As I explained to my medical student this morning that I was ordering an ultrasound on a patient first because the insurance company wouldn’t authorize a CT scan without it, it occurred to me that medicine derailed from its true purpose. Shortly later, I found myself again pointing out why I was prescribing a certain medicine rather than the one I wanted because it was not on the formulary of ...

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Unhealthy behaviors such as smoking, overeating, or lack of exercise lead to chronic health conditions, and many patients wanting to make positive changes to their health may seek the advice of their doctor to do so. But our insurance payment system works against supporting people when they want to act in a healthy way, and some of these payment decisions seem rooted in prejudices against those suffering from certain conditions. Smoking ...

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ama_logoA guest column by the American Medical Association, exclusive to KevinMD.com. Since the 1970s, women have been carving out an increasingly large role in medicine, and the profession is becoming more representative of our society. September is Women in Medicine Month, a great time to acknowledge the changing face of medicine, but also to note that female physicians are not ...

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Well, cement trucks and health care used to have a lot in common. Now all of that has changed. Cement plants have a market that is determined by the time it takes for special trucks to transport wet cement and get it in place before it sets. We see those cement trucks out on the roads with their spinning cargo bins — and all of them are bound to a local, ...

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Many of us have moms and dads or older friends and relatives in nursing home facilities and care very much about their well-being and the supports they receive. But who’s caring for the care aides who do the bulk of the frontline work in nursing homes? Their welfare is almost entirely overlooked in the health system. And it turns out, the health of the care aide affects the Read more...

I have two hours until I’m due to breastfeed my seventh-month-old baby again, so I’ll make this quick: Breastfeeding is really hard for many and our environment and current policy context makes it even harder. The month of August has been declared “National Breastfeeding Month” by the United States Breastfeeding Committee — an organization committed to “creating a landscape of breastfeeding support” by advocating for policy changes ...

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To me, my white coat symbolizes a willingness to care for my fellow man, and every day I strive to fulfill that challenge. But even the brightest white coat has a few stains. Growing up in a small Midwestern town, I just didn’t “get” the homeless community. They were completely isolated from my day to day life. Surrounded by my local community, I just assumed that the homeless were either ...

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American medicine is in trouble, and the men and women who run our country’s medical societies are just the ones to save it. Think about the trouble, the confusion, the upheaval. Some call it reform. Some call it progress. Some call it just more damn, unnecessary change. Health care is such a politically volatile phrase that it’s tough to have a civil conversation about what’s working and what isn’t. In Texas, ...

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Will physicians go extinct? Artificial intelligence, legislation, profit motives in the health care industry, and clever lobbying by non-physician providers may all contribute to our demise. However, I believe the existential threat to our profession stems from the ranks of physicians themselves. 1. Unwillingness to embrace activism Pathologist and writer Rudolph Virchow once said: “The physician is the natural attorney of the poor.” Like most physicians, my goal is to provide evidence-based ...

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While hundreds of doctors have submitted (mostly unfavorable) comments to CMS on the proposed evaluation and management changes, there are other issues which seem to be receiving much less attention than they deserve. And one of those may hit physicians who perform procedures in the wallet. In 2015, Congress asked CMS to analyze the global period data to ensure procedure weighting accurately reflected the actual work done by physicians. Of course, ...

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