Post Author: Rocky Bilhartz, MD

No matter what Trump does to health care, we must accept an imperfect reality

Policy
December 12, 2016

Tom is a forty-three-year-old self-employed painter and father of two.

He’s currently in remission from lung cancer, having been first diagnosed five years ago. At the time of his diagnosis, he did not have health insurance. Thankfully, for him, American law had finally made it illegal for health insurance companies to discriminate against individuals with preexisting conditions.

Tom had to be offered insurance at community rates. And, this was a good thing …

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The interference in health care is mesmerizing

Policy
October 3, 2016

“Beep,” went the machine.

I left a message and hung up.

My patient, Mr. G, had just been denied a medicine by his health insurer. It’s the same medication for the same condition that he had been taking last year.

I was leaving a message on his behalf.

You can be assured that if you hand an insurance card to the front desk employee at your doctor’s office, your doctor deals with health insurers …

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Health care has far too many medical panels

Conditions
August 10, 2016

We are assembling too many panels of people in the name of health these days. Too many.

They usually seem like a good idea. I’ve been supportive before. I assumed we needed them. More of them.

I might have been wrong.

There was a day when I believed my food would be toxic, my medicine harmful, and my safety gone without them. But, I’ve come to believe I was mistaken.

I was wrong because …

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How butterflies are bad omens for health care

Policy
November 26, 2015

After reading my latest post about conflicts of interest in health care, my wife suggested that I write a piece about butterflies. Something pretty, she said. Natural. Peaceful.

Since hostility is never my goal, I thought I’d give it a try.

I read for an entire evening on butterflies — their life cycle, behavior, mechanisms for protection, and how different cultures view them. All I could keep thinking about was how much my grandmother …

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Is routine home blood pressure monitoring really such a good idea?

Conditions
November 5, 2015

It has occurred to me that this is a terrible idea.

In fact, it’s possibly the least beneficial thing for the general health of a population to have gained momentum in recent years. I’m not discussing cigarettes or e-cigarettes or low-yield cancer screening procedures. I’m not talking about diet drinks or sugary drinks.

I’m talking about home blood pressure monitoring.

It’s a terrible idea.

OK, I get it. The idea sounds benign. Buy your own …

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Health inspectors should be trained to do what doctors do

Physician
September 28, 2015

This story is a great one.

It’s about a female dog with only three legs. Her fourth leg was amputated following a traumatic accident as a puppy.

Now, when she walks, she has a hitch in her step. And, when she hitches, she kicks the stump of her injured leg outward.

Step, step, hitch. Step, step, hitch.

One day, the female dog has puppies. And, her puppies do what all puppies do. They nurse. They watch. …

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Less regulation in health care. Please.

Policy
September 14, 2015

Pharmaceutical drugs cost too much. The new ones are always so expensive.

Hence, we need more regulations. And, the government should impose them. Set price limits. Cap drugmaker profits. This will make it better for all of us. The paternalism of our government should be the strongest when we are ill. Because we may need that medicine.

The government should regulate things more so we can get it cheaper.

Case in point. One new medication …

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This doctor is on a mission to take back medicine

Policy
August 25, 2015

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I’m taking back medicine.

If you didn’t know it left or that someone stole it, I’ll give you a pass. Medicine has been disguised for a long time now. And, when you leave the scene in camouflage, you often go unnoticed.

Medicine is supposed to be the science or practice of diagnosing, treating, and preventing disease. I love medicine. There’s so much to learn. Lots …

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Those in charge of EHRs are uninterested in cooperation. How sad.

Tech
August 10, 2015

Eleven billion dollars.

Sounds like a lot of money, doesn’t it?

It is. But, I’ll give you even more perspective, Tony Robbins style.

Eleven seconds ago you started reading this page. A few blinks of an eye. But, eleven million seconds? That was a few months back. 127 days to be exact. Can you remember what you were doing then? Eleven million seconds have passed since you did it.

But, when you jump to billions, you’ll …

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Conflicts of interest aren’t only about financial incentives

Meds
June 30, 2015

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Everyone has an angle. Everyone.

Your doctor? Sure. But, he or she isn’t the only one. The pharmaceutical company? Of course. The medical device company? The hospital? The insurance company? You get the point. Everyone has an angle. Everyone has a conflict of interest. Know it. Get over it. It’s time to focus on something else.

Like filling up your car with gas. In …

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Applying pay for performance in medicine to public schools

Policy
June 7, 2015

My oldest son is almost a second grader.

He attends a public elementary school in town, and very soon, he will start preparing for an exam known as the STAAR test.

The STAAR test is an “assessment of academic readiness.” In my state, it gets administered to publicly-funded school children. Students must pass the exam to continue progressing in school, and ultimately, students must master the exit level test to graduate high school.

There’s good …

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The problem of “less is more” in American health care

Policy
June 3, 2015

Dr. Atul Gawande is an American surgeon and public health extraordinaire. He is one of the most successful physician authors of this century, and he writes routinely for the New Yorker. His most recent article discussing unnecessary health care is, as expected, a good read.

I applaud Dr. Gawande’s passion towards advancing medicine. And, yes, there is universal agreement that we need to be better in America at providing high-quality low-cost health care. …

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Why CMS should get out of measuring health quality

Policy
April 28, 2015

This is important to you. Trust me.

If you’re young at heart, it matters because it’s your tax dollars this April. If you’re wiser in years, it directly affects your health and the system you’ve been pumping money into for decades. This is the same medical system that you thought would take care of you later in life. Again, this is about your money and your health, so read on.

Government-funded health insurance in the United States is administered …

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The silliest four letters in health care: PQRS

Policy
April 4, 2015

It has become perhaps the silliest four letters in health care: PQRS. It stands for Physician Quality Reporting System. It’s another this and another that created by the Centers for Medicare & Medicaid Services (CMS). After you read this, you’ll be like me, scratching your head trying to understand why anyone thinks our health care system is better under CMS’s leadership.

CMS has setup a thing called PQRS, so physicians across the country …

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The two towers of medicine.  Which one will you choose?

Policy
March 1, 2015

Come, let us build ourselves a city, with a tower that reaches to the heavens, so that we may make a name for ourselves. 
– Genesis 11:4

With these words, so begins the biblical story of The Tower of Babel. The tale was written, at least in part, to explain the origin of different languages. Essentially, a group of earth’s early inhabitants started to build a tower to the sky in order …

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