Here’s a little story from the early days of my first job as a chairman of surgery. Shortly after I assumed the role of surgical chairman in a community teaching hospital at the ripe old age of 40 and having absolutely no administrative experience, I visited a mentor of mine whom I had known since I was a medical student. He had been serving in a similar role at a larger ...

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A recent article, "Burned Out Nurses Linked to More Infections," addresses an important issue that is often overlooked and ignored. Let’s be brutally honest, without an appropriate nursing workforce, our entire healthcare system would collapse.  As our healthcare system continues to shift to a business and profit model, both nurse and physician burnout will only increase. Decisions to “cut corners” by not providing adequate nursing staff are made on a daily ...

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A recent case from Dayton, OH highlights the tangled mess of emergency department specialty coverage, federal law, and out-of-network insurance benefits.  When these interact, patients, doctors, insurers and hospitals can be left frustrated and perplexed. Here’s a brief summary. A 6-year old boy suffered a fingertip injury and the emergency staff called the covering plastic surgeon, who repaired the injury.  The surgeon, who does not participate with insurance, submitted a bill ...

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AMA works to reduce administrative burden for physiciansA guest column by the American Medical Association, exclusive to KevinMD.com. Since the American Medical Association launched our National Health Insurer Report Card in 2008, there has been noticeable progress by health insurers in response to the AMA's call to improve the accuracy, efficiency and transparency of their claims processing. The AMA has been working constructively with insurers, and as a result ...

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Mr. Omer had once held a position of social prominence, a moral influence on the lives of individuals and communities.  Until one year ago. A construction accident changed everything. He suffered injuries that left him in control of only one side of his body and his mind functioning as a 5-year old child. Most recently, he had resided in an extended rehabilitation nursing facility, until yesterday. When the nurse tried to arouse ...

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Encouraging patients to be more engaged, may also encourage more people to go beyond assertive to demanding care unsupported by good clinical judgment. Of course, physicians worry that saying “no” to a patient increases their risk of being disliked, dismissed, or even sued for medical malpractice. Greater transparency in health care means patients are more aware of options for screening, testing, procedures, and medications—often via direct advertising or public service campaigns. ...

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On a recent afternoon, Hansel Tookes stood on a sidewalk in downtown Miami, peering into a thicket of scraggly weeds. "I found a bunch over here," he said, edging toward an overpass. A small orange plastic cap came into sight, and next to it two slender insulin syringes, with the needles exposed. Scattered about were tiny plastic zipper bags -- evidence that the needles had been used to inject heroin ...

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Recently New Yorker staff writers and best-selling authors Malcolm Gladwell and Atul Gawande addressed the question of whether the problem in health care is that patients are too reliant on doctors and don't have the ability to make decisions. In reading between the lines, is that the reason health care is not affordable and care not commoditized or consumer driven like other industries? At a conference for America's Health Insurance Plans, ...

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Unless you’ve lately returned from a retreat at a remote Cistercian abbey, if you’re interested at all in women’s issues you’ve probably read Anne-Marie Slaughter’s recent article in the Atlantic, "Why Women Still Can’t Have It All."  The author eloquently tells how she left her dream job in the State Department as the first woman director of policy planning in order to return to her husband, her two ...

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As odd as this might sound, my mother was upset when I declared my intention to go to medical school. It wasn’t the mountain of debt I was sure to incur since I’d already figured out how to get Uncle Sam to pick up the bill (a small deal that put me in a military uniform for a decade).  It wasn’t the fact that medical school would delay the litter of ...

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