Health Policy and Public Health

Physicians writing on KevinMD about policy as it reaches the exam room: prior authorization and the state and federal rules now written for it, scope of practice laws state by state, the CDC opioid guideline and what forced tapers did to patients, and public health from vaccination to the pandemic. Four maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words, Opioids: what physicians and pain patients say, in their own words, and Vaccines: what physicians say, in their own words.

Who are the physicians that make the decision to deny care?

Wes Fisher, MD

Physician

April 17, 2013

A phone conference had been arranged. They wanted to talk to me about a denial for payment on a portion of a patient’s pre-authorized procedure after the fact. Its participants: the regional medical director of a large insurance company, his female assistant administrator, and me.

He cordially introduced himself as a pediatrician by trade from a large well-known (and highly respected) academic institution with impeccable credentials responsible for our region of the United States. …

Dear Congress: Listen to doctors on the front lines of medicine

Matthew Moeller, MD

Health Policy

April 17, 2013

US_Congress_02

A follow-up to Dear lawmakers: This is what it’s like to be a doctor today.

Thank you to everyone for the positive feedback. Over 60,000 Facebook “likes”, tweets, and newspaper requests was quite a surprise. I was especially moved by the multiple tweets from hospices, physician groups, and individuals recommending my article. This article really has hit a nerve and shed …

America’s health system is dangerously out of balance

Brian Klepper, PhD

Health Policy

April 13, 2013

For a large and growing number of us with meager or no coverage, health care is the ultimate “gotcha.” Events conspire, we receive care and then are on the hook for a car- or house-sized bill. There are few alternatives except going without or going broke.

Steven Brill’s recent cover story clearly detailed the predatory health care pricing that has been ruinous for many rank-and-file Americans. In Brill’s report, a key mechanism, …

Health reform faces tension with integrated health systems

Kevin Pho, MD

KevinMD

April 13, 2013

kaiser permanente

The following column was published on March 26th, 2013 in the New York Times’ Room for Debate blog.

In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement may improve patient care, whether it will shield …

The Physician Payment Sunshine Act is here: Are you ready?

Jeremy Lazarus, MD

Health Policy

April 12, 2013

A guest column by the American Medical Association, exclusive to KevinMD.com.

Information is a source of learning. But unless it is organized, processed and available to the right people in a format for decision making, it is a burden, not a benefit.

-Former ServiceMaster CEO C. William Pollard

The new Physician Payment Sunshine Act (Sunshine Act) was created by Congress to ensure transparency in physicians’ …

Increasing the role of nurse practitioners in the inpatient setting

Gene Uzawa Dorio, MD

Physician

April 12, 2013

We are fortunate in our country to have the best medical technology in the world. Unfortunately, delivery of this technology, reflected in a worldwide healthcare ranking of 37th, is a disservice to the American people and must be rectified especially when Cuba is ranked 39th.

As provisions of the Affordable Care Act are put in place, a daunting factor is the shortage of doctors who will be needed to provide this …

Health reform: China offers a cautionary tale

Leana Wen, MD

Health Policy

April 9, 2013

Wang Li is a 48-year old farmer from Dalian, China. After a two-day trip to the major provincial hospital, he’s heading home to his village to die. Wang has lung cancer, and even with insurance, his surgery will cost him 20,000RMB—$3,000, which is twice his annual salary. The surgery would be curative, but it doesn’t matter. “I cannot burden my family,” he said.

I am a Chinese-born, American …

Why physicians should sympathize with federal employees

Bob Doherty

Health Policy

April 5, 2013

“Physicians care more about their pocketbooks than taking care of patients. They are self-interested and overpaid. They want to control everything. They don’t know what life is like in the real world of patients.”

By now, I am sure that physician readers of this blog can feel their blood boiling, for good reason. Why would I, as the principal staff advocate for internal medicine physicians, put such pernicious, unfair, inaccurate quotes …

Lawmakers shouldn’t care about the personal hardships of doctors

Anonymous

Health Policy

April 4, 2013

A response to Dear lawmakers: This is what it’s like to be a doctor today.

With a family and financial background that eerily matches Dr. Moeller’s, please count me as one soon-to-be physician who does not share the notion that lawmakers should spend their time being overly concerned with the demands placed on physicians or physician compensation. In fact, I …

Doctors should stop being compared to the airline industry

Jordan Grumet, MD

Health Policy

April 3, 2013

We have to stop comparing ourselves to the airline industry.

