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The unintended beneficial consequences of Obamacare

Health Policy

November 17, 2013

From the point of view of the rational humble classical liberal, Obamacare sucks.

We rebel against the further intrusion of a narcissistic national government into our lives, as any sane person would who recognizes the value of liberty and the repeatedly proven harm of collectivism.

Given that the national government constantly takes away liberty, and given that even the Constitution has been unable to defend our liberty against the onslaught of the …

A little known rule in the ACA could pose financial risk to doctors

Michael L. Smith, JD and George F. Indest III, JD

Health Policy

November 17, 2013

A little known rule published by CMS to implement the Affordable Care Act (ACA) could pose a significant financial risk for doctors, hospitals and other healthcare providers. The rule requires health plans participating in the exchanges to provide individuals purchasing insurance through the exchanges a grace period before terminating the coverage for non payment of the premiums. Doctors and other healthcare providers will continue to provide care during the grace …

3 tips to overcome embarrassment in the doctor-patient relationship

Koushik Shaw, MD

Patient

November 17, 2013

There’s an elephant in the room, one that’s preventing patients from getting the most out of their visits to the doctor — and the name of that elephant is embarrassment.

It’s not unusual to feel uncomfortable about some of the more intimate aspects of your health, but too often this discomfort turns into outright embarrassment. This embarrassment can lead to omissions, which in turn make it impossible for your doctor to …

Can doctors help patients live fully after a medical diagnosis?

Christina Rasmussen

Patient

November 17, 2013

An excerpt from Second Firsts: Live, Laugh, and Love Again.

I spent nearly 4 years in the waiting areas and patient rooms of cancer hospitals. I was not the one with cancer but my husband was. He was diagnosed with stage IV colon cancer.

He was only 31 years old.

I remember …

Second thoughts about how to die

Gregg B. Jackson, PhD

Patient

November 17, 2013

While recently confronted with a cancer scare and several months of inconclusive diagnostics, I found myself thinking about how I want to die.

Following some reading, my first answer was to die at home, with control over my care, and without substantial pain, views that are widely shared by others. But the more I thought about this, the less satisfactory the answer seemed.

For instance, being at home was never of high …

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Second thoughts about how to die

How young eyes are devastated by diabetes

Erin K. Walsh, MD

Conditions and Diseases

November 16, 2013

Children who live with diabetes, like all children with chronic diseases, learn to grow up rather quickly. In order to survive, they must learn how to manage a disease with which most adults struggle. In particular, not only must children completely change their diet, but they also have to deal with checking blood sugars daily, time and dose insulin shots, all while trying to fit into a world where they …

We are sheltered from global health diseases

Lucy Zhu

Conditions and Diseases

November 16, 2013

“I don’t even know what I have.”

Those were some of the first words that came out of the mouth of a 25-year-old Caucasian female at the county hospital. Amy, as I will hereby recall, presented with fever, malaise, chills, and sweats, supposedly from an unknown cause. She had recently come back from a trip to Africa with her boyfriend. Quite the exotic romantic getaway, but the only problem was that …

Do you believe sick and disabled people deserve care?

Duncan Cross

Health Policy

November 16, 2013

The roll out of Healthcare.gov has given plenty of ammunition to opponents of health care reform, who style themselves as crusaders against incompetence. While many who oppose the program do so in good faith, some critics carry an ugly prejudice against sick and disabled people.

That prejudice is “just deserts” — the idea that people get what they deserve. Rich people deserve their luxury. Poor people deserve their poverty. Sick and …

The emotional health literacy block

Diana Dilger

Patient

November 16, 2013

Imagine your spouse, parent, or best friend gets a left ventricular assist device (LVAD). This is a mechanical device put into their chest. A wire sticks out of their body and connects to a bunch of different electronic pieces you’ve never seen before. You’re in charge of making sure this wire stays clean. If it doesn’t, it could mean infection and possible death. So, you know. It’s kind of a big responsibility.

