Health policy and public health

4,357 articles · Since 2004

Articles, page 78

Are Medicare procedure payments in jeopardy?

August 31, 2018Aug 31, 2018

While hundreds of doctors have submitted (mostly unfavorable) comments to CMS on the proposed evaluation and management changes, other issues seem to be receiving much less attention than they deserve. And one of those may hit physicians who perform procedures…

In 2015, Congress asked CMS to analyze the global period data to ensure procedure weighting accurately reflected the actual work done by physicians. Of course, when Congress asks …

Health policy

What being held at the Mexican border is really like

Vidya Ramanathan, MD, MPH

August 30, 2018Aug 30, 20182

She tells me that she sees them at night when she is lying in her bunk bed — eight to a room. Grotesque forms with masks over their heads and guns across their chests. She hears panicked shrieks, but is never certain if they are coming from the next trailer, or if they are inside her head. They cannot be nightmares, because she never sleeps. She reminds herself that haunting …

Physician voices

Want to change the health system? Find your why.

Gil C. Grimes, MD

August 29, 2018Aug 29, 20182

Can the health system survive? It comes down to the people. It is not about their work, but how they feel: feeling valued, feeling their work is valuable to those they serve, and feeling valuable doing the work. It is…

Can the health system survive?

It comes down to the people. It is not about their work, but how they feel: feeling valued, feeling their work is valuable to those they serve, and feeling valuable doing the work. It is work as an extension of what you believe, what you love and how you want the world to be reflected back to you.

For 22 years, I have watched systems work to …

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Health policy

3 ways to decrease emergency department wait times

Robert Pearl, MD

August 28, 2018Aug 28, 20182

Have you ever been the only customer in your local supermarket? Although the experience can be a bit unnerving, at first, you soon start to notice the advantages: No line at the deli, no pushy shoppers, no carts jamming up the produce section. As you breeze through checkout, you think to yourself, “Gee, I could get used to this.”

Now, imagine walking into an empty waiting area at your local emergency …

Physician voices

Not all doctors are physicians

Ira Nash, MD

August 28, 2018Aug 28, 201845

A colleague recently sent me a link to the American College of Cathopathic Physicians a new organization whose mission “is to protect the professional autonomy and advocate for a full, broad scope of practice for DNPs as a ‘cathopathic physician’…

I was, I admit, so stunned by the statement that I thought the whole thing might be an elaborate joke. It was only …

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Not all doctors are physicians

Health policy

Why this physician teaches health policy in medical school

Kenneth Lin, MD

August 28, 2018Aug 28, 2018

From 2009 to 2012, I directed the graduate course "Fundamentals of Clinical Preventive Medicine" at Johns Hopkins University's Bloomberg School of Public Health. It was a required course for Hopkins preventive medicine residents, and also usually attracted other master's level…

From 2009 to 2012, I directed the graduate course “Fundamentals of Clinical Preventive Medicine” at Johns Hopkins University’s Bloomberg School of Public Health. It was a required course for Hopkins preventive medicine residents, and also usually attracted other master’s level public health students and undergraduates with a strong interest in medicine. The class size was 15 to 25 students. In that setting, with a small group who generally believed that …

Health policy

A physician gun owner’s suggestion

Edwin Leap, MD

August 26, 2018Aug 26, 201819

So let’s get down to it. Everyone is tired of shooting sprees. If you’re a gun owner, you’re tired of seeing weapons abused and misused to harm the innocent. If you’re a gun opponent, you feel the same way but can’t imagine why anyone has these weapons in the first place. I get it. I hope both sides get it.

I’ve thought about this a lot. I’m a gun owner. I …

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A physician gun owner’s suggestion

Health policy

Can direct primary care save us from the tapeworms of insurance?

Niran S. Al-Agba, MD

August 24, 2018Aug 24, 20187

When Amazon, Berkshire Hathaway, and JP Morgan (AmBerGan) announced their health care partnership, Berkshire CEO Warren Buffett declared “the ballooning costs of health care act as a hungry tapeworm on the American economy.” He is right. Our broken system is infested with tapeworms. Tapeworms are parasites; they exploit their hosts, drain resources, and suck the life out of their prey. Unfortunately, Buffet failed to call attention to the tapeworms specifically; …

Physician voices

Remember that your doctor is also human

Praveen Suthrum

August 19, 2018Aug 19, 20183

“I love what I do. I hate what I have to do.” It's a quote that doctors attribute to their profession behind closed doors. As patients, we are so overwhelmed with our own problems. We fail to notice that our…

“I love what I do. I hate what I have to do.”

It’s a quote that doctors attribute to their profession behind closed doors. As patients, we are so overwhelmed with our own problems. We fail to notice that our doctor may be battling her own problems with a complicated system.

But what do we care? Our meeting with the doctor is a paid transaction. We are owed our money’s due. Empathy …

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Remember that your doctor is also human

Health policy

Do uninsured patients receive more unnecessary care?

Peter Ubel, MD

August 17, 2018Aug 17, 201810

American physicians dole out lots of unnecessary medical care to their patients. They prescribe things like antibiotics for people with viral infections, order expensive CT scans for patients with transitory back pain, and obtain screening EKGs for people with no signs or symptoms of heart disease. Some critics even accuse physicians of ordering such services to bolster their revenue.

