An excerpt from Under the Gun: An ER Doctor’s Cure for America’s Gun Epidemic.
My phone buzzed in the pocket of my blue jeans one Saturday night at around 10:30 p.m. as the standing-room-only crowd at Minute Maid Park, clothed in vibrant orange tones, erupted in cheers. It was game two of the 2019 American League Division Series playoffs between the Houston Astros …
What a doctor felt when his neighbor was shot
With the Christmas holiday rapidly approaching, it has me thinking about what the family of faith should think about health care in America. As a physician, I’ve spent over a decade of my life trying to use my faith in science and evidence to inform people about an optimal way to practice medicine and, as someone trained in health policy and management, how to structure the United States’ health care …
A theological answer to our health care crisis
Thirteen years ago, as a student in New York City, I marched across the Brooklyn Bridge to implore my colleagues to fight for universal health care. That day, I enunciated what has become my personal mission by saying, “We need universal coverage that is portable. We need universal coverage that is comprehensive. We need universal coverage that ensures equal access to care. Most importantly, we need you — to lead …
A path to universal health coverage in America
I’ve got a confession to make. I own stock in a firearms maker.
Seems ironic that someone like myself — a physician has cared for countless victims of gun violence and someone who advocates for evidence-based policies to avert gun deaths — would not only own guns himself but also be a stockholder of a company that manufactures them.
Let me explain how this happened. When I first got out of residency, …
Why this physician divested from a firearms maker
The controversy over health care reform often boils down to two issues: coverage and cost. The Affordable Care Act (ACA) made significant impact on the coverage issue, dropping the uninsured rate below 10 percent for the first time in the recorded history of the United States, covering 20+ million Americans in the 8 years since it was passed, and putting the United States on a reasonable …
Expanding coverage and cutting health care costs: ideas for 2018
Congress has returned to DC in the wake of the defeat of Paul Ryan’s American Health Care Act. And while shouting “repeal and replace” might win elections, this debacle proves that the American people will not tolerate their families, friends, and neighbors losing healthcare coverage just so rich people can get tax cuts.
Yet, Congress will certainly revisit health reform again. With the Republican caucus fractured, Paul Ryan should seek out …
Obamacare isn’t a disaster. Failing to improve upon it would be.
The Centers for Medicare and Medicaid Services released a massive amount of information regarding how much money it paid out to individual doctors. For the policy nerds out there, here is the original data. For everyone else, here is a simple way to look up how much your own doctor made. I decided to search for myself in the database …
How much Medicare pays doctors requires context
Recently, another installment was published from the research team of the Oregon Health Insurance Experiment. The major finding — Medicaid coverage results in a 40% increase in emergency department (ER) use. Many of the health care pundits quickly sifted through the scientific results to support their opinions.
You can read some of them here:
Sarah Kliff reports the facts: Expanding Medicaid doesn’t reduce ER trips. It increases them. Scott Gottlieb claims that Read more…
What the Oregon Health Study has told us so far
A recent article in the Annals of Emergency Medicine analyzed the revenue increases due to emergency physicians for services delivered to currently uninsured individuals when they begin to receive coverage (via either Medicaid or private plans) under the Affordable Care Act.
The authors analyzed payments for outpatient emergency department (ED) visits using the Medical Expenditure Panel Survey from 2005-2010. They looked into characteristics of charges and payments for the following groups: …
How the Affordable Care Act will affect emergency department payments
In recent years, there has been a shift away from solo practice to group practice among physicians. The trend, which some say began in the early 2000s, appears to have accelerated with new incentives proscribed in legislation such as the Affordable Care Act. The push for accountable care organizations seems to be fostering the rapid reorganization of medicine from one based on …
Is the death of the solo practitioner a bad thing?
I recently spoke at the Student National Medical Association’s (SNMA) Annual Medical Education Conference in Louisville, KY. Accompanying me was former SNMA President Bryant Cameron Webb, MD, JD. We covered three main topics in our workshop: medical education, the practice of medicine, and the underserved.
Medical education
Many people believe that there is, or soon will be, a physician shortage. There are nearly 1 million physicians scattered across America representing a ratio …
Reflections on medical education, medical practice and the underserved
One of my doctor friends and I were talking the other day about her cold symptoms – stuffy nose, nasty mucous, facial congestion. No fever. It had only been going on a couple of days but she said to me: “I think I might need some antibiotics.” Now, in our profession, we realize that there is no scientific reason to treat …
Doctors need to learn is how to help more while doing less
I was working in the ER this weekend when one of my nurses asked me a simple question: “How would you fix the health care system?” Obviously, this is a complex problem requiring complex solutions, but in an environment where at any minute a heart attack or a stroke could disrupt a conversation I prepared a sound bite for an answer.
“Do …
Fix our health system: Be like Switzerland
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Why does health care cost so much more in the United States than in other countries? The answer is exceedingly complex; pharmaceuticals, hospitals, and physician services (among others) comprise the multiple slices of the health care pie that in the United States is about twice the size of the next largest spender for health care services.
A new study from one of President Obama’s appointees (note: this study was written prior …
Are physician services to blame for high health costs?
With sixteen million more Americans expected to gain health care coverage in the coming years as a result of the Affordable Care Act, access to actual health care providers may become more difficult. This may be especially true for patients with marginal coverage such as Medicaid.
The Kaiser Family Foundation recently explored the role of non-physician clinicians – specifically nurse practitioners (NPs) and physician assistants (PAs) …
The role of non-physician clinicians in primary care
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