Cleveland and northeast Ohio are not hospitable to private practice medicine.  I should know.  I’m one of them.  Private practice is fading as health care reform suffocates it by design.  When this occurs, the public will have lost physicians who, in my view, have practiced patient advocacy and service at a higher level than our employed counterparts. Keep in mind that the first half of my professional career was spent as ...

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cpc-docs11 On January 7, 2013, a federal appeals court rejected six Georgia primary care physicians’ (PCPs) challenge to the Centers for Medicare and Medicaid Services’ (CMS) 20-year, sole-source relationship with the secretive, specialist-dominated federal advisory committee that determines the relative value of medical services. The American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC) is, in the court’s view, not subject to ...

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Not long ago, I blogged about a plastic surgeon who aggressively pursues patients who refuse to pay her bills. The state is suing her to make her stop and also considering lifting her medical license. The central theme is that she makes patients who she sees in the ED to sign a form stating that they will pay her. It is unlikely that the patients are aware of ...

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Better Care for Individuals, Better Health for Populations, and Lower Per Capita Costs -ihi.org If you stop to think about the holy grail of health care reform, also known as the Triple Aim, it sounds like a grand challenge involving wizardry or wishful thinking or worse, propaganda for the masses, particularly the last part. It’s like attempting to build a better driving machine, with better fuel efficiency at lower cost. ...

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For years we’ve read that the US faces a looming shortage of nurses. Shortfalls in the hundreds of thousands of nurses are routinely predicted. These predictions have been good for nursing schools, which have used the promise of ample employment opportunities to more than double the number of nursing students over the last 10 years, according to CNN. Yet somehow 43 percent of newly-licensed RNs can’t find jobs within 18 months. ...

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alice-in-wonderland_3 Trying to figure out what is going on with health care costs is like Alice’s adventures in Wonderland, things are just getting curiouser and curiouser. To illustrate:  which of the following statements do you think are correct? 1.    It’s been 50 years since health care costs increased this slowly. 2.    The U.S. spends more on healthcare than any other country but our health is ...

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To treat observation care as simply a loophole that allows hospitals to avoid the Medicare penalties from readmissions -- as Brad Wright, an assistant professor of health management and policy at the University of Iowa did earlier this month -- is to take a short-sighted approach to a complex health issue. Observation care in fact aims to address several of healthcare’s thorniest challenges head on. In the process, a ...

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Adam Smith would disagree, Karl Marx would be appalled, and heck even Milton Friedman and Ayn Rand would be raising objections. But for some peculiar reason, there are enough contemporary lesser economic minds scattered throughout the entire philosophical spectrum, that are advocating for, and enabling the execution of, a government induced transition of our health care system to an oligopoly model ...

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“Pay for performance” made headlines again this week, when Health and Hospitals Corporation (HHC), the multi-billion dollar corporation which operates New York City’s public hospitals, announced that they will be linking physician reimbursement to pre-determined “quality” metrics and patient satisfaction scores. This announcement comes quickly on the heels of details recently released by the Centers for Medicare and Medicaid Services (CMS) regarding its first Medicare payment adjustment to hospitals under the ...

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“He’s dead, Jim.” So here’s my beef. At the recent Forbes Healthcare Summit  there was a lot of focus on speakers and vendors offering very cool new tech, from future “Tricorders” that can diagnose multiple diseases, is non-invasive, and hand-held; personal genomics, where data from your own genome is cheap and easy to get and can be integrated with clinical knowledge to produce better care; targeted therapies for various diseases, ...

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