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.

Compare your own practice patterns to the national average. Here’s how.

Physician Finance
August 21, 2017

In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, has been a window (albeit a cracked and opaque window) into the practice patterns and reimbursement of individual physicians.

It includes most payments for services …

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Compare your own practice patterns to the national average. Here’s how.

This frontier of medicine and surgery has been largely ignored for many years

Physician
August 21, 2017

Medical and surgical research is breaking boundaries at an astounding pace. From genetic modification and stem cell therapy to robotic and 3-D printing technology, scientific advancement is finding novel, unique and unprecedented solutions to complex, challenging diseases. Indeed, such is the rate of change that I am certain the last eight years of my surgical training in the UK will likely be rendered obsolete within the next twenty years of …

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This frontier of medicine and surgery has been largely ignored for many years

A letter from a parent to her child’s pediatrician

Physician
August 21, 2017

I am a child psychiatrist who is also a patient, a mother of patients and the wife of a patient. I have lived all sides of health care and appreciate the complexity that is our American health care system. After a recent move to a different part of town, we decided to find a new pediatrician for our daughters.

I knew that we had several good options near our home. When …

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A letter from a parent to her child’s pediatrician

Minnesota and measles: Andrew Wakefield targets refugees

Physician
August 20, 2017

I had the pleasure of traveling to Rochester, Minnesota for a wedding this summer.  Minnesota is home to more people from Somalia than any other state. My home of Columbus, Ohio is also a hub for people from Somalia.  As a pediatric resident, I take care of Somali-American children and work with Somali American healthcare providers every day.

It was surreal, then, to set foot in a state recovering from a …

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Minnesota and measles: Andrew Wakefield targets refugees

Do we really have a choice in health care?

Health Policy
August 18, 2017

As every physician practicing today knows, health care is in a constant state of flux. The latest news from Washington creates even more uncertainty. What we do know is that, for the foreseeable future, there will be an emphasis on team care, coordination, technology and, of course, meeting the requirements of the ever-expanding alphabet soup of acronyms, from MACRA to MIPS and beyond.

As I think about all the changes of …

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Do we really have a choice in health care?

Let’s change the mediocre status quo of health care

Patient
August 18, 2017

On a daily basis, I am introduced to new people from all walks of life. Some sit on the board of directors, some are CEOs, some are presidents, some are middle managers and other administrators, some are investors, others are entrepreneurs, and some are physicians, nurses, case managers and even patients.

I listen to people talk about the big challenges in health care. It costs too much, we have a shortage …

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Let’s change the mediocre status quo of health care

To those who want government-run health care: Be careful what you wish for

Health Policy
August 15, 2017

“Hello Dr. Payne, thanks for calling back, there’s a consult I’d like you to see.”

“What’s going on?”

“Well there’s a patient up on 7 East who …”

“Wait a minute. 7 East … isn’t there some other specialist covering there?”

“No Dr. Payne, the schedule says you on Wednesdays.”

“Oh, I’ll check that.”

“OK, Dr. Payne, well we have this 72-year old, Mrs. Jones, who originally got admitted with pneumonia. She now has unusual inflammatory …

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To those who want government-run health care: Be careful what you wish for

The problem with the free market in health care

Health Policy
August 14, 2017

Competition often works. Competing dry cleaners or donut shops must either improve the quality of their product or keep their prices low, or customers will go somewhere else for their cruller fix. In time, the better businesses — the ones that provide tastier pastries at a lower price — will thrive, and less-good, more-expensive businesses will go away. In the long run, all customers benefit from competition between businesses.

That’s how …

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The problem with the free market in health care

Improve Medicaid with these simple steps

Health Policy
August 14, 2017

Recently, the Republicans’ health insurance bill was withdrawn, partly because of some Senators’ fear of underfunding Medicaid. The media and Democrats have clearly identified Medicaid as a wedge issue that divides Republicans. Unfortunately, those Republicans that have chosen to support conventional Medicaid, as opposed to supporting a much-needed revamp of this program, have succumbed to false advertisements. So let me review some facts, and suggest some common sense changes that …

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Improve Medicaid with these simple steps

How to unite doctors in these divided times

Health Policy
August 12, 2017

American doctors are unhappy about a lot of things. Americans, in general, are unhappy about a lot of things. In many ways, both groups share similar concerns. But the road back to happiness may follow a similar path for both, as well.

American doctors once felt part of something special. American health care, by reputation at least, was the best in the world, and we were its proud emissaries. We functioned …

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How to unite doctors in these divided times

Here’s why this doctor came around to single-payer insurance

Health Policy
August 11, 2017

The two biggest sources of frustration for the majority of physicians are the EMR systems and bureaucracy within the work environment that physicians are forced to deal with daily. EMRs are a ship that has sailed, unfortunately, and our only option currently is to try and improve this situation.

However, the bureaucracy and administrative burdens that physicians encounter are issues that we should challenge, and I feel single payer is a …

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Here’s why this doctor came around to single-payer insurance

Turn physicians into powerful health care influencers

KevinMD
August 11, 2017

Physicians have so many tools available to us that can turn them into powerful health care influencers.

A KevinMD keynote video excerpt.  I’m currently considering opportunities for 2018: Please visit my physician keynote speaking page to find out more.

Turn physicians into powerful health care influencers

Health care in American is on life support, and the future is uncharted

Health Policy
August 7, 2017

At this time in history, it may serve us well to reflect on the tortuous past, the harrowing present and the unpredictable future of health care in America.

First and foremost we must recognize we do not have “a health care system” — rather our health care is delivered in an uncoordinated, misaligned and exorbitantly expensive fashion. For example, 1 in 5 Medicare patients are readmitted to the hospital within 30 days of discharge, …

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Health care in American is on life support, and the future is uncharted

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This is what to remember in health reform: We are all one patient

Health Policy
August 7, 2017

As a physician, I am often discouraged when I turn on the news and read about the state of health care in our country. I can see all 397 sides of the debate and some truth in all sides. The enormous cost of medicine is overwhelming to comprehend for patients and families and even to those of us in medicine.

I think it is important to know all that goes into …

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This is what to remember in health reform: We are all one patient

Sometimes high-tech care can be high value

Conditions and Diseases
August 7, 2017

“Can you hear it?” she asked with a smile. The thin, pleasant lady seemed as struck by her murmur as I was. She was calm, perhaps amused by the clumsy second-year medical student listening to her heart.

“Yes, yes I can,” I replied, barely concealing my excitement. We had just learned about the heart sounds in class. This was my first time hearing anything abnormal on a patient, though it was …

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Sometimes high-tech care can be high value

A single-payer system is the American way

Health Policy
August 7, 2017

As is customary for every administration in recent history, the Trump administration chose to impale itself on the national spear known as health care in America. The consequences so far are precisely as I expected, but one intriguing phenomenon is surprisingly beginning to emerge. People are starting to talk about single payer. People who are not avowed socialists, people who benefit handsomely from the health care status quo seem to …

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A single-payer system is the American way

Stop piling on physicians: The last straw in burnout

Physician
August 6, 2017

We are all familiar with the saying: “the last straw.” It refers to the fable of the camel who could carry heavy loads.

In the story, the camel is a beast of burden. Its owner, in an effort to transport as much straw as possible, keeps piling more and more on the camel’s back. Camels are strong and can handle a lot. But at some point, even the strongest camel will …

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Stop piling on physicians: The last straw in burnout

Health reform is stalled. Here’s how to do it right.

Health Policy
August 5, 2017

I told you so.  I also told the POTUS in my open letter, but he did not read it.

Who could honestly believe the nation would support dumping coverage for 22 million people?  As David Leonhard wrote recently op-ed in the New York Times: “They [Republicans and President Trump] had only one big weakness, in fact: They weren’t dealing in reality.”  When faced with reality, it is interesting what a few good …

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Health reform is stalled. Here’s how to do it right.

Bridges and roads are also important to your health

Health Policy
August 5, 2017

Two seemingly unrelated national policy debates are afoot, and we can’t adequately address one unless we address the other.

Health care reform has been the hottest topic. What to do about America’s aging infrastructure has been less animated but may be more pressing.

Yet even as cracks in America’s health system and infrastructure expand, political divides between parties and within parties have stalled efforts to develop policies and implement solutions. Problematically, debates …

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Bridges and roads are also important to your health

Would single payer work? The real devil is in the details.

Health Policy
August 4, 2017

When I began my career as a physician in the late 1990s, I was relatively apolitical. Since then, as our health care system has crumbled, and as its demise (and our repeated failure to fix things) has increasingly affected my patients and my practice, I have become very political. In 2008, I began giving lectures in the community in support of a single-payer health reform model. My political leanings tend …

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Would single payer work? The real devil is in the details.

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