Only in the United States could a virus like H1N1 bring out the worst in medical politics and greed. We are facing a pandemic that requires coordination, communication and the best of medical practice. But what are we getting? Strikes, lawsuits and anything but putting patients first. The California Nurse Association (CNA), is taking this opportunity to call a strike on three large Catholic hospital chains (which comprise a total of ...

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by Bruce Goldman The U.S. health care system, although it's the costliest in the world, doesn't even deliver the goods when it comes to delivering health. That's the conventional wisdom. But is it true? At least a few well-researched studies by credentialed and respected experts suggest we might want to pause to consider whether, in the mad dash now underway to fix our ailing health care system, we could inadvertently end up ...

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Hidden in the Senate version of health reform is wording that would require insurers to consider covering Christian Science prayer treatments. Although not expected to be a big expense, this is causing some consternation, as it blurs the line between church and state. And this would likely invite other religious groups to organize, so they can receive federal dollars as well. Introduced by Sen. Orrin G. Hatch (R-Utah), it is somewhat ...

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Originally published in MedPage Today by Charles Bankhead, MedPage Today Staff Writer The physician workforce in the U.S. is growing smaller and younger, according to data from the Census Bureau, but conflicting estimates make it difficult to determine just how many doctors are out there -- and how many the nation will need. The census survey showed 67,000 fewer physicians than estimates based ...

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I would like to introduce you a remarkable article by Edward J. Volpintesta, MD, a 65-year old solo primary care doctor in Bethel, Connecticut. Dr. Volpintesta is a veritable writing machine and has been published in The Wall Street Journal, the New York Times, medical journals, and other publications. His articles cry for a deeper understanding of primary care dilemmas. In the October issue of Connecticut Medicine, Dr. Volpintesta hits the ...

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Of the myriad of proposals meant to change the health care system, including switching to electronic records, paying for performance, and adhering to evidence-based standards, very little attention is being paid to how they will be implemented, and the unintended consequences that may arise. Annie Brewster, an urgent care provider in Boston, outlines this in a nice commentary: "Reform should make my job more, not less, satisfying. Of course, doctors should ...

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After a painful, summer-long labor, Senate Finance eventually had to be induced before it gave birth to a health reform bill of its own. But give birth it finally did, and the products of its conception now stand alongside the offspring of 4 other proud Congressional committees. But please! Save the silver spoons and bunting! None of the quintuplets does enough to assure there will be enough PCPs out there to ...

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I think by now there is not a person in the US who cannot quote at least approximately how much we spend annually on healthcare. Fewer people appreciate that nearly 1/3 of this $2.2 trillion bill is eaten by hospitalizations, amounting to about $680 billion. Although the data in the diagram below represent a single year, the overall distribution of expenses is remarkably constant over time.
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Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have. I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern ...

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by Bruce Douglas, MD I've been practicing my health care specialty for sixty years and have enjoyed almost every minute of it. The minutes I have not enjoyed all have to do with "money." Financial transactions in doctors' offices are the root of most evils in the relationship between doctor and patient. Along with that evil goes an additional detraction from good, humane health care called the fee-for-service system, which ...

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