With American health care in the midst of rapid transformation, both doctors and patients will be forced to adapt to changes stemming from the Affordable Care Act, also known as “Obamacare.” Of course, everyone responds to change differently. But is it possible to predict how doctors will adapt to health care reform based on the year they were born? The answer may surprise some patients and even force them to think differently ...

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Politics in the US is discouragingly partisan. National politics has become increasingly partisan since at least the late ’60s, when the passage of civil rights legislation influenced many conservative southern Democrats to join the Republican Party. Even state politics has become more partisan, where even famously nice people in Wisconsin have found themselves battling their neighbors across political divisions. Fortunately, most of life does not force us to confront our political differences, meaning ...

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Doctor: “Phil, you have pneumonia.” Phil: “Oh noes. What shall I do?” Doctor: “Just take these red pills, here.” Phil: “Great! I feel better already! When can I go back to work?” Doctor: “I think in about 2 weeks. Or maybe 2 months. And actually, don’t take those red pills -- these blue ones are better. It could take a few years for you to get better, and I’ll be retired by then. Here, ...

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The janitor approached my office manager with a very worried expression.  "Uh, Brenda ..." he said, hesitantly. "Yes?" she replied, wondering what janitorial emergency was looming in her near future. "Uh ...well ... I was cleaning Dr. Lamberts' office yesterday and I noticed on his computer ..."  He cleared his throat nervously, "Uh ... his computer had something on it." "Something on his computer? You mean on top of the computer, or on ...

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Whenever a discussion of health care policy is initiated, the importance of health insurance, of extending coverage, takes center stage. The need for insurance quickly becomes an undeniable truth, a universal imperative. And no one ever seems to question this subtle premise before getting more patients fitted with shiny, new policies. This was precisely the case with the Affordable Care Act. My question, however, is simple. Where is the evidence that ...

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With the rollout of Obamacare, we are living in a moment in which there is no dearth of heated debates among friends, family, and co-workers. And often times, these debates degrade to become emotion vs. emotion, or even ad hominem, and so these initially well-meaning conversations morph into heated arguments that lead nowhere. (Even Immanuel Kant advised debaters to out-shout opponents when more civil methods of discourse had failed.) It is far ...

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A version of column was published on March 5, 2014 in the New York Times’ Room for Debate blog. To remedy our fragmented health system, reformers want to consolidate health care.  President Obama, for instance, has praised integrated health systems like the Mayo Clinic as a model for national reform.  To that end, the Affordable Care Act drives more hospitals to become more Mayo-like by purchasing physician practices.  Today, about 39% ...

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American consumers value the freedom to comparison shop. We like to survey a variety of options and select "the one" that what we really want. If we want triple-ply, select-a-size paper towels with a blue shepherdess imprinted on them, then we expect to be able to find them in aisle 9. Deny us options and we’ll take our business elsewhere. When it comes to health care, though, endless options may not ...

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I first heard about the ICD-10 when I was working at a small start-up, trying to develop an EMR for a string of dialysis clinics. It was always spoken of with a certain gravity, like the ominous visit from an aunt that nobody in the family likes, but feels obligated to see.  Practical (read: business) people hate ICD-10. It’s giant and unwieldy. Doctors think it’ll be an excuse to bilk ...

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Health insurance reform was long overdue. But did it need to be done the way the architects of the Affordable Care Act did it? Obamacare was enacted, and the private health insurance market fundamentally changed, so that we could cover millions of people who previously couldn't get coverage. Are enough people getting coverage who didn't have it before to justify the sacrifices the people who were already covered -- in the individual, ...

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