The Centers for Medicare and Medicaid (CMS) sets the rates all physicians get paid and insurance companies base their rates on the same formula. So who creates the formula? Well, it’s the doctors, silly! Or at least some of the doctors. Here’s how it works. A 31-member committee formed by the American Medical Association is made up of representatives from the various specialty societies. This Relative Value Update Committee (RUC) meets ...

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The massive confusion about Obamacare (the Affordable Care Act) is much worse than I thought. The Kaiser Family Foundation came out with a poll that shows 42% of Americans don't even know that Obamacare is the law. Seven percent of people think the Supreme Court struck it down and 12% think Congress repealed it. I understand that there is confusion about the way it will work and who will be affected. ...

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The baby boomers are strictly identified as being born between 1946 and 1964. The boom lasted 19 years and delivered 76 million total births. "Leading edge" boomers were between 1946 and 1955. They were the generation that were the wealthiest, most active, and most physically fit generation that had ever lived. They were special and expected to have better lives than their parents. Well, those leading edge boomers are now middle ...

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Questions to ask before your CT scan The United States is higher in its use of computed tomography (CT) scans than any other industrialized country. There were about 3 million scans done in the U.S. in 1980. By 2007 that number had risen to 70 million. A number of articles published in medical journals over the past few years have reported that excess radiation delivered by these scans will ...

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Antibiotics for your viral cold: Why its hard to do the right thing Winter is officially here and  we are in the cold and flu season.  This is the time that patients get sick with viral illnesses and primary care doctors get even more frustrated as they try to do the right thing for patients.  What is the right thing? First of all we want to relieve suffering.  But we also want to do that ...

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There are an estimated 1,638,910 new cases of the dreadful disease diagnosed in 2012 in the United States, not including non-melanoma skin cancers. Cancer is not just one disease but is a term that represents more than 100 diseases with different causes. The basic unit of life is cells, and cancer always begins in cells. When the normal process of cell growth and division is altered, these abnormal cells divide without ...

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Traditionally, the patient chart stayed in the doctors office and rarely did a patient get a glimpse of anything in the record.  Photocopying the chart is expensive and no physician would let a chart leave her office because the record must be held safely for a minimum of 7 years.   Now more and more offices are doing away with clunky paper charts and electronic medical records are becoming the ...

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There is do doubt that the way pharmaceutical companies market drugs to both doctors and consumers sways prescribing and drives up health costs.  Prescription drug costs have outpaced other health care spending and are predicted to exceed the growth rates for hospital care and physician services going forward from 2010-2019. Two researchers (Howard Brody, MD, PHD, University of Texas Medical Galveston and Donald Wright, PhD,  University of Medicine and Dentistry ...

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When we think of osteoarthritis (OA), we think of chronic "wear and tear" on a joint that has just plain worn out.  Many patients with arthritis become less and less active and that is actually the worst thing for an arthritic joint. A study published in Arthritis and Rheumatism looked at the functional performance in 2589 adults with knee OA and found that ...

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Arnold Schwarzenegger's revelation about his long-term  affair with his household employee that involved a child being born is the latest in a string of powerful men with career ending flaws.  Add to that the  shocking arrest this week of powerful Dominique Strauss-Kahn for allegedly raping a hotel maid and we must ask, "What the heck is going on with these guys?" I can't count the number of heartfelt apologies that ...

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