Paul Pender practiced clinical ophthalmology for 38 years, specializing in the medical and surgical treatment of eye diseases. He completed his residency at the world-renowned Wills Eye Hospital. His honors include a lecture series in his name by the New England Ophthalmological Society and the Secretariat Award from the American Academy of Ophthalmology for his work on webinars for clinicians.
Pender is passionate about patient-centered care. He believes that the patient-physician relationship should serve as the fundamental building block for health care reform. He is an advisor to Vxtra Health, a company committed to collaborating with physicians to earn trust and to reduce health care costs. By limiting the drain on health benefits budgets by intermediaries (health insurance companies, pharmacy benefits managers, and hospital systems), Vxtra Health establishes a path toward a new model of care, based on price transparency and fiduciary responsibility, starting with self-insured middle market employers.
He writes on timely medical issues on his website, his KevinMD author's page, and other popular social media. He is the author of Rebuilding Trust in Health Care: A Doctor's Prescription for a Post-Pandemic America (2020) and the ebook Standing Up and Speaking Out for Patients and Doctors: First Steps Toward Focused Health Care Solutions (2023).
In 2026, the movement in health care toward accountability has begun. A future press release will mark this year as the crescendo that put transparency on price and fiduciary responsibility back into health care. It starts with self-insured employers who have funded health benefits for their workforce under the latest provisions of ERISA, the Employee Retirement Income and Security Act. At long last, the black box that held the secrets …
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Self-insured employer health plans face a new reckoning
Connecting with another human being in a meaningful way allows a physician to practice the art and the science of medicine. Showing you care helps to gain trust, and helping to alleviate pain and suffering establishes a bond. When you give of yourself on behalf of your patient, as a caregiver you share something not many people get to experience—compassion-driven skill. Choosing a career in health care is most often …
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Why meaningful patient connections matter in medicine
Are you satisfied with your health benefits plan? That’s one of the many questions asked of over 2,000 employers, running large and small businesses, by the annual survey from KFF. Approximately 153 million workers and their families receive health benefits from employers in the U.S. Therefore, the survey results offer a window on the current satisfaction (or lack thereof) of health plans, whether by self-insured entities or as part …
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Employer health plans need a makeover
Harvard researchers who recently wrote an essay analyzed data from Medicare to draw conclusions about hospitalists and surgeons who treat hospital in-patients for non-elective admissions. The researchers grouped the physicians by age to determine which groups performed better. The yardstick by which they were measured was mortality within 30 days of admission. The sample size was significant—over 700,000 Medicare patients, all over 65 years of age. What they found were …
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Youth vs. experience: Who wins in medicine?
Patients may find themselves caught in the middle between their health insurance company and their oncologist when it comes to selecting the drugs used to treat their cancer. Why is this?
The American Cancer Society explains biologic drugs (derived from living organisms such as yeast, bacteria, or animal cells) and biosimilar drugs, which behave similarly to the original, patented (i.e., brand) drug. It is important to note that biosimilar drugs are …
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Caught in the middle: How health insurance companies influence cancer drug selection
I recently read the article, “Perfectionism will kill you.”
Our perfectionism is often worn like a badge of honor. It signifies our complete commitment, at times at the expense of others. Wanting to do your best job is what drives “good” perfectionism. Woody Allen quipped, “80 percent of life is just showing up.” And the other 20 percent is reserved for perfectionists.
Success often comes from attention to detail, something perfectionists …
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Why perfectionists in medicine need to practice compassion
In a published statement in JAMA Network on May 24/31, 2022, the U.S. Preventive Services Task Force found that there was insufficient evidence for screening for primary open-angle glaucoma in adults. They could not find a way to balance harms versus benefits for screening in general. But is this reasoning faulty?
It is well known that Black and Hispanic populations suffer a greater incidence and severity of glaucoma, …
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Open-angle glaucoma: To screen or not to screen?
As a practicing ophthalmologist, I saw many patients who had developed blurred vision, glare, or trouble reading. These patients needed to understand that cataracts were the cause of their vision problems and how the cataracts developed and how they should be treated. I would begin the explanation by using a large, plastic eye model to show the lens’s position and how a clouded lens would affect vision. I would then …
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The dichotomy of patient needs and patient wants
Anyone can win at poker when dealt a royal flush. But what can you do when the cards you are dealt don’t appear winning at all? My answer: Make the best of what you have.
Recently I learned of a colleague who sustained a broken back in an accident. He continues to work, wearing a brace and not taking pain medication. I know from watching his videos that he routinely handles …
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Playing the hand you are dealt
“Take it or leave it” is not negotiation but coercion.
Physicians have been subject to this tactic for much too long. As an ophthalmologist in clinical practice for nearly four decades, I experienced too often what a recent author on KevinMD described as a one-sided arrangement with a health insurance company. “Here is the fee schedule. Here is the document to sign.” End of story.
If you object to the terms of …
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“Take it or leave it” is not negotiation but coercion
“We can’t sit in the stands – we have to get messy and play on the field.”
The casual observer, the season ticket holder, the player, and the coach have very different levels of knowledge, skill, and passion for a professional sport. The casual observer may be confused, not even understanding the fundamentals of the game. The season ticket holder likely has some experience with the sport, possibly playing as a …
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Getting messy in the game of health care
The surgeon becomes the surgical patient. That was my summary thought after discussing my vision problem with my former partner, an ophthalmologist well versed in treating cataracts. Despite having performed eye surgery on thousands of patients in the course of my own professional career, the “privilege” of being on the other side of the knife was not without some anxiety.
Two factors helped limit my concern. First, I trusted my surgeon …
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The other side of the knife
A powerful communications medium, with the chance to get into someone else’s mind and connect through experience. Sometimes the experience is vicarious, because not everyone has lived what the storyteller has. But the storyteller’s words can have a profound effect, and the listener can appreciate what is told within a recognizable context. Shakespeare’s works are an immense collection of stories, of triumph and tragedy, of love and sacrifice, of comedy …
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A physician shares stories online and is now a published author
It is a busy time of year. I made my rounds to collect my skis after tuning, to pick up items for our Christmas guests, to get my haircut, and to claim my new eyeglasses. I drove to my golf course and took a half-hour walk on snow-covered paths with my dog. Dropped him at the groomers, then made stops for last-minute food shopping. While my wife took on the masses at a megastore, …
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The profound influence of a physician’s mother
A lot of media attention, including television, print, and online sources, is focused on various plans to revolutionize the delivery of health care in America. Critics point to medical errors, waste of resources, and lack of access among the numerous factors requiring the replacement of our health care system. To many politicians and think tank experts, the combination of government support programs (including Medicare, Medicaid, and Social Security disability) plus …
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Parallel thinking won’t solve problems in health care
After finishing the pitch for my book at a recent Harvard Writers’ Conference in Boston, I felt relieved and encouraged by the judges’ comments. As I waited for my turn at the podium, I glanced above my notes over the faces of 300 of my fellow attendees who had accomplished so much in their respective fields of medicine, nursing, and counseling.
The pitches made by these would-be authors revealed an amazing …
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A physician writes for catharsis
