Public Health & Policy

Virtual organizations in health care

Tech

January 1, 2022

In almost all organizations, an employee has a supervisor responsible for guiding the employee in doing their job. This requires good communication between the two.

Currently, in medicine, especially during stays in the hospital, there is a similar relationship between physicians: The attending physician recruits the necessary specialist physicians to provide care for the patient and supervises their care. The difference is that this relationship is just for the patient, and …

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Virtual organizations in health care

CPT coding changes: 5 proven methods of how to do more with less

James Maskell

Policy

December 31, 2021

It’s well known that coding changes drive provider behavior, and billing behavior drives provider decisions.

For the last 30 years, little has changed in health insurance billing, which is why the standard of care within the payer system has remained, well, standard.

Then the pandemic hit, and suddenly everything was turned on its head. Patient demands increased sharply, office visits became impossible or prohibited across most of the country, and with telemedicine, …

The U.S. doesn’t have enough faculty to train the next generation of nurses

Rayna M. Letourneau, PhD, RN

Policy

December 29, 2021

Despite a national nursing shortage in the United States, over 80,000 qualified applications were not accepted at U.S. nursing schools in 2020, according to the American Association of Colleges of Nursing.

This was due primarily to a shortage of nursing professors and a limited number of clinical placements where nursing students get practical job training. Additional constraints include a …

Emotional epidemiology of disease is as critical as clinical epidemiology

Danielle Ofri, MD, PhD

Physician

December 28, 2021

At this point in the COVID vaccination campaign, nearly all American adults who want the vaccine have gotten it, and are gratefully snapping up their boosters. Those who decline vaccination are largely impervious to public service announcements, community pressure, and case counts turbocharged by the Omicron variant.

Public health experts emphasize that primary care doctors and nurses are the key to this last mile of the vaccination effort. …

Why health care delivery is an exceptionally different industry: Why does it matter?

Joe Mandato and Ryan Van Wert, MD

Policy

December 27, 2021

Third in a series. Please read part 1 and part 2.

We expect that most readers have noticed the differences in health care delivery compared to other industries that we discussed in part 1 and part 2. Those differences relate to board governance, health care leadership, infrastructure, and operations. Readers probably also noticed that these differences …

High deductible health insurance is bankrupting Americans

Ben Aiken, MD

Policy

December 24, 2021

Two decades ago, high deductible health plans barely existed. Today, more than half of the U.S. workforce is on one, which are plans with deductibles greater than $1300 per individual or $2,600 for a family.

It’s a growing, undiscussed problem for public health. Most doctors have had patients refuse treatment due to out-of-pocket costs caused by their high deductible health plan. All the while medical debt continues to …

The goal of health care is in peril

Vincent Roddy, MD

Policy

December 23, 2021

Introduction and background

As an emergency department medical director and physician, a busy emergency department can be a thing of beauty to me. We work hard to set up systems that will provide the care our patients need. Despite our best efforts, almost daily, variables occur that throw the system into chaos and lead to inefficiency. The COVID-19 pandemic unveiled and exacerbated many challenges that affect our ability to provide the …

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The goal of health care is in peril

Life along the railway lines in Bangladesh during Bishwa Ijtema: a physician’s photojournal

Glenn Mark Losack, MD

Physician

December 23, 2021

The Bishwa Ijtema meaning “global congregation” is an annual gathering of millions of Muslims in Tongi, by the banks of the Turag river, just north of Dhaka, in Bangladesh. Bangladesh is predominantly a Muslim nation. This yearly “BI” is one of the largest peaceful gatherings in the world. The Ijtema is a prayer meeting spread over three days, usually in January during which attending devotees perform daily prayers while listening …

Why health care delivery is an exceptionally different industry: health system infrastructure and health system operations and execution

Joe Mandato and Ryan Van Wert, MD

Policy

December 22, 2021

Second in a series. Please read part 1.

The business of health care delivery differs markedly from other consumer and service industries in many ways. First and foremost, the economics differ. Specifically, the payers of medical care are often different from the customers, the government and third-party insurers are the primary payers, demand is inelastic, quality metrics are typically unavailable, and the industry consists largely …

Is life more than breathing and a heartbeat?

