The U.S. Department of Health and Human Services (HHS) advocates the "creative destruction" of the traditional system of U.S.physicians practicing solo or in small groups operating as small businesses. Republicans and Democrats approve of ACOs in concept. The Affordable Care Act of 2010 calls for shifting from fragmented care provided ...

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A guest column by the American Medical Association, exclusive to KevinMD.com. A wise physician once said, "Health is not valued til sickness comes." The same can certainly be said about health insurance. This concept is at the heart of our current debate about individual responsibility for health insurance coverage. While we hope never to need surgery or chemotherapy or to have an unexpected accident or illness, it’s certain that many of ...

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by William Schumacher, MD Am I the only one excited about the future of healthcare? With all the prevailing pessimism about America’s "dysfunctional" health" system, optimists (and I am one) sometimes feel stranded on our own lonely islands. It’s not that we don’t know what the challenges are.  I have been practicing emergency medicine for over 30 years, and there ...

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The patient entered her private solo physician’s office and handed her medical ID card to the doctor.  He put the card in his desktop reader and reviewed her medical history.   All of her visits, vaccinations, medications, tests, x-rays etc from all providers were inscribed on the data chip in the card.  The card also included insurance and billing information.  At the end of the visit, he updated her information on ...

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On March 31, 2011 CMS issued its proposed rules for Accountable Care Organizations (over 400 pages). There is now a 60-day comment period.  Shortly thereafter, the final rules will be issued.  I am sure there will be changes in the proposed rules as there were changes in the “meaningful use” rules for electronic health records (EHR’s).  Yet, much of the intent of ...

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As a specialist, one of the saddest truisms about practicing medicine in the private world has always been how little one’s clinical skills determines referrals. Unfortunately, as our present healthcare climate pushes "providers" to consolidate along the lines of major hospital networks this injustice will only worsen. A decade-or-so ago when I started private practice it was obvious that referrals came to me because of my association with an established ...

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One year after passage of the Affordable Care Act, the Department of Health and Human Services (HHS) has unveiled two programs that will most certainly be transformative for U.S. healthcare, affecting both quality and safety. With the announcement of the first-ever National Quality Strategy in March, HHS signaled a strong commitment to improving the quality of healthcare. In essence, ...

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After all the ridiculous fear-mongering about "death panels," Congress dropped a proposal to encourage end-of-life planning from the health reform legislation passed last March. But the administration had in fact quietly included reimbursing doctors for end-of-life counseling along with a host of new Medicare regulations. The provision, which authorizes payment for “voluntary advance care planning,” went into ...

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Primary care is a unique field of medicine. Primary care physicians (PCPs) are the gatekeepers to specialized care, provide preventative care, and most importantly, they have the ability to manage patients with multiple chronic conditions. Thus, primary care physicians are in prime position to become the point men in the Read more...

Now that I'm well out of my reckless youth phase of my life, I try to preserve the efficacy of my brain. With my lifestyle, there's three actions I take to ensure the integrity of my brain.

  1. Always wear a bike helmet when I bike
  2. Avoid over-consumption of alcohol
  3. Avoid looking at doctor bills and insurance "statement of benefits"
The first two ...

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