Of …

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The emotional health literacy block

Boxer at Rest: A physician’s interpretation

Jeffrey M. Levine, MD

Physician

November 16, 2013

Recently, an ancient sculptural masterpiece has been on temporary display in the Metropolitan Museum of Art’s Greek and Roman halls. On loan from Rome’s Museo Nazionale Romano, “Boxer at Rest” depicts a battered pugilist immediately after a fight. His face bears evidence of broken nasal bones, swelling and hematoma under his right eye, and multiple lacerations and abrasions to his nose, cheeks, and forehead. One secret …

MKSAP: 61-year-old woman with hot flushes

mksap

Conditions and Diseases

November 16, 2013

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

A 61-year-old woman is evaluated for hot flushes, which have been persistent for the last 10 years. They occur at least 7 times per day, last for approximately 60 seconds, and are associated with severe sweating, palpitations, and occasional nausea. She is awakened several times per night. She has tried herbal medications, …

Michael Palmer: A doctor first, in the truest sense of the word

Miranda Fielding, MD

Physician

November 15, 2013

I was saddened earlier this week to read, first on Facebook as posted by his son Daniel, that Michael Palmer had passed away after suffering a heart attack and then a stroke, while going through customs in New York on the way back from a trip to Africa. Many of you know Dr. Palmer as the bestselling author who wrote medical mystery thrillers like “The Sisterhood” in …

Gun imagery in PG-13 movies is targeting our teens

Wendy Sue Swanson, MD

Conditions and Diseases

November 15, 2013

PG-13 movies now have more gun violence than R-rated ones.

I was in fourth grade when Red Dawn debuted as the first PG-13 rated movie back in 1985. At the time Red Dawn was released, it was considered one of the most violent films by The National Coalition on Television Violence, with a rate of 134 acts of violence per hour, or 2.23 per minute. And although not every PG-13 movie has had …

Asthma in children: A complete primer

Christopher Johnson, MD

Conditions and Diseases

November 15, 2013

Asthma is a common problem in children — nearly 10% now have it — and the number is increasing. Researchers are not sure of the reasons for this steady increase, but decreased air quality, lower activity levels among children, and an increase childhood obesity have all been implicated. Whatever the cause, it means that millions of American children take medicine for asthma. A significant number of these children end up in …

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Asthma in children: A complete primer

How can we judge the ideal health system of the future?

Suneel Dhand, MD

Health Policy

November 15, 2013

Over the last couple of years, we have been witnessing the start of a seismic shift in healthcare philosophy. For far too long, the system has been totally focused on rewarding quantity: The more patients seen, tests performed, procedures completed — the higher the incentives.

Now, instead of rewarding healthcare providers for quantity in the “fee-for-service” model, we are moving towards a system that rightly focuses on the quality of care …

Our veterans drive the transformation of healthcare

Tracy Gaudet, MD

Health Policy

November 15, 2013

I was hired in 2011 by the Veterans Health Administration (VHA) to direct the Office of Patient Centered Care and Cultural Transformation and charged with ensuring that the VA transforms from physician-centered care to personalized, patient-centered care that is based on relationships, built on trust, and committed to positive results over the veteran’s lifetime.

This undertaking represents one of the most massive changes in the philosophy and process for healthcare delivery …

Can technology be a change agent for health care?

Jay Parkinson, MD

Health Technology

November 15, 2013

I was invited to attend a private breakfast with book author, surgeon, and New Yorker contributor Dr. Atul Gawande shortly before Dr. Gawande’s talk at The New Yorker Festival. Over breakfast, Dr. Gawande spoke with IBM executive Dr. Paul Grundy on the future of health care. The event was sponsored by IBM so there was plenty of talk about how technology can and will influence the practice of medicine — …

Doctors need to remember that they need to be human first

David L. Katz, MD

Medical Education

November 14, 2013

In medicine, we pledge: primum non nocere. First, do no harm. But before we can do no harm as doctors, we need to be doctors. And before we can be doctors, we need to be human beings. Being a doctor is a great privilege, but it is a subordinate privilege. Being human comes first.

I distinctly recall the time in my medical education when I realized I was becoming more medical …

Repeal the SGR and enact a permanent solution that supports physicians

Coalition of State Medical Societies

Health Policy

November 14, 2013

Congress is closer than ever to repealing Medicare’s sustainable growth rate (SGR) formula. Competing plans, with traction, are on the table. The leaders of American medicine are convening this weekend in our nation’s capital.

The Coalition of State Medical Societies — representing nearly 160,000 members in nine states — calls on Congress to act decisively, but not rashly.

Congress must act now to repeal the flawed SGR formula used to pay physicians …

Why our personal health data will become less private

Joseph Kvedar, MD

Health Technology

November 14, 2013

I have been following the news about the National Security Agency (NSA) access to our phone records with great interest. If we as a society don’t sort some of this out, we’ll see a repeat in the health sector a few years from now.

These discussions seem to pivot on issues of population-level safety vs. personal liberty, and on trust vs. suspicion re: how much of the process is driven by …

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