By now everyone has heard that the Centers for Medicare and Medicaid Services (CMS) has proposed to dramatically change the way physicians get paid for evaluation and management (E&M) services in the office as part of the proposed 2019 Physician Fee Schedule Rule. In fact, as of the end of July, CMS has received over 600 comments on the proposed rule, with virtually all of them criticizing the proposal. I ...

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The health care system has never been so complex as it is today. As doctors, we’ve seen the struggles that happen just trying to help patients get the medical care they need. Patients are now ladened with high deductibles and often are the victims of baseless denied coverage for diagnostic tests and medication. Insurance companies insist that they are not practicing medicine, merely making coverage determinations and that the patient is ...

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As more doctor pay is being tied to patient satisfaction and “outcomes,” a recent Forbes article argues that “It’s only a matter of time before physicians will see the bulk of their compensation tied to quality measures.” To prepare for this pay-for-performance apocalypse, the article cites Medical Group Management Association (MGMA) CEO Haylee Fischer-Wright, MD, who urges physicians to “build data ...

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In the recent weeks we’ve seen frequent headlines alerting people around the country to dangerous heat waves.  Physicians and nurses see these headlines and the human results of the heatwaves in the form of heat illness, people burdened with lung ailments and suffering from deteriorating air quality, and a range of individual harms brought on by wildfires and torrential downpours.   Current trends in extreme temperatures are alarming and clearly linked ...

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A guest column by the American College of Emergency Physicians, exclusive to KevinMD.com. Emergency medical care in the United States is a unique success story. Born from military tactics, emergency medicine has grown exponentially in size and sophistication from its early days. What was once a patchwork of inspired professionals cobbled together at a moment’s notice is now a highly esteemed medical specialty; singularly trained and expertly equipped ...

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STAT_Logo If Atul Gawande’s first week as CEO of a health care startup was anything like mine, I hope he is able to get away from it all and enjoy a completely relaxing weekend. He will have earned it.

After Gawande was named to head the joint venture between Amazon, Berkshire Hathaway, and JPMorgan, some critics said that choosing ...

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Engaging in an economic conversation about the conventional compensation of a physician leads one to believe that doctors are well-to-do. In the minds of most citizens, school-tuition board members and even local neighbors, if you’re a physician the presumption is that you are economically prosperous, maybe even rich. This sociological assumption probably sounds false to most whom honorably don the white coat. Perhaps a decade or two ago, when medical ...

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Today’s news is full of commentary about work requirements for Medicaid. Is work a prerequisite for health care or is health a prerequisite for work? Not to complicate things, but can we even agree on what health care is? I don’t think we can, and it largely falls back on what we want to share in paying for. A patient with an ugly skin lesion can have it removed if it might ...

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The word “historic” is often used by PR professionals to hype something that is, well, pretty run-of-the-mill.  They figure that no one is going to read a news release that announces “[Name of organization] proposes small change that really won’t make much of a difference.”  The problem is that when something is done that really measures up to being historic, the recipient is less likely to believe it, kind of ...

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Author’s note: My personal reflection about the Sutherland Springs mass shooting was written before the horrific events at Stoneman Douglas High School and Santa Fe High School. The chorus of voices has only increased in amplitude regarding the calls to responsible action on firearm safety. While a larger debate continues in Washington, DC, I ask myself again: What can I do now as a medical provider to make a difference? ...

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