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.
When I read the Washington Post article about the CDC censoring seven words last Friday night, my mind immediately jumped to the youth I take care of every day in my Baltimore clinic. It felt like a direct attack on the very patients I became a doctor to treat: the transgender young person initiating gender-affirming hormone treatment; the young woman seeking inpatient addiction treatment for the first …
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The CDC word ban: an attack on the patients I treat
Many of the everyday coalface problems we face in health care are simply due to suboptimal communication. It could be the patient or family member who doesn’t know what’s going on in the hospital, the nurse who is confused about orders, or the doctor who doesn’t understand the reasoning behind the seemingly terrible administrative directive they are receiving.
Take it from me, as someone who has seen health care at close …
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Why is health communication so poor? Here are 5 reasons why.
Results of a study released JAMA Cardiology demonstrated that lower readmission rates among hospitalized heart failure patients, a key focus of recent Medicare value-based payment efforts, were associated with increased patient mortality. In other words, patients admitted to the hospital for heart failure are being re-admitted less frequently, but dying at higher numbers. Value-based pay, as it turns out, where monetary incentives and penalties are tied …
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How value-based pay can worsen patient outcomes
For Dr. Peter Cram, an American internist who spent most of his career practicing in Iowa City, Iowa, moving here about four years ago was almost a no-brainer.
He’s part of a small cohort of American doctors who, for personal or professional reasons, have moved north to practice in Canada’s single-payer system. Now when he sees patients, he doesn’t worry about whether they can afford treatment. He knows “everyone gets a …
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Can we implement the Canadian health system in America?
Like it or not, the Medicare Access and CHIP Reauthorization Act (MACRA) legislation will affect virtually all health care providers practicing in the U.S. Although I sympathize with Dr. Hahn’s sentiment in his article “If Medicare wants value, it should cancel MACRA,” lamenting this legislation feels like “another layer of senseless rules, data collection and more rules.”
MACRA ushers in a long-overdue value-based payment system designed to foster …
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A nurse’s reaction to MACRA haters
The Affordable Care Act, a.k.a. “Obamacare,” has roiled America since the day it was signed into law in 2010. From the start, the public was almost evenly divided between those who supported it and those who opposed it.
They still are. The November monthly tracking poll from the Kaiser Family Foundation found that 50 percent of those polled had a favorable view of the health law, while 46 …
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Why do people hate Obamacare?
In today’s health and political discussions, opioid abuse dominates the conversation despite being only part of our country’s substance use epidemic. Prenatal substance use remains an uncontrolled public health problem with high costs to women, children, and society. Part of the problem is the difficulty in measuring the extent of the problem nationwide.
Most prenatal substance use prevalence data comes from substance treatment programs and national self-report surveys, likely leading to …
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Stop criminalizing prenatal substance abuse
Many physicians in different fields have voiced criticisms against direct-to-consumer (DTC) prescription drug ads. First, a 2013 survey found that 74 percent of physicians believe DTC drug ads overemphasize the benefits of the drugs and misinform patients. Steven Nissen, a Cleveland Clinic cardiologist, interviewed by Rebecca Ruiz on DTC prescription drug ads states, “It’s almost impossible for the public to actually parse the ads and come …
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Here’s why direct-to-consumer drug ads need FDA oversight
In a very unique study, researchers have tabulated how often family physicians provide patient care that is not covered with a CPT code. This is a little complex, for the non-physicians and even for many physicians to grasp, so I will provide a little more background first.
CPT stands for Current Procedural Terminology, which is the book written by the American Medical Association (AMA) since about 1965. This …
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How the CPT system shortchanges primary care
I am honored to be a member of the medical profession. Being a physician is a great job and a highly rewarding thing to do. One of the aspects that I like most, unlike so many other desk or number jobs, is that you can never go home in this line of work thinking that you haven’t done something good with your day (if you do, there’s something seriously wrong).
The …
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Fix the broken windows of the medical profession
I often say in my keynotes that KevinMD shares the story of the many who intersect with our health care system, but are rarely heard from.
KevinMD has completed its 14th year as the web’s leading social media platform for these voices. Over 3,000 contributors power the site, and together, we are making our voice heard as our health care world changes around us.
I sincerely appreciate your readership …
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10 most popular KevinMD stories of 2017
While on the way to a national meeting on health and public policy, I ponder on what the practice of medicine has become and whether this meeting will provide any hope for improvement. It hasn’t been clear to me that those most responsible for public health policy are listening to doctors. Politicians have been leading this charge, sometimes solo, sometimes in a group but rarely in a collaborative fashion — …
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Can technology and the art of medicine coexist?
In case you missed it: Sutter Health, the Northern California health system titan was recently sanctioned for intentionally destroying 192 boxes of material relating to its anticompetitive actions and alleged overcharges. The material, which amounted to 10 years’ worth of evidence, was initially slated to be destroyed in 2035. Sutter’s Vice President, Melissa Brendt, authorized her executive assistant, Sita Santagata, to destroy …
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Sutter Health’s antitrust case matters. Here’s why.
What would medical education that is relevant for the here and now — for America in the early 21st century — address? It is impossible to teach the content relevant for an entire career. It is important to educate practitioners able to adapt to the changing landscape of medicine. We must consider what the future might hold.
Watching science fiction may serve to prompt future physicians to practice preventive medicine for …
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Are post-apocalyptic disaster films inspiration for doctors?
Linda Radach has had six hip replacement operations since 2006, three on each side. Osteoarthritis was the reason she needed surgery in the first place, but replacing her hips in some ways only worsened her troubles.
Following two of the procedures, the implanted metal socket didn’t integrate with the bone of her own hip socket and was loose, causing excruciating pain. Most recently, the titanium metal ball in her hip corroded.
The …
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Your plumber offers a money-back guarantee. Should your doctor?
