Health policy and public health

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Articles, page 69

Technology is corrupting the culture of medicine

July 2, 2019Jul 2, 2019

To help then-candidate Bill Clinton remain focused on the No. 1 voter issue ahead of the 1992 presidential elections, political strategist James Carville coined an unforgettable mantra, which he posted inside Clinton campaign headquarters. It read, “The economy, stupid.” The…

It read, “The economy, stupid.”

The quote became famous both for its edginess and wisdom, reminding us to separate the big picture from everything else.

In health care, it can be hard to define the “big picture” issue when …

Physician voices

Physicians: Do not be intimidated by administrators

Suneel Dhand, MD

June 28, 2019Jun 28, 20196

A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have …

Conditions and diseases

How climate change affects your skin

David Fivenson, MD & Sultan H. Qiblawi

June 27, 2019Jun 27, 20192

Global climate change is reaching a critical mass. Since the advent of the industrial revolution, we have seen the global mean temperatures increase by 1°C (1.8°F), and significant steps must be taken by 2030 to mitigate an even larger global…

Global climate change is reaching a critical mass.

Since the advent of the industrial revolution, we have seen the global mean temperatures increase by 1°C (1.8°F), and significant steps must be taken by 2030 to mitigate an even larger global temperature increase of 1.5 to 3C as predicted by 2030. In other words, we are in dire need of change.

This change is not only reliant on governmental policy change but is …

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How climate change affects your skin

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Physician voices

A physician volunteers with migrants. Here’s what she saw.

Sheryl Recinos, MD

June 26, 2019Jun 26, 20192

“At least seven children are known to have died in immigration custody since last year,” according to a NBC News report last month. I recently spent a Saturday working with amnesty-seekers that had been detained at California detention centers in…

“At least seven children are known to have died in immigration custody since last year,” according to a NBC News report last month.

I recently spent a Saturday working with amnesty-seekers that had been detained at California detention centers in the desert. They were dropped off at bus and train stations in the desert in Southern California, most with no money and no ability to …

Health policy

Can the states fix our national health care disaster?

Elisabeth Rosenthal, MD

June 26, 2019Jun 26, 20194

Earlier this year, California’s new governor, Gavin Newsom, promised to pursue a smörgåsbord of changes to his state’s health care system: state negotiation of drug prices, a requirement that every Californian have health insurance, more assistance to help middle-class Californians…

The proposals fell short of the sweeping government-run single-payer plan Newsom had supported during his …

Health policy

Cancer care costs everyone too much. What can we do about it?

Andrew Hertler, MD

June 24, 2019Jun 24, 2019

Today's fee-for-service oncology business model misaligns incentives by rewarding practices for keeping margins and service volumes high — even when it's wasteful — rather than for optimizing patient outcomes. While discussions of drug pricing dominate the cost control conversation, we,…

Today’s fee-for-service oncology business model misaligns incentives by rewarding practices for keeping margins and service volumes high — even when it’s wasteful — rather than for optimizing patient outcomes.

While discussions of drug pricing dominate the cost control conversation, we, as practitioners, have been abdicating responsibility and missing the opportunity to address cancer’s financial toxicity. We can do better. The practice-level assumption of financial risk for patient care — or the …

Physician voices

Physicians have been reduced to overpaid dairy farm labor

Kyle Varner, MD

June 24, 2019Jun 24, 201912

I can tell you why there is a high burnout rate in the medical profession, but to do so, I have to explain why there isn’t one for small private practices. When I was finishing up medical school, I went…

I can tell you why there is a high burnout rate in the medical profession, but to do so, I have to explain why there isn’t one for small private practices.

When I was finishing up medical school, I went to see a general practitioner. Now, this doctor had an unbelievably high level of charisma. To say he was engaged in his patient’s health care would be an understatement. Not only would …

Physician voices

Why MIPS is a useless mental exercise

Linda Girgis, MD

June 23, 2019Jun 23, 2019

Every day I receive all kinds of emails and other ads telling me about services offering me help to meet MIPS quality metrics. While they may be helpful, most doctors don’t see the need for such a program. It drives up costs in administering and time in needless metrics reporting. Yet, give us a new regulation and a whole industry is going to pop up to profit off of our …

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Why MIPS is a useless mental exercise

Health policy

A new rule that could be a game changer for health care

Elisabeth Rosenthal, MD

June 19, 2019Jun 19, 20193

As President Donald Trump was fighting with Congress over the shutdown and funding for a border wall, his administration implemented a new rule that could be a game changer for health care. Now, hospitals must publicly reveal the contents of…

As President Donald Trump was fighting with Congress over the shutdown and funding for a border wall, his administration implemented a new rule that could be a game changer for health care.

