Health policy and public health

4,357 articles · Since 2004

Articles, page 91

It’s time to speak with a collective voice: Why doctors should unionize

October 31, 2017Oct 31, 201719

Since the birth of our nation, labor unions have existed in one form or another in the United States. Unions are a force to protect the "working population" from inequality, gaps in wages and a political system failing to represent…

Since the birth of our nation, labor unions have existed in one form or another in the United States. Unions are a force to protect the “working population” from inequality, gaps in wages and a political system failing to represent specific industry groups. Historically, unions organize skilled workers in a specific corporation, such as a railroad or production plant. However, unions can organize numerous workers within a particular industry. Known …

Physician voices

The key to health care is to have a great team

Heather Hansen, JD

October 30, 2017Oct 30, 2017

I was a chubby kid, but my parents still introduced me to lots of sports. Soccer, swimming, tennis, basketball; so many sports, when all I wanted to do was read and eat Doritos. I wasn’t particularly good at any of them, but some of my teams were better than good. We were champs. My swim team won the Cape Cod Summer League, my soccer team won its division one year, …

Physician voices

Is rising maternal mortality just hype? Nope, here’s why.

Valerie A. Jones, MD

October 30, 2017Oct 30, 20177

The statistics are staggering. The high maternal mortality rate in the U.S. has been a matter of great interest and debate, spurring a reflective look into our health care system to determine why our country is on the wrong end…

The statistics are staggering.

The high maternal mortality rate in the U.S. has been a matter of great interest and debate, spurring a reflective look into our health care system to determine why our country is on the wrong end of this statistic. The reasons and numbers vary across the country and notably in the state of Maryland, which has had a higher than average maternal mortality rate, the number of …

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Conditions and diseases

The opioid epidemic: What we can learn from history

Adam Rodman, MD

October 29, 2017Oct 29, 201715

It’s no secret that the United States is in the midst of an opiate epidemic. Almost 60,000 people died last year from overdoses, and overdose deaths are now the most common killer of Americans under the age of 50. Physicians and our patients have finally started the difficult conversation about what it will take to stop the suffering. But what’s been missing from this conversation is that this is not …

Conditions and diseases

How is mental health care failing American patients?

Linda Girgis, MD

October 28, 2017Oct 28, 20172

According to the National Institute of Mental Health (NIMH), about 9.8 million adults (or 4 percent of all adults) over the age of 18 years suffered a serious mental illness in 2015. A serious mental illness is one that affects a patient’s daily functioning. Considering all mental illness in adults in the same time period, 43.4 million adults (or 17.9 percent) who met the criteria for a …

Health policy

What health care can learn from Game of Thrones

Robert Pearl, MD

October 25, 2017Oct 25, 2017

Over the past seven seasons, Game of Thrones fans have demonstrated the ability to spot an emerging threat early on -- a quality more leaders in health care need to possess. If you've tuned into the popular HBO series from…

Over the past seven seasons, Game of Thrones fans have demonstrated the ability to spot an emerging threat early on — a quality more leaders in health care need to possess.

If you’ve tuned into the popular HBO series from the beginning, you likely recall Ned Stark (Lord of Winterfell) forecasting doom and gloom in the show’s opening episode, appropriately titled “Winter Is Coming.” Right then, you knew something bad was …

Health policy

Fixing the American health care system is simple. Here’s how to do it.

Matthew Hahn, MD

October 25, 2017Oct 25, 201759

If we listen to the president, fixing the American health care system is too complicated. It is not actually that complicated. The number one issue is cost. Even with many millions of people unable to access care, we already spend close to twenty percent of every dollar in the U.S. on health care. If we hope to include everyone in the health care system, then we need to lower health …

Physician voices

An interview with an American doctor working in Canada

Suneel Dhand, MD

October 24, 2017Oct 24, 2017

A couple of weeks ago I visited Canada. It was my first visit in a very long time. We were in Ontario, spending most of the time in the Toronto area, and also getting to visit the majestic Niagara Falls for the day. I’ve heard so much over the years about the differences between neighbors USA and Canada, and in even just a few days there, agreed that there are …

Drugs and prescribing

Beware of online retailers selling designer benzodiazepines

Abraham M. Nussbaum, MD

October 24, 2017Oct 24, 2017

One of Max’s friends taught him an easy way to buy shady drugs. What he learned almost killed him, and it opened my eyes to a hiding-in-plain-sight source of dangerous drugs that is amplifying the opioid epidemic. When Max (not…

When Max (not his real name) developed pancreatitis a decade ago, his physicians prescribed opioids to ease his extreme …

Health policy

You can pick any two, but only two: conversations about health care costs

Darrell E. White, MD

October 24, 2017Oct 24, 20174

My wife Beth and I had a rather spirited discussion about how we in the U.S. might be able to pay for the health care of our citizens. Being ever practical, and also owning the job of writing the checks that pay for the health insurance our company offers its associates (including us), Beth in effect is arguing for a national consensus on something we might describe as a baseline …

Health policy

Is the U.S. addicted to fee-for-service health care?

