Patients deserve a medical malpractice early offerThe following column was published on March 25, 2012 in the Nashua Telegraph. Medical malpractice historically has been a contentious issue. Doctors have argued that the system is broken, promotes multi-million dollar awards disproportionate to the injuries suffered, and encourages the ordering of unnecessary tests to avoid being sued, a practice known as defensive medicine. Trial attorneys, on the other ...

Read more...

The following column was published on April 11, 2012 in CNN. When you visit the doctor, chances are you are given a prescription for a drug or an order for an X-ray or lab test. Before you leave, it's important to ask whether your doctor's recommendations are truly necessary. Even though much of what physicians do is meant to help patients, sometimes it's not always the case. Drugs may have harmful side ...

Read more...

Conservatives should love the Affordable Care ActAnd progressives should want health reform to fail. No, you read that right. Counter-intuitive?  Let me explain.  As the fate of the Affordable Care Act hangs in the balance in the Supreme Court, both progressive and conservative pundits have been working overtime to discern the future of health reform. The traditional thinking is that progressives direly want health reform to move forward, ...

Read more...

The following column was published on March 26, 2012 in CNN. With the Supreme Court set to hear oral arguments about the constitutionality of the President Obama's health care law, more patients than ever have been asking for my thoughts about health reform. I practice primary care in southern New Hampshire near the Massachusetts border, which gives me a firsthand look at how health reform has impacted my neighboring state. Despite flaws ...

Read more...

Will patients accept focused networks in todays economy?In a bid to save money, health insurers are coming out with what's known as "focused networks," which typically exclude the highest cost hospitals. In the Boston area, one such plan comes from health insurer Harvard Pilgrim Health Care, whose plan excludes Partner's Health Care institutions.  That's significant, since Partners includes the famed Massachusetts General Hospital as well as ...

Read more...

Should doctors be forbidden to complain about money?The Patient Centered Medical Home is supposed to be the solution to our primary care woes. Endorsed by both the American Academy of Family Physicians and the American College of Physicians, this new model of primary care creates a team-based approach to patient care, with a cadre of care managers and nurses assisting physicians to manage patients with chronic disease. ...

Read more...

Why electronic medical records may not save moneyA recent study from Health Affairs has been generating some buzz, as well as passionate rebuttals. According to the study, doctors who used electronic medical records actually ordered more tests, compared to those who used paper records. There was a 40% increase in ordering imaging tests, a number that increased to a whopping 70% when it came to advanced tests, ...

Read more...

Reducing the emotional impact of medical malpracticeA version of this op-ed was published on January 17, 2012 in USA Today. Ask doctors about what concerns them the most, and chances are they'll say, "medical malpractice."  Indeed, most physicians will be sued sometime during their careers.  A recent New England Journal of Medicine study found that 75% of doctors who practice psychiatry, pediatrics or family medicine will ...

Read more...

How patient satisfaction can killPatient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores. High scores are even used by hospitals as a powerful marketing tool. But, in the end, are patient satisfaction scores hurting patients? I wrote about the issue previously, saying that
Read more...

How I approach ovarian cancer screening with patients Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease is at an advanced stage. Tests to look for the disease, such as the transvaginal ultrasound or the CA-125 blood test, are not specific enough. That leads to false positive tests that necessitate more studies that may not ...

Read more...