Health Policy and Public Health

Physicians writing on KevinMD about policy as it reaches the exam room: prior authorization and the state and federal rules now written for it, scope of practice laws state by state, the CDC opioid guideline and what forced tapers did to patients, and public health from vaccination to the pandemic. Four maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words, Opioids: what physicians and pain patients say, in their own words, and Vaccines: what physicians say, in their own words.

Groupon for medical care is symptomatic of our broken system

Lauren Weber

Health Policy

September 13, 2019

Emory University medical fellow Dr. Nicole Herbst was shocked when she saw three patients who came in with abnormal results from chest CT scans they had bought on Groupon.

Yes, Groupon — the online coupon mecca that also sells discounted fitness classes and foosball tables.

Similar deals have shown up for various lung, heart and full-body scans across Atlanta, as well as in Read more…

Groupon for medical care is symptomatic of our broken system

Women in medicine are trailblazers, advocates, and leaders

Patrice A. Harris, MD

Physician

September 13, 2019

A guest column by the American Medical Association, exclusive to KevinMD.com.

Each September, the American Medical Association (AMA) is proud to recognize and honor the immense contributions women make to the House of Medicine. Such recognition is particularly appropriate this year. I count myself lucky to be joined by two exceptional women physicians in holding the offices of president, president-elect, and immediate past …

Should doctors take more responsibility for quality metrics?

Sarah Gebauer, MD

Health Policy

September 12, 2019

How do you react when presented with your quality data?

In my experience, physicians generally respond by:

Ignoring the metrics
Arguing about why the metrics are wrong
Saying the metrics are stupid

A lot of doctors refuse to participate in the process of developing, reviewing and refining quality metrics. Although this has the definite advantage of feeling like you’re sticking it to “the man,” it feeds an unhelpful cycle that eventually hurts …

How hospitals drive up health costs

Elisabeth Rosenthal, MD

Health Policy

September 11, 2019

As voters fume about the high cost of health care, politicians have been targeting two well-deserved villains: pharmaceutical companies, whose prices have risen more than inflation, and insurers, who pay their executives millions in salaries while raising premiums and deductibles.

Although the Democratic presidential candidates have devoted copious airtime to debating health care, many of the country’s leading health policy experts have wondered why they have given a total pass …

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How hospitals drive up health costs

Why should you belong to a medical professional society?

Philip A. Masters, MD

Health Policy

September 8, 2019

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Because I work for a medical specialty society, I’m frequently asked by non-members why I believe they should belong to a medical professional society. This is a particularly relevant question these days given the rapidly changing landscape of medicine and with physicians becoming …

The insanely brazen effort to remake medicine into a consumer industry

Margalit Gur-Arie

Health Policy

September 6, 2019

For over a decade, Washington, DC has been busy with fixing health care. For over a decade, the same government bureaucracy, the same advocacy (read lobbying) organizations, the same expert think tanks, the same academic centers, the same business associations, with the same people hopping around from one entity to the next, have been generating and applying the same “innovative solutions” differentiated solely by their aggrandizing names. The result? Health …

Use pediatric research to solve the threat of gun violence

Vivek Balasubramaniam, MD, Joyce Javier, MD, MPH, Shetal Shah, MD, and Debra L. Weiner, MD, PhD

Health Policy

September 6, 2019

The recent Philadelphia-, El Paso- and Dayton-area shootings brought all my memories back. As a pediatric pulmonary and critical care physician, I have been here so many times before.

At 11:12 a.m. on a Wednesday last September, as I sat in my office enjoying a sunny day in the Midwest, I received a two-word text from my 15-year old high school junior: “I’m OK.”

“What happened?” I asked. “Active shooter at Greenway …

Advancing women in medicine — with a whisper

Jennifer A. Best, MD

Physician

September 5, 2019

Personal journal entry, September 11, 2017:

Sometimes we wear womanhood like a yoke — burdensome on our shoulders, as we carry the torch for younger women coming behind. Sometimes, we swing womanhood as a sword, slicing, and jousting for survival in a world that started without us, and in some cases, would be more than happy to continue that way. Sometimes, womanhood surrounds us thick as a fog, wrapping us in …

Why can e-cigarettes advertise on TV?

Michelle Andrews

Health Policy

September 1, 2019

Why does e-cigarette maker Juul advertise its product on TV when cigarette ads are banned? The short answer: Because it can.

For nearly 50 years, cigarette advertising has been banned from TV and radio. But electronic cigarettes — those battery-operated devices that often resemble oversized USB flash drives with flavored nicotine “pods” that clip in on the end — aren’t addressed in the law.

Since launching its product in …

Read more…

Why can e-cigarettes advertise on TV?

