We're spending an inordinate amount of time and effort trying to convince doctors to change the way they practice. Most recently, for instance, a study came out saying that doctors aren't following back pain guidelines.  Or from a broader perspective, consider the Choosing Wisely campaign, which lists scores of tests and treatments that are ordered too frequently. Various carrots and sticks have been used to steer physicians to ...

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The following column was published on May 29th, 2013 in the New York Times’ Room for Debate blog, which asked the question, "Is Obamacare too complicated to succeed?" Is the Affordable Care Act complicated? Of course it is. Even one of its architects concedes that it is phenomenally complex. Why? To pass, it had to be contorted to satisfy a number of special interest groups. As its major reforms are implemented ...

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To improve patient safety, lawyers need to embrace transparency too How do we reduce medical errors? It’s a question at the forefront of the minds medical and policy leaders today.  Entire books have been devoted to the subject, and there is no shortage of suggestions to improve patient safety. Internist Danielle Ofri recently wrote a New York Times op-ed on the issue, where she reflected on a “near miss” she had during ...

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Finding a doctor online and researching your physician on the Internet Part of the KevinMD toolkit series. "How can I find a doctor online?" A seemingly simple question, but patients are often confronted with too much information on the Internet, with variable quality. Finding a doctor a similar to completing a puzzle.  Like puzzle pieces, there are many resources available, including word of mouth, hospitals, insurance companies, and physician ...

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One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners.  This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have. Simply Google “nurse practitioner” on this site, for instance, and you’ll see ...

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The KevinMD toolkit: Blogging Part of the KevinMD toolkit series. A lot of people ask me, “What tools do you use for blogging, speaking, when you’re on the road, seeing patients etc. …” So I decided to start a series that describe what tools I use, and why. The first explored my speaking toolkit.  This one details the technical tools I use to run KevinMD.com.  I’ll discuss ...

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Curb prescription drug abuse by following Mayor Bloomberg A version of this column was published in USA Today on April 1, 2013. Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than 16,000 deaths a year.  And for every death, significantly ...

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Health reformers should learn from doctor owned hospitals As part of the health reform movement, hospitals that meet various quality measures, like reduced readmission rates or improved patient satisfaction measures, get financially rewarded.  Those that don’t will be penalized. How’s it going so far? Well, it appears that safety net hospitals that can least afford a financial hit are getting dinged, while doctor-owned hospitals are getting rewarded. Oops. According to Kaiser Health ...

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Boston rises in the wake of tragedy “Daddy, a bomb blew up in Boston!” That was how my 4-year old greeted me when I came home this evening. Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the gravity of the event as mainstream media caught up. I practice in Nashua, NH, which is about 45 minutes north of Boston.  But ...

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Health reform faces tension with integrated health systems The following column was published on March 26th, 2013 in the New York Times’ Room for Debate blog. In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement may improve patient care, whether it will shield ...

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