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Will patients accept focused networks in today’s economy?

Kevin Pho, MD

KevinMD

March 20, 2012

In a bid to save money, health insurers are coming out with what’s known as “focused networks,” which typically exclude the highest cost hospitals.

In the Boston area, one such plan comes from health insurer Harvard Pilgrim Health Care, whose plan excludes Partner’s Health Care institutions. That’s significant, since Partners includes the famed Massachusetts General Hospital as well as Brigham and …

When medical students first deal with death

Dr. Irma Faruqi

Medical Education

March 20, 2012

Very few are as starkly aware of the transience of life as those working in the healthcare profession. We are expected to be, for want of a better word, immune to it; as if each death we face is somehow a vaccine that will eventually, with regular booster doses, provide us with enough immunity to be resistant to the Grim Reaper.

We spend years studying, arming ourselves with pages and pages …

Is the patient experience enhanced by modern technology?

Robert Rowley, MD

Health Technology

March 19, 2012

Most physicians went into the practice of medicine motivated (at least in part) by the reward that comes from that human-to-human connection. The reward that comes from helping people. It was true of my generation of physicians, it was true of those before me, and is true of newer generations of physicians who grew up in a more interconnected, digitized world.

We are now at a time in medicine where an …

10 strategic questions to ask yourself about the future of health care

Joe Flower

Health Policy

March 19, 2012

Today and for the next few years the weather of this industry will be dominated by pervasive, discontinuous change. Structures, revenue streams, relationships of every level: All are shifting in fundamental ways. Specifically, the weather will be driven by:

i) invention and propagation of new business models;
ii) shifting risk onto both the provider and the patient, accompanied by building of new risk-based relationships, contracts and alliances;
iii) smart primary care coming to …

How political agendas erode the doctor-patient relationship

Maggie Kozel, MD

Health Policy

March 19, 2012

Your doctor’s exam room is getting overcrowded. Modern US health care means that, like it or not, you and your physician are sharing that once private space with an insurance executive constantly hissing in your doctor’s ears to move it along. You are also sharing it with pharmaceutical marketers, lobbyists from the food industry … special interest groups of every stripe.

Now move over and make room for one more interested …

Why doctors aren’t prescribing health apps to patients

Travis Good, MD, MBA

Health Technology

March 19, 2012

The BBC had a story recently about general practitioners (GPs) in the UK prescribing health apps to patients. The idea is that prescribed apps would be free to patients, even if they had a cost associated with them, so I’m assuming that the NHS would pick of the tab for such apps.

The story has gotten a lot of attention, and I think with good reason. I’ve written before and …

Why isn’t everyone excited about robotic assisted surgery?

Kelly Wright, MD

Physician

March 19, 2012

It’s cool. So cool, that President Obama used one. So cool, it’s been on the cover of Newsweek. It’s been in multiple television commercials, radio advertisements, highway billboards, and was even coined one of the top 14 medical breakthroughs of 2011 by Boston Magazine, a city teeming with medical innovation. Yet surgeons and health economists are unable to explain the fascinating rise of robotic-assisted surgery.

Currently, a single company manufactures and …

How to be like Betty White when you get older

Melanie Lane, MD

Physician

March 19, 2012

I aspire to be Betty White when I grow up; she’s witty, funny, brilliant, and beautiful. I can’t wait to coo, “My eyes are up here,” to the hot guy who’s just busted down my door, when I’m 90 years old.

“What’s the secret to her vivaciousness?” I wonder. She is probably genetically gifted a la George Burns, but I bet she has done more to preserve her looks and her …

Physician burnout: Why it’s not a fair fight

Dike Drummond, MD

Physician

March 19, 2012

Every day physicians and other healthcare professionals are engaged in an invisible battle at work.

In one corner is our desire to help other people, make a difference and practice the skills we worked so hard to perfect.

In the opposite corner is burnout and it’s entire gang. Most of us don’t recognize burnout has a whole team on its side. We are outnumbered at least ten to one. I call this …

Neglecting the patient in the era of health IT and EMR

athenahealth

Physician

March 18, 2012

In advance of their annual User Conference, the social media team at athenahealth was able to talk about modern medicine with the event’s keynote speaker, Dr. Abraham Verghese. A physician and Stanford professor, Verghese has also authored several books, including the New York Times bestseller, “Cutting for Stone.” Here he talks about the importance of being present during the exam, in an era with so many distractions threatening to …

Hearing loss affects more people than you think

Mike Armstrong, MD

Conditions and Diseases

March 18, 2012

Despite remarkable changes in technology, only 20% of patients who could benefit from hearing aids actually wear them. Reasons vary, but include a lack of awareness among patients and physicians, fear of stigmatization, and failure to recognize the immense value of hearing aids on social life and productivity.

