Health policy and public health

4,357 articles · Since 2004

Articles, page 139

Become not just a physician, but a great physician

June 20, 2012Jun 20, 20122

As the nation, physicians, hospitals, and political pundits await the Supreme Court’s decision on the Affordable Care Act, I find myself waiting for something else: to begin medical school. I will be hitting the books, studying vigorously, and desperately trying to remember the myriad of information being thrown at me well after the justices decide the fate of President Obama’s landmark legislation. So what does this mean for me, or …

Health policy

If the individual mandate is struck down, what happens next?

Kevin Pho, MD

June 18, 2012Jun 18, 20122

The following column was published on June 17th, 2012 in the New York Times’ Room for Debate blog. In this election year, the Supreme Court’s judgment on the Affordable Care Act will be interpreted through a political lens. But the…

The following column was published on June 17th, 2012 in the New York Times’ Room for Debate blog.

In this election year, the Supreme Court’s judgment on the Affordable Care Act will be interpreted through a political lens. But the decision will have real-life consequences on patients, whose voice won’t be heard through the ensuing partisan din.

If the individual mandate …

Health policy

Do we have too many hospital beds?

Joanne Conroy, MD

June 16, 2012Jun 16, 2012

Stranded capital is a new term, a derivation of the term stranded costs that emerged from the deregulation of electric companies. It refers to “the existing investments in infrastructure for the incumbent utility which may become redundant in a competitive environment.” Many academic medical centers are weighing the importance of meeting current demand while considering the risk that, in a future competitive environment, dramatic declines could occur in the need …

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Do we have too many hospital beds?

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Health policy

Our health problems will remain, despite how the Supreme Court rules

Ricky Choi, MD

June 13, 2012Jun 13, 20127

I was recently honored to attend a discussion at the White House, convened by Health and Human Services Secretary Kathleen Sebelius. It was one of those rare "clear my schedule immediately" invitations; I thank my patients and family for allowing…

I was recently honored to attend a discussion at the White House, convened by Health and Human Services Secretary Kathleen Sebelius. It was one of those rare “clear my schedule immediately” invitations; I thank my patients and family for allowing me to take this last minute trip.

Physician leaders from around the country were invited to the White House for a dialogue with lead government health officials (specifically administrators from the …

Health policy

AMA: Moving past a failed Medicare formula to focus on quality care

Peter W. Carmel, MD

June 11, 2012Jun 11, 20124

The Medicare physician payment formula is a case-study in failed policy. Physicians have long known that it is not working. Polls show that an overwhelming 94 percent of Americans believe the massive cuts it schedules are a serious problem for seniors. Even members of Congress from both parties agree – and that is no small accomplishment – that it is …

Drugs and prescribing

The impact of prescription drug costs on health spending

Cathleen London, MD

June 10, 2012Jun 10, 20126

I am employed by a hospital, and have health insurance through my job. The coverage is comprehensive, and the cost has an employer contribution and employee contribution. I still get confused (though I have the hospital's own plan) about what…

The prescription plan that comes with this insurance is straight forward: $40 for …

Health policy

Is there a future for smaller physician practices after health reform?

Bob Doherty

June 10, 2012Jun 10, 20127

The medical profession has always been marked by division: town versus gown, primary care versus specialty medicine, states versus national. But the real fault line today is not defined by specialty, geography, or teaching versus practice, but by size of…

Physicians in smaller practices, without regard to specialty or where they are located, are embattled and defensive—and therefore are more skeptical when someone tries to peddle the need for delivery …

Health policy

What does an ACO mean in small town America?

Robert Provenzano, MD

June 9, 2012Jun 9, 20123

At the end of long days I often stand gazing out my window at the beautiful, timeless Rocky Mountains in Colorado Springs and am taken by their sense of permanence. I recently returned from Nampa, Idaho, where I presented hospital…

The parallels between the timeless mountains and the physicians I met in Nampa struck me. Strange, you say? Maybe, but I am accustomed to the …

Health policy

ACP: Reducing expenses at the ground level of health care

American College of Physicians & Fred Ralston Jr., MD

June 2, 2012Jun 2, 2012

A guest column by the American College of Physicians, exclusive to KevinMD.com. I will never forget asking my teenage son what appeared to be a simple question. His answer, after a long pause, was “It’s complicated.” If you ask many…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

I will never forget asking my teenage son what appeared to be a simple question. His answer, after a long pause, was “It’s complicated.” If you ask many of us about health care in the U.S., there is often an answer that points quickly to a particular villain or a simple fix that would change everything. Unfortunately things …

Health policy

Isn’t caring for your child worth as much as caring for your parents?