Sitting on the lounge chair at the pool, I can’t believe that just hours ago I was sludging the wintry streets of Chicago, rushing to the airport. The kids clucked away happily in the back seat as the adults in front where more subdued. As grownups do, we kept running through our mental checklists even though the ship had already sailed, we …

The movement for medical price transparency is happening

G. Keith Smith, MD

Health Policy

April 1, 2013

Years ago, I hired a carpenter to build a deck in my backyard. He showed up with a pencil behind his ear, a spiral notebook, and a tape measure. I told him what I was looking for, and he made a few suggestions. After 15 minutes of measuring and taking notes, he handed me a piece of paper with how much it …

Our most scarce health resources are asked to carry the largest load

Jordan Grumet, MD

Health Technology

March 26, 2013

It happened, of all times, when I was in the car driving the kids to violin practice. My pager buzzed with a message from one of the medical floors. I waited till the car was parked, and dutifully pecked the numbers on my cell phone.

Hello doctor, we have your patient, can you please put admitting orders into EPIC?

I, of course, like most doctors, wasn’t sitting by my phone waiting at a computer terminal. …

Why is cost so obscure in healthcare?

Corey A. Siegel, MD

Physician

March 23, 2013

I am embarrassed. I am a specialist taking care of patients with inflammatory bowel diseases, which include Crohn’s disease and ulcerative colitis. I spend more than half of my time at work related to research regarding the benefits and risks of treatment options for these diseases. Specifically, I aim to translate the vast medical literature published on this topic into tools for patients (and their parents) to help them better …

Read more…

Why is cost so obscure in healthcare?

Measuring quality: What doctors and teachers have in common

Shirie Leng, MD

Health Policy

March 21, 2013

I was watching Jon Stewart recently, and he had Michelle Rhee on. For anyone who doesn’t know her, she’s the superintendent of schools in Washington D.C. who made a bunch of reforms that caused some controversy and resulted in her being one of the main spokespersons for education reform in this country. Her conversation with Jon made me realize the similarities between …

Dear lawmakers: This is what it’s like to be a doctor today

Matthew Moeller, MD

Physician

March 20, 2013

I am writing this letter because I feel that our leaders and lawmakers do not have an accurate picture of what it actually entails to become a physician today; specifically, the financial, intellectual, social, mental, and physical demands of the profession. This is an opinion that is shared amongst many of my colleagues. Because of these concerns, I would like to …

AMA: Helping physicians thrive in an evolving healthcare system

Jeremy Lazarus, MD

Health Policy

March 20, 2013

A guest column by the American Medical Association, exclusive to KevinMD.com.

As American health care continues to transform, physicians in every state and specialty are attempting to comply with new rules, expectations and costs, and must evolve to meet new health care demands. The American Medical Association (AMA) is committed to helping physicians not only navigate the changing environment, but thrive in …

Empower whistleblowers to improve the health of all Americans

Kenneth Lin, MD

Physician

March 18, 2013

The first instinct of a bureaucracy is self-preservation, and health care bureaucracies are no exception. This rule applies not only to government agencies, but to academic and industry settings as well. This was the conclusion I came to after listening to a panel of scientist and physician “whistleblowers” at the Selling Sickness 2013 conference in Washington, DC.

One by one, they described their painful discoveries that widely prescribed …

Health reformers fail to hold patients accountable for health costs

Kevin Pho, MD

KevinMD

March 15, 2013

To cut costs in our health system, reformers target the massive of waste. One way to reduce waste is to change the way doctors are paid. The fee for service payment system, they say, encourages doctors to prescribe more expensive care, which lines their pockets and drive up the cost of care.

To combat this trend, reformers often have providers in their crosshairs, …

Why the primary care physician shortage is overblown

Peter Ubel, MD

Physician

March 14, 2013

Are there really too few primary care physicians? And if so, what can we do to solve the PCP shortage? The standard answer to the first question is “yes, we have too few PCPs.” And the standard solution is to train more such docs, or allow more foreign-trained primary care docs into the country or, better yet, simply pay PCPs more money, so that graduating medical students will be more …

Is this the year Congress repeals the SGR?

Bob Doherty

Health Policy

March 13, 2013

An elderly doctor passes away, and he find himself standing before the Pearly Gates. The Almighty greets him and says, “In recognition of your stellar life of service to your patients, family and community, I welcome you to paradise. And because I know that doctors have a great sense of curiosity about all things, you can now ask me any question—any—and I will answer it.” The doctor ponders for a …

Health Policy and Public Health

Health Policy and Public Health

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts