Health policy and public health

4,357 articles · Since 2004

Articles, page 83

Stranger Things are happening in health care

May 3, 2018May 3, 20183

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…

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

Health policy

Why should health care professionals care about gun control?

Sobia Ansari, MD, MPH

April 26, 2018Apr 26, 201811

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 …

Health policy

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

American Society of Anesthesiologists & Linda Hertzberg, MD

April 25, 2018Apr 25, 201892

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…

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 Jose), is the latest effort by special interests to unilaterally implement state control …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Health policy

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

Hans Duvefelt, MD

April 22, 2018Apr 22, 201839

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%…

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

Health policy

Gun violence in America is a multifactorial problem

Randall S. Fong, MD

April 18, 2018Apr 18, 201833

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, …

Health policy

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

Mark Kelley, MD

April 14, 2018Apr 14, 201810

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…

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 …

Health policy

A radical proposal to save America’s hospitals

Robert Pearl, MD

April 12, 2018Apr 12, 20187

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,…

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 …

Health policy

A case for climate activism: but where are the medical students?

Caroline Wellbery, MD & Rhett Engelking, MS

April 10, 2018Apr 10, 201823

Now that the children have shouldered their muskets and taken aim -- figuratively speaking, of course -- against the gun lobby, maybe we can interest them in another partisan conflict that’s even more sweepingly about their survival: climate change. Not…

Now that the children have shouldered their muskets and taken aim — figuratively speaking, of course — against the gun lobby, maybe we can interest them in another partisan conflict that’s even more sweepingly about their survival: climate change. Not to minimize the horrific consequences of school shootings, but there are many more lives at stake from climate calamities. Threats from sea level rise, flooding, wildfires, and storms are multiplying …

Physician voices

I experienced trauma working in Iraq. I see it now among America’s doctors.

Elizabeth Métraux

April 9, 2018Apr 9, 20187

I was on my honeymoon in Colombia when I first became aware of the true extent of my post-traumatic stress disorder. My husband and I were walking across a smooth, granite platform to take a closer look at a fountain in downtown Cartagena. As we neared the structure, mist from the fountain’s jets dampened the ground …

Physician voices

The referral system to specialists: It’s a nightmare

Fred N. Pelzman, MD

April 7, 2018Apr 7, 201831

I need your help. I'm trying to figure out how to get rid of something that's terribly broken in our process of taking care of patients, and I can't do it alone. It's time to kill the referrals process, get…

I need your help.

I’m trying to figure out how to get rid of something that’s terribly broken in our process of taking care of patients, and I can’t do it alone.

It’s time to kill the referrals process, get rid of them altogether.

Every day, a huge proportion of the messages we receive through the electronic health record are requests for us to “put in a referral.”

Patient has low back pain, has …

Health policy

Medicine could use more common sense

Leonard Zwelling, MD

April 6, 2018Apr 6, 2018

A hundred years ago, the practice of medicine was just that: the practice of professionals specially trained to alleviate suffering and heal the sick. Doctors had a fiduciary responsibility to put the needs of their patients before their own. A…

Flash forward.

Medicine is big business. Trillions of dollars are spent every year in the health care …

Read more…

Medicine could use more common sense

Health policy

A reimbursement structure that can benefit primary care

Matthew Dyer

April 3, 2018Apr 3, 20184

By their nature, fee-for-service reimbursement schemes incentivize procedures over prevention. This creates a serious moral hazard: If you keep your patient panel healthy through early interventions and exhaustive lifestyle counseling, then there are fewer profitable procedures to do. On the other hand, if you let your patients become critically ill, then you will be rewarded handsomely for all of the (now) medically necessary procedures and tests that you can perform …

Physician voices

To those who think doctors make money on opioids

Ryan Steele, DO

April 1, 2018Apr 1, 20183

A casual reader scanning the headlines would rightly infer a direct cause-and-effect relationship between pharmaceutical company payments and the number of opioid prescriptions written based on this headline displayed prominently on the CNN homepage. What follows is nothing short of a character assassination of the medical profession, portrayed as complicit drug pushers in bed with the pharmaceutical industry. Rather than a reasoned look at the history of causes of the …

Medical education

Learning the health care ecosystem is an uphill battle

Mohammed Ahmed

March 30, 2018Mar 30, 2018

The short white coat, breast pocket full of colorful pens, side pockets bulging with gauze pads and suture kits, a simultaneous look of bewilderment, excitement and fear. Pathognomonic signs of the third-year medical student on wards. Third year of medical school is a period of learning how to diagnose disease, treat patients and understand what it means to be a doctor in this health care landscape. There is not enough …

Physician voices

This National Doctors’ Day, conquer the physician shortage one mentor at a time

Heather Smith, MD, MPH

March 30, 2018Mar 30, 2018

March 30th is National Doctors’ Day, a day set aside to recognize physicians, their work, and their contributions to society and the community. Though we are used to thinking of the profession of physician as something many parents hope their…

According to a March 2017 report by the Association of American Medical Colleges, the U.S. will …

Health policy

The health insurance industry is like a house of cards

Linda Girgis, MD

March 29, 2018Mar 29, 2018

You go to your doctor because you are suffering pain, fatigue, or some equally debilitating ailment. Your doctor examines you and is worried there may be a serious underlying medical reason for your symptoms and orders a test. But, before you can have that test done to determine the cause of your symptoms, the insurance company must agree that you need it in order for them to cover the cost …

Health policy

What is the perfect fee-for-service system?

Matthew Hahn, MD

March 29, 2018Mar 29, 201833

It is wildly popular to say that the chief culprit in the U.S. health care system is the traditional fee-for-service payment system, which rewards physicians for volume but not quality, leading to high-cost, low-quality health care. It supposedly follows that…

Despite the popularity of these arguments, both aspects have been shown to be wrong. Studies show that the rising cost of American health …

Conditions and diseases

Too much testing: Are patients to blame?

Kevin Lomangino

March 28, 2018Mar 28, 201814

Our health care system in the United States is notorious for providing a lot of unnecessary medical care — something we’ve written about extensively. Doctors may provide that unnecessary care because they perceive that patients are expecting or requesting it.…

Our health care system in the United States is notorious for providing a lot of unnecessary medical care — something we’ve written about extensively.

Doctors may provide that unnecessary care because they perceive that patients are expecting or requesting it.

If health care professionals don’t provide the aggressive care that patients believe they require, the thinking goes, patients won’t be satisfied, and the doctor-patient relationship will suffer. Plus, the patient will just go …

Drugs and prescribing

Crippling drug costs: the role of insurers

Janice Boughton, MD

March 27, 2018Mar 27, 20182

Drug costs in the U.S. are higher than in in any other industrialized country in the world. Our cost for an insulin glargine (long-acting insulin) pen is $76.80 and in Canada, so very few miles away, it costs $19.60. The latter price is reasonable. The former price can make the difference between being able to afford a life-saving drug and dying. It is illegal, however, for a U.S. citizen to …

Health policy

The real cost of not having health insurance

Jen Baker-Porazinski, MD

March 27, 2018Mar 27, 201823

I was behind schedule (again). My next patient was Helen, a non-compliant diabetic that hadn’t been into my office in over two years. Her blood sugars weren’t controlled at her last visit when I’d tried to impress on her the…

Clearly, I’d failed. Maybe I’d even chased her away? No pill I prescribed would help her diabetes …

Health policy and public health

Articles, page 83

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular