Here in the U.S., we slip and slide around the reality of rationing. We like to believe we can have it all, do it all, that there are no bounds. And if you have money in the U.S., that is more or less true. Until now.
Personal protective equipment and test kits for COVID-19 are in short supply. I won’t explore the myriad of reasons of why …
It’s the R-word again: rationing
As medical trainees, we will shape the rapidly changing health care environment in this country. We are fiercely advocating for our disadvantaged patients, debating the price of life-saving medications, and carefully considering how the upcoming elections will shape the health care system in which we both provide and receive care. All the while, we handle our responsibilities and prepare to care for critically ill patients during a seemingly inevitable pandemic. …
Medical trainees need knowledge and education on health care systems and policy
In 2009, when more than $35 billion was invested in expanding national electronic health record (EHR) uptake, one of many advantages touted was its value as a tool for managing population health. This promise has failed to materialize due to a chaotic rollout of non-communicating systems. Today, as we confront COVID-19, the coronavirus wreaking international havoc, the need for such a tool is exquisitely evident.
How could …
Would Medicare for all help us combat COVID-19?
Obesity is a topic that literally hits home for me. For the past two years, the website WalletHub has voted the McAllen-Edinburg-Mission TX metroplex as the “fattest city in America.” As a health care provider, this is deeply disturbing because it puts my community at high risk for a wide variety of health problems, including but not limited to coronary artery disease, diabetes, stroke, and several cancers such as liver, kidney, breast, …
What’s to blame for the obesity epidemic?
The year 2020 might bear witness to a significant shift in control of health care from the providers, insurers, and the government to actual health care consumers.
First, it was the politicians, then the tech conferences and promises of 5G, and now global pandemic scares are all signaling the demand for remote health care.
The delivery of health care has been in the hands of hospitals and physicians for nearly a century. …
Telehealth: Get ready for big changes in health care
Over the last few years, there has been a slew of articles about patients receiving surprise bills after ER visits. One woman was charged $5,751 for an ice pack and a bandage. An infant was charged $937 for an antibiotic ointment. Who sends bills like that? Is it the ER doctors? No. It’s large corporations.
ER docs want to help you regardless of …
Who are responsible for outrageous medical bills? Hint: It’s not doctors.
A guest column by the American College of Physicians, exclusive to KevinMD.
Although I work for the American College of Physicians, I’m writing this as a general internist who has practiced both primary care and hospital-based medicine for over 25 years.
Hopefully by now, you are aware of Better is Possible: The American College of Physicians’ …
Reclaiming the future of health care
I became a physician to help people. So isn’t fighting for issues that help protect my patients such as racial equality, LGBTQ rights, gender pay equity, access to health care, and education all part of patient care?
Don’t my patients want to have a doctor who is fighting for them both in the office and outside it?
When I started working as a resident physician and later went on to my attending …
Why doctors should get political
February is a short month. Even this year with leap day. So short. Maybe that is why I am so mad at what Company X did to me.
My health insurance company stole eight hours and six minutes from me in February. I will never get it back.
This is my story of trying to get Company X to pay its part of two drugs I take for seizures. Very important drugs. …
Health insurer: I want my 8 hours and 6 minutes back
Does anyone really want health care for all? I promise this is not a political rant.
Americans, of any political persuasion, should not be misled by the implications of health care for all: It does not mean medical care for all. Providing a card stating you have health insurance is only a nominal solution, provided by politicians, who are looking for a superficial fix. Our problems are more complex than such …
Health care and sick care are interchangeable
109.
This is the number of people who died each day from firearms in the U.S. in 2017, the most recent year for which the CDC has published data. It is a staggering number, one that deeply damages the fabric of communities and tears families apart.
What’s perhaps most disconcerting is that this number – 109 – may not come as a shock. We have become so numb …
Gun violence requires medical intervention
Readers of my articles know that no one has been more critical of Obamacare’s flaws––particularly over the impact the program has had on middle-class consumers in the individual health insurance market.
And, readers already know that no one has been more supportive of the Medicaid expansion from the very beginning.
Now, the Trump administration wants to give states the option to abolish the open-ended federal funding of Medicaid via fixed block grants …
Supporters of Obamacare should consider this Trump proposal
Working in urgent care, I’ve started supervising some of the other providers at sites other than my own — 19 sites in all in Pennsylvania and Delaware — so I hear about a lot of patient situations.
The urgent care site where I work is in an affluent area. Most of our patients are employed or retired and have health insurance, though I have certainly encountered a number of patients …
Urgent care is emblematic of problems in our health system
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Gun violence has become a public health epidemic. Despite countless deaths in mass shootings over the last two decades, the Dickey Amendment—a provision inserted into the 1996 spending bill which blocked federal funding for research on gun violence—remains on the books. While every politician, media pundit, and policy expert “know” the solution, the answers are not that simple.
In reality, the factors which have fueled the rise in gun violence across …
The impact of economic inequality on the incidence of mass shootings
Spiraling costs, poor quality outcomes, and inequities in access to care are driving significant and long overdue changes to the way health care is administered and managed in the United States.
And while the U.S. spends more on health care per person than other wealthy countries, its health outcomes are no better than those in other developed countries. In fact, it performs worse in several health metrics, including life expectancy, infant …
5 disruptive trends transforming health care
Legislators have found a new way to insert themselves into the physician-patient relationship. In October and November 2019, news stories regarding a parental dispute over the treatment of a transgender child prompted legislators in Texas, Kentucky, and Georgia to announce plans to introduce bills that would prohibit medical and surgical treatment of transgender children under age 18.
Since then, Read more…
Legislators, please stay out of our exam rooms. Especially when it comes to children and gender.
Ever since the publication of the infamous 2016 BMJ opinion piece claiming medical error should be considered the third leading cause of death in the U.S., the debate on the true incidence of deaths caused by medical error has been raging. Many, including me, felt the estimate of 251,000 deaths per year from medical error was grossly inflated. For example, the paper extrapolated the number of deaths from …
Medical error is not the third leading cause of death
Our local newspaper recently ran an article on the top of its front page, stating that our monopoly health system is now “expanding health care cost discounts.” The article was actually a press release – free advertising on the front page. As a primary care physician who refers patients to this health system, I wanted to know what these discounts really meant.
So, I asked the newspaper in an editorial, “what …
What do hospital discounts really mean?
The Affordable Care Act, aka “Obamacare,” has improved patient’s access to health care since its passing in 2010.
The increase in coverage, however, does not address the restriction of prior authorization (PA), where a physician is required by a patient’s insurance company to obtain special approval from the insurance company for a medication or treatment. PA is not only needed for medication, but also for scans, potential …
Prior authorization is another barrier to cost-effective care
I just watched the movie 1917 at the theatre. Shot in a unique way giving an immersive experience, showing the frontline reality of war through an unforgettable human story, it has to be one of the greatest war movies ever made. I’d encourage everyone to go watch it. I learned a fair bit about the First World while I was in high school in the United Kingdom. Its stories are …
Health care is like lions for lambs
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