Transparency -- including price, quality, and effectiveness of medical services-- is a vital component to lowering costs and improving outcomes.  However, it is imperative transparency go hand-in-hand with financial incentives for patients and consumers; otherwise, the quest will be in vain.  The single best way of reducing costs while not worsening health outcomes is to redistribute resources from less cost-effective health services to more cost-effective ones.  Americans are extremely uncomfortable ...

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When Louisiana resident Andrea Mongler wrote to her senator, Bill Cassidy, in support of the Affordable Care Act, she wasn’t surprised to get an email back detailing the law’s faults. Cassidy, a Republican who is also a physician, has been a vocal critic. “Obamacare” he wrote in January, “does not lower costs or improve quality, but rather it raises taxes and allows a presidentially handpicked ‘Health Landing Pages Choices Commissioner’ ...

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When I go to work, I take a lot of things with me. Everyone has their ritual, right? I take my backpack with my computer inside. I take my phone. I take charging cords, the true modern lifeline. I take lunch. I carry a pen, flashlight and pocket knife. On a more abstract level, I take the wonderful education I received as a medical student and resident, coupled with my years ...

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The phones, the phones, the phones. Every time we look, everywhere we look, getting the phone answered seems to be a problem we just can't lick, a continual thorn in the side of our practice, something that's hindering all the other efforts we try to make things better, to get ourselves to the best care environment for our patients, our staff, and our providers.

Without ...

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My cohort graduated from our psychiatry residency almost ten years ago. The level of frustration and disappointment we’ve all experienced within the past two years is striking. Some have taken leadership roles, only to relinquish them because of fatigue from fruitless discussions with administrators. Others have tried to alert senior managers about dangerous and irresponsible clinical practices. Their efforts were unsuccessful because concerns about finances trumped concerns about clinical services. With ...

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I grew up in the United Kingdom and have friends and family who rely on the National Health Service. I’ve written previously how I believe that, despite the idea of a completely free at the point of use health care system sounding very noble -- and there are certainly many great things about the NHS -- it’s not a model that has been copied in any other country. As someone who ...

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The moment that an accreditation team shows up unannounced can spike the pulse of even the most seasoned hospital executive. The next several days will amount to one big exam for the safety and quality of care, as surveyors meet with executives, managers and care teams, and watch first-hand as care is delivered. Make the wrong move or give a wrong answer, have them see rust on a ceiling sprinkler, ...

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When people ask me why I, an applied mathematician, study diabetes, I tell them that I am motivated for both scientific and human reasons. The Conversation Type 2 diabetes runs in my family. My grandfather died of complications related to the condition. My mother was diagnosed with the disease when I was 10 years old, and my Aunt Zacharoula suffered from it. I myself am pre-diabetic. As ...

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After writing my 21st post about appendicitis back in November, I swore I would not write about it again for the foreseeable future. Well, the future is now because investigators from the United Kingdom and Canada just published a meta-analysis including ten papers and 413 children about the efficacy and safety of nonoperative treatment for appendicitis in children. They concluded that nonoperative management is effective in 96 percent ...

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STAT_Logo There’s absolutely no good reason why Sally should have been in the hospital. Not a day over 60, she had come to the emergency department for severe gastrointestinal pain and was then moved to a bed on the 10th floor of one of the hospital’s two towers. I met Sally (not her real name) during my first year in medical ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 81-year-old man is evaluated in the office 3 days following a percutaneous coronary intervention with placement of a bare metal stent in the left anterior descending artery for angina refractory to maximal medical therapy. He indicates that he feels well except for palpitations that were not present before the procedure. ...

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March is colon cancer awareness month. Created by gastroenterologist Amit Sachdev, this video was selected by the American Society of Gastrointestinal Endoscopy as part of their colorectal cancer screening campaign.  Enjoy. Image credit: Shutterstock.com

When I tweeted this on Monday morning about the House GOP bill to “repeal and replace” the Affordable Care Act, I had no idea that it would result in me appearing on MSNBC’s Last Word with Lawrence O’Donnell or that it and my other tweets would be referenced by NBC News, a New York Times editorial, or for that matter, a retweet from singer-songwriter John Legend! I mention ...

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The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed, “We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients, and they’re equal that we prioritize the commercial insured patients enough so … We can ...

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Uncertainty surrounding health system reform and the future of the Affordable Care Act has left many physicians with questions about how current proposals will affect them and their patients. Stakes could not be greater for patients who may again face the stark, life-or-death choices arising from the possible loss of health insurance. As a longtime member of the American Medical Association's Board of Trustees and a former president of the ...

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At this point, much has been made of the health care bill the Republican administration has put forth to replace the ACA. We’ve heard the details of the bill, we’ve seen the numbers. We know that the U.S. Congressional Budget Office has forecast that 24 million more people will be uninsured by 2026 if House Representatives replace the ACA with the current bill proposed by the Trump administration. We know ...

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Dear pharmacist, You just paged me and, I must admit, I’m not feeling excited to call back. I estimate that I probably get paged, called, texted or stopped in person by you exactly X·102 per day, where “X” is the number of days I’ve been on service. Despite all of the interactions over the years, I have never stopped to really consider our relationship. Here are a few of our most ...

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  Think about it; athletes aren’t the ones who document their performance. It’s other people that keep the score. That’s a whole science in itself. People talk for hours after the game or tournament is over about how each athlete did this or that in whatever way they did it, and the numbers are in many cases captured by extremely sophisticated electronic equipment. Physicians work hard to diagnose and treat their patients, ...

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Earlier this month, a mourning widower stormed the office of the physician who had been providing life-saving cancer therapy to his young wife which failed. He shot and killed him. Or did he? Before judging, let’s examine the facts associated with this case. 1. Juan Gonzalez, BCND was not a medical doctor. In fact, his “doctorate” was awarded via a naturopathic program. He did not possess, nor was required to possess a ...

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Once upon a long 18 years ago, I got sick. I was sick from a growth in my brain. The growth was found after I'd shuttled from doctor to doctor, from appointment to appointment, from X-ray to scan. It took a year. By then, my pain was clothed in shame. Undiagnosed pain does that: It draws the gaze of friends, family and providers. Everyone looks for the cause. "Soul pain," said one doctor. ...

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