Pay for performance and shared savings are good, but they’re not the solution

Policy
January 9, 2025

Think about every health care reform effort we’ve been working on for the last decade or two, including accountable care organizations (ACOs) and the value-based purchasing models from CMS. The vast majority of them use one or both of the following strategies in an attempt to financially reward providers for delivering higher value (it’s like they’ve realized that financial incentives need to be fixed!):

  • Quality bonuses: For providers who deliver …

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Losing control of how the health care system treats patients

Physician
January 9, 2025

Particularly over the last 10 to 20 years, medical care has been vertically integrated so that many of us—most of us—are now working for larger health conglomerates. As part of this transition, more and more of our management is professional, with MBAs or their health care equivalent, running our working environments and collecting our billings from which they generate our salaries.

The Economist, a British journal, tells us that in 2022, …

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Strategies for patient-centered and employee-focused care

Podcast
January 8, 2025
YouTube video

This article is sponsored by NRC Health.

In the evolving landscape of health care, our consumers, patients, and workforce are undergoing significant demographic changes. At the heart of these changes are generational differences in attitudes, beliefs, and behaviors. These generational influences don’t …

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Reviving the emotional flatline: Addressing burnout in health care professionals

Physician
January 8, 2025

As an emergency room physician with over 20 years of experience, I’ve faced countless moments of emotional intensity—saving lives, delivering difficult news, and navigating the chaos of a health care system stretched to its limits. Yet, it wasn’t a catastrophic patient case or a bad day at work that led me to my breaking point. It was the slow, relentless erosion of my emotional capacity. I call this state the …

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A clarion call about medical malpractice to leaders in health care

Physician
January 8, 2025

There are one million physicians practicing medicine in the United States. No medical intervention they recommend is immune from a complication. The exact number of complications is unknown. Some are medical errors inherent to the intervention, while others are random errors of nature caused by external factors.

When you add to this the fact that there are more lawyers in the United States today than ever before, something has to give. …

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How cognitive biases are sabotaging your wealth-building efforts [PODCAST]

Podcast
January 7, 2025
YouTube video

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Join us as we explore the hidden pitfalls of behavioral finance with financial planner Shane Tenny. Discover how cognitive biases like overconfidence, confirmation bias, and loss aversion can derail even the most successful …

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What if transitions of care resembled transitions of power?

Physician
January 7, 2025

The peaceful transition of power to the 47th president of the U.S. occurred January 6, 2025. It was the loser of the presidential election who ensured an orderly process and ironically certified the results.

In medicine, transitions of care – whether from inpatient to skilled nursing facility, from hospital to home, or during the passing of responsibility from one practitioner to another – represent pivotal moments in the continuity of patient …

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A heartfelt journey from oncology to the ER: How mentoring young doctors changed me

Physician
January 7, 2025

I have worked in clinical oncology in Pakistan. As an oncology physician, I was not supposed to interact with patients in the ER. Recently, I had the opportunity to work with recent medical graduates in an emergency medicine setting. This experience was new for me, as I have been focused on oncology for a long time.

However, that’s the beauty of life—it pushes us to do things we never thought we …

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Why stress and trauma are at the heart of autoimmune diseases [PODCAST]

Podcast
January 6, 2025
YouTube video

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Join us as we dive into the complexities of autoimmune diseases with family physician Pamela Buchanan. Discover the profound connections between chronic stress, systemic inequities, and immune health, particularly for women and Black …

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How lab values management can improve cancer testing and treatment

Conditions
January 6, 2025

When it comes to medical breakthroughs, it can be a long journey between discovery and implementation.

Implementing new technologies and therapies for patients is often hindered by slow adoption, inaccurate application, and delays caused by the rapid pace of guideline updates, which providers may struggle to keep up with. These challenges can prevent patients from fully benefiting from medical breakthroughs, leaving their potential only partially realized.

