Hi, I’m Rob. I’m a recovering doctor.
Yeah, I know I used that line once before, but it’s a special day for me today. Humor me. Five years ago today, I earned my last money from an insurance company. Yep, today is my five-year sobriety date.
Five years.
That was before the Affordable Care Act before the Cubs won the World Series. Before anyone knelt for the national anthem, and …
Meet the primary care doctor who’s happy with his job
One of the most popular narratives in American public discourse, especially as it pertains to health care, is that government is bad, and the free market, meaning private industry, is good. And the natural extension of this line of reasoning is that the government cannot, and therefore should not be part of any health care reform solution. Further, only the free market is capable of fixing things, and it was …
In health care reform, what’s the ideal role of government?
It was my childhood dream to become an airline pilot. We lived near Heathrow airport in London, and I was a diligent plane spotter (please save the jokes). I had a book when I was nine years old that listed all civil aviation registrations, and I would mark them off as I spotted different planes through my binoculars, coming into land at the world’s busiest international airport. My flying memories …
Health care is ultimately about our patients. That must remain our focus.
I recently had an experience that opened my eyes to a big problem in medicine: availability.
My son came to me one morning and said he was kept awake by the dripping over his bed. My roof was leaking. Once I found the source of the leak and discovered that it was more than I wanted to tackle, I needed to find a roofer.
Every call to a roofing company resulted in …
The difference between doctors and roofers? Not much.
As Harvey’s devastation raged through Houston recently, the city’s mayor was compelled to address rumors that those seeking aid could be deported.
In the wake of a statewide ban on “sanctuary cities,” the mayor sought to reassure the Houston area’s more than 500,000 undocumented immigrants that they would not be targeted for deportation at emergency shelters.
Nevertheless, out of the disaster …
Anti-immigrant policies put people at risk during Harvey. And that’s just the beginning.
Traditionally, many medical students use the proverbial “last summer of their lives” to conduct basic/clinical research, shadow or go abroad. If you want to be a leader in health care or are simply unsure of what to do over the summer, you should try something more exotic and unexpected — work in finance or industry.
Wall Street, big pharma and private insurers have long been the moral punching bags of clinicians …
Want to change medicine? Work in finance.
The current conversation regarding health care reform in the U.S. is essentially pointless. It can be boiled down into four statements: Obamacare stinks, so we need to get rid of it; Obamacare doesn’t stink, so we just need to improve upon it; the insurance companies are to blame, so a government single-payer system is the best idea; the government is to blame, and only the free market can fix health …
A health care solution to rival single payer
American physicians deserve to be paid well for their work. As a physician, myself, I know what it takes to become a doctor in the U.S. Four years of late nights in the college library in hopes of achieving a GPA commensurate with medical school admission; then four years of medical school, which makes the college work load feel light in retrospect; then, in my case, three years of residency …
Doctors should be paid well. But how much is enough?
This week is National Primary Care Week, an opportunity to engage medical students and healthcare stakeholders in a national discussion around the tremendous role that primary care plays in our health care system.
With so much debate about the high price of health care in the United States, too often one of the most effective methods of controlling costs is overlooked: primary care. A wealth of research continues to show that …
Primary care makes a difference for patients and the nation
The news cycle over the last several days has been dominated by President Trump’s interjection into the row about NFL players refusing to stand during the national anthem. The media went into hysteria following his curse remarks, and a full-blown row has gone on to develop. Turning this issue into a national political one is a great shame on so many different levels, including not least the reality …
Why this physician thinks everyone should stand for the national anthem
An eleventh nursing home resident has died after an air conditioning failure following last week’s Hurricane Irma. The Rehabilitation Center at Hollywood Hills, located outside of Fort Lauderdale, was one of 160 nursing homes that had no electricity and no air conditioning, as power lines across the state were decimated by the storm. Yet, it was the only nursing home facility in the state of Florida where multiple deaths occurred …
Poor leadership and disastrous decision-making are to blame for Florida’s nursing home deaths
Fatal police encounters can engender PTSD in non-white communities and forever impact interactions with police. In the last few years, we have witnessed in horror the erosion of trust between public servants charged to protect the community and the non-white communities they serve. The killing of Philando Castile and Charleena Lyles compounded the horror, as their violent deaths were witnessed by their young children, spouses and, for Philando, social media. …
Philando Castile, Charleena Lyles, and PTSD: The consequences of fatal police encounters
The main character in the popular film Groundhog Day is caught in a time loop where he must repeat the same day over and over again.
The U.S. Senate is now having its own Groundhog Day moment as it debates (yet again) a law to replace the Affordable Care Act. To add to the drama, Senator Bernie Sanders (I-Vt.) is promoting his single payer alternative popularly branded as “Medicare for All.” In a recent …
What’s the greatest threat to health reform?
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Quality-based Medicare payment is far from a new concept. However, the Quality Payment Program (QPP), created by the Medicare Access and CHIP Reauthorization Act (MACRA), introduces a new vocabulary, complex requirements and fast-approaching deadlines. Physicians have little time left to successfully navigate the program and avoid penalties for 2017.
A recent survey by the American Medical Association (AMA) …
Last call for MIPS reporting: 6 steps to be prepared
Although I am now working part time, I still get my academy’s monthly newsletter. I pretty much ignore the ads and any clinical studies that do not directly affect the work I am doing now, but I still find myself drawn to stories with a political bent. Namely, those stories that reflect the latest health reform controversy. The vast majority of these stories do not mention anything really new, just …
9 reasons you shouldn’t expect health care to change
Health care is falling apart. We all know it, we can feel it, but it’s hard to say why it’s happening or even what is happening, we just know that it is true. And as bad as it is for patients, it’s even worse for providers. We know that there is something wrong. We want to help people. We are busy all day long seeing patients. Why doesn’t it feel …
Physicians have the power to save our health care system
The national debate on health care is moving into a new, hopefully bipartisan phase.
The fundamental underlying challenge is cost – the massive and ever-rising price of care which drives nearly all disputes, from access to benefit levels to Medicaid expansion.
So far, policymakers have tried to reduce costs by tinkering with how care is delivered. But focusing on care delivery to save money is like trying to reduce …
Want to fix America’s health care? We need to focus on food.
A dear friend who is many years my senior recently remarked that he has stopped watching television. “I’m tired of seeing all the bad s%&t that’s happening in the world. I know it’s happening, but I can’t do much about it, and it makes me depressed. I want to hear some good news stories.”
He is correct, of course. we all could use a good news story or two.
To be sure, our news media has evolved …
A hospital invested tens of millions to preserve its community and won
He was approximately 75 pounds and appeared to be wasting away. Although he was only 43 years old, he had end-stage AIDS. Even in this cachectic state, he continued to refuse to eat the hospital food because he didn’t like it. After speaking at length with him, he said that he only wanted porridge with meat or “fat cakes,” both of which we did not serve in the hospital. He …
The challenges of leaving a positive impact while practicing as a physician in another country
So much for repealing and replacing Obamacare. The Graham-Cassidy Senate bill is on life support. Members of the Senate death panel have made their decision, leaving their patient on palliative care to spend the last few days of life on heavy pain meds but without lifesaving treatments.
Death is scheduled for the end of September when time runs out on the reconciliation rules which allow the Senate to pass legislation …
So much for repealing and replacing Obamacare. What’s next?
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