Recently, I wondered why Medicare could not control its costs using the investigative power of the federal government instead of releasing physician payment data and relying on journalists to do the work. Two stories that appeared within days of each other raise a similar question about the private insurance industry's methods. An article in Modern Healthcare described the impending closure of the proton-beam therapy center at Indiana University, one of ...

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The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including Hugh Jackman and Julie Andrews. With a physician who is an expert in airway anatomy at her side, and all the technologic advantages of a modern clinic in Manhattan’s upper east side, the ...

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Part 2 of a series (read part 1). I realized I was entering into a process the rules of which were entirely separate from normal human interaction when it hit me that news of the lawsuit was in the newspaper before anyone had had the decency to contact me. What kind of people act like that? Civilized behavior, respectfulness -- in short, all the ways in which you'd think nice ...

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One hundred forty-nine messages. This is what I return to on my first day back from vacation. Many of them were marked with a little red arrow, indicating a high-priority phone message. Recharging with a little time off is a darn good thing, something we all need, and something which has been shown to help all of us be better at what we do. All of us, no matter what our jobs are. ...

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I have been following the progress of bedside ultrasound (using ultrasound as a diagnostic tool during my physical exam of patients) as it gets a foothold in standard medical practice since I first started learning to do it about 3 years ago. Every so often a study comes out which warms my heart as it proves that less (radiation, expense) is more in treating patients. An article came out in the ...

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She was sick.  Not sick like a high fever, body aches and a runny nose.  Sick like she had spent the last half a decade in nursing homes as most of her internal organs failed.  There was oxygen, and dialysis, and a colostomy.  She propelled herself vigorously through the crowded halls in the custodial wing of the nursing home, her wheelchair a natural extension of her body thoroughly unhampered by ...

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If you are a physician like me who performs procedures, then rarely you will cause a medical complication. This is a reality of medical life. If perforation of the colon with colonoscopy occurs at a rate of 1 in 1,500, and you do 3,000 colonoscopies each year, then you can do the math. Remember that a complication is a blameless event, in contrast to a negligent act when the physician is ...

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“Mr. Jones’ chest x-ray looks normal,” the intern said to me on morning rounds. Mr. Jones just had a transhiatal esophagectomy (THE).  The esophagus is the muscular tube that connects the back of one’s throat to their stomach.  It can develop cancer or become completely dysfunctional because of benign processes, and therefore need to be removed. A THE involves cutting out the patient’s esophagus, in Mr. Jones’ case for cancer, bringing the stomach up ...

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How hospitals discourage doctors: A step by step guide Not accustomed to visiting hospital executive suites, I took my seat in the waiting room somewhat warily. Seated across from me was a handsome man in a well-tailored three-piece suit, whose thoroughly professional appearance made me -- in my rumpled white coat, sheaves of dog-eared paper bulging from both pockets -- feel out of place. Within a minute, an administrative secretary came out and ...

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The Affordable Care Act (ACA), commonly known as Obamacare, increased the availability of FDA-approved contraception to women through cost-free coverage under the contraceptive mandate. With the exception of some religiously affiliated insurance plans and employers who are legally exempt, this mandate supports women’s access to comprehensive reproductive health care, including the most effective forms of contraception. However, an integral part of family planning was left out of the legislation: contraceptive ...

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