There’s been a lot of controversy recently about workplace wellness programs: Do they save money for employers on health care costs? Can they produce measurable benefits for employee health? Do they unfairly punish people who are unable to participate? Are these programs just a ploy to shift medical costs to unhealthy employees? Recently Austin Frakt and Aaron Carroll revisited these questions in a piece for the New York Times’ Upshot column, “
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The Affordable Care Act (ACA), commonly known as Obamacare, increased the availability of FDA-approved contraception to women through cost-free coverage under the contraceptive mandate. With the exception of some religiously affiliated insurance plans and employers who are legally exempt, this mandate supports women’s access to comprehensive reproductive health care, including the most effective forms of contraception. However, an integral part of family planning was left out of the legislation: contraceptive ...

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1. Physician assistant (PA) growth will remain unprecedented. Demand is driving growth and PA program expansion.  The educational programs are charging students higher tuition costs for these coveted PA positions. PA students now acquire unparalleled debt, according to a recent Robert Graham Center report; one in four PA students owed more than $100,000. Although high student debt may impact PA graduates ability to go into fields like primary ...

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If I were punched by an unknown man in an elevator there would be little doubt that my assailant would be prosecuted. If the trauma were enough to cause me to lose consciousness, meaning I suffered brain trauma, my attacker would likely be charged with aggravated assault. No one would be surprised if he received jail time. No one would think twice if he lost his job. However, if I ...

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Part of a series. Patients need doctors that take time to listen which means a limited number of patients under care. Employers need programs that reduce costs and ideally improve the health of their staff. These apparently disparate needs can come together in a new model for effective company-sponsored primary care programs. Those of you who have followed this series know that I am an advocate for PCPs finding ways to ...

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Let’s talk about expectations. And I’m talking the Dickens’ kind. When you watch television, the food flaunts itself before you. Tempting you with golden buns and perfectly placed pickles. The models eating those perfectly styled burgers are the same -- airbrushed to perfection. Most often, limbs are stretched to unrealistic proportions and curves are molded and erased to fit someone’s view of beauty. When someone first takes the baby steps to venture into ...

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There is much talk about cynicism in medicine, and I remember being confronted by it almost from the beginning. In fact, I still remember how shocked I was the first time I heard a provider describe a patient in a disparaging matter. We were responding to a 911 call regarding a woman in her 30s who was feeling short of breath. I remember being worried; she seemed too young to be ...

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I have a patient who is a full blown sufferer of health anxiety. He firmly believes he has full-blown AIDS after a single extramarital sexual contact (non-genital) one month prior with a woman not known to have HIV. (Reality check: The other person didn’t have HIV, the specific contact as described was ridiculously unlikely to have transmitted the virus had it been present, and AIDS takes months to years to develop ...

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Patient appreciation: Why I still love being a doctor Judging from recent articlessurveys, and blog posts, the medical profession is remarkably demoralized. Typical complaints range from “feeling like a beaten dog” to “living in humiliating servitude,” to being forced to practice “treadmill medicine.” Interestingly, the public response to these complaints is largely indifferent. The prevailing attitude (if the comments sections of online articles and blog posts are representative) seems ...

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Once again government regulators have put in place well-meaning rules without anticipating the consequences. We all hate sitting around in the emergency department waiting to be seen and to be treated. On October 15, 2014 as part of the new Affordable Health Care Act and the patient satisfaction portion, hospital ERs will have about 180 minutes from the time you arrive and sign in to evaluate you , treat you ...

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