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How the ACO regulations set the stage for Accountable Care Organizations

David Harlow

Health Policy

April 13, 2011

ACO regulations and related federal issuances hit the street, after several months of waiting — from CMS, OIG, FTC, DOJ and IRS.

They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to limited Stark self-referral ban and anti-kickback statute waivers in the fraud and abuse arena, to new frameworks for antitrust analysis, to rules governing joint ventures involving taxable …

Screen your sleep lab when evaluating your insomnia

Colleen Kelly Mellor

Patient

April 12, 2011

Insomnia plagues me. In that, I’m no different from millions of other Americans. But I am different in that I sought supposed experts to help me deal with this situation. My experience proved to be a nightmare.

First, I believed my sleeplessness due to the fact I feel “on,” all the time, doing too many things in the space of 24 hours. …

Preventing disease saves the crippling costs of tertiary care

Kohar Jones, MD

Physician

April 12, 2011

When I was a family medicine intern, I met a diabetic patient in the hospital who had stopped seeing his regular doctor after he lost his job and his health insurance.

His untreated diabetes made his feet go numb. He stepped on a nail and didn’t realize it until he noticed …

Google affects how clinicians and the public collect diagnostic information

William R. Yates, MD

Conditions and Diseases

April 12, 2011

My Google Reader accidentally picked up an intriguing abstract that examined a research study of resources that medical students use in solving diagnostic cases.

The abstract was picked up because it contained the word “exercise” that is one of my PubMed filter queries. Although we often think that most diagnostic decision-making occurs from learned information stored in physician’s brains, information resources can …

Could alternative medicine practitioners take the lead in health policy?

Emily Lu

Physician

April 12, 2011

Recently, I attended a conference on integrative medicine. It was a lovely conference and I learned a lot: about Chinese therapies used for cancer, about osteopathic manipulation, and about the growing community of doctors that respect the value of complimentary medicine practices and are working to integrate them into their general practice.

I also left with a sense of dissatisfaction with what …

Palliative care and medical interventions are not mutually exclusive

Kevin

Physician

April 12, 2011

by Neha Jain, MD

Think back to your first memory of death.

Was it a loved one? A stranger? A pet? Were you sad, happy, or just curious?

My grandmother, Nani, died unexpectedly. During the wake, my cousins and I played together in the bedroom where we had been restricted. All through that memory, there’s a strange, dark, terrible …

Ordering tests may take food out of the mouths of our patients

Kevin

Patient

April 11, 2011

by Tarcia Edmunds-Jehu

Sitting in an exam room I am watching my patient struggling to ask a difficult question that she clearly does not want to ask.

After several attempts at starting and a few half finished sentences she finally manages to mumble a request for help with obtaining food for herself and her two daughters. She is a 41-year-old woman, 32 weeks pregnant with her third …

When a patient evokes an emotional reaction from a physician

Brian Goldman, MD

Patient

April 11, 2011

When it comes to caring for the sick, it’s often assumed that health professionals and their patients usually get along.

But that’s not always true. Sales people call some of their customers difficult. Turns out that doctors do exactly the same thing with theirs. An article in the current issue of the journal Neurology provides a catalog of difficult …

Stop and really think about what you want from life

Susan Biali Haas, MD

Physician

April 11, 2011

A friend and I made a pact today. No more hanging out halfway, it’s all or nothing. Each of us has a dream for our lives.

Our respective dreams are almost the same, and they’re dreams that we’d almost cast aside or given up on. Why? Because they require so much faith, dedication, focus and endurance to pull off. Neither of us had wholeheartedly committed to the dream.

I’ve had a small …

If you want good pediatric care, stay away from retail clinics

Roy Benaroch, MD

Physician

April 11, 2011

They’re everywhere, all of a sudden: little medical kiosks tucked into the back of drug stores, grocery stores, and big box outlets.

With names like “Minute Clinic” or “RediClinic,” they stress speedy, in-and-out service. And of course, you’re already there in the store, ready to buy whatever has been prescribed. A win-win, no?

No.

