If the government was a physician, it wouldn't be an ordinary doctor like you or I. It would be a sexy actor like the ones we see on those medical melodramas that have become so popular over the last few years.  His hair coiffed, his jacket pressed and free of stains, and his manor confident he would rush into the trauma bay.  As the beeping monitor flat lines, he would sweep the nurses ...

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Is it possible that health care can become more effective, more personalized, more attuned to real health and wellness in a manner that truly benefits the patient as a customer/client? The answer is “yes” but it will require understanding the dysfunction in the delivery system today, dealing with the growing shortage of primary care physicians and their non-sustainable business model, changing the insurance paradigm from prepaid medical care to (high deductible) ...

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The Supreme Court has spoken. The Affordable Care Act is upheld.  So what does this mean for those of us actually involved in health care? First, there is a lot of work to do. The Court has reached its decision with regard to the legal issues; what remains are the challenges of improving the quality of care, lowering its cost, providing access to those who need the care, integrating technology into ...

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The drama surrounding the Supreme Court decision upholding the ACA as constitutional has ended. As legions of reporters and bloggers have written, the law has far-reaching effects. In my corner of medicine it will greatly help (already has, really) a small but not insignificant number of children and families. These families are those who have a child with a severe chronic medical condition.  Many of these these children spend time ...

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Dear Ms. Patient, I hope this letter finds you well. Let me begin by saying that it is such a privilege to care for your family. It has been a joy to watch your children grow and your family thrive. I'm sure you will agree that we have been through a lot together. As you know, I am devoted to help in keeping your family healthy, despite the many obstacles that have arisen. ...

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When President Obama turned 50 last year, he made an “informed patient request” for a PSA (prostate specific antigen) test. This is the blood test routinely used to screen men over 50 for possible prostate cancer. The President received his PSA test. But under ObamaCare, you may not be able to. Now that ObamaCare has been upheld by the Supreme Court, all of its major provisions will be in force, ...

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President Obama enjoyed a towering victory that I feel leaves the GOP reeling, although they are spinning the Supreme Court’s validation of Obamacare as a great gust of wind at their backs. While I would not have expected a different response from them, I fear that there is a developing wind that may blow them away in November. I offer this analysis as a tepid Romney supporter who will be voting more ...

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On the day the U.S. Supreme Court delivered its historic decision on the Affordable Care Act (ACA), aka Obamacare, I was rounding on my hospital patients: a man on the ventilator with pneumonia who had private insurance, one elderly woman with abdominal pain going for gall bladder surgery on Medicare, and one middle aged obese woman with a skin infection without any health insurance. On my patients' TV screens I watched ...

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Nothing in life is free. In the midst of all the turmoil and excitement surrounding the newly passed Affordable Care Act, I believe we should not lose sight of the bigger picture: providing better healthcare at a lower cost for more people.  The idea of the Patient Centered Medical Home, although in its trial stages thus far, is what we should be focusing on as physicians and health care providers. Much has been ...

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Early in my medical training I envisioned myself as an old-fashioned family doctor. Marcus Welby, MD was well before my time, but he seemed like a good fictional role model for a naive student-doctor. (Especially considering Dr. Cox of Scrubs was my alternate choice.) After finishing my primary classroom studies, I was eager to leave the stacks of paper behind and to learn from real clinicians caring for real people. After donning my short white coat ...

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