Ronald Hirsch, MD
Physician
In a recent article in the New England Journal of Medicine, a rheumatologist at a teaching hospital lamented about "hospital problems," a phenomenon where patients are not allowed to stay in the hospital when they no longer have a medical…
In a recent article in the New England Journal of Medicine, a rheumatologist at a teaching hospital lamented about “hospital problems,” a phenomenon where patients are not allowed to stay in the hospital when they no longer have a medical necessity for hospital care, even though the physician may want to keep the patient longer to wait for test results or get prepped for a test. He proceeds to …
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Challenges of prolonging hospital stays
Physician
There is no one prototypical physician. Every physician has their own practice style, their own knowledge base, and their own preferred method of communication. In my role as medical director for case management at my community hospital, I was given…
There is no one prototypical physician. Every physician has their own practice style, their own knowledge base, and their own preferred method of communication. In my role as medical director for case management at my community hospital, I was given 30 minutes during new nursing orientation to provide nurses tips when communicating with doctors.
I put together this list of things that physicians wished hospital nurses knew about them, both good …
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Physician secrets that nurses need to know
Health Policy
While hundreds of doctors have submitted (mostly unfavorable) comments to CMS on the proposed evaluation and management changes, other issues seem to be receiving much less attention than they deserve. And one of those may hit physicians who perform procedures…
While hundreds of doctors have submitted (mostly unfavorable) comments to CMS on the proposed evaluation and management changes, other issues seem to be receiving much less attention than they deserve. And one of those may hit physicians who perform procedures in the wallet.
In 2015, Congress asked CMS to analyze the global period data to ensure procedure weighting accurately reflected the actual work done by physicians. Of course, when Congress asks …
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Are Medicare procedure payments in jeopardy?
Health Policy
By now, everyone has heard that the Centers for Medicare and Medicaid Services (CMS) has proposed to dramatically change how physicians get paid for evaluation and management (E&M) services in the office as part of the proposed 2019 Physician Fee…
By now, everyone has heard that the Centers for Medicare and Medicaid Services (CMS) has proposed to dramatically change how physicians get paid for evaluation and management (E&M) services in the office as part of the proposed 2019 Physician Fee Schedule Rule. In fact, as of the end of July, CMS has received over 600 comments on the proposed rule, with virtually all of them criticizing the proposal. I suspect …
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Don’t throw the E&M baby out with the bath water: the proposed CMS changes
Health Policy
A recent article suggested that using observation status for a hospitalized veteran was dishonorable to his years of service to our country because observation would subject him to higher out-of-pocket costs. This post created quite a lot of discussion and…
A recent article suggested that using observation status for a hospitalized veteran was dishonorable to his years of service to our country because observation would subject him to higher out-of-pocket costs. This post created quite a lot of discussion and debate. While I agree with the author and commenters that observation is confusing to all and that there has to be a better way, the premise that observation …
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In defense of Medicare’s observation status
Physician
The media is full of stories about the current opioid crisis. But unlike many national crises, such as the Flint lead-contaminated water crisis, the focus is on solutions, not blame. A few weeks ago, the Centers for Disease Control and…
The media is full of stories about the current opioid crisis. But unlike many national crises, such as the Flint lead-contaminated water crisis, the focus is on solutions, not blame. A few weeks ago, the Centers for Disease Control and Prevention issued guidelines for prescribing opioids in chronic pain. Congress approved funding for prevention and treatment, and the US HHS released a “National Pain Strategy.”
So to fulfill …
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The opioid epidemic: It’s time to place blame where it belongs
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