I read a fascinating article from ProPublica about a nurse practitioner (NP), Heather Alfonso, who pleaded guilty in June to accepting $83,000 in payments from a drug company in exchange for prescribing a high priced drug used to treat cancer pain. However disturbing this is, notably in the data released by the federal government on payments by drug and device companies to doctors and teaching hospitals, the payments ...

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growth-in-administrators_opt I’m taking back medicine. If you didn’t know it left or that someone stole it, I’ll give you a pass. Medicine has been disguised for a long time now. And, when you leave the scene in camouflage, you often go unnoticed. Medicine is supposed to be the science or practice of diagnosing, treating, and preventing disease. I love medicine. There’s so much to learn. Lots ...

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Now we’re giving star ratings to hospitals? Does anyone think this is a good idea? Actually, I do. Hospital rating schemes have cropped up all over the place, and sorting out what’s important and what isn’t is difficult and time consuming. The Centers for Medicare & Medicaid Services (CMS) runs the best known and most comprehensive hospital rating website, Hospital Compare. But, unlike most “rating” systems, Hospital Compare ...

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shutterstock_208716340 Ever since Medicare started using patient satisfaction surveys in 2012 to calculate hospital reimbursements, the healthcare system has been looking to the hospitality industry to learn how to make patients enjoy their hospital stay. Hotels do have the answer, but hospitals are looking in all the wrong places. What hospitals are doing wrong The concept behind Medicare’s HCAHPS survey -- a short questionnaire asking ...

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Part of a series. Patients need doctors that take time to listen which means a limited number of patients under care. Employers need programs that reduce costs and ideally improve the health of their staff. These apparently disparate needs can come together in a new model for effective company-sponsored primary care programs. Those of you who have followed this series know that I am an advocate for PCPs finding ways to ...

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There was a doctor. The doctor had an office. In the office, he had a practice. The doctor worked hard, was honest, smart and compassionate. He took care of many patients, everyday, and helped many people. The people paid with cents, checks, and chickens. He was solo, alone, by himself. It was good. There was a hospital, near the doctor. It was an important hospital. It took care of many patients, ...

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The history of American medicine is the story of the rise and fall of a professional guild.  In the 19th and early 20th centuries, physicians distinguished themselves from other healers by banding together to form professional associations dedicated to science-based practice.  Even more important, medical ethics put the patient first, above considerations of personal gain or even collective social goods.  The medical guild may have been insular, self-protectively territorial and ...

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shutterstock_261978071 Dr. Melos is a gastroenterologist in solo practice in a medium-sized Midwestern city.  One day she hears a knock on her door. When she answers, she finds two representatives of Athenian Health System, who request a few minutes of her time.  She invites them to take a seat in her office. After exchanging pleasantries, the visitors get down to business. They extend Dr. Melos an ...

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shutterstock_231494431 "Doctor, the patient is complaining," said my secretary in a hush-hush voice. “She has been waiting for 30 minutes.” “She” had an appointment for later in the afternoon but phoned our office about 2 hours before the scheduled time, and requested to come earlier. No emergency. No acute complaints. We always try to accommodate, and pushed to “squeeze” her in. The earlier time, ...

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shutterstock_196597025 He’s loud, brash and audacious. He’s been a celebrity for decades, a well-known businessman and reality TV star. And anyone who is even remotely following the news at the moment knows he’s also dominating headlines with his presidential run. I’m going to pause here to say that I’m not going to get into the politics of anything he has said -- no ...

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