The patient was in pain and had been for over a year. And it was getting worse, not better. Exhausting all avenues of treatment, I decided it was time to refer him to a pain management doctor. Because of the injury to his back, the patient lost his job and his health care coverage. With no alternative for health care coverage, he ended up covered by Medicaid. While health care ...

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Every health care system in the world is facing its fair share of challenges. Aging populations, the exponential increase in chronic diseases such as heart disease and diabetes, expensive new treatments—all at a time when most countries desperately need to curtail rising health care costs to save their economies. At the two extremes, we have fully public-funded (socialized) medicine versus entirely free-market (private) health care delivery systems. I’ve written previously ...

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It is time for me to dig out from under the frustrating quagmire of paperwork imposed on me by my insurance contracts so I can reclaim my sanity and love of my work. I am terminating all of my in-network contracts, firing my billing service, and focusing my clinic time and energy entirely on patient care.  Removing my practice from the control and limitations of health care insurance companies allows ...

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With Donald Trump’s promise to repeal and replace Obamacare on many Americans’ minds, there are numerous questions about how the health care system will work in the very near future. There are equally as many, if not more, outlandish speculations. Donald Trump was elected a week ago and doesn’t assume office for two more months. Much of what will get changed and how is yet unknown. Yet the mainstream media has been quick ...

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The Wall Street Journal, The Washington Post, CBS News and other news outlets have led with headlines touting the big news that Donald Trump is willing to keep parts of the Affordable Care Act -- notably the pre-existing condition protections and the ability for children up to the age of 26 to stay on their parents policies. Except this isn’t news. In May, Trump’s policy advisor told Healthline that a ...

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With the election of Trump and a Republican Congress, it looks like the ACA is doomed. Will it be repealed in whole or in part? Will something replace it? None of us, including the new administration, know exactly what will happen. But if it does get repealed, what exactly are the consequences? The ACA was never a full health care overhaul. It was a form of insurance reform that used subsidies ...

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In my previous post, "Have physicians finally joined the working class," I discussed the changes in the health care system regarding physicians roles in these systems. In this post, I propose two strategies that could help physicians regain some influence over their work and to participate fully not just in the execution of strategy from management but also have an input in creating it. Building unions There has been a ...

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Like many of you, I have experienced a turmoil of emotions since Tuesday night’s presidential election.  Sadness, anger, fear, disgust, and uncertainty have permeated my thoughts since I learned of our new reality.  What does the future hold?  What will the consequences be for my gay, minority, and Muslim friends, family, and patients?  How will this affect the vulnerable children that I care for every day? As I began to process ...

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My son was underperforming at school, and I was gently encouraging him to try harder (if gesticulating like an over-caffeinated Italian qualifies as gentle encouragement). He could not understand why I was upset: “Dad, most of my friends are doing drugs and engaging in unprotected sex. You should be rewarding me for being such a good kid.” “Reward you for not being bad?!,” I replied incredulously. That made no sense to ...

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The world is not going to end.  We witnessed a revolution earlier recently.  The people have spoken, and they chose the anti-establishment, street smart, government shrinking candidate who bucks the status quo.  We find ourselves in uncharted territory, with an unpredictable President-elect, who has unclear plans for health care.  Here is what we do know.  Mr. Trump is a successful entrepreneur.  Forbes describes the entrepreneurship pathway as having no ...

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