We physicians like to think that we are really different from other workers.  We physicians, perhaps thinking back to that medical school application essay we all wrote, really believe that we went into this career to simply help others.  We physicians truly believe that we always put our patients first. Because we sincerely believe all of the above, we are shocked when someone like Uwe Reinhardt points out that collectively we ...

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The Patient Protection and Affordable Care Act cleared two major hurdles in 2012: the Supreme Court ruling on constitutionality and the reelection of President Barack Obama. However, in 2013 there is a very good chance that Courts will see much more of the health care reform law due to objections regarding the contraception mandate. Despite the bills legal successes in the past, there are (at publication) more than
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A recent New York Times headline read that "Medicare Is Faulted on Shift to Electronic Records."  The story describes an Office of Inspector General (OIG) report, released November 29, 2012, that faults the Centers for Medicare and Medicaid Services (CMS) for not providing adequate oversight of the Meaningful Use incentive program. Going after “waste, fraud, and abuse” always makes good headlines, but in this case, the story ...

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Today, I come back to the tragedy of medical economics in this country. And I would apply that word "tragedy" in at least two ways. The first tragedy is that we are headed for fiscal disaster in this country because of healthcare costs. We now spend twice as much per person on healthcare as the average per person cost of all developed countries. During the past several decades, the inflation rate for ...

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Not long after posting a recent column which, admittedly, was somewhat critical of healthcare providers in and around New York City following Super Storm Sandy, I decided to get a clearer picture from someone intimately connected to the disaster – my own brother. A few months ago, Ira Nash, MD, was appointed Medical Director for Physician and Ambulatory Network Services at North Shore Long Island Jewish Health System (NSHS), a ...

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Some physicians will make over 7 times what the average college dropout will earn over a lifetime. Even within medicine there are significant differences in lifetime earnings between primary care, surgery, and specialty care. With the recent Powerball lottery jackpot at a record high, there was a lot of daydreaming going on recently for many Americans, maybe even some doctors: What would you do if you actually won it all? ...

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I think horses can teach us some things about health promotion. We invoke them routinely, although I suspect we are unaware of it much of the time. Three of the more salient themes in modern health promotion involve incentives, disincentives, and what/how much people drink -- with a particular emphasis, of course, on less soda, and more water. I hear hoofbeats in all of them. Incentives are particularly prominent in
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I hope my patients are satisfied. This is everything. Improving the lives of people is why doctors do what they do. How much we help our patients is the metric. It’s the peg we hang our self-esteem on. So yes, of course, patient satisfaction is really important. But that doesn’t mean it’s a good idea to link it with dollars. In fact, on a list of well-meaning but really dumb reform ...

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The Bipartisan Policy Report titled “What is Driving US Health Care Spending? America’s Unsustainable Health Care Cost Growth” issued in September lists seven factors increasing American health care costs. The “fiscal cliff” debates include many of these arguments. While these factors do indeed play roles in American health care, almost all are at work in other industrialized countries, all of whom provide better care to more people for half what we ...

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ObamaCare: All roads lead to single payer When the marketing of ObamaCare began in 2009, I always believed that the end game was for a federal single payer system. Since the present Affordable Care Act, (ACA), was passed in 2010, there has been nothing to convince me otherwise. The only reason single-payer wasn’t passed two years ago was because it was hard enough to arm-twist and bribe even ...

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