Everyone knows that if you’re …

Physician characteristics that are universally appreciated

Michael A. Zadeh, MD

Physician

April 11, 2011

The relationship a physician has not only with their patients, but also with their patient’s families, has long been the foundation of the medical system.

Over the course of time this once valued bond has had its ups and downs; however today with the internet, Obama healthcare reform, and Medicare cuts to name a few, the doctor-patient relationship finds itself in its …

Physicians referring patients to a diagnostic facility they own

Bob Doherty

Health Policy

April 10, 2011

Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue – a practice called “self-referral” – unless the facility is located in their own practice.

This exemption exists to allow patients with access to a laboratory test, x-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less …

Federal workers worried about a shutdown should do what doctors do

Edwin Leap, MD

Physician

April 10, 2011

I have a suggestion for all of those federal workers who were concerned about a government shutdown.

To all those who already have better insurance and better benefits than most in the private sector; for all those whose jobs pay more than equivalent private sector jobs for the same activities. Do what hospitals do. ‘Go to your jobs, and do the necessary work anyway.’

It is ironic, but hardly surprising, that the …

Why patients seek a second opinion

Howard Luks, MD

Patient

April 10, 2011

This has been a very busy week already. I have seen many second opinions and I am always very interested in the reason why the patient initiated the second opinion.

In many situations it was simply to see if I would perform the surgery. After I spent a while listening to the patient, examining them and coming up with an appropriate …

Read more…

Why patients seek a second opinion

Talking social media and health reform with medical students

Kevin Pho, MD

KevinMD

April 9, 2011

I recently concluded a trip down to Nashville, TN where I gave my talk on the health care-social media intersection at Vanderbilt University School of Medicine.

My audience normally consists of physicians and hospital staff, so talking to students was a refreshing change.

I had the opportunity to have dinner the night before, and breakfast and lunch the day …

Are memory loss and mood disorders actually diabetes of the brain?

Kevin

Conditions and Diseases

April 9, 2011

An excerpt from Feed Your Brain Lose Your Belly.

by Larry McCleary, MD

As diseases, memory loss and mood disorders appear to have very little in common. But could memory loss (even severe memory loss such as that which occurs in Alzheimer’s disease) and mood illnesses such as depression and bipolar disorder, actually be treated much the same …

7 procedures that can affect the way you breathe and sleep

Steven Y. Park, MD

Conditions and Diseases

April 9, 2011

Millions of surgical operations are performed every year to improve your health, beauty, and even your smile, but there’s a hidden danger in some of the most common procedures that can aggravate if not actually cause obstructive sleep apnea.

Sleep apnea happens when your jaws are too narrow, which constricts the internal soft tissue layer that lines your upper breathing passageways, from …

What your patient appreciates, and what causes hurt and confusion

Shara Yurkiewicz

Patient

April 9, 2011

Listening to patients for the past two weeks, we learned quite a bit about what patients appreciated about their doctors and what had left them hurt and confused.

The good:

M., an elderly lady with a very close relationship with her primary care physician, said she had been to many bad doctors in her life. She knew right away that her current doctor …

Becoming the official caregiver to your sick parent

StorytellERdoc, MD

Patient

April 8, 2011

I imagine the world as a vast, boundless frontier weathered by our swirling human emotions and complicated energies — hurricanes of intense heartbreak and tornadoes of joyous, unbridled celebrations, with every weather pattern in between. Sunshine and rain included.

If I could gather this world, foolishly believing that I could sweep my arms and hands through the unsuspecting air to collect a smaller, more-contained version of reality, I know with absolute …

Maintaining private space when patients share trying times with you

Yann Meunier, MD

Physician

April 8, 2011

Year: 1987

Setting: Pitie-Salpetriere Hospital in Paris, France
Position: Specialist in tropical diseases

I am a consultant in tropical diseases at the Pitie-Salpetriere Hospital in Paris in professor Marc Gentilini’s department, which has been receiving HIV/AIDS patients from all parts of the world since the onset of the pandemic.

Indeed, in the early days most patients came from Haiti and Africa and were seen primarily in tropical disease …