Robert Pearl, MD

October 20, 2017Oct 20, 201717

For its many users, health care’s fee-for-service reimbursement methodology is like an addiction, similar to gambling, cigarette smoking, and pain pill abuse. Doctors and hospitals in the clutches of this flawed payment model have grown dependent on providing more and…

I don’t use this metaphor lightly, nor wish to trivialize our nation’s growing problem with addiction. Rather, as a …

Physician voices

The Hippocratic Oath, updated for today

Mick Connors, MD

October 20, 2017Oct 20, 2017

I am not a curmudgeon, but I am worried about the current plight of health care and the attack on the Hippocratic Oath. Bigger health care is sold as better and more efficient with the premise of lowering health care costs. The promised financial outcomes and efficiencies for the physician and their patients have not materialized. Instead, while physicians struggle with non-clinical demands on their time, patients are being pushed …

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The Hippocratic Oath, updated for today

Health policy

Why immunization rates should not be used as a quality indicator

Niran S. Al-Agba, MD

October 19, 2017Oct 19, 2017

As policy experts cling to pay-for-performance (P4P) as an indicator of health care quality and shy away from fee-for-service, childhood immunization rates are being utilized as a benchmark. At first, glance, vaccinating children on time seems like a reasonable method to gauge how well a primary care physician does their job. Unfortunately, the parental vaccine hesitancy trend is gaining in popularity. Studies have shown when pediatricians are specifically trained to counsel parents on …

Health policy

When it comes to consumer choice, more is not always better

Peter Ubel, MD

October 18, 2017Oct 18, 20172

Mark Letterman’s rheumatoid arthritis had been progressing unrelentingly despite popping dozens of pills each week -- eight methotrexate pills on Mondays alone. Letterman felt like he was 63 going on 93. If rheumatoid arthritis progresses unchecked, it is as debilitating…

Mark Letterman’s rheumatoid arthritis had been progressing unrelentingly despite popping dozens of pills each week — eight methotrexate pills on Mondays alone. Letterman felt like he was 63 going on 93.

If rheumatoid arthritis progresses unchecked, it is as debilitating of a disease as can be imagined. Don’t think garden variety arthritis that only interferes with activities like, um, gardening. Think: finger and wrist joints so inflamed it feels like your …

Physician voices

As a leader, you can be liked or respected. But rarely both.

Sasha K. Shillcutt, MD

October 18, 2017Oct 18, 20173

I want to talk about the word everyone seems to use: drama. This word is used in many facets, to describe conflict, negative interactions with others, disagreements, or obstruction to a new idea. No one likes drama. Yet some people…

I want to talk about the word everyone seems to use: drama. This word is used in many facets, to describe conflict, negative interactions with others, disagreements, or obstruction to a new idea.

No one likes drama. Yet some people seem to instigate it, and others seem to have to deal with it on a rotating basis.

We all wish we could ignore it, avoid it, and leave it for people who …

Physician voices

The high cost of hospitalists

Richard Young, MD

October 18, 2017Oct 18, 201710

Hospitalists, doctors who only see patients in the hospital, almost always in a shift work model, are the fastest growing “specialty” in medicine, from nothing about 15 years ago to about 50,000 today. There were some studies that I won’t review much here that showed some benefits from hospitalists compared to “usual care” in highly controlled environments, outcomes such as a 0.4 per day decrease in length of stay with …

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The high cost of hospitalists

Health policy

Why HSAs are not the answer to our health care system problems

Cory Michael, MD

October 16, 2017Oct 16, 20175

I was talking to a physician in my hospital several years ago, and he expressed his frustration that the annual well-child exams for his four kids were expensive. Puzzled, I stated that I found it odd that a doctor’s own health insurance plan had poor coverage for routine care, and he replied that his group jointly decided on a plan with considerable upfront out-of-pocket costs. Why would doctors buy bad …

Health policy

Reduce parallel play to provide decent health care for all

Peggy A. Rothbaum, PhD

October 16, 2017Oct 16, 20175

I have been doing health care research and advocacy for over 20 years. I've seen a lot of passion, anger, and rhetoric around the issues. The health care crisis is simple in that everyone needs health care. The question is…

I have been doing health care research and advocacy for over 20 years. I’ve seen a lot of passion, anger, and rhetoric around the issues. The health care crisis is simple in that everyone needs health care. The question is what to do about it and who should pay for it.

It’s not an easy answer. For starters, we have turned into a culture of entitlement. This includes health care. It …

Health policy

The most far-reaching effects of our failed leadership

Matthew Hahn, MD

October 15, 2017Oct 15, 201763

We were once a nation noted for its achievements. We are now a nation that gets nothing done, unable to make even the slightest movement forward despite multiple national crises -- a desperately broken health care system, a horrifying opioid…

We were once a nation noted for its achievements. We are now a nation that gets nothing done, unable to make even the slightest movement forward despite multiple national crises — a desperately broken health care system, a horrifying opioid epidemic, sickening gun-related mass murders, the threat of nuclear war, and massive storms resulting from man-made climate change. In the face of such monumental challenges, when bold action is needed, …

Physician voices

This psychiatrist does most of her work outside of the traditional system

Maria Yang, MD

October 15, 2017Oct 15, 2017

Every now and then, when some people learn what kind of work I do, they say, “You’re doing God’s work. Thank you.” They mean well, so I accept the compliment, though I also tack on, “I also like what I…

Every now and then, when some people learn what kind of work I do, they say, “You’re doing God’s work. Thank you.”

They mean well, so I accept the compliment, though I also tack on, “I also like what I do. It’s meaningful work for me.”

So many of the people I see, whether in my current job or in my past jobs working in other underserved communities, have a lot going …

Health policy and public health

Articles, page 91

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