Over the past decade, there has been yet another debate about whether pay-for-performance, the notion that the amount you get paid is tied to some measure of how you perform, “works” or not. It’s a silly debate, with proponents pointing to the logic that “you get what you pay for” and critics arguing that the evidence is not very encouraging. Both sides ...
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California doesn’t have enough doctors to provide healthcare to newly insured patients.
California state senator Ed Hernandez asks, "What good is it if they [state citizens] are going to have a health insurance card but no access to doctors?"
Wait. Health care insurance doesn’t mean that patients will have access to health care? Where have I heard that being said for more than 3 years?
The government is ...
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An excerpt from Pet Goats and Pap Smears.
My dad is eighty-eight years old. He finally retired from medicine at eighty-six. I call to check on him. “What are you up to, Dad?”
“I just returned from synagogue a few hours ago. Right now I’m catching up on my reading. I’m finishing up the fiftieth anniversary issue of Medical Economics.
That’s Dad living it up on a Saturday night.
“It ...
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A response to The creative destruction of the American family physician.
Dr. Brooks' column shines a bright light on the misconception that some subspecialists have about the core of primary medical care and family medicine. As a former nurse practitioner and current family physician, I'd like to point out the flaws of his argument.
At a time when the health care community is working to end the fragmentation, duplication and gross ...
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From 1974 to 1982, a group of researchers conducted the RAND Health Insurance Experiment. In lay terms, what they did was assign people to different levels of insurance coverage, with a particular focus on the amount of co-payments, co-insurance, and deductibles that people had to pay, and then they observed their use of the health care system. As you might expect, those who had to pay more out of their ...
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Over the past several months, the state of Oregon has been pursuing an aggressive approach to solving the healthcare crisis that many states are dealing with.
A couple of years ago Oregon was facing a $2 billion deficit in their Medicaid program, with few solutions to repair the situation. The governor was reluctant to take the obvious step of cutting doctors' pay for ...
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When I was in medical school in the 1990s, students were given a bleak picture of the life of a subspecialist. We were told that there would be few job opportunities and that the only way to ensure a job was to pursue a career in primary care. Many of my classmates did go into primary care but the majority of us accepted residency positions in surgery, neurosurgery and other ...
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Consumerism in health care is coming to mean patients must shop around for the best price — for a doctor’s visit, Cipro, health insurance and maybe even your next operation. The marketplace gurus are telling us we can buy health care like TV sets and search for the lowest price tag.
But can you really choose a place for surgery based on the ...
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Should marijuana be legal, for either medical or recreational use? I think the best initial answer to this is: It's a crummy question! We are good at those.
It's a crummy question, because it calls for answers based on unsubstantiated opinion. Answering it does not invoke or even encourage any relevant evidence, or precedent. So what would a better question be? How about: On what basis should any particular substance be ...
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Cleveland and northeast Ohio are not hospitable to private practice medicine. I should know. I’m one of them. Private practice is fading as health care reform suffocates it by design. When this occurs, the public will have lost physicians who, in my view, have practiced patient advocacy and service at a higher level than our employed counterparts.
Keep in mind that the first half of my professional career was spent as ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
Dear lawmakers: This is what it’s like to be a doctor today
Matthew Moeller, MD | PhysicianA gun owner responds to Sandy Hook
Edwin Leap, MD | PhysicianIs Chris Christie too obese to run for president?
Jeffrey Parks, MD | PhysicianIf I’m wrong about guns, can you please explain why?
Claire McCarthy, MD | PhysicianPrimary care doctors may no longer be needed
Doug Olson, MD | PhysicianWalgreens moves into primary care, and it’s our own damn fault
Kevin Pho, MD | Kevin's Take