How nurse practitioners can expand abortion access

Vanessa Shields-Haas, RN

Health Policy

September 1, 2019

It has been a savage few months for reproductive rights, with 12 states passing 26 bills to ban abortion, including measures that ban abortion as early as six weeks into pregnancy, as well as attempting to outlaw safe methods of abortion. In the face of this extreme, unprecedented wave of attacks, several states pursued an alternative route, passing laws that expand the scope of abortion providers …

These medical students support Medicare for all. Here’s why.

Scott Swartz and Bradley Heinz

Health Policy

August 31, 2019

The most difficult part of our first year of medical school wasn’t memorizing anatomy or mastering the patient interview, but seeing firsthand how broken our current health care system is. We pay twice as much as other wealthy nations for health care, but receive some of the worst outcomes. Many factors contribute to this dysfunction, and one looms large: a medical system dominated by for-profit private insurers. We hear about …

It’s time to seriously study gun violence

Michael B. Bagg

Health Policy

August 29, 2019

I have been working on gun violence prevention for the past two years. After the Las Vegas shooting, I worked with a fellow medical student to create a course teaching medical students about gun violence and how it relates to medicine. We taught future physicians, the ones who will be responsible for treating gun injuries, about the complexities of firearms in America. I have spoken to medical student members of …

Why the Lancet’s editorial on Kashmir is unhelpful

Dr. Saurabh Jha

Health Policy

August 29, 2019

If Rudolph Virchow’s observation that “medicine is a social science and politics is nothing but medicine writ large” is true, then medicine is bias writ large because politics is nothing but bias on steroids. Virchow’s maxim is now adopted by medical journals which freely mix medicine with politics. No journal has taken this mixology to greater depths than the Lancet. In its pages, you’ll find tomes on the efficacy of …

The story of a hospital collapse and how small towns were devastated

Barbara Feder Ostrov and Lauren Weber

Health Policy

August 28, 2019

The money was so good in the beginning, and it seemed it might gush forever, right through tiny country hospitals in Missouri, Oklahoma, Tennessee and into the coffers of companies controlled by Jorge A. Perez, his family, and business partners.

It was his “secret sauce,” the rotund Miami entrepreneur would smilingly tell people in their no-stoplight towns. The money-making ventures he proposed sounded complicated, sure, but he said they would bring …

How closing rural hospitals cost patient lives

Sarah Jane Tribble

Health Policy

August 26, 2019

For more than 30 minutes, Robert Findley lay unconscious in the back of an ambulance next to Mercy Hospital Fort Scott on a frigid February morning with paramedics hand-pumping oxygen into his lungs. A helipad sat just across the icy parking lot from the hospital’s emergency department, which had recently shuttered its doors, like hundreds of rural hospitals nationwide.

Suspecting an intracerebral hemorrhage and knowing the ER was no longer …

The public health solution to gun deaths

Nancy Dodson, MD, MPH, Jeffrey Oestreicher, MD and Nina Agrawal, MD

Health Policy

August 23, 2019

Last year, the National Rifle Association chided physicians to “stay in their lane” when it comes to gun violence.

Our lane.

We responded, sharing images on Twitter of bloody trauma bays and blood-soaked scrubs. Memories were stirred, like the night one of us spent in an emergency room, waiting for foster care to be arranged for an infant and toddler who were orphaned after the murder-suicide of their …

Quality improvement: Helping boost everyone’s triple aim

Michael A. Weiss, DO

Health Policy

August 23, 2019

Recently, the Pacific Business Group on Health (PBGH), L.A. Care Health Plan, and the Southwest Pediatric Practice Transformation Network (a partnership of CHOC Children’s Hospital and Rady Children’s Hospital) came together to announce some incredible news and set the table for the future. With support from CMMI, over the course of the last four years, our organizations collaborated on a major quality improvement program for both primary and specialty care. …

Gun violence in America is a national emergency

Hussain Lalani, MD and Justin Lowenthal

Health Policy

August 21, 2019

Gun violence in America is a national emergency. We are tired of suturing closed bullet holes that our society refuses to prevent. Congress should return to Washington during the August recess and legislate universal background checks for all gun sales, establish so-called red flag laws nationally, and fund gun violence prevention research.

As medical providers, we are gravely concerned about the impact gun violence has on our patients. Physicians are the …

Is direct contracting an answer to soaring health costs?

Julie Appleby

Health Policy

August 20, 2019

Colorado’s ski resort areas in Summit County have a high cost of living, among the highest in the country. The people who visit these places — Keystone, Breckenridge and Copper Mountain — can afford it.

Many of those who live and work there can’t, especially when they get sick.

In addition to expensive rent, they pay some of the steepest health insurance premiums in the nation. Hospital costs are …

The trauma of separating young children at the border

Nickey Jafari, MD

Physician

August 17, 2019

Being a medical resident is really hard. This is not only due to the infamous number of hours you work, but you are truly responsible for patient care for the first time. That is a heavy responsibility, especially when you constantly feel inadequately prepared. You never feel like you have enough time to read, and you never stop feeling like you could be doing a better job.

Despite the schedule and …