Originally published in MedPage Today
by Joyce Frieden, MedPage Today News Editor
With the House and Senate now in basic agreement on healthcare reform and President Barack Obama about to sign the underlying bill into law, opponents are gearing up to challenge the legislation on a variety of fronts.
This effort was beginning even before Sunday’s House vote sent the Senate …
Healthcare reform will be challenged in states
Thanks all who responded to my recent USA Today piece, Patient-satisfaction surveys have drawbacks.
But in a letter published in the paper yesterday, a reader from Oklahoma City was quite unhappy with my take.
Mark R. Heaton writes, somewhat angrily:
Dr. Kevin Pho’s recent opinion piece was not only arrogant but also grossly naive.
His basic premise was twofold:
• Doctors know best and should therefore ignore patient feedback regarding possible tests and treatments.
• …
Patient input in their treatment should be valued by doctors
The following is part of a series of original guest columns by the American College of Physicians.
by Steven Weinberger, MD, FACP
The New England Journal of Medicine‘s March 11 issue included an interesting “Clinical Decisions” article. Looking at a hypothetical case of an endocrinologist with time-unlimited board certification, the editors posed the question of whether he should voluntarily …
ACP: To whom are physicians accountable?
I haven’t ever saved a life. No doctor has. We may prolong the inevitable, but we don’t save anyone. We aren’t immortal, and weren’t meant to be. We die. All things do. Plants, animals, even stars. Death is as much a part of life as birth. And yet, at times people chase medical science as if we have immortality in all our gadgets and pills.
Why am I writing this?
A few …
Futile care has human and financial costs
Originally published in MedPage Today
After a year-long struggle and often-raucous partisan debate, the House of Representatives passed an historic health care reform package late Sunday night.
The vote on the last of the two bills in the package was 220-211. All 178 Republicans, along with 33 Democrats, voted against the measure. The margin was similar on the other measure; both …
Health care reform passes the House in a historic vote
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
Earlier this year, Harvard’s Partners Healthcare put a cap on payments its physicians can receive for serving on corporate boards at $5,000 a day.
Although the cap primarily affects top researchers and executives, it is by far the stiffest limit imposed by any academic medical center, and drives deeper the …
Industry relationships with physicians are coming under fire
Heading into the final weekend of Mr. Toad’s Wild Ride, who could have guessed that in a year that brought us Death Panels, Pickup Trucks, “You Lie”, The Cornhusker Compromise, Bart Stupak (boy, that must have been a tough name to grow up with), and the Senate Parliamentarian-as-Rock-Star, we would be on the cusp of passing a perfectly …
Healthcare reform is an achievement but isn’t perfect
Originally published in MedPage Today
by John Gever
This meditation was evoked by the prospect that my basement could be filled with E. coli-laden mud next week.
I live within a few yards of Wheeling Creek, a tributary of the Ohio River that drains about 250 square miles of northern West Virginia and southwestern Pennsylvania. This week has brought temperatures near 70 degrees, …
Flood insurance by the government, but no public option
Middle age introduces itself in many ways; one is atrial fibrillation. Youth, vigor and a medically-problem free life was seemingly right there in the recent past. A rhythm doctor often hears this suddenness of onset described as “Doc, yesterday, I was fine.” As is always the case for a first episode of an arrhythmia, yesterday, you were fine, but today is indeed a new day.
It happened during a bike ride. …
Atrial fibrillation as experienced by an electrophysiologist
As correctional health care professionals, there may be times when we are tempted to conduct ourselves in a less than professional manner simply because we can.
We may be able to get away with speaking to our patients rudely, using profanity profusely, or wearing inappropriate clothing. After all, we work in jails and prisons. This culture is far from prim and proper. And, our patients are inmates. Many may tolerate misbehavior …
Professionalism matters in correctional health care
If there is anything about economics that has been proven over and over, it is that price controls do not work. The unintended consequences are usually worse than the problem that led to the solution in the first place.
Massachusetts legislators, feeling the frustration of higher insurance premiums, are now considering a bill to limit doctor and hospital reimbursement payments to 110% of Medicare rates, or perhaps some other percentage …
Medicare rates and capping payments to hospitals
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
For patients without known heart disease, the diagnostic yield of coronary angiography appears to be low, researchers found.
Only about 38% of those referred to the cath lab for the elective procedure had obstructive coronary artery disease, Manesh R. Patel, MD, of Duke University, and colleagues reported online in the New England …
Coronary angiography is being overused
If you are a physician, therapist or any other helping professional whose business model relies on third party manged care reimbursement you are engaged in the world’s worst business model.
Let me start with a story to set the stage.
Imagine you are a bright, idealistic college student. You’re good at academics, want to make a difference in the world and have hundreds of career options in front of you.
After lots of …
Business model woes traps doctors and impedes health care
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Ten years ago, I was an Emergency Medicine Resident and wanted to die. Today, I’m a general practitioner in part-time practice and am in love with life. What made the difference? I signed up for a dance class.
Reports on physician burnout list the personality traits that set us up for trouble: we’re excessively conscientious, feel overly responsible, want to please everyone, and function on an extremely high level – even …
Dance healed this physician and helped with burnout
Originally published in MedPage Today
by Liz O’Brien
My grandmother and her hospital roommate — aged, tiny, frail, and sporting matching bright pink hairnets.
They looked like twins — two thin shrubs in winter that had each sprouted an improbable, big pink rose.
Although sick and scared, my grandmother had admired the pink hairnet on the lady in the next bed, so my mother …
Medicare and how a grandmother worries about its costs
by Brian Eule
While the debate continues to rage over the health care reform bill in Washington D.C., today at Noon Eastern time, the newest class of 15,000-plus graduating medical students will get their marching orders, beginning their lives working in medicine.
It’s called Match Day and each year, on the third Thursday of March, the nation’s graduating medical school students gather with their classmates and wait for an envelope with their …
Match Day and how each medical school celebrates
A 21% cut for Medicare physician fees is set to go into place soon. This year, fixing physician payment has been overshadowed by all the talk about health insurance reform.
In fact, I remember being invited to talk about healthcare reform on a panel for medical students this past fall. As part of my remarks, I mentioned the 21% pending cut in physician payment and recall the questions and …
Medicare doc fix questions and answers
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
Taxing junk food may help reduce obesity and improve health, researchers have found.
Patients got significantly less of their energy (calories) from soda or pizza when there was a 10% increase in the price of either (P<0.001), Penny Gordon-Larsen, PhD, of the University of North Carolina at Chapel Hill, and colleagues …
Taxing junk food may improve your health
Homebirth advocates like to tout the many “advantages” of giving birth at home. High on the list is limiting exposure to hospital acquired infections, and since only your “own germs” are in your home, you are protected.
Yes, you are protected from hospital acquired infections, but the most dangerous infectious agents are actually those that live inside the mother, not the ones in the hospital. Consider that for newborns both Group …
Homebirth does not protect against serious maternal infections
At my office we provide care for a fair number of patients without medical insurance. Sometimes we are faced situations with no good options.
At a patient visit, often times the diagnosis is not clear without doing some diagnostic tests other than the history and physical exam. Many of these tests are ordered from sources outside the office, where I have little or no control over the cost of the test …
Patient costs when making medical decisions
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