up on subspecialty referrals …
A call for accountability in health care
The United States spends more on health care per capita than any other country in the world — yet health outcomes continue to fall short. In order to close the spending gap with other countries, United States health care policy must focus on reducing costs. While a variety of suggestions have been put forth by economists and medical professionals on how to cut spending and improve health, one Read more…
The many benefits of strengthening the primary care workforce
Several years ago, a group of us concerned about health care costs and outcomes met with some local HR benefit managers. One was the head HR person of a city. In part of the conversation, she raved about a local chain of urgent care centers. She loved the fact that she could go to one after work to get her steroid shot for her colds. I had enough experience dealing …
What administrators don’t understand about urgent care centers
The bloated nature of health insurance in the United States has been a much-discussed topic in recent years. Particularly with the advent of the Affordable Health Care Act as well in response to physicians’ frustrations and increasing burnout from dealing with the constraints imposed on them by insurance companies, and at times being forced to provide suboptimal care for their patients in response to these constraints.
As an example, I had …
It is time for stewardship of our health insurance system
This article is sponsored by Careers by KevinMD.com.
Daily headlines in newspapers and on websites across the nation and around the Internet seem to inspire and anger, and it’s only natural that politics is a topic on everyone’s mind. We’re all concerned about the economy. We’re all eager to see our political leaders solve the problem of unemployment. …
How to deal with politics in the workplace
Everyone thinks of “Medicare for all” as a liberal idea, an extremely liberal one embraced by the socialist wing of the Democratic Party. It’s an idea Democrats were hesitant to embrace in the Obama era, for being too far out of mainstream political thought. It was thought of as an idea that was too easy to demonize as socialism.
What everyone seems to be forgetting is that “Medicare for …
The conservative appeal of Medicare for all
Two years ago, when I was still in residency I happened to be on overnight call the day prior to election day.
An associate program director of my residency program asked me if I wouldn’t mind being a doctor of record who evaluates whether I agree a patient is too sick to go to the polls. They forwarded to me names of patients who expressed interest in voting and were already …
Help hospitalized patients vote by requesting emergency ballots
Early voting began recently in Texas with unprecedented excitement, as a record 15 million registered voters made their way to the polls. Reports say polls are looking more like Black Friday shopping lines than early voting locations. Although we cannot predict the results of the election, one thing is clear: healthcare is the top issue. This is hardly surprising given …
It’s time we start voting at our local hospitals
As pediatricians who care for fragile, premature babies — we know firsthand the road to child health runs through quality health insurance coverage. Our patients require breathing machines, customized intravenous nutrition, expensive, specialized equipment and 24/7 monitoring in the neonatal intensive care unit, often with a dedicated nurse.
The high-tech care our patients require is supremely expensive. And quality health insurance partially supports these costs, which for premature babies, can be …
This is how your vote affects children’s health
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On November 6th voters in Massachusetts are facing a very important health care-related question. In addition to voting for political parties in the midterms, they also face three ballot questions. The first of these is whether there should be mandatory state enforced nurse-to-patient ratios. For a general medical or surgical floor, this will be no more than four patients for every registered nurse. For other types of adult floors and the …
Should there be mandatory state enforced nurse-to-patient ratios?
We do not rely on the benevolence of the butcher, the brewer, or the baker to feed ourselves — Adam Smith observed in the “Wealth of Nations” (1776) — but on their regard for their own interest. The desire to pursue a profitable living also holds true for doctors and nurses, notwithstanding the moral dimensions of their labor.
Health care is a service like any other. We ought to expect price …
Health care is expensive. It’s time to treat the cause.
I am a huge fan of Britain’s National Health Service (NHS), but probably not for the reasons many people might assume. It’s not because it’s “socialist” (a horribly inaccurate description), or that it’s nationalized, or anything like that. I’m a huge fan because somehow the people of Britain have developed the courage to talk about health care using very adult language. In the U.S., we can rarely progress beyond the …
The British are unafraid to talk about rationing. That’s something to admire.
Value remains one of the most widely invoked and variably interpreted concept in American health care delivery. Beyond patients, stakeholder groups across the health care ecosystem are undertaking value-based initiatives, including payers (e.g., value-based insurance design and payments), provider organizations (e.g., value-based care redesign), pharmaceutical companies and pharmacy benefits managers (e.g., value-based pricing and formularies), and private companies (e.g., value-based technology assessment).
This trend highlights a critical point: Discussions about value …
Lessons from the meeting of different value-based concepts
The topic of paying for long-term care is an overlooked issue in health care.
None of us want to think about living our final days in the nursing home, but statistically speaking, many of us will. How will you pay for it? What are the options?
Long-term care in this country can be divided into two general classes based on funding: governmental and private payers. In terms of government programs, Medicaid will …
Elizabeth Warren describes medical bills as “the leading cause of personal bankruptcy” in the United States. She bases that opinion in part on her own research, in which she and her collaborators surveyed people who had experienced personal bankruptcy, asked them whether they’d experienced health-related financial distress, and concluded that 60 percent of all bankruptcies in the U.S. result from illness …
Medical bankruptcies happen less frequently than you think
Like prep sports or prime-time television, medical meetings have seasons.
In the spring and fall, my calendar fills with invitations to speak. I try to get to the venue a few hours before I’m scheduled to speak, so I can “take the pulse” of fellow doctors, asking them about their practices, patients and the future of medicine.
Figuratively speaking, the industry’s pulse is racing with fear. I’ve observed that in just the past …
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