Hearing loss affects 36 million Americans according to the National Institute on Deafness and other Communication Disorders (NIDCD). One third of people …

Bias and error are rampant in medical literature

Anonymous

Physician

March 18, 2012

A heretic essay in JAMA by Vinay Prasad (Northwestern of Chicago), Adam Cifu (U. of Chicago) and John Ioannidis (Stanford) should be required reading for every medical student and resident and to pass any board certification exam in any specialty … in my humble opinion.

John Ioannidis became one of my personal heroes with the publication of his great paper in PLoS Medicine, “Why Most Published Research Findings Are False,” and its …

Unregulated supplements are a tragedy in waiting

George Lundberg, MD and Gilbert Ross, MD

Medications

March 17, 2012

The latest supplement toxic alert thankfully involves only two young soldiers who died suddenly, both reported to have the unregulated amphetamine-like dimethylamylamine, DMAA, aka “Jack3d” and “OxyelitePro,” as the suspected death-dealing toxicant.

Who knows how many other unexplained deaths and near-deaths can be attributed to the vast experiment foisted upon an unwary American populace by such drugs — I mean, “supplements”?

Thanks to 1994’s Hatch Act, the Dietary Supplement Health …

Care coordination is key to fixing health care

Curaspan Connections

Health Policy

March 17, 2012

Author of the new book “The Future of Health Care Delivery” and the former CEO of the University of Maryland Medical Center, Stephen C. Schimpff, MD, FACP, says effective care coordination, especially for patients with chronic illness, requires technology, more involvement of primary-care physicians and a health-care system – not a medical-care system.

A physician, educator and cancer researcher for more than 40 years, Dr. Schimpff shares his …

Why this pediatrician quit medicine

Lumi St. Claire, MD

Health Policy

March 17, 2012

There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine. I don’t know that any one of them is more important than the other (it really just depends on which day you ask me). One that stands out for me though as a universal problem shared by millions is Managed Health Care, and the imposition it has posed on …

Read more…

Why this pediatrician quit medicine

Essential patient communication tips for physicians

Jennifer Kelly, MD, PhD

Physician

March 17, 2012

The manner in which a physician communicates information to a patient is as important as the information being communicated. Patients who understand their doctors are more likely to acknowledge health problems, understand their treatment options, modify their behavior accordingly, and follow their medication schedules. In fact, research has shown that effective patient-physician communication can improve a patient’s health as quantifiably as many drugs—perhaps providing a partial explanation for the powerful placebo …

The USPSTF should stay independent from politics

Nilesh Kalyanaraman, MD

Health Policy

March 16, 2012

The United States Preventive Services Task Force (USPSTF) is a federal committee composed of private sector experts in prevention and primary care. Its mandate is to make recommendations as to which preventive services are beneficial, which are useless and which are harmful. Disconcertingly, there is a small but vocal opposition to the USPSTF as embodied by an op-ed piece in the Wall Street Journal by Dr. Scott Gottlieb.

Dr. Gottlieb’s main argument against the USPSTF is …

Empathy is an essential ingredient of the work of a doctor

Dr. Leah Kaminsky

Physician

March 16, 2012

They say a good doctor needs to be able to stand in his patient’s shoes, but Stuart only had one; a size 12, left foot Nike Air Max. Back in May 1991, after his car ran off an Australian country road, wrapping itself around a gum tree, Stuart ended up losing a leg. In a photo taken at the scene of the accident the following day, you can see a …

Healthcare consolidation may bend the cost curve the wrong way

Mitchell Brooks, MD

Health Policy

March 16, 2012

Last year, Ann Mathews wrote a brilliant piece in the Wall Street Journal about the future of medical care in the United States. It is an extremely informative study and provides the reader with a very fine 50,000-foot view of the current condition of its subject.

What she did not mention, or truly highlight, is the threatening trend that is taking place with ever increasing rapidity, of hospital conglomerates, both …

Complex, painful and expensive medical procedures at the end of life

Janice Boughton, MD

Physician

March 16, 2012

It isn’t that it was a bad day, because it wasn’t really. There was too much work, yes, and I ended up staying late, but it was mostly made of good interactions and I felt generally competent. So, no, it wasn’t just a bad day. Still, this evening I feel like the best possible future would be one in which there was no technological medical care, where we just worked …

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