Deductibles and donuts change the flavor of health careA guest column by the American College of Physicians, exclusive to KevinMD.com. In the annual cycle of a medical practice, there are seasons. For example, we have "flu season," "poison ivy season," "camp or school physical season," “snowbirds back from Florida season,” and in my part of the world, "Lyme disease season." There are other seasons that physicians must endure that have ...

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The administration has confirmed that the individual policies that were supposed to be cancelled because of Obamacare can now remain in force another two years. For months I have been saying millions of individual health insurance policies will be cancelled by year-end -- most deferred until December because of the carriers' early renewal programs and because of President Obama's request the policies be extended in the states that have allowed it. The ...

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March 2nd through the 8th was National Patient Safety Awareness Week -- I don’t really know what that means either.  We seem to have a lot of these kinds of days and weeks -- my daughters pointed out that March 4 was National Pancake Day -- with resultant implications for our family meals. But back to patient safety and National Patient Safety Awareness Week. In recognition, I thought it would be useful to ...

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Next in a series. You the patient are really not the customer of the physician. Since the insurer will determine whether and how much the physician will be paid for attending to your needs, you are largely a bystander in the relationship. The doctor’s customer has become the insurer. Our system of care is definitely not customer-focused. Doctors truly believe that they have the patient’s best interests in mind and they ...

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I truly enjoy the practice of medicine.  The challenge, the complexity, and the constant evolution, combined with the opportunity to continually, positively, and substantially affect people's lives should lead to an exciting career. However, the economics of medicine as a business have sapped much of this enjoyment for everyone involved. As the government strives to save health care dollars, the hospitals and insurance companies gear up their high priced lobbyists to guide ...

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Comcast recently announced it is merging with Time Warner, the 2nd largest cable company in the US. Together, this deal nets Comcast an estimated 57% of the cable subscriber marketplace and heralds a new oligarchy in US media and entertainment. It’s big news for Comcast, but  aren’t as excited. Why? Because both Comcast and Time Warner have been consistently rated the worst providers of customer service in the cable industry. Now as they ...

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AMA: Urge Congress to repeal the SGR nowA guest column by the American Medical Association, exclusive to KevinMD.com. It’s crunch time for our nation’s physicians. After an 11-year battle, we stand closer now than ever before to repealing Medicare’s fatally-flawed sustainable growth rate (SGR) formula. With the introduction of the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 last month, Congress took a critical step toward reforming ...

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"Hey doc, I saw on an ad on the TV last night about this new asthma inhaler.  Shouldn't I give it a try?" This type of question would occur several times a week.  When I started practicing medicine it was considered unethical to advertise medical treatments.  Now, we're bombarded with enticements for tests and treatments.  The inhaler the patient requested cost $264 a month -- more than double what he was ...

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The Republicans have an alternative to Obamacare and they may have given the Democrats a big political gift. The proposal was unveiled by Republican Senators Richard Burr (NC), Tom Coburn (OK), and Orrin Hatch (UT). The Republican plan targets many of the most unpopular parts of the Affordable Care Act such as expensive mandated benefits and the resulting lack of choice, the individual mandate, the employer mandate, and age-rating disruptions. My sense is ...

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As an internist (yes, I am a specialist, just not a subspecialist), I do no procedures.  Patients pay me (albeit mostly indirectly) for my cognitive skills.  But we live in a culture that seemingly rewards procedures more that pure cognition.  Now I understand that procedures are not mindless.  Physicians doing procedures must think prior to the procedure, during the procedure and after the procedure.  But cognition without procedures seems undervalued. The ...

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