When interviewing for my book, I asked about insurance, but the topic came up even when I didn't specifically ask about it. It was never positive in relation to practice. A doctor said, "I expected to be around tough and hard cases. I expected it to be hard. I did not expect to have to think if the insurance company will not pay for it."Another one said, "This completely changes the ...

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It was nearing the end of my day at the mobile health clinic where I work as a nurse practitioner, providing free, comprehensive primary care to uninsured patients in central Florida. Clinic was officially over, and we were no longer taking patients; I was signing notes and finishing up some teaching points with a PA student when a woman walked up and asked me if she could “talk to me ...

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Mark Kelley wrote a clear piece explaining that friends and providers are still patient’s most trusted medical referral resources in a piece titled, "Why quality reports for hospitals and doctors are interesting but flawed." Mr. Kelley cited unsynchronized, inconsistent systems as a source of frustration rather than insight for patients. The most common online referral database for patients? Yelp. We are living in a health care crisis. Health ...

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Exactly a year ago, on the day of the election, I wrote a piece that touched upon humankind’s turbulent history, basic traits and inevitable propensity for division and conflict based upon an amazing book I read: “A Little History of the World.” I related it to the election that was taking place on that day. A year on, it seems like our country is no less politically ...

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If all politics is local, then Washington’s health care debacle has brought politics to the front stoop of every health care provider in America. There is no escaping it – debates taking place on Capitol Hill are set to affect the very survival of our patients. Irrespective of political leanings, doctors, nurses and providers of all stripes have ethical and professional obligations to speak up and become engaged in order ...

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Yet another round of attempted health care reform has come and gone, and once again, failed. And so, the traditional open enrollment season for health insurance is upon us, and as usual, many Americans are facing outlandish increases in premiums, skyrocketing deductible amounts, and shrinking coverage. Americans are increasingly enslaved and endangered by the rising costs and the growing dysfunction. Fixing things is, to put things in the proper perspective, ...

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As a trainee at a large private health system (residency) followed by a NCI-designed comprehensive cancer (fellowship) in two large metropolitan areas in the United States, I was not prepared to face the challenges of working at a university setting affiliated with a county (public) hospital in more rural west-Texas.  After one and a half years of experience as a practicing urologic oncologist, these are the five challenges I have ...

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Eat what you kill. Sounds like a mantra from a survival reality show, right? Akin to “eat or be eaten,” “kill or be killed.” It’s also a common reference to the prevailing business model in our American scarcity-minded, competition-driven, fee-for-service health care culture. How ironic, the application of these words to this profession. It was explained to me essentially as: “Every man for himself, and you’re a minion. You are expected ...

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When Aneurin Bevan was asked how he convinced doctors to come on board the National Health Service (NHS) he allegedly replied, “I stuffed their mouths full of gold.” Bevan recognized that to conscript doctors to the largest socialist experiment in health care in the world he had to appeal not so much to their morals, but their pockets. There is much piety about the NHS. It is the envy of the ...

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On September 30th of this year, the Children’s Health Insurance Program (CHIP) ran out of federal funding. While CHIP has not received as much publicity as the Affordable Care Act (ACA), it has had a major impact on the American population: providing health insurance for 9 million children who would otherwise not be insured. Despite its success, there is currently a debate about the funding of CHIP. CHIP, which was passed ...

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