It has become perhaps the silliest four letters in health care: PQRS. It stands for Physician Quality Reporting System. It’s another this and another that created by the Centers for Medicare & Medicaid Services (CMS). After you read this, you’ll be like me, scratching your head trying to understand why anyone thinks our health care system is better under CMS’s leadership.
CMS has setup a thing called PQRS, so physicians across the country …
It’s hard to miss the headlines and breaking news feeds on the latest medical studies showing the health benefits of plant-based eating patterns: Vegetarian diets lower the risk or colorectal cancer. Dementia can be delayed through a healthful diet, cognitive training, and physical exercise. Folic acid — a plant-based product of foliage, or leafy greens — boosts heart health. And that’s just in the past few days.
I recently took another survey confirming the obvious: As a resident, I am horribly burnt out. I sat, along with a half-dozen health care providers and bemoaned our current states. What, if anything, can we do about this? The typical answers came up: sleep more, increase our commitment to enjoyable activities outside of work. Oddly enough, there was little talk about the daily work itself, and how the medical culture …
Peanut allergy is a worldwide concern, but especially in Western countries, in which prevalence has doubled in the last ten years, to a rate of 1.4 to 3.0 percent of children. To prevent the development of peanut allergy, national guidelines have attempted to keep pace with this crisis, with recommendations, at first, of delayed exposure to peanut and, more recently, of earlier exposure. But a universally accepted and research-supported approach …
There are a lot of frustrated and unhappy people out there when it comes to their perception of health care today. The contemporary practice of medicine is changing, rapidly, and those changes have been a challenge for patients and physicians alike. The list of reasons for this is lengthy. Certainly physicians and hospitals are finding it difficult at times to meet all the changes and demands put on them, by …
Referring physicians are critically important not just for the care and attention we provide patients but also for the referrals we make to specialists. Patients don’t have access to the same data or knowledge that we as healthcare professionals possess, so as referring physicians we can have a significant impact on our patients’ health after they’ve left our immediate care.
Big data has given us more information than ever in making …
The time of year that brings friends, family, and colleagues together to cheer and commiserate over brackets and games. When it comes to the final two weekends, it is often the same teams year after year. What can the coaches of great teams teach us about doctoring?
Preparation and fundamentals (John Wooden, UCLA)
The first thing coach John Wooden taught his players was how to put on their shoes and socks. …
“Samantha is your next patient,” my medical assistant informs me in my primary care clinic. Samantha is a Caucasian woman in her late 40s, and I typically find her in the room with well-groomed blond hair and a cheerful outfit, such as a pink blouse, a flowery skirt, and golden sandals. She has been my patient for over a year, and I know that her life is anything but cheerful. …
The last few days have been really busy, but they still felt controlled, almost leisurely and smooth. Patients have been seen on time, my office notes have been completed in real-time, and my superbills have been submitted before each patient reached the check-out station. Things were really humming.
The new nurse noticed that I was humming each time I dashed back to …
I used to think that there was a communication gulf between doctors and patients. Somewhere in the hubbub of the harried office visit some secret sauce was missing. A divide that was so fundamental that both parties often left the room feeling disjointed and uneasy. Patients wondered if doctors truly heard them. Physicians wondered if anyone was listening to what they were saying. The tension ebbed and flowed but never …
Like most of my age cohort, I was brought up to believe that the great Satan threatening to undermine the bloated American health care system was our broken-down, antiquated, self-interested model of reimbursement for care provided called “fee-for-service.” Being a professional who, to the best of my ability, tries to maximize the value of the care I provide to my patients, I subscribed wholly to the notion that the cause …
Recently, I had the opportunity to sit at the table with some of the nation’s top thought leaders. We convened at the Newseum in Washington, DC, for the Healthcare Leadership Council’s National Dialogue for Healthcare Innovation; it was like a health policy nerd red carpet. Center for Medicare Director Sean Cavanaugh was there. Leapfrog Group CEO Leah Binder was there. America’s favorite bioethicist–oncologist–provocateur Zeke Emanuel was there. The chief executives …
I’m in a room full of doctors at my mom’s 50th medical school reunion when I announce, “It’s almost March 30th!” I pause. “Doesn’t anyone know what March 30th is?” Nobody has a clue.
March 30th is National Doctors’ Day! Who knew? I never heard of it — until a friend told me last week.
Veterans know about Veterans Day. Mothers know about …
Recently, I was asked to fill a questionnaire during check-out at a hotel in India. I was very pleased with my stay, so I agreed to provide feedback. It is worth pointing out that if I was only mildly satisfied I would not have agreed. If I was disappointed with my stay, I would have filled the form more enthusiastically.
One of the most revolting pleasures in life is to read learned opinions and in-depth analyses of consumers’ behavior written by beautiful people clad in designer clothing, dining at eclectic chic trattorias or enjoying the occasional canapé under crystal candelabra at their favorite charity gala. These wondrous creatures, having pored over a few disjointed numbers selectively allowed to escape from our struggle with health care, are informing us that there …
As the Affordable Care Act continues to impact millions of Americans through its second year of implementation, many things have become clear to both patients and health care providers alike: nothing is as it seems. While the ACA has provided health care to millions of previously uninsured Americans, it has also robbed many patients of their doctors and has forced others into higher premium, lower service plans. Even those with …
It came out of nowhere. One of those life lessons that I didn’t know I needed to learn. Until I did. There I was, at a weekend business retreat, hobnobbing with a group of women executives. Feeling only slightly out of my element. Trying to blend in.
There was a break in the meeting. And what happened next made me rethink how …
Behind every doctor is a little boy or girl who once watched helplessly. Maybe it was her father or grandfather who suffered under the weight of a disease that was deemed all but incurable. Perhaps her own skin was battered and bruised by the repeated trauma of an unrelenting tourniquet. She swore that when (if) she got older she would protect the innocent from such things. Her vow was the …
I recently had an interesting conversation with several co-residents about how our health care system should evaluate physician performance. If nothing else, the discussion highlighted how challenging this issue has been for almost all medical specialties, including internal medicine, where the controversy has been punctuated by debates about maintenance of certification (MOC) and licensure. It remains to be seen what will develop after the American Board of Internal Medicine recently …
