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.
Let’s burn health insurance down. Greedy corporate bastards should burn. Big Pharma and big hospitals should probably burn too. You know who else is really, really, bad? Wall Street. Let’s burn the banks. And let’s burn Big Tech and the entire Silicon Valley cartel. Let’s also burn Big Agribusiness that’s making us fat and sick. And let’s burn the Oil companies that are destroying the planet, and let’s burn the …
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The problem with burning health insurance down
Washington state Sen. Maureen Walsh (R-Walla Walla) became a national headline for alleging that “[nurses] probably play cards for a considerable amount of the day” during debate on legislation mandating break periods. Many nurses have mailed decks of cards to Walsh and posted pictures of blood-spattered emergency department walls in order to call attention to “last night’s card game,” driving home the point that they aren’t “playing” anything …
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Lawmakers should stop trash-talking health care professionals
“I don’t know what happened” is probably one of the most common phrases any parent hears. Last weekend, while wrapping my son’s bleeding head in gauze from our first aid kit, this was the best explanation my daughter could muster as to why her two-year-old brother was screaming, holding tightly to a blood-covered plastic ice cream cone. In the end, it was a complete accident (he hit his head on …
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Our broken health system is your fault
The tale is told of a large realm, of 1.4 billion, the largest nation in the world. It has a culture that is old, rich and grounded. A citizen’s worth can be understood, determined, exalted or decried. In modern times said country has a visionary leader for life. His foresight includes the automation of culture through the use of big datasets, mass surveillance, facial recognition, and artificial intelligence. A citizen’s …
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Are we making artificial intelligence biased?
“I have the CPAP machine. I’ve had it for a year, but I don’t have electricity in my house. I stayed with my aunt who has electricity but things didn’t work out,” said the young Navajo man, his massive belly protruding out from underneath the tray table.
The old Navajo man with Parkinson’s disease, unable to walk fast enough to make it to the outhouse in time, had started taking anti-diarrheal …
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The systemic poverty in Navajo Nation is a national travesty
One of the arguments made against adopting single-payer health care in this country is that it would “lead to rationing.” This assumes that we lucky people in the U.S. have unlimited access to whatever health care we need and are at risk of losing it.
This argument came to mind when I saw a few recent news items. One was that a federal judge, U.S. District Judge Robert Scola, recused himself …
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In a single-payer system, who will be doing the rationing?
During college and medical school, my summer employment acquainted me with members of organized crime families. Now, reflecting on my full career as a primary care clinician, geriatrician, and researcher on health care delivery improvement, I have discovered that several insights from organized crime could guide medical professionals’ responses to our country’s health care crisis.
Organized crime and the U.S. health care industry have more in common than might be immediately …
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What do organized crime and health care have in common?
“Were you on the hurricane emails this weekend?”
This was not the question I expected to start the week.
I came to Raleigh, North Carolina to spend part of my fourth year of medical school as special assistant to Dr. Mandy Cohen, the secretary of the Department of Health and Human Services in North Carolina. I wanted to work in government — to understand what public service meant, gain operational experience and …
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What volunteering during a crisis taught this medical student
According to Wikipedia, a livestock guardian dog is a type of pastoral dog bred for the purpose of protecting livestock from predators. If only our doctors had these noble creatures to protect them from the predators of the world, to alert them when those interested in only the “bottom line” entered the halls of healing, our medical practices. Apparently, a “fox is guarding the hen house,” one who is not …
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Physicians and patients must work together to improve health care
Lately, I have been contemplating the growing political divide in this country. We seem perpetually locked in a state of partisan gridlock. Our nation is stuck in a continuous news cycle dominated by party politics. This perpetuates party divisions and takes us further away from bipartisan consensus on how to achieve and sustain the common good. The gulf between the parties has become so deep, that we can’t even agree …
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Political games are destroying our national state of health
Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …
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Why doctors crash planes
On the matter of climate change and global warming, the fuse is lit. The current epoch of Earth is the “Anthropocene,” meaning that for the foreseeable future, the destiny of our planet will be mainly determined by human activity. In the past half-century by some accounts, we’ve managed to alter our climate as much as it has changed in all of previously recorded time. And according to accurate records and …
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Planetary health has become the major determining factor of human health
Recently, I was at a health care facility in a semi-urban region, less than 100 miles from a major metro. It had a whiff of industry from good times that have long drifted by.
I tried to locate a Starbucks. Google Maps spotted one and took me towards the local university campus. As I drove there, I noticed several pain management clinics advertising themselves in unusual ways for “relief.”
Once inside the …
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Seeing the effects of the opioid crisis play out live
Honestly, I have never been a big fan of insurance. I am not much of a gambler, and paying for insurance feels like betting on my own misfortune. I have never purchased insurance for a cell phone or appliance. I would rather save the money and make an effort to take care of my possessions. I reluctantly have car insurance, homeowners’ insurance, disability insurance, life insurance, and health insurance. The …
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Why is health insurance so unaffordable?
I’m constantly awed by the fact that I get to be part of one of the best hospitals in the world, especially because as a kid, I grew up without health insurance.
These were the days before the Affordable Care Act; there was no penalty for going without health coverage. As a non-citizen, I was ineligible for Medicaid, and private health care was prohibitively expensive for my family. Fortunately, I was …
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A medical student grew up without health insurance. Here’s why that matters.
Health products are increasingly moving from the realm of the medical professional to the consumer. Direct-to-consumer (DTC) versions of teeth alignment kits, genetic tests, hearing aids, heart-rhythm monitors, neurostimulation devices, and mental health tools are already on the market, causing professional organizations of dentists, geneticists, audiologists, cardiologists, neurologists, and Read more…
5 ways to address the issues of direct-to-consumer health products
