Mindnumbing: How Medicare fees are calculated
"To arrive at the spending target for 2006, for example, officials first looked at the target for 2005, which reflects the cumulative difference between actual expenditures and allowed expenditures for all years between 2005 and the base year of 1996.
Next, they calculated the 'sustainable growth rate' or SGR, which measures changes in four areas: physician fees (including lab fees and the ...
June 2005
All Stories
Merck is trying to clean up its image
"The intent of the campaign, which is to continue through the end of the year, can be divined from its slogan: 'Merck. Where patients come first.'"
The United States leads the world in activist medicine
Someone gets it: Talking about "activist" medicine and how the US leads the world in it
"I define activist medicine as procedures, treatments, and consultations that have a low probability of affecting the outcome. The procedures and consultations are undertaken to rule out unlikely possibilities, to confirm diagnoses, to improve chances of success, and to reassure patients . . .
. . . I suspect the United States ...
There is little incentive for obstetricians to back up home-birth midwives, because of the potential for malpractice suits
"Some midwives choose to forgo malpractice insurance, saying that their close relationship with clients makes it less likely that they will be sued."
How treating migrants may be crippling hospital care
"The federal law that put the hospitals on the hook for the medical bills of illegals goes by the acronym EMTALA--Emergency Medical Treatment and Active Labor Act. It says that anybody who shows up in an ER must get screened, treated and stabilized, regardless of citizenship or ability to pay.
But since its passage in 1985, the definition of emergency ...
There simply aren't enough hours in the day for many family doctors to deliver high-quality care to people with chronic conditions
Thanks for the news flash. One helpful recommendation: "Ostbye's team set forth a number of suggestions to ameliorate the problem, including writing patient care guidelines with real-world conditions in mind.
'There is a lot to be said for having guidelines, but it seems they are often written ...
Some want to take Viagra off the Medicaid and Medicare coverage list
"Left unchanged, Medicaid and Medicare will spend about $2 billion on sexual-enhancement drugs between 2006 and 2015, the Congressional Budget Office has estimated.
Taxpayers should pay for medically necessary drugs, not drugs that enhance people's sex lives - whether recipients are sex offenders or not."
JAMA defensive medicine study explains why doctors order more tests
Malpractice fears put doctors on defense
"When Geoffrey Blatt went to medical school, he was taught not to order unnecessary tests for his patients. Now, even some patients with headaches get brain scans.
'You're afraid of the one-in-10,000 patient that may have a brain tumor,' the Kansas City neurosurgeon said.
And afraid that the patient may sue for malpractice.
Defensive medicine like this has become standard operating ...
retired doc's thoughts on the recent compensation figures
"Delta also provides current average locum tenens bill rate per 8 hour day and, of course, they show a similar ordinal ranking. But it gets worse. While the internist, FP and ped all make $760 per day, the CRNA brings in $1,140 and a hospitalist makes $975. An internist has to sub specialize to make more than an anesthesia nurse."
Kevin Pho, MD
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
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Many medical decisions require shared decision making
The following column was published on April 1, 2012 in USA Today. I recently saw a middle-age man in my primary care clinic...
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Patients deserve a medical malpractice early offer
The following column was published on March 25, 2012 in the Nashua Telegraph. Medical malpractice historically has been a contentious issue. Doctors...
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Discussing whether tests actually help patients or cause more harm
The following column was published on April 11, 2012 in CNN. When you visit the doctor, chances are you are given a...
Physician
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Being a good doctor is no more an achievement than being a good Mom
At no other time in my medical training was I as confident that, with hard work and dedication, I could master the...
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The malpractice risk of volunteer medical coverage at sporting events
From Outside Online, an article about how physicians are increasingly hesitant to provide volunteer medical coverage at athletic events: "Last year, 13 Americans...
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What does a perfect pediatrics practice look like?
I had a phenomenal day in clinic yesterday. Imperfect for sure but inspiring, connected, and busy. I felt useful and like anybody...
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Tips to improve your patient satisfaction scores
Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is...
Patient
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What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
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Embracing the longing without the outcome
I’m not sure when I stopped missing my husband. I suppose familiarity crept in after 7 years together and I rarely felt...
Policy
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
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How to save a trillion dollars in health care
It is both conventional wisdom and factual truth that, unimpeded, American healthcare cost inflation will bankrupt the United States economically, educationally, socially,...
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How the Affordable Care Act combats preventable hospital infections
As the Supreme Court deliberates the Affordable Care Act, Americans should take a closer look at the commonsense reforms embedded in the...
Tech
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EMR liability needs to go further than just the physician
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
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AMA: Changes are needed in the stage 2 meaningful use EHR proposal
A guest column by the American Medical Association, exclusive to KevinMD.com. Continuing our efforts to move medicine forward while prioritizing patient care and minimizing...
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EMRs require better user-centered design
Healthcare IT News recently asked, “Do doctors have to be typists to get MU incentives?” That question reminded me that given the...
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Electronic records don’t tell us stories that make cognitive sense
One morning recently, I found another physician standing morosely at one of the mobile computer terminals we refer to as “cows”—computers on...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