For example, the development of genomic …

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How burnout nearly killed me—and what doctors must do to survive

Physician
January 6, 2025

I’ve wanted to be a doctor since I was 12. Growing up, I idolized my pediatrician, Dr. Helen Nash, one of the first Black female physicians in St. Louis. Her warmth and competence left a lasting impression on me. Medicine became my calling, my purpose, and my dream. I worked tirelessly through high school, college, medical school, and residency to make that dream a reality. But no one warned me …

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From liquid handcuffs to miracle molecule: MOTAA would expand methadone access and help fight the overdose epidemic

Conditions
January 6, 2025

Kayla was referred to our addiction clinic after a visit to the emergency department for a skin infection, common in people who use drugs intravenously. Recognizing her fentanyl use was escalating out of her control, she made an appointment to discuss starting buprenorphine, a mainstay of treatment for opioid use disorder (OUD). While our initial office visit with Kayla was straightforward and optimistic, during subsequent visits she continued to experience …

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How a unified agreement could help the preceptor shortage [PODCAST]

Podcast
January 5, 2025
YouTube video

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We discuss the transformative potential of a standardized affiliation agreement (SAA) in nurse practitioner education with Lynn McComas, CEO and founder of PreceptorLink. As a recognized expert in precepting nurse practitioners and advanced …

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The untold story of a nurse’s final shift after 47 years of service

Conditions
January 5, 2025

I was on the phone with my sister when I thought I heard a knock at the door. Then another. My dogs barked, and I told her, “Don’t hang up.” My chest tightened. Nightmares of someone coming for me flashed through my mind—a stranger lurking in the dark.

After more than 40 years as a nurse, transitioning from the chaos of the ER to the intensity of the ICU, I thought …

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Fostering health care innovation through federal policy: a case for direct primary care

Policy
January 5, 2025

Abstract

The United States health care system faces escalating costs, access disparities, and significant physician burnout. Direct primary care (DPC) offers a transformative approach by emphasizing patient-centered care, price transparency, and reduced administrative burdens. Yet, federal policy reforms are necessary to scale this model nationally. This article outlines actionable federal policy recommendations, identifying how mechanisms like agency rulemaking and budget reconciliation can be used to drive adoption, expand access, and empower …

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The case for cryptocurrency payments in health care

Finance
January 5, 2025

Bitcoin has recently surged past $100,000, marking a pivotal moment in the adoption of cryptocurrency worldwide. Coupled with a regulatory environment under the Trump administration that promises to be more favorable to digital assets, now is the time for medical practices to consider integrating cryptocurrency payments into their operations. This combination of market momentum and policy support offers practices a unique opportunity to attract a broader clientele and improve financial …

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Why we need to talk about poop more often [PODCAST]

Podcast
January 4, 2025
YouTube video

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We explore the often-overlooked world of bowel health with colorectal surgeon Carmen Fong. Carmen shares her journey into this specialty, the stigma surrounding bowel habits, and the critical need to normalize conversations about …

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How seniors and doctors can safeguard their homes from lawsuit risks

Physician
January 4, 2025

As a physician, I have always faced the stigma of being considered a “deep pocket.” What does that mean? Because of my profession, I was considered a high-salaried worker with assets that might have significant financial value, including a private practice and property.

Doctors have sometimes been “targeted” in malpractice lawsuits in past decades because of this stigma. But now, if you live in California and certain parts of the US …

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How night volunteers could transform health care during staff shortages

Physician
January 4, 2025

Inpatient caregiving companions, especially during nights, may hold significant value in enhancing patient recovery and expediting discharge. Hospital nights can be tumultuous not only for inpatients but also for their caregivers, whether professional or personal. This need persists despite humanity’s adaptation to varying chronotypes—lion, bear, wolf, and dolphin—which have enabled people to transcend their diurnal instincts for the collective good. Nevertheless, the challenges of nighttime caregiving remain profound.

A critical issue …

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