Now, hospitals must publicly reveal the contents of their master price lists — called “chargemasters” — online. These are the prices that most patients never notice because their insurers negotiate them down or they appear buried as line …

Health policy

The devaluation of physicians

Mark Lopatin, MD

June 19, 2019Jun 19, 201925

Chip Kelly was a former coach and general manager of my beloved Philadelphia Eagles. He was a firm believer in his “system” and felt that his players were disposable and easily replaced. Because of that, he proceeded to trade away or release very talented players and replace them with less talented players. Needless to say that without the talent, the team self-destructed, the fans were angered, and it was only …

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The devaluation of physicians

Health policy

The power of advocacy: How doctors can be empowered physicians

Amaryllis Sánchez Wohlever, MD

June 16, 2019Jun 16, 20194

An excerpt from Recapturing Joy in Medicine, During my year as chief resident, I was also president of the Florida Association of Family Medicine Residents. The faculty at my residency program inspired me by their excellence as clinicians and teachers.…

An excerpt from Recapturing Joy in Medicine,

During my year as chief resident, I was also president of the Florida Association of Family Medicine Residents. The faculty at my residency program inspired me by their excellence as clinicians and teachers. I trusted their judgment and insight, so when they encouraged me to get involved in our state medical academy, I decided to go for it. More than two decades …

Physician voices

Death threats won’t stop this doctor from advocating for vaccines

Linda Girgis, MD

June 14, 2019Jun 14, 20192

In the U.S., we now have an outbreak of measles where the cases number more than it has in decades. Most of the people being infected are unvaccinated, and we’ve all seen the media reports of the growing tide of anti-vaxxers. While the CDC, WHO, and pretty much every medical and scientific authority across the globe stand by the efficacy and safety of vaccines, those opposed rather rely on the …

Health policy

How pharmacy-based primary care takes the low-hanging fruit

Charles Dinerstein, MD, MBA

June 13, 2019Jun 13, 201911

With the announcement of CVS Health HUBs, the synergy of data and business is rapidly coming to the health sector; health systems will become havens only for the severely acutely ill, the more complex, the expensive. In the same way that urgent care centers catered to low acuity, high financial margin problems that both financially supported and congested emergency departments, HealthHUBs will take similar problems away from primary …

Health policy

Language matters: the not-so-innocuous provider effect

Torie S. Sepah, MD

June 10, 2019Jun 10, 20199

Language matters. The use of the word "provider" may seem innocuous, but it is significant both for patients and physicians. For patients, it has been perhaps the most pronounced step — if not leap — away from transparency. (Who is…

Language matters. The use of the word “provider” may seem innocuous, but it is significant both for patients and physicians.

For patients, it has been perhaps the most pronounced step — if not leap — away from transparency. (Who is who? Nurse, doctor, chiropractor, podiatrist, psychologist? Doesn’t matter — everyone is a “provider.”)

For physicians, the ramifications have been two-fold. One on hand, the use of the word is a demotion by …

Physician voices

Putting patients first by letting patients go

Cynthia Williams, MD

June 9, 2019Jun 9, 20193

Like many primary care physicians in this health care marketplace, I found myself operating on a hamster wheel of volume care, seeing more and more patients and spending less and less time with them. The pressure on my practice, my patients and my staff was unsustainable. With new regulations and declining reimbursements, there was no way to provide the levels of support and service that are so important, especially to …

Health policy

In our health system, who “owns” patients?

American College of Physicians & Philip A. Masters, MD

June 7, 2019Jun 7, 20192

A guest column by the American College of Physicians, exclusive to KevinMD.com. When talking with patients - particularly those with multiple, complicated medical issues - it often doesn’t take very long to hear about their increasingly suboptimal and sometimes harrowing…

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

When talking with patients – particularly those with multiple, complicated medical issues – it often doesn’t take very long to hear about their increasingly suboptimal and sometimes harrowing interactions with our health care system.

Examples include inpatient experiences in which care is provided by a constantly shifting team consisting of individuals from multiple medical disciplines …

Health policy

When physician pay packages become hospital kickbacks

Jordan Rau

June 6, 2019Jun 6, 20193

For a hospital that had once labored to break even, Wheeling Hospital displayed abnormally deep pockets when recruiting doctors. To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic…

For a hospital that had once labored to break even, Wheeling Hospital displayed abnormally deep pockets when recruiting doctors.

To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic for him to run on its campus in Wheeling, W.Va. It paid Tune as much as $1.2 million a year — well above the salaries of 90% of pain management physicians …

Health policy

The epidemic of violence against health care workers

Marlene Harris-Taylor

June 3, 2019Jun 3, 20198

Across the country, many doctors, nurses and other health care workers have remained silent about what is being called an epidemic of violence against them. The violent outbursts come from patients and patients’ families. And for years, it has been…

Across the country, many doctors, nurses and other health care workers have remained silent about what is being called an epidemic of violence against them.

The violent outbursts come from patients and patients’ families. And for years, it has been considered part of the job.

When you visit the Cleveland Clinic emergency department — whether as a patient, family member or friend — a large sign directs you toward a metal detector.

An …

Health policy

Pay people for their kidneys? It’s time.

Robert Pearl, MD

May 31, 2019May 31, 20193

These are trying times for health care optimists. Despite all the hype surrounding breakthroughs in clinical practice and technology, American medicine is stuck in in neutral. Though the engine is revving loudly, little progress is being made. This unfortunate truth…

This unfortunate truth came into clearer light last week when I was preparing lesson plans for the health care strategy course I teach at the Stanford Graduate School of Business. During the first class of …

Health policy

Medicare for all will kill jobs. But it may be necessary.

Elisabeth Rosenthal, MD

May 31, 2019May 31, 201920

As calls for radical health reform grow louder, many on the right, in the center and in the health care industry are arguing that proposals like “Medicare for all” would cause economic ruin, decimating a sector that represents nearly 20%…

While exploring a presidential run, former Starbucks chief Howard Schultz called Medicare for all “not American,” adding, “What industry are we going to abolish next — …

Health policy and public health

Articles, page 69

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