I am a hospitalist at a safety-net hospital. Through my work, I have come to understand how our daily decisions — filtered through our own biases — influence how health care is implemented, and I had a personal teacher in my first year as an attending. Soon after starting my job, I met Mr. K. He was in his 40s, well-kempt, soft-spoken and had the good habit of looking people ...

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Recently I posted a piece, describing research out of Johns Hopkins, showing that when patients come to ERs -- either with no insurance or insurance that is out-of-network -- they often face charges that are four, six, or even ten-fold greater than what Medicare would pay for the same services. After the post, I was inundated with angry tweets and emails, mainly from emergency medicine ...

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This year marks the 50th anniversary of the passage of the Fair Housing Act, which formally outlaws racial discrimination in the sale and rental of housing. The Act, passed in the wake of the assassination of Dr. Martin Luther King Jr., had, at its core, the goal of affirmatively promoting equitable and integrated housing across the United States. Earlier this year, however, the current presidential administration announced that it would suspend an ...

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After a semester of medical school, I returned home to the Antelope Valley in California, an area CNN coined, “health care’s nowhere land” because of low health insurance rates and limited provider networks that force residents to travel far for care. I wanted to help my family and neighbors by using the physical exam skills I learned during my first few months as a medical student, but ...

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Less than one year ago, on an early fall evening in Las Vegas, 59 people were killed at the outdoor Harvest music festival. A single shooter injured hundreds more, using firearms purchased through lawful channels. There have been many mass shootings in our country, before and since, and in 2015, deaths from gun violence eclipsed for the first time deaths from motor vehicle accidents. Not long after Las Vegas, discussion emerged in ...

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On my morning commute as I read this NPR article, memories started flooding my brain. I could not control myself and had to write this. My last name “Theetha Kariyanna" has its origin from a small village Theetha and added to it is my dad's name Kariyanna (a local folk god). Back in my school days, the name was weird to my friends as the name ...

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What’s the cost of the procedure? A common (and, frankly, reasonable) question from patients contemplating a surgery. “It depends” is the honest and accurate answer — yet frustrating to provider and patient. The reason for the ambiguity is that it’s all but impossible to tell a patient what his or her own cost will be. Patients (again, reasonably) express frustration as to why there isn’t a set price for a given operational procedure. ...

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I’m writing this piece because I’m finally at the point that I am truly angry. I am angry at how physicians have become devalued in modern health care. I’m angry at how systems of care have participated in this by replacing physicians with lesser trained mid-level practitioners. I’m angry at how our title “doctor” has been hijacked to allow patients to be misled or, in many cases, deceived. It wasn’t that ...

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In the recent years, there is a growing trend in the health care industry whereby private practitioners and independent groups are being acquired by larger companies. This trend is a result of growing complexities of running a private practice and increased expectations of hospital administrators from hospital-based specialists such as anesthesiologists, radiologists and pathologists. I will concentrate on anesthesia as it is my area of specialization, and I have some relevant ...

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Like all doctors, I am frustrated when I see my patients missing out on what could be years of good health. And our medical system is so dysfunctional that it’s tempting for doctors and patients to blame poor health outcomes on how we pay for medical care. But, our ridiculous payment system is a symptom, not the cause of our problems, and fixing our medical system is not going to ...

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