by Esther Buddenhagen, MSW I write as a lay person concerned about the gap between what many people should receive and what they actually receive. The question of good medical care for ordinary people is being buried not only by insurance issues but by failure to come to terms with what primary care should be about. Even Atul Gawande, who is particularly good at making distinctions between good and ...

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Health reformers often cite the Mayo Clinic as a model for how all medical practices should look like. It's often mentioned by the President, and indeed, studies do back up their claims of higher quality, lower cost, care. But in a recent piece from the Washington Post, some are questioning whether the stellar results from the Mayo are due to demographics. The Mayo Clinic has a very low Medicaid patient ...

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by Gary R. Gibson, MD, FACP In his 2007 book Critical, Tom Daschle said lawmakers were "flummoxed" when attempting to craft specific reform legislation. They seem flummoxed again as they fail to recognize the primacy of the patient-physician covenant and try to analyze a complex problem without a suitable conceptual model. The formula below represents a valid conceptual model describing health care costs. "E" is expressed in monetary units ...

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Two things are missing from the bustling conversations on health care reform jamming the Internet highway. First, where among the finger-pointing anecdotes and critical analyses of our “broken” American medical system are the stories and discussions of all that is right? Second, where is our sense of hope? I’ve experienced American health care from an unusual, yet useful, vantage: that of a physician with chronically recurring cancer. From both sides of ...

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Into the valley of health reform Bestrode the one hundred senators. Comprehensivists to the left, Incrementalists to the right. Squarely in the middle sat the arcane, Senator Olympia Snowe of Maine. Bespoke the comprehensivists. It must be done all at once. Evoked the incrementalists. No, it must be done one at a time. Bespoke the comprehensivists. We simply cannot wait any longer. Evoked the incrementalists, Why not,you've waited a century already. Bespoke the comprehensivists. It must be done right now. Evoked the incrementalists. No, it must be ...

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There can be little doubt that the lethal combination of aging baby boomers, the obesity epidemic, and the growing success of medical and interventional therapies for CV disease (resulting in more and more survivors of major events) is going to produce a flood of cardiovascular disease in the coming decades, and cardiologists in great numbers will be needed to care for these people. However, that doesn’t mean that the message conveyed ...

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by Matthew DiPaola, MD When the country was first founded, about 10 percent of national representatives cited medicine as their profession. Since 1960, only 1 percent of Congress has been made up by physicians. Historical differences in training duration aside, those numbers alone should tell you who is driving the Washington version of reform. It ain’t doctors. In medical school, we were fortunate enough to have a pretty extensive ...

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by David Alway, MD In thinking about socialism and medicine in the United States let's adopt socialist point of view and ponder some logical conclusions. Injustice Exists The socialist notices that some people are starving, don't have adequate shelter, or are relatively uneducated. He also observes that others are very well off, having access to the finest meals, enough money to buy grand homes and are well-educated. This state of affairs, ...

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Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer Soft drinks and other beverages loaded with sugar should be taxed as a public health hazard, much as cigarettes are, a group of prominent medical researchers says. medpage-today Since extensive evidence ties sugary drinks to an epidemic of obesity and related health problems, such as heart disease and diabetes, they ...

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Newsweek's Sharon Begley pens an excellent piece on why Americans will reject evidence-based medical decisions. She opens with a vignette, which every emergency physician should be familiar with:

A 4-year-old suffers minor head trauma, perhaps from falling off a swing and hitting her head on the ground. She is dazed, and although she doesn't lose consciousness her worried parents—visions of subdural hematomas and concussion dancing in their own heads—rush her to the ...

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