So what happens when uninsured patients make it to the doctor’s office …

Health policy

A physician contemplates Medicare blended rates

Ira Nash, MD

August 15, 2018Aug 15, 201819

I am a terrible coder. I think I am a pretty good doctor, but when it comes to coding, the process of figuring out which billing code to pick to assign to a bill for an office visit, I am…

I am a terrible coder. I think I am a pretty good doctor, but when it comes to coding, the process of figuring out which billing code to pick to assign to a bill for an office visit, I am hopeless. No matter how many times I have had the rules explained to me, or how much feedback I have been given about specific visits, or which “pocket guide” to …

Health policy

Hospital mergers and the risk to patient safety

Mark E. Reynolds & Susan Haas, MD & William Berry, MD

August 14, 2018Aug 14, 20183

"Better patient care” is the reason hospital and health systems usually give when they merge or acquire one another. Our research suggests that mergers and affiliations might, paradoxically, increase the risk of harm to patients in the short run. Improving…

“Better patient care” is the reason hospital and health systems usually give when they merge or acquire one another. Our research suggests that mergers and affiliations might, paradoxically, increase the risk of harm to patients in the short run. Improving the safety of patient care is possible during mergers and affiliations, but requires intentional efforts.

What happens after …

Health policy

4 disturbing trends in health care

Praveen Suthrum

August 13, 2018Aug 13, 20186

It's easy to get excited about technological advances such as nanobots that swim in blood to deliver drugs or 3-D printers that print human tissues. However, in our enthusiasm to find the next fix, we are failing to notice the…

It’s easy to get excited about technological advances such as nanobots that swim in blood to deliver drugs or 3-D printers that print human tissues. However, in our enthusiasm to find the next fix, we are failing to notice the ground slipping underneath the health care industry.

Here are four trends that are changing health care but on the surface are too unsexy for us to care about.

Trend 1: The doctor-patient …

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4 disturbing trends in health care

Health policy

Atul Gawande’s prescient 2012 TED talk

Natalie Hodge, MD

August 12, 2018Aug 12, 20186

Health care is buzzing as Atul Gawande has been selected as CEO of the Berkshire-Hathaway/Amazon/JP Morgan strategic venture. I was thrilled they picked a physician, like myself, in the trenches to run their gig. After hearing the news, I remembered Gawande’s TED Talk from 2012 and decided to catch up on it during my flight to the Healthcare Finance Management Association Annual Meeting and Innovation Lab.

After watching the …

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Atul Gawande’s prescient 2012 TED talk

Health policy

How our health care system traumatizes patients

Linda Girgis, MD

August 9, 2018Aug 9, 20185

The health care system has never been so complex as it is today. As doctors, we’ve seen the struggles that happen just trying to help patients get the medical care they need. Patients are now ladened with high deductibles and…

Insurance companies insist that they are not practicing medicine, merely making coverage determinations and that the patient is …

Health policy

Stop treating doctors like school children

Rebekah Bernard, MD

August 8, 2018Aug 8, 201824

As more doctor pay is being tied to patient satisfaction and “outcomes,” a recent Forbes article argues that “It’s only a matter of time before physicians will see the bulk of their compensation tied to quality measures.” To prepare for this pay-for-performance apocalypse, the article cites Medical Group Management Association (MGMA) CEO Haylee Fischer-Wright, MD, who urges physicians to “build data analyses” and take …

Physician voices

Our medical degrees are in boxes

Marc Braunstein, MD, PhD

August 5, 2018Aug 5, 20183

I remember visiting my pediatrician as a child, and even at a young age I was in awe of his degrees hanging on the wall. Looking back, I think I may have looked like the kid in Norman Rockwell’s Doctor with my behind in the air waiting to get a vaccination while staring in fascination at my pediatrician’s diplomas. Even at that young age, I could appreciate that these placards …

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Our medical degrees are in boxes

Health policy

Doctors need to lead the way on divestment from fossil fuels

Mona Sarfaty, MD, MPH

July 31, 2018Jul 31, 201815

In the recent weeks we’ve seen frequent headlines alerting people around the country to dangerous heat waves. Physicians and nurses see these headlines and the human results of the heatwaves in the form of heat illness, people burdened with lung ailments and suffering from deteriorating air quality, and a range of individual harms brought on by wildfires and torrential downpours. Current trends in extreme temperatures are alarming and clearly linked …

Physician voices

Serving the underserved: a win-win situation

Cory Michael, MD

July 28, 2018Jul 28, 2018

Medical school was a difficult adjustment for me. Coming from a blue-collar background and lacking a medical pedigree, I did not relate to most of my classmates, and I made very few friends. That changed when I met J., a…

Medical school was a difficult adjustment for me. Coming from a blue-collar background and lacking a medical pedigree, I did not relate to most of my classmates, and I made very few friends.

That changed when I met J., a second-generation physician-to-be without the competitive guile or sense of entitlement implicit in most of the medical students I had met. With a generous personality undoubtedly sculpted by the experience of motherhood, …

Physician voices

The consequences of taking patients at their word

Thomas D. Guastavino, MD

July 26, 2018Jul 26, 201817

A recent stir was created regarding a California pediatrician Dr. Bob Sears. Dr. Sears is sympathetic to parents who do not want their children vaccinated. Apparently, Dr. Sears got in trouble with the California State Medical Board for not producing medical records to support a parent’s claim that their son could not take vaccines because of adverse reactions, including “loss of urinary function and going limp,” and instead, just taking …

Health policy and public health

Articles, page 78

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