Health policy and public health

4,357 articles · Since 2004

Articles, page 164

Doctors working in an ambulatory care clinic

October 18, 2010Oct 18, 201012

It would be difficult today to be connected to medicine as either a provider or a consumer and not be aware of the existence of free-standing ambulatory care centers. Their usual habitat is along a suburban commercial strip, and their…

It would be difficult today to be connected to medicine as either a provider or a consumer and not be aware of the existence of free-standing ambulatory care centers.

Their usual habitat is along a suburban commercial strip, and their presence is generally announced by a well-lit sign displaying a hyphenated medical name, corporate-logo style. The ambulatory care center, known to much of the public as the “walk-in clinic,” is less …

Health policy

Is healthcare is a right? A balanced opinion

Patrick W. Hisel, MD

October 15, 2010Oct 15, 2010178

Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill. Mr. Mathews pointed out that people get old and no longer have an adequate income source to take…

Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill.

Mr. Mathews pointed out that people get old and no longer have an adequate income source to take care of their basic needs, and pointed to this as a reason to force working Americans to save for our retirement through a government program as a sort of …

Health policy

Tips for questioning costs in today’s health care system

Joanna Fief

October 14, 2010Oct 14, 201015

by Joanna Fief About two years ago in the wee hours of the morning, I found myself in a local emergency room with severe stomach pain, incessant vomiting and dehydration. It wasn’t pretty, and I was desperate for something –…

by Joanna Fief

About two years ago in the wee hours of the morning, I found myself in a local emergency room with severe stomach pain, incessant vomiting and dehydration. It wasn’t pretty, and I was desperate for something – anything – to ease my pain and stop my vomiting.

Gratefully, within minutes of receiving an IV with medications for pain and nausea, my symptoms subsided. After a couple of blood tests …

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Health policy

Selecting health insurance requires free choice for individuals

William Bayer

October 13, 2010Oct 13, 201010

Buying health insurance across state lines and health savings accounts are good - but they do not resolve the core issue. The core issue is that the employer is making the main choice for the employees, leaving them essentially with…

Buying health insurance across state lines and health savings accounts are good – but they do not resolve the core issue.

The core issue is that the employer is making the main choice for the employees, leaving them essentially with a choice between small, medium or large. That may satisfy the most important needs, but it does not encourage competition because the consumer is …

Health policy

Making health care better, faster, and cheaper with collective innovations

Joe Flower

October 12, 2010Oct 12, 20105

The country seems to have shifted in less than 18 months from a slogan of “Yes We Can!” to “Oh, well…” and a shrug, then back to “Cool! I think. What was that, really?” Hopes for a true rebirth of…

The country seems to have shifted in less than 18 months from a slogan of “Yes We Can!” to “Oh, well…” and a shrug, then back to “Cool! I think. What was that, really?”

Hopes for a true rebirth of health care turned into the Year of Screaming Inanely, then took that long slide from what we might hope for to what we might settle for. Yet suddenly it seems like …

Health policy

Quality programs have social and medical consequences

Douglas Perednia, MD

October 9, 2010Oct 9, 20104

Like it or not, “garbage in, garbage out” is the rule rather than the exception for the vast majority of bureaucratically dictated “quality control” programs that we’re ever likely to launch. There are three primary reasons for this. First and…

First and foremost, there’s Goodhart’s Law:

“Originally, an economic theory stating that if a particular definition of the money supply were to be used as the basis for monetary policy, the stability

…

Health policy

Why doctors should care about Regional Extension Centers (RECs)

David B. Nash, MD, MBA

October 8, 2010Oct 8, 201020

Over the past year, states across the country have begun to develop Regional Extension Centers (RECs) to help support the broad electronic health record (EHR) initiative passed as part of the economic stimulus package in 2009. Why should physicians care?…

Why should physicians care? With benefit of a little background information, the answer is pretty clear.

The evidence suggests — and it is generally believed — that adoption of EHRs by physicians and other healthcare providers …

Physician voices

How to foster a cycle of excellence in medicine

Ron Li

October 8, 2010Oct 8, 20102

“What does it take to be good at something in which failure is so easy, so effortless?” asks Atul Gawande in his book, Better. For medical students who will soon have responsibility over people’s lives, it’s a daunting question. It draws out our fears of messing up and making mistakes. Of getting a lower grade than our peers on a Structure Function exam. Of answering a question incorrectly and embarrassing …

Health policy

Doctors should work weekends, and how reformers alienate physicians

Kevin Pho, MD

October 5, 2010Oct 5, 201058

Peter Orszag wants doctors to work weekends. The former director of the White House Office of Management and Budget wrote as much in this past weekend's New York Times: Doctors, like most people, don’t love to work weekends, and they…

Peter Orszag wants doctors to work weekends.

The former director of the White House Office of Management and Budget wrote as much in this past weekend’s New York Times:

Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their industry can no longer afford to protect them from the inevitable. Imagine a drugstore open only five days a week, or

…

Health policy

6 points every physician should consider about Medicare ACOs

Asa Lockhart, MD

October 5, 2010Oct 5, 2010

by Asa Lockhart, MD Doctors, that age-old business advice still applies: Take your time and read carefully, and evaluate what it might mean to your patients and your practice, before you sign a contract. Specifically, the Patient Protection and Affordable…

by Asa Lockhart, MD

Doctors, that age-old business advice still applies: Take your time and read carefully, and evaluate what it might mean to your patients and your practice, before you sign a contract.

