Most mornings, I opt to take the red line commuter train from my apartment in Bethesda, Maryland to my hospital in Washington, DC. Despite the costly two-way fare, it’s a worthwhile journey because it’s a chance to observe the various other commuters making their way to all sorts of destinations. It’s a people watcher’s dream! Some look dressed to impress on Capitol Hill or in corporate offices. Others look as ...

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The Affordable Care Act. Obamacare. No matter what you call it, the law has two main goals: Insure more (all?) Americans, and in doing so, lower the aggregate costs of health care in the U.S. After year one of the Act’s main rollout, there is no doubt about the first goal: Millions more Americans now have health insurance. Many have purchased it on the exchanges, whether they are state-run (best example might ...

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Health reform: Great for patients, but this doctor lost his job As an employed physician specialist working in an underserved community, I am thrilled with the Affordable Care Act (ACA). I was initially a skeptic of the program because of the cost to taxpayers, but I have since witnessed first hand the tremendous benefits. People with limited resources and real problems can now get help without suffering financial harm. Those with chronic ...

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The Affordable Care Act (ACA) has created an unprecedented opportunity to improve the well-being and economic security of millions of Americans, including lesbian, gay, bisexual, and transgender (LGBT) people and their families. Notably, health care reform has the potential to reduce and eliminate LGBT health disparities by improving access to quality, affordable health insurance coverage that connects LGBT individuals and communities with the care they need. However, this opportunity ...

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Assimilating independent physician practices: Is resistance futile? Fans of Star Trek: The Next Generation will recall that the most disturbing aliens encountered by the Federation were the Borg, a part-cyber, part human collective race that functioned as an integrated and cyber-connected whole that existed only for the good of the collective, rather than as distinct individuals with their own thoughts and personalities -- much like honey bees work together as ...

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The Sunshine Act escalates the war on physicians The media has feasted on the recent release of data by the Center for Medicare and Medicaid Services (CMS) that details payments made by the pharmaceutical and device companies to hospitals and physicians in 2013. This was part of the the Physician Payments Sunshine Act (PPSA) -- also known as section 6002 of the Affordable Care Act (ACA) of 2010. What the ...

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As I finish my post-operative care routine for my 9-day-old patient, I notice that the cerebral oximetry machine is not picking up a strong signal. Despite troubleshooting, I am unable to figure out how to fix the problem, and I head to the Pixus to get a new sensor. Unfortunately, this one does not work either, and we must use a smaller sensor to pick up an adequate signal on ...

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There is no excuse for physicians to take advantage of vulnerable patients Patients are being stuck with huge and unexpected medical care bills in circumstances where they have no say in selecting the physician who is billing them, and no way for them to know in advance which services the physicians would render or what it would cost them, says the New York Times. Mr. Peter Drier received a “surprise $117,000 medical bill from ...

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Around the country, for every health system that is successfully navigating the early years of value-based health care, there are several others that are failing -- even though many don’t yet realize it.   These failing organizationscan’t or won’t restructure themselves to deliver effective, efficient and affordable care. I’ve come to the conclusion, after observing struggling systems, that two basic characteristics are necessary for systems to transform themselves in response to external pressures: execution and motivation. Successful systems have ...

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Physicians, whether practicing medicine or not, should not be involved in clinical research. They should never be consulted on development of new drugs and medical devices. Doctors should not invent new treatments, and should never supervise clinical trials. They should not travel to or speak at conferences either, and they should banish all entrepreneurial notions out of their heads. If they insist on engaging in these activities, they should do ...

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