I believe the projected shortage of physicians caused by  the Affordable Care Act will drive primary care into two opposite tracks. Each is a distinct and logical response to the patient overload and each points out gaping holes in our medical education that must be addressed. The Association of American Medical Colleges  estimates that there will be a shortage of 63,000 doctors by 2015 and 130,600 by 2025 in the wake ...

Read more...

He was a "frequent flyer" -- a patient with multiple health problems who gets admitted to the hospital repeatedly. It was usually because he hadn't taken his medicine correctly, if at all. When he left the hospital 10 days earlier, he told his physician that he wouldn't have problems filling his prescriptions, because he had Medicaid. But when he arrived at his local drug store, it wasn't so easy. "I was ...

Read more...

Accountable care is here – both as a way of doing business and an approach to providing high quality health care.  With accountable care, the potential for reducing overall health care costs, realigning incentives and focusing clinical resources on prevention and disease management is now a real opportunity. Physicians who aren’t ready to transition their practices to operate in a manner required under accountable care models will increasingly find themselves ...

Read more...

Health care reform is a locomotive barreling down America's tracks. In two years, the Affordable Care Act (ACA) will cover some 30 out of 50 million of us that currently lack health insurance, provided neither the Supreme Court nor a new president overturns the law. Political beliefs aside, it would seem that supplying insurance to protect the health of more people is a societal good. Though the costs of reform ...

Read more...

The insurance system for healthcare is perverse. The individual is not the customer of the healthcare company; in most cases it is the employer or the government (i.e., Medicare, Medicaid). They physician works for the insurer who determines for what and for how much the doctor is paid. But are the insurance companies the blame that is often placed on them for our current state of affairs? This system abrogates the ...

Read more...

Medicare has suddenly become a centerpiece issue in the 2012 election—but not in a good way.  Instead of an informed debate about Medicare’s present and future place in our health care system, the politicians have subjected us to a daily assault of nonsense over substance: Let’s start with the nonsense accusation by Governor Romney that "There's only one president that I know of in history that robbed Medicare, $716 billion to ...

Read more...

Several interesting facts crossed my computer screen recently.  The first was a Tweet by American Medical News that the first CT scan was performed on August 25th 1973.  The second focused on the large number of practicing physicians who suffer from burnout, and the third was an article, which cited a talk given by Vinod Khosia in which he is quoted as saying “80 percent of doctors could ...

Read more...

May I tiptoe onto a ledge for a moment? Some (just-back-from-Europe) thoughts on health care policy, perhaps? One of the many differences between the European Society of Cardiology (ESC) Congress and a typical American cardiology meeting was the scarcity of healthcare policy sessions at the ESC. That’s hard to explain; perhaps European countries are settled on their own systems and do not wish to -- or can’t -- influence their neighbors. It goes ...

Read more...

If you believe what most people are saying about health care reform and future practice models, you or your physician, will soon be part of an accountable care organization (ACO). Health policy experts tell us that as physicians, we'll be embarking on a wonderful journey that bears no resemblance to the HMO/managed care heyday of the early 1990s.  Of course, there'll be similarities, like limited networks, top down implementation of health protocols, and ...

Read more...

It’s impossible to watch the news these days. Whether you’re conservative, liberal, independent or non-committed, it’s impossible to avoid the political bickering these days as the US Presidential campaign enters its final countdown. As a physician, seeing the video of Granny being pushed off a cliff is about all I can handle. Seriously? No politician I know has to deal directly with Granny, but I do. I have to look ...

Read more...

Most Popular