Specifically, the Patient Protection and Affordable Care Act (PPACA) paves the way for Medicare shared savings accountable care organizations (ACOs).

Conceptually, this type of ACO is a collaboration of physicians and health care providers …

Physician voices

Our love affair with technology holds primary care back

Allen Perkins, MD

October 4, 2010Oct 4, 20107

My wife and I were invited to dinner at the home of one of my daughter’s friends. My daughter is a graduate of the International Baccalaureate program of Murphy High and her friends tend to be interesting. This particular friend…

This particular friend is majoring in pre-med and has parents who immigrated from Vietnam following the fall of Saigon. As is usual when one has a physician dinner guest (and perhaps when one doesn’t) …

Health policy

Can accountable care organizations lower costs and improve quality?

Jaan Sidorov, MD

October 3, 2010Oct 3, 2010

Somewhere in the Obama Administration, there is an elitist central cabal that operates with the support of the highest organs of our central government. It conspires in windowless basement rooms to plot the gun control, mass vaccinations and the nationalization…

Healthcare, however, is its maximum target. Much like pieces on a chess board, and with the support of renegade organizations like …

Medical education

Should social justice matter when choosing medical students?

James Gaulte, MD

September 30, 2010Sep 30, 201049

Should medical student applicants be chosen less for their demonstrated ability to master large amounts of knowledge and solve problems and more for their social consciousness and desire to push forward with social justice? That appears to be the suggestion…

That appears to be the suggestion of a panel of experts from the AMA in a project called the Initiative to Transform Medicine (ITM) who believe an altruism deficiency underlies …

Health policy

How judging doctors by the numbers may be meaningless

Richard Reece, MD

September 30, 2010Sep 30, 201014

How do you judge how good a doctor is? By personal interaction? By what relatives and friends say? By whether he or she is on time when you go for your visit? By doctor rating websites on the Internet? By…

Or do you do it by the numbers? The federal …

Physician voices

Explaining the critical gap of primary care physicians

David B. Nash, MD, MBA

September 29, 2010Sep 29, 201025

There is a critical gap in the supply of primary care physicians in the U.S., and it should come as no surprise that our existing primary care delivery and payment models are at the heart of the issue. The traditional…

The traditional primary care model — medical care provided by a physician and a small support staff, often without benefit of health information technology (HIT) — was developed at a time when the …

Physician voices

Boston Medical Center gets screwed by the Massachusetts government

Kevin Pho, MD

September 29, 2010Sep 29, 201020

Boston Medical Center has provided care to the underserved and Medicaid population in Boston for almost 150 years. And what's happening to the venerable institution is gut-wrenching to read. I trained at Boston Medical Center (BMC), completing my internal medicine…

Boston Medical Center has provided care to the underserved and Medicaid population in Boston for almost 150 years. And what’s happening to the venerable institution is gut-wrenching to read.

I trained at Boston Medical Center (BMC), completing my internal medicine residency there in 2002. A recent write-up in Boston Magazine highlights the financial trouble the hospital is going through:

Boston Medical Center is almost broke, perilously close to what

…

Medical education

How a medical student can exacerbate the high cost of health care

Suchita Shah

September 28, 2010Sep 28, 201020

Even as a medical student, I’m already complicit in exacerbating the problem of the high cost of health care. It hit me one day, during my medicine rotation. We were working up a patient, and I was ordering tests with…

Even as a medical student, I’m already complicit in exacerbating the problem of the high cost of health care.

It hit me one day, during my medicine rotation. We were working up a patient, and I was ordering tests with my resident. The patient had liver disease and perhaps some ascites.

He came in for another issue, and this wasn’t of primary concern to us, and we really wouldn’t have …

Health policy

A system based on units of activity encourages more units of care

Stephen C. Schimpff, MD

September 27, 2010Sep 27, 20104

Today we mostly have prepaid medical care insurance with some co-pays and deductibles – both with commercial insurance and with Medicare. In other words, our insurance covers essentially everything from basic and routine care to the catastrophic. And the insurance…

Today we mostly have prepaid medical care insurance with some co-pays and deductibles – both with commercial insurance and with Medicare.

In other words, our insurance covers essentially everything from basic and routine care to the catastrophic. And the insurance pays out based on units of care – a visit, a test, a procedure, a hospitalization, a prescription. This creates a system in which providers (physicians, …

Health policy

Wanting better health care shouldn’t be conservative or liberal

Aaron E. Carroll, MD

September 25, 2010Sep 25, 20108

I remember this one moment back in the midst of health care reform when I was sitting in a radio studio, feeling pretty glum about the whole ordeal, and I mused aloud, “I wonder if anyone is enjoying this at…

For some of us, improving the health care system is more than a passing fancy. I’m a health services researcher. It’s my job. Those people on the TV pay attention …

Health technology

Physicians deserve to be compensated for time spent on email

Jared Sinclair, RN

September 24, 2010Sep 24, 201019

Dr. Wes, a blogging cardiologist, posted a follow-up to his recent post on e-mail correspondence between physicians and patients. The majority of emails he receives tend to be for very simple things like checking a lab result. Current EMRs don’t…

Dr. Wes, a blogging cardiologist, posted a follow-up to his recent post on e-mail correspondence between physicians and patients.

The majority of emails he receives tend to be for very simple things like checking a lab result.

Current EMRs don’t make reviewing and sharing lab values efficient. Dr. Wes writes:

[O]ur current model of the electronic medical record sending every single result to our inbasket, even though it contains

…

Health policy and public health

Articles, page 164

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