I’m writing this piece because I’m finally at the point that I am truly angry. I am angry at how physicians have become devalued in modern health care. I’m angry at how systems of care have participated in this by replacing physicians with lesser trained mid-level practitioners. I’m angry at how our title “doctor” has been hijacked to allow patients to be misled or, in many cases, deceived.
It wasn’t that …
You extend a firm handshake and get ready to sit down at the table across from your mentor for the first time.
Woah, wait. Let’s back up to the legwork that should have happened prior to this meeting. First step, you found the mentor (see this post for practical ideas on how to find a mentor). Neither you nor the mentor have a lot of time — a frequent obstacle often …
The Affordable Care Act (ACA), widely known as “Obamacare,” has survived several repeal attempts by Congress. Storm clouds, however, are still on the horizon.
The ACA’s individual mandate obligates every American to be covered by comprehensive health insurance. This requirement has been the most unpopular feature of the law. That’s because healthy people, especially those who are self-employed or between jobs, have found the ACA premiums too expensive.
They are not alone. Health …
I’m sitting in the waiting area across the endoscopy room of a major hospital. Mindless talk show TV runs in the background. Patients are waiting patiently. They anxiously look up every now and then from their phones towards the reception desk.
It’s a scene I’ve experienced for years while working in health care while waiting for doctors.
But there’s something different in the air now.
Patients, like those around me, will encounter a …
As we continue to attempt to restructure how health care is measured, reimbursed and organized, we must hold true to the idea that health care is simply not a service commodity.
“A commodity is any good or service (“products” or “activities”) produced by human labor and offered as a product for general sale on the market.” Our health care delivery model continues to evolve as we move away from the fee-for-service (FFS) model …
Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on …
Why don’t doctors advocate for themselves? Or young doctors, at least. Maybe it’s because we’re bombarded with patient care, never ending-educational opportunities or the mountain of electronic medical records that still need signed.
Maybe it’s because it’s too overwhelming. Understanding and conquering the health care behemoth that organizations, third-party payers, and the government have created seems nearly impossible if you’re not already on your way to adding a master of health …
Why is U.S. health care so costly compared to other developed countries? A recently published report provides some insights.
In a study of 11 countries, Harvard researchers found that while the United States has the highest health costs relative to its GDP, its use of services is average. More specifically, the U.S. ranks lower than nearly every other country in doctors’ visits, hospitalizations, hospital days, and consultative services.
The difference is …
I need your help.
I’m trying to figure out how to get rid of something that’s terribly broken in our process of taking care of patients, and I can’t do it alone.
It’s time to kill the referrals process, get rid of them altogether.
Every day, a huge proportion of the messages we receive through the electronic health record are requests for us to “put in a referral.”
Patient has low back pain, has …
All eyes are on interest rates as investors look for more signs of trouble ahead.
If their concerns over higher-than-expected inflation prove accurate, many players in the U.S. economy will suffer the burden of higher costs. But perhaps no sector would feel the strain more than health care. Higher costs would be just the start of many problems to come for providers, insurers and, eventually, patients.
Surging inflation would create a vicious …
I have worked with some great nurse practitioners (NPs) who I consider to be friends. They play a vital role in team-based practice. This is not about NP bashing. Nor is it a turf war; now that I’m retired, I have no turf to protect. I am a member of Physicians for Patient Protection out of real concern for the future of medicine in this country.
I want there to be …
During his 2004 stand up “Never Scared,” Chris Rock said, “I love rap music, but I am tired of defending it.” That statement, for me, holds true more today than ever before. Mumbling about nonsense is already hard to defend and only gets worse when the first line to every song these days has a reference to drugs.
Drugs, sex, and money have always been an important part of music, and …
Anyone who has ever tried to buy health insurance in the open marketplace knows how difficult and expensive it can be. I spent years working at jobs that did not provide health insurance, and I remember the annual feeling of dread when I received notice of the new premium increase. The only way I could keep the cost affordable was by continually raising the deductible until eventually, I was paying …
ADVERTISEMENT
I am pediatrician who has been practicing for almost twenty years. During my career, I have been employed by two different free-standing children’s hospitals, a non-profit community-based health center, and now I own my own practice. In every setting, I have had to generate coding and billing for my work even when my salary was independent of that billing.
There is no other profession that would dutifully learn the “rules” of …
There are many apt comparisons to be made between aviation and health care. As a (lapsed) instrument-rated pilot, I may have some insight about the system in which planes function on a daily basis in the United States. It is truly an impressive system which is (to paraphrase Don Berwick) well-designed to achieve the safety results that it does. However, the kind of statement that some health care safety leaders …
The United States is facing a looming physician shortage, and some groups see this as an opportunity to promote an agenda of replacing physicians with nurses.
The nurse-as-doctor concept appeared in the Institute of Medicine Future of Nursing 2011 report, which called for a radical change to the nursing structure in the United States, including a goal of …
ADVERTISEMENT
What would medical education that is relevant for the here and now — for America in the early 21st century — address? It is impossible to teach the content relevant for an entire career. It is important to educate practitioners able to adapt to the changing landscape of medicine. We must consider what the future might hold.
Watching science fiction may serve to prompt future physicians to practice preventive medicine for …
The announcement that CVS plans to acquire Aetna for US$69 billion raises hope and concerns.
The transaction would create a new health care giant. Aetna is the third-largest health insurer in the United States, insuring about 46.7 million people.
CVS operates 9,700 pharmacies and 1,000 MinuteClinics. A decade ago, it also purchased Caremark and now operates …
When interviewing for my book, I asked about insurance, but the topic came up even when I didn’t specifically ask about it. It was never positive in relation to practice.
A doctor said, “I expected to be around tough and hard cases. I expected it to be hard. I did not expect to have to think if the insurance company will not pay for it.”Another one said, “This completely changes the …
ADVERTISEMENT
Eat what you kill.
Sounds like a mantra from a survival reality show, right? Akin to “eat or be eaten,” “kill or be killed.” It’s also a common reference to the prevailing business model in our American scarcity-minded, competition-driven, fee-for-service health care culture. How ironic, the application of these words to this profession. It was explained to me essentially as: “Every man for himself, and you’re a minion. You are expected …
Get free updates delivered free to your inbox.
