Jimmy Kimmel recently delivered a 13-minute monologue that transfixed the nation.  He told the story of how his newborn son, Billy, was diagnosed with a potentially fatal cardiac anomaly, tetralogy of Fallot, and had undergone emergency surgery. He painted the picture of a sick child and a terrified family, who have the benefit of excellent care that ends well. He complimented the nurses and physicians who had ...

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Barely ten years ago, 350,000 completely preventable AIDS deaths occurred in South Africa because of their president’s obstinacy. He recommended that women treat their HIV with beetroot and lemon juice. It’s hard to believe until you realize the same thing just happened here. HJ Resolution 43 was just signed into law by President Trump, giving states the ability to reject federal grants (called Title X grants) to family planning providers and ...

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Physicians and patients are fighting a growing hypocrisy in American medicine. Examples abound, such as criticism that doctors are overprescribing antibiotics and contributing to resistance, while insurance companies simultaneously incentivize their members to use telemedicine programs or urgent cares instead of visiting their primary care physician. My own insurance company, Cigna, recently sent me a letter notifying me that I will have a reduced co-pay if ...

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Maintenance of certification (MOC) for something as significant as the practice of medicine seems like a harmless enough idea. But for physicians across the country who dedicate thousands of hours to study, earn licensure, achieve board certification, and practice medicine, MOC is not only unnecessary but also a resource-consuming mandate that does nothing to improve patient outcomes and quality of care. According to the American Board of Medical Specialty’s (ABMS’) own ...

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Recently, the online version of JAMA published an original investigation entitled "Patient Mortality During Unannounced Accreditation Surveys at US Hospitals." The purpose of this investigation was to determine the effect of heightened vigilance during unannounced accreditation surveys on safety and quality of inpatient care. The authors found that there was a significant reduction in mortality in patients admitted during the week of surveys by The Joint Commission. The change was ...

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Nonprofit hospitals have higher profit margins than most for-profit hospitals after accounting for their tax obligations. 3900 (62 percent) of U.S. Hospitals are nonprofit and therefore tax-exempt — they pay no property tax, no federal or state income tax and no sales tax. An article published in Health Affairs found seven of the nation’s 10 most profitable hospitals were of the nonprofit variety, each earning ...

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For much of the first 100 days of the new Congress and administration, the news has featured health care and the frequently rancorous debate on its future. Will the Affordable Care Act (ACA) be repealed, replaced, revised or remain essentially intact? Will funding be cut or will subsides and cost-sharing reduction payments stay the same in order to encourage insurers to stay on the health care exchanges? At this point, we’re ...

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Congress has returned to DC in the wake of the defeat of Paul Ryan’s American Health Care Act. And while shouting "repeal and replace" might win elections, this debacle proves that the American people will not tolerate their families, friends, and neighbors losing healthcare coverage just so rich people can get tax cuts. Yet, Congress will certainly revisit health reform again. With the Republican caucus fractured, Paul Ryan should seek out ...

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The Affordable Care Act Medicaid expansion resulted in unanticipated negative consequences for many patients and physicians in rural, underserved or medically isolated communities across America. Consolidation of health care entities was financially incentivized by the ACA, and slowly my beloved corner of the Pacific Northwest is becoming a medical wasteland. In a beautiful community on the Olympic Peninsula, just north of where I live and practice, it happened again; another private ...

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The Trump administration has made clear its intentions to drastically reduce the size and intrusive nature of government. Let’s hope that extends to the Medicare Access and CHIP Reauthorization Act, otherwise known as MACRA, the heavy-handed new government “value-based payment” program for medical care, enacted in 2015, and set to rear its ugly head beginning this year. MACRA must die. MACRA is administrative overkill in an industry already overburdened by ...

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