If the government was a physician, it wouldn't be an ordinary doctor like you or I.
It would be a sexy actor like the ones we see on those medical melodramas that have become so popular over the last few years. His hair coiffed, his jacket pressed and free of stains, and his manor confident he would rush into the trauma bay. As the beeping monitor flat lines, he would sweep the nurses ...
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Nothing in life is free.
In the midst of all the turmoil and excitement surrounding the newly passed Affordable Care Act, I believe we should not lose sight of the bigger picture: providing better healthcare at a lower cost for more people. The idea of the Patient Centered Medical Home, although in its trial stages thus far, is what we should be focusing on as physicians and health care providers.
Much has been ...
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I was recently struck by two conversations that I had with acquaintances about recent experiences that they had had with their primary care physicians. The first occurred at my local pool. A fellow swimmer asked me if I took new Medicare patients. She bemoaned that she was abandoned -- her beloved physician of over 20 years had sent out a letter announcing that she would no longer accept Medicare patients. My ...
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The Supreme Court upheld the Affordable Care Act.
I'll leave the detailed legal analysis to other commentators that you'll no doubt find elsewhere.
Although some may not feel this way, this is an outcome everybody should be happy with.
Most important, patients should be happy. As I wrote in the New York Times Room for Debate recently, the ACA has ...
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Physician Quality Reporting (PQRI) sounds good, doesn’t it? After all, delivering “quality” is what it’s all about, right? Maybe. Maybe the government’s efforts are really designed to improve the quality of the practice of medicine in the US. Unfortunately, PQRI has fallen short of its reported goal by a long shot.
PQRI is time consuming. PQRI is expensive. I think PQRI has more potential to do harm than it does to ...
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The following column was published on June 17th, 2012 in the New York Times’ Room for Debate blog.
In this election year, the Supreme Court’s judgment on the Affordable Care Act will be interpreted through a political lens. But the decision will have real-life consequences on patients, whose voice won’t be heard through the ensuing partisan din.
If the individual mandate ...
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The Medicare physician payment formula is a case-study in failed policy. Physicians have long known that it is not working. Polls show that an overwhelming 94 percent of Americans believe the massive cuts it schedules are a serious problem for seniors. Even members of Congress from both parties agree – and that is no small accomplishment – that it is ...
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While there is an extensive literature on how tired, overworked physicians provide lower quality medical care, one thing that has been ignored by advocates of quality improvement is that overwork financially harms hospitals as well. Just as tired physicians sometimes fail to attend to certain clinical details, they are also more likely to commit errors when writing the notes which ultimately are used during the coding process. If hospitals consider ...
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I love it when I see Medicaid patients on my schedule for the day. Working at a community health center, our doors are open to all people, regardless of their ability to pay. It’s hard to run a medical office when you get $20 for a visit, which is what our uninsured patients pay. So when a patient has Medicaid we know we’ll get paid a decent reimbursement for that ...
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Slightly over a year ago, the Department of Justice (DOJ) launched an investigation of a large number of institutions regarding concerns that implantable cardiac defibrillator (ICD) procedures were performed for reasons outside of the criteria set forth in Medicare’s National Coverage Decision (NCD). This investigation occurred just after Al-Khatib and others published a report January 4, 2011 in JAMA that suggested as many as 22.5% of implantable defibrillators implanted ...
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