Health policy and public health

4,357 articles · Since 2004

Articles, page 158

Slowing health costs requires answering 3 simple questions

March 19, 2011Mar 19, 201115

If we ever slow health care cost inflation to a sustainable pace, it will be because we learn how to ask 3 simple questions when thinking about a medical treatment. Does it improve quality of life for the patient? Does…

If we ever slow health care cost inflation to a sustainable pace, it will be because we learn how to ask 3 simple questions when thinking about a medical treatment.

Does it improve quality of life for the patient?
Does it extend the patient’s life?
How much does it cost?

Asking the questions are of course much simpler than figuring out the …

Health policy

A global view on effectiveness research

Christopher Johnson, MD

March 18, 2011Mar 18, 20113

We badly need effectiveness research — which medical treatments work and which ones don’t. After all, some reasonable estimates are that a third or so what we spend on medical treatments is for things that aren’t known to work, or worse, don’t work. Effectiveness research means comparing two competing therapies to see which works better; if both work the same, our preference …

Read more…

A global view on effectiveness research

Health policy

The next generation of public health won’t involve the medical world

Jay Parkinson, MD

March 17, 2011Mar 17, 201112

I received my Masters in Public Health from Johns Hopkins in 2006. I took a course on transportation safety where we focused on designing roads for safety, making airlines safer, and decreasing the risk of medical helicopter crashes. In 2007,…

In 2007, I worked for Public Citizen, Ralph Nader’s consumer advocacy group. Ralph’s book, Unsafe at Any Speed, forced the automobile industry to focus on converting their cars from …

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Medical education

Match Day 2011: Family medicine grows, but enough to save primary care?

Kevin Pho, MD

March 17, 2011Mar 17, 201111

Match Day marks one of the most important days in a medical student's career. A computer algorithm "matches" prospective doctors with the residency program they're destined go to. It's also a look at the future trends for various specialties. With…

Match Day marks one of the most important days in a medical student’s career.

A computer algorithm “matches” prospective doctors with the residency program they’re destined go to.

It’s also a look at the future trends for various specialties. With a major part of health reform about to be implemented, one naturally gravitates towards primary care, where there currently is a …

Physician voices

The National Health Service Corps impact on primary care doctors

Kohar Jones, MD

March 17, 2011Mar 17, 20113

Before I had even begun medical school, I already knew that I would enter primary care when I finished. I had successfully applied for and received a scholarship from the National Health Service Corps Scholars program. By the time I graduated, I knew that after my three years of residency training, I would practice in an underserved area for at least four years, one year of service to America for …

Health policy

Health costs need to be addressed by doctors, patients, and lawyers

Kevin Pho, MD

March 15, 2011Mar 15, 201128

It's no secret that our health system encourages doctors to order too many tests. Compounded with the widespread belief that more tests equates to better medicine, the reasons why health costs are spiraling out of control aren't a secret. In…

It’s no secret that our health system encourages doctors to order too many tests. Compounded with the widespread belief that more tests equates to better medicine, the reasons why health costs are spiraling out of control aren’t a secret.

In a perspective piece from the New England Journal of Medicine, physician Sean Palfrey notes our dire situation:

Recent advances

…

Patient voices

Danger of multiple emergency room visits to different hospitals

Jeffrey I. Kreisberg, PhD

March 13, 2011Mar 13, 2011

If you are one of the more than 100 million Americans who visit emergency rooms (ER) at least once a year, you’re not alone. Americans, insured and not, make ample use of hospital emergency rooms. One out of every five…

If you are one of the more than 100 million Americans who visit emergency rooms (ER) at least once a year, you’re not alone.

Americans, insured and not, make ample use of hospital emergency rooms. One out of every five visited an ER at least once in 2007, the latest year for which the National Center for Health Statistics …

Health policy

The differences between comparative and clinical effectiveness

Peter J. Pitts

March 13, 2011Mar 13, 20113

by Peter J. Pitts "Newspeak," the language of Big Brother, was designed "not to extend but to diminish the range of thought." Some well-known examples of Newspeak are Bellyfeel (a blind, enthusiastic acceptance of an idea), Duckspeak (meaning literally to…

by Peter J. Pitts

“Newspeak,” the language of Big Brother, was designed “not to extend but to diminish the range of thought.”

Some well-known examples of Newspeak are Bellyfeel (a blind, enthusiastic acceptance of an idea), Duckspeak (meaning literally to quack like a duck or to speak without thinking), Crimethink (the Newspeak word for thought crime) and Goodthink (or “political orthodoxy”).

Which brings us from the nightmare fantasy of “1984” to the health …

Health policy

Withholding liver transplants for Medicaid recipients in Arizona

Gary Levin, MD

March 12, 2011Mar 12, 201112

Governor Brewer’s decision to withhold liver transplants for Medicaid recipients in Arizona should serve as a loud warning to the electorate regarding governmental intrusions into health care financing and health care operations. The decision was ill advised on the basis…

The decision was ill advised on the basis of multiple factors. The survival rates differ from one facility to another.

What is the liver transplant survival rate and what information needs to be considered when looking at such numbers?

For example, …

Physician voices

Why team based primary care won’t help evidence based medicine soon

Kevin Pho, MD

March 11, 2011Mar 11, 201114

Despite the advances in evidence-based medicine, not every patient benefits. In a recent column from the New York Times, Pauline Chen looks at a study showing exploring the issue: For many patients, evidence-based medicine isn’t working. Two-thirds of patients with…

Despite the advances in evidence-based medicine, not every patient benefits.