Nilesh Kalyanaraman, MD

May 30, 2012May 30, 201210

I love it when I see Medicaid patients on my schedule for the day. Working at a community health center, our doors are open to all people, regardless of their ability to pay. It’s hard to run a medical office when you get $20 for a visit, which is what our uninsured patients pay. So when a patient has Medicaid we know we’ll get paid a decent reimbursement for that …

Health policy

A population health approach to wellness

David B. Nash, MD, MBA

May 28, 2012May 28, 20123

FACT: Four determinants of health account for 40% of all deaths in the U.S. – smoking, unhealthy diet, physical inactivity, and alcohol use. FACT: A mere 3% of Americans do all of the relatively "simple" things they should to stay…

FACT: Four determinants of health account for 40% of all deaths in the U.S. – smoking, unhealthy diet, physical inactivity, and alcohol use.

FACT: A mere 3% of Americans do all of the relatively “simple” things they should to stay healthy – i.e., exercise for 20 minutes 3 times a week, don’t smoke, eat fruits and vegetables regularly, wear seat belts regularly, and remain at their appropriate BMI.

FACT: According to the …

Health policy

Our medical-industrial system is long overdue for a real shakeup

Jim deMaine, MD

May 25, 2012May 25, 201219

Recently I was sent this commentary on the issue of health care costs. It seemed like a pretty good summary of the problem to me, though it didn't delve into solutions or the current controversy about the Affordable Health Care…

Recently I was sent this commentary on the issue of health care costs. It seemed like a pretty good summary of the problem to me, though it didn’t delve into solutions or the current controversy about the Affordable Health Care Act. In our country, we’ve built up a huge medical-industrial system that can do lots of good but at a huge cost. It seems that we are on the brink of a …

Health policy

What American medicine can learn from a cruise ship clinic

Barbara Hales, MD

May 25, 2012May 25, 20123

Recently, I had a wonderful opportunity to cruise the Mediterranean and visit some fascinating cities. The land excursions were mind-expanding but quite physical. The rugged terrain and steep hills were not difficult to walk upon because I was in good…

But, what if I wasn’t? Questions raced through my mind such as:

What if I got sick onboard the ship?

What if I got injured?

What type of doctor signs on …

Physician voices

Why Priscilla Chan may become the country’s most influential doctor

Kevin Pho, MD

May 22, 2012May 22, 20128

Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from medical school, but also married Facebook founder Mark Zuckerberg. When I brought this up on Twitter, someone responded…

Who has the potential to be the most influential physician of our generation?

It’s Priscilla Chan, who not only recently graduated from medical school, but also married Facebook founder Mark Zuckerberg.

When I brought this up on Twitter, someone responded that it was “disappointing at the same time. I’m certain her own merits and studies would have made waves alone.”

But her influence …

Physician voices

Why physicians are susceptible to hardball tactics

Bradley Evans, MD

May 21, 2012May 21, 201213

I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the meeting. The topic was healthcare reform and its effect on hospitals and physicians. Included were discussions on patient-centered…

The course director made it crystal clear that there will be no place in the future for …

Health policy

What should America’s health care vision be?

Stephen C. Schimpff, MD

May 21, 2012May 21, 20128

America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the same time has a dysfunctional care delivery system. A new vision is needed. Vision is a leadership concept…

Vision is a leadership concept that presents an idea, garners support and then develops the coalitions to bring it to fruition. America needs to envision what its care delivery system should be and then determine, as …

Physician voices

Can pit crews really heal medicine?

Scrub, MD

May 17, 2012May 17, 2012

In his recent TED talk, Atul Gawande harkens back to the central thesis of his recent book The Checklist Manifesto: How to Get Things Right that medicine has become too complex for physicians to act as cowboys and instead should…

In his recent TED talk, Atul Gawande harkens back to the central thesis of his recent book The Checklist Manifesto: How to Get Things Right that medicine has become too complex for physicians to act as cowboys and instead should adopt the paradigm of a pit crew, utilizing teamwork and the humble checklist to solve problems and avert emergencies.

Is this really true though? Can “pit crews” heal medicine? To extend the …

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Can pit crews really heal medicine?

Physician voices

Am I going to die because I cannot afford the test?

Ralph Freidin, MD

May 11, 2012May 11, 201213

On my way to the hospital last week, I heard a 26-year-old woman describe her experience of becoming deathly ill. When she first realized that the many bruises appearing spontaneously across her body were unusual, she was working as coffee shop to pay off school loans. With the urging of a friend, she went to see a physician. The diagnosis was acute leukemia.

Her job did not provide health insurance and …

Physician voices

Teams are key to solving the American health care crisis

Davis Liu, MD

May 10, 2012May 10, 20126

Solving the American health care system crisis is among the most complex and important challenges facing this generation. Is it possible to provide high quality care with better access at a more affordable cost? Is this problem solvable or simply to complicated? Though that answer is not yet clear, what is increasingly apparent is that a new type leadership is needed if there is any hope in achieving this goal.

Professor …

Health policy

Repairing the tear in health care’s safety net with social media

Mark Britton

May 8, 2012May 8, 2012

The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a noble and necessary function within the U.S. healthcare system. No one dedicated to the field of care giving can deny the importance of providing appropriate medical care for this population. The safety net is literally a lifeline for many in need.

But for all of the vital and positive …

Health policy and public health

Articles, page 139

Real physician voices, twice a week

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