M. Bennet Broner, PhD

Conditions

December 20, 2021

A few months back, I read about a two-year-old child with a terminal cardiac condition who has spent her life in a hospital bed attached to multiple devices that maintained her survival. At the staff’s request, the institution’s ethics committee reviewed the child’s history and prognosis and decided that the equipment could be disconnected. Her mother repeatedly blocked this option, insisting that the child, although frequently sedated, had a “bubbly …

Key change are needed to make the No Surprises Act work as Congress intended

Gerald E. Harmon, MD

Policy

December 19, 2021

Physicians prioritize patient needs above all other considerations. To advance that mission, the AMA works tirelessly to improve access to quality, affordable health coverage for everyone, which includes protecting patients from the financial harm posed by unanticipated medical bills that can be generated through out-of-network care.

That is why the AMA has joined the American Hospital Association in asking the courts to …

Why health care delivery is an exceptionally different industry: board of directors and CEOs

Joe Mandato and Ryan Van Wert, MD

Policy

December 17, 2021

First in a series.

The Kyle Rittenhouse acquittal: a contrasting physician opinion

Anonymous

Physician

December 16, 2021

Please also read the contrasting opinion article, “Doctoring during Kyle Rittenhouse’s acquittal.”

The Kyle Rittenhouse acquittal. We need to know the truth: There has been much misinformation and some downright lies on social media and mainstream media regarding this. Some social media outlets have blocked any positive comments regarding Rittenhouse. A man who contributed $25 to a GoFundMe site to support Rittenhouse, (before the social media platform canceled …

The bipartisan infrastructure deal is now law, but here’s what it forgets

Charles Sanky, MD, MPH

Policy

December 16, 2021

In June 2021, the Biden administration announced bipartisan support for federal legislation to rebuild our nation’s crumbling infrastructure. The Infrastructure Investment and Jobs Act seeks to revive highway, transit, rail, and public work systems, as well as improve broadband internet access, mitigate the supply chain crisis and combat climate change.

Like most Americans, I am grateful that we are …

Monica Gandhi, MD on why hospitalizations better measure COVID’s impact [PODCAST]

The Podcast by KevinMD

Podcast

December 13, 2021

Welcome to an expedited episode of The Podcast by KevinMD. Monica Gandhi is an infectious disease physician and co-author of the New York Times opinion article, “Why Hospitalizations Are Now a Better Indicator of Covid’s Impact.”

Transcript

Kevin Pho, MD: Hi, and welcome to the show where we share …

We have an obligation to keep firearms out of the hands of children

Shayla A. Sullivant, MD

Policy

December 8, 2021

We are saddened by another school shooting in America. Four lives were cut short, and one young man who was obviously crying out for help clearly did not get it.

There are so many pieces to this puzzle to examine. So many areas where we can improve. As a child psychiatrist, I am fully aware that our mental health system is broken. So many families seeking care run into barriers and …

Why the Build Back Better Act is an investment, not a cost

Shirin Shafazand, MD

Policy

November 28, 2021

The original Build Back Better Act proposed various provisions to improve Americans’ lives, including two years of free community college, child care assistance, and investments in clean energy. The steep price tag has led many to question whether or not we can afford to spend so much.

But as a pulmonary and critical care physician at a major metropolitan hospital, I have a different question: can we afford not to?

Every day in …

What medicine can learn from the antiwork movement

Brendan James Flanagan, MD

Physician

November 26, 2021

A record number of Americans are choosing to quit their jobs. This phenomenon has been termed The Great Resignation by economists. The reasons for the Great Resignation are multifactorial and a subject of great debate, but some insight can be gleaned from the rise of a movement that has been called ‘antiwork’. This movement is probably best embodied by the immensely popular /antiwork Reddit forum, where aggrieved employees share stories …

Health care has crossed into a realm of moral injury and systemic collapse

Anonymous

Physician

November 23, 2021

Recently I have been more quiet than usual. Less writing. Less fire and brimstone. Quiet, at least for me. But anyone who is paying attention knows that when the most passionate and the most invested get quiet, something is truly amiss. Whether it be a looming threat or a very real and present crisis is unknown, but the fact remains that in that silence lives the very real possibility of …

“Take it or leave it” is not negotiation but coercion

Paul Pender, MD

Policy

November 23, 2021

“Take it or leave it” is not negotiation but coercion.

Physicians have been subject to this tactic for much too long. As an ophthalmologist in clinical practice for nearly four decades, I experienced too often what a recent author on KevinMD described as a one-sided arrangement with a health insurance company. “Here is the fee schedule. Here is the document to sign.” End of story.

If you object to the terms of …