A guest column by the American Medical Association, exclusive to KevinMD.com. Let me start by wishing you and your families a very happy and healthy new year. This is my first column of 2012 for this blog, and I am excited to talk about a new initiative that is beginning this year. Medicare accountable care organizations (ACOs) have been discussed at length ...

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Most hospital managers have never had the power to exert leverage over their most valuable resource, the physician, who, after all, admits the patients who make the hospital’s economic existence possible in the first place. So I wrote in introducing a chapter in my first book in 1988. I hastened to add, however, at the close of that chapter, these admonishments: 1. The economic powers of the hospital is shifting from those ...

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I am a little fish in a big sea. And so are most of us. Or used to be. For better and for worse, the era of private-practice, outpatient medicine as we know it is coming to an end. And faster than we thought. The choice now: down size or super size. No longer can a doctor operate a private practice as a solo practitioner or in a small group practice. ...

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As the new year starts, I'm eager for a fresh start and working on improving myself both physically and emotionally. I'm also eager for the NFL playoffs and seeing how my favorite team, the New England Patriots, fares under the leadership of Coach Bill Belichick and quarterback Tom Brady. Doctors and health care can learn much from their examples. Over the past decade, the New England Patriots have been dominant ...

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Health care is in crisis. Reimbursements from insurance companies continue to dwindle, while the expenses of running an office continue to rise.  Looming cuts in Medicare are only weeks away, and many physicians may stop taking Medicare.  If these cuts go into affect, it is possible that primary care physicians could lose up to 50% of their salary.  Just recently CNN reported that some doctors are going bankrupt. How ...

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“The moral test of government is how it treats those who are in the dawn of life, the children; those who are at the twilight of life, the aged; and those in the shadows of life, the sick, the needy, and the handicapped.” We all know that health care in America is too expensive and yet ineffective, falling consistently at the bottom of the rankings of industrialized nations when it comes ...

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About six weeks ago, while in clinic, I developed pain in my stomach -- specifically, in my right upper quadrant, just below the ribs.  I had experienced this a few times before, but this time it seemed more persistent than usual.  Following the rule that physicians make the worst patients, I kept working through it until my nurse told me I looked poorly, and made me see my own primary ...

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Dear United States House of Representatives and Senate: I really hope that you enjoy your Christmas break going back home to your families. While you're home, I really hope that you will hear from those constituents who will be affected by the 27.4 percent Medicare physician pay reduction that is schedule to take effect January 1st. I really hope that the American Academy of Family Physicians, the American Medical Association, ...

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How do companies curb health care costs? Do healthier employees lead to increased productivity?  Several progressive companies believe so and have committed to providing employees with programs to help engage them in a healthier lifestyle. As part of the incentives to lead a healthier lifestyle some employers have instituted a penalty and reward system tied to the companies’ benefits.  For example, smokers may incur a significant surcharge to the cost of their ...

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I met with my staff yesterday to discuss the effect of a 27% cut in Medicare reimbursement on our patients and our office.  I had a really lousy day, explaining to my elders what would happen if Congress fails to act.  One of my patients aptly pointed out that Congress has not acted responsibly in the last 20 years and that it would take a miracle for them to get their ...

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