In a recent column from the New York Times, Pauline Chen looks at a study showing exploring the issue:

For many patients, evidence-based medicine isn’t working. Two-thirds of patients with diabetes, a disease with some of the strongest evidence-based guidelines available, continue to have trouble controlling their blood sugar levels; and only half of all

…

Physician voices

What should we expect of a physician leader today?

Stephen C. Schimpff, MD

March 11, 2011Mar 11, 2011

What should we expect of a physician leader today? I believe it should be something much different than what leaders do now. Today, a hospital physician CEO might be expected to develop new or improved clinical programs, in part by…

What should we expect of a physician leader today? I believe it should be something much different than what leaders do now.

Today, a hospital physician CEO might be expected to develop new or improved clinical programs, in part by recruiting the best and the brightest, by building new wings, and by purchasing new technologies. The measure of success would be improved finances as a result of added …

Health policy

Challenge the constitutionality of EMTALA

Lucy Hornstein, MD

March 11, 2011Mar 11, 201129

Here is a letter to the editor in a recent Philadelphia Inquirer: … In 1986, Congress passed and President Ronald Reagan signed the Emergency Medical Treatment and Active Labor law, which requires hospitals to admit all who arrive at the…

Here is a letter to the editor in a recent Philadelphia Inquirer:

… In 1986, Congress passed and President Ronald Reagan signed the Emergency Medical Treatment and Active Labor law, which requires hospitals to admit all who arrive at the emergency room and treat them without regard for their ability to pay.

In essence, we had federally mandated national health care – signed

…

Physician voices

Hospitals taking over private practices

Manoj Jain, MD, MPH

March 8, 2011Mar 8, 201125

A decade and a half ago, when I moved to Memphis, I proudly hung a sign outside an office I shared with another doctor. It had my name followed by an MD. I had started my own small business as…

A decade and a half ago, when I moved to Memphis, I proudly hung a sign outside an office I shared with another doctor. It had my name followed by an MD. I had started my own small business as a solo practitioner in medicine.

Over the years, the practice has grown. I now have several employees and my own office, with the names of several other doctors alongside mine on …

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Hospitals taking over private practices

Physician voices

Primary care physicians are rebelling against the system

Robert Centor, MD

March 6, 2011Mar 6, 201171

I believe primary care docs are rebelling against the system. The system has made primary care physicians suffer emotionally and financially. The system has taken the greatest form of medical care – that consisting of continuity, comprehensiveness, complexity and completeness…

Now I talk about “the system” in an anthropomorphic sense, but “the system” is virtual. “The system” has no conscious, it is not deliberate, rather it represents …

Patient voices

Free health screening: A service to our community’s health

Steven Reznick, MD

March 4, 2011Mar 4, 20112

Last weekend I had the privilege of supervising University of Miami Miller School of Medicine students at a free public health screening in Pompano Beach, Florida. The screening was sponsored by the medical school, with the assistance of community leaders, and held in a local public school. The program organization, recruitment of student and faculty volunteers and management of the program was undertaken and implemented by the students. It is …

Health policy

Repeal of reform won’t fix our health system

Brad Wright, PhD

March 4, 2011Mar 4, 201139

The system we had before health reform became law was simply not working. I think we can all agree on that. A significant number of people oppose "Obamacare." I can understand that. But repeal doesn't really solve the problem. Sure,…

The system we had before health reform became law was simply not working. I think we can all agree on that. A significant number of people oppose “Obamacare.” I can understand that. But repeal doesn’t really solve the problem. Sure, if you think that health reform has or will actually make our system worse than it was before, it seems prudent to undo the legislation, but that brings us back …

Physician voices

Proton beam therapy and the medical arms race

Paul Levy

March 2, 2011Mar 2, 20115

Proton beam therapy is an effective modality for killing certain types of cancer cells. New England and the Northeast are fortunate to have a proton beam machine at Massachusetts General Hospital, where it has been in use for some time…

But what happens when everyone wants one? Well, we see the medical arms race at work again.

These …

Health policy

Requests for OTC prescriptions for a FSA burdens primary care

Matthew Mintz, MD

February 27, 2011Feb 27, 201124

As reported by MSNBC, the federal government will no longer allow flexible spending accounts (FSAs) to be used for over the counter medications, without a prescription. FSAs, which are offered by many employers, allow you to use tax free dollars…

As reported by MSNBC, the federal government will no longer allow flexible spending accounts (FSAs) to be used for over the counter medications, without a prescription. FSAs, which are offered by many employers, allow you to use tax free dollars for medical expenses that aren’t covered by your insurance. FSAs are a great idea and can be used for things like eye glasses, dentistry, or even …

Physician voices

Understand the medical economics of a primary care practice

Maggie Kozel, MD

February 26, 2011Feb 26, 201134

If we are going to make rational decisions about health care reform, it helps to understand the medical economics of a primary care practice. I was ten years out of medical school by the time I joined Narragansett Bay Pediatrics,…

If we are going to make rational decisions about health care reform, it helps to understand the medical economics of a primary care practice.

I was ten years out of medical school by the time I joined Narragansett Bay Pediatrics, a group practice in southern Rhode Island, and I was earning a salary of $48,000 for my “part-time” position. I worked in the office 24 hours per week, and covered nights …

Health policy and public health

Articles, page 158

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