Part of a series. Readers of my posts know that I am a strong advocate for primary care and for granting the PCP added time per patient. Older patients in particular with both their many impairments and chronic illnesses need more time per visit. Here is an approach by a continuing care retirement community developer/manager to assure that the PCPs have adequate time for each resident, most of whom ...

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A long, long time ago, hospitals existed to admit patients when they were sick, treat them with medicines or surgery and good nursing care, and discharge them after they became well. Hospital care was at one time a charity, which evolved into a nonprofit service, before it became a very big business. In olden days, nonprofit hospitals charged patients straightforward fees for their services. Then, when you were just a young whippersnapper ...

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"I love my job." Throughout the year 2015, a national campaign called Health is Primary has held seminars with primary care doctors around the country. The point was to remind Americans of a basic truth about health care: Primary care physicians are the lynchpin of any health care system.  In every country, more emphasis on primary care leads to better health outcomes at lower cost. I got to be the ...

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Health care providers and patients alike have been physically and emotionally frustrated when dealing with health care’s rising cost. Legislative restrictions based on cost often defy logic and common sense in a way that most people have never encountered. But what is it specifically about the health care market that gives us these fundamentally perverse situations? Many point fingers at insurance companies, big pharma, hospitals owned by private equity firms, ...

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If she had been eligible for Medicare, the hospital would have charged the government $10,000 for the services it provided to her, with Medicare picking up most of the tab. But lacking insurance, she was billed directly from the hospital, and not for a mere $10,000. The total charge: $120,000! That 1,200 percent markup is extreme. But out of the 50 U.S. hospitals with the largest price markups, 49 are for-profit ...

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There are three visions of peace in the seemingly never ending, but really rather brief, Israeli-Palestinian perpetual crisis. One peace features two independent countries living in collaborative harmony on a piece of land approximately the size of New Jersey. Another peace yearns for a messianic Jewish state stretching from the blue Mediterranean shores to the Jordan River, and possibly beyond. The third and final peace is expected to materialize after ...

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I admit that on one level hearing and reading about the many complaints from physicians about the changes in health care that make their daily practice steadily less productive, less enjoyable and less satisfying along with insights into all the reasons why our system is dysfunctional is helpful in at least knowing my pain is widely shared. Maybe it’s the simple act of venting that bonds us to some small degree, ...

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Most of us would agree that there aren't enough valid and meaningful health care quality measures to guide patients' choices of hospitals and physicians. While the federal government has steadily expanded the number of publicly available measures on its Hospital Compare website, it still falls short of what many patients, payers, and providers would like. This is particularly true in the realm of outcomes such as ...

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Part of a series. PCPs in the current reimbursement model are obliged for business reasons to see many patients per day which, of course, means less time per patient. PCPs are frustrated, and patients are less satisfied. With less time, it is hard to build a strong doctor–patient relationship and without it there is less opportunity to build trust. Readers of my posts at KevinMD know that I ...

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Planned Parenthood is under attack, and certainly not for the first time. The organization, federally funded by the Family Planning Services and Population Research Act since 1970, provides a wide range of medical services to women (and men), including routine physical exams, STI screenings, contraception, and abortion. This latest movement against the organization gained traction following a series of heavily-edited videos from the so-called Center of Medical Progress, ...

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