First I believe our health care system must be better so I’m always curious to hear how others might propose to fix it. I recently had the opportunity to listen in two conversations with businessman David Goldhill about how healthcare might be made better. Goldhill lost his father to a hospital acquired infection and witnessed multiple errors during his hospitalization which compelled him to write not only a piece in ...

Read more...

Ensuring that Americans who live in rural areas have access to healthcare has always been a policy priority.  In healthcare, where nearly every policy decision seems contentious and partisan, there has been widespread, bipartisan support for helping providers who work in rural areas.  The hallmark of the policy effort has been the Critical Access Hospital (CAH) program– and new evidence from our latest paper in the Journal of the ...

Read more...

I’m sure that many of you have read the New York Times post  titled "Job Prospects are Dimming for Radiology Trainees." I don’t know about you, but this article made me feel more than ever that in order to choose the right specialty, you have to predict the future of the field. Don’t choose a field that’s going to be heavily affected ...

Read more...

We are frequently reminded by the General Accounting Office and CMS that a great proportion of Medicare health costs are incurred in the last three months of a patient’s life. Health care policy experts have tried to reduce these costs by encouraging end of life planning.  Living wills, health care directives and the availability of hospice and palliative services will not put a dent in these costs because of human ...

Read more...

Several months ago, as I was in the last few months of my private practice, I watched the Joy Luck Club with my wife.  I had seen the movie many times before, but somehow at that moment in time, when I was grieving for my practice and my profession, I began to have some startling clarity. Specifically, I was particularly struck by this dialogue:

I tell you the story because I was raised the Chinese ...

Read more...

We recently marked the third anniversary of the passage of the Affordable Care Act by reflecting on the positive changes it has brought about and by mulling over the multifaceted challenges that stymie our efforts to build more accessibility, equity, quality, safety, and cost-effectiveness into one of the most complex healthcare systems in the world. Reining in healthcare costs, a central element in the reforms we seek, is inextricably linked to ...

Read more...

I recently wrote about some of the unintended, but positive, consequences that could result from employers dropping employer-sponsored health insurance (ESI). Following that post, many weighed in about various other consequences of such behavior from employers and what that means for health care coverage for millions of families in the US. One issue in particular caught my attention; not only because of the touching stories associated with the ...

Read more...

A dark wind is beginning to blow through the tortured landscape of health care in America. At the confluence of the corporate cold front with the warm front of technology innovation, a storm is brewing. A storm that may grow into gentle and much needed rain showers, or the grandest tornado ever experienced by mankind, and unlike the wondrous works of nature, the path taken here is completely within our ...

Read more...

In 2006, Governor Mitt Romney signed Chapter 58 of the Acts of 2006 entitled “An Act Providing Access to Affordable, Quality, Accountable Health Care.”  It has been described by many names, including Massachusetts Healthcare Reform (MHR), Romneycare, or simply, as the template for the Affordable Care Act.  The goal of the act was straightforward: to ensure near-universal access to health insurance for citizens of the Commonwealth of Massachusetts.  ...

Read more...

US_Congress_02 A follow-up to Dear lawmakers: This is what it’s like to be a doctor today. Thank you to everyone for the positive feedback.  Over 60,000 Facebook “likes”, tweets, and newspaper requests was quite a surprise. I was especially moved by the multiple tweets from hospices, physician groups, and individuals recommending my article. This article really has hit a nerve and shed light ...

Read more...