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.

Bias is widespread on both sides of the political spectrum

Edwin Leap, MD

Physician

May 17, 2018

Without doubt, the future of medicine will include mandatory education for physicians on their conscious and unconscious biases. The politically and culturally progressive nature of medical education and graduate medical education almost ensure that this will eventually be a deeply-ingrained part of our training and our continuing certification. I’m sure that as our culture purports to discover ever new and egregious forms of bias, we will be endlessly reminded, in …

Why some physicians thrive and some struggle to survive

Praveen Suthrum

Health Policy

May 15, 2018

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 …

Physicians: Let us rise. Let us lead.

Julie K. Gunther, MD

Physician

May 15, 2018

As has been much discussed in the last few years, our health care system is in crisis. We spend $3 trillion a year on Medicare. MRIs bill out at $5,000. My recent bilateral mastectomy totaled $33,000 with $800 of that actually going to my surgeon.

I left my role as an employed physician in the traditional insurance-based fee-for-service structure because I spent 80 or more hours a week typing, collecting data, …

Read more…

Physicians: Let us rise. Let us lead.

A relatively simple solution to physician burnout

David E. Hockman, MD

Physician

May 15, 2018

Physician burnout is increasing at an alarming rate. According to a January 2017 AMA Wire report, physician burnout rate has increased from 2013 to 2017 across every specialty in medicine. Greater than 50 percent of primary care providers are burned out. Therefore, every patient at the entry point of medical care is, more likely than not, going to be treated by a burned out physician. The question is why are …

What matters in an optimal consumer health care market

Richard Reece, MD

Health Policy

May 14, 2018

An excerpt from Are We There Yet?: The Road to Universal Health Care.

Getting your business matters. Much of what’s happening now in health care and retail markets concerns pleasing you, health care consumers and patients, and getting your business.

The internet matters. You’re almost all wired now. The internet is …

A better way of using Lyft and Uber in health care

Peter F. Nichol, MD, PhD

Health Policy

May 13, 2018

Recently there was an article in the Washington Post titled, “Uber and Lyft think they can solve one of medicine’s biggest problems,” in which these two companies are angling to provide better, safer more reliable transportation for patients. While I applaud this mission, given the depth and reach of both companies, I think they may be underselling their abilities to improve health care delivery and reduce cost.

Recently, one of my …

Health care is not a service commodity

Peter Spence, MD, MBA

Health Policy

May 12, 2018

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 …

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Health care is not a service commodity

Children shouldn’t worry about being hungry in school

Melinda Stoops, PhD

Health Policy

May 11, 2018

Last fall, my nine-year-old daughter asked me to buy some extra lunch items at the grocery store because she and a friend of hers were going to take turns bringing in food for a classmate who couldn’t afford to purchase lunch at school. I was reminded of this conversation last week, when the school committee in my city voted to no longer deny middle- and high-school students lunch if they …

What makes you an effective change agent in health care?

Ashwini M. Zenooz, MD

Physician

May 11, 2018

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 …

Does federal law violate our right to health care?

Matthew Dyer

Health Policy

May 9, 2018

Proponents of universal health care believe that health care is a universal human right, but is it a constitutionally-protected right, and if so, how does the U.S. Constitution compel the government to protect that right?

We can make the argument that the right to health care is indeed protected under the Ninth Amendment, which states, “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage …

We can no longer tolerate an inhumane health care system

Surafel Tsega, MD

Health Policy

May 5, 2018

She said her insurance wouldn’t cover her oxygen.

I didn’t believe her. She needed it. She had an irreversible lung disease that made walking a block feel like a hundred-yard sprint. It was no trouble showing she needed it– her blood oxygen levels would drop below 85 percent with any activity (normal levels are between 95 to 100 percent). Surely this was a minor administrative hurdle. I told her I was …

5 ways young physicians can advocate for themselves

Lauren A. Umstattd, MD

Health Policy

May 4, 2018

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 …

The drip, drip, drip of hate in the U.S.

Rebecca Thaxton, MD

Physician

May 4, 2018

Editor’s note: This article contains racial slurs essential to the story.

A few days ago at my breakfast table, over coffee and my usual peanut butter protein shake, I read Doug Brunk’s article in Family Practice News about gun violence. The article reminded me that on the same day in history (April 16th, 2007) that the Virginia Tech shooter killed 32 people and injured 23 others, 231 other gun casualties occurred …

Stranger Things are happening in health care

Robert Pearl, MD

Health Policy

May 3, 2018

About 30 miles east of LA, on the quiet tree-lined campus of Claremont Graduate University, sunlight pierces the ornately covered windows of a lower-level classroom in Harper Hall. A glow is cast upon the 25 students of Dr. Debbie Freund’s health policy course; PhD candidates and practicing physicians among them.

Many of these bright young scholars will go on to take leadership roles in health policy, public health, IT and medical research. I …

Why should health care professionals care about gun control?

Sobia Ansari, MD, MPH

Health Policy

April 26, 2018

On March 24th, one of the largest demonstrations for gun control in U.S. history took place across the nation. Represented at the March for Our Lives were a diverse group of organizations and people, including young people affected by school shootings across the country, parents who have lost children to gun violence, members of law enforcement, teachers and educators and people exposed to community violence in urban neighborhoods.

I participated in …

A bill to drive physicians out of practice in the state of California

Linda Hertzberg, MD

Health Policy

April 25, 2018

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

If you have not yet heard about Assembly Bill (AB) 3087, a bill that was presented in the California State Assembly this spring, you should keep reading and be very concerned. This bill, introduced by Assemblymember Ash Kalra (D- San …

Benefit vs. social responsibility: a profound ethical dilemma in medicine today

Hans Duvefelt, MD

Health Policy

April 22, 2018

Brilinta, at $6.50 per pill, twice a day, reduces cardiovascular events more than generic Plavix, which costs 50 cents per pill, once a day. But only a little: 20% relative or 2% absolute risk reduction. The event risk was 10% with the more expensive drug and 12% with the one that costs 82% less.

Put differently, if 100 patients were treated with Brilinta for a year, at a cost …

Gun violence in America is a multifactorial problem

Randall S. Fong, MD

Health Policy

April 18, 2018

Let me warn you — I own guns. I love to shoot. And I’m a strong supporter of the Second Amendment. This may seem hypocritical coming from a doctor, but don’t shoot me figuratively speaking, of course — before I make my case. Any mass killing is a horrifying event. Any senseless death is riveting. Obviously, this goes without saying, but as a doctor whose purpose is to save lives, …

America leads the world in high tech care and health care costs

Mark Kelley, MD

Health Policy

April 14, 2018

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 …

A radical proposal to save America’s hospitals

Robert Pearl, MD

Health Policy

April 12, 2018

Hospitals serve as the economic lifeblood of their communities. They are the second-largest source of private-sector jobs in the United States, employing 5.4 million Americans who, together, embrace a virtuous mission to heal and help others in need.

And yet, every year, more and more of them are forced to shut their doors. With soaring costs, eroding margins and mounting pressure from competing providers, the American hospital industry is on life …

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