"Philadelphia is a sanctuary where we can live in peace," said Mrs. Lopez, a patient at a local clinic caring for the undocumented. "It wasn't always this way, and we lived in constant fear," she added, referring to Philadelphia's recent adoption of "sanctuary city" policies, adopted also by dozens of other cities and counties across the country. What exactly are these "sanctuaries"? Whom do they protect? And why should physicians ...

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I’m a trial attorney, and I’m a woman. Since 76 percent of all lead trial counsel are men, I know what it’s like to be a woman in a traditionally male profession. I also give workshops to women in the medical profession, and I listen to their stories of harassment. I’ve been following the #MeToo movement with interest. It started in Hollywood, and has expanded to Silicon Valley, to ...

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There is an accepted storyline in American health care that is so ingrained in our culture that it is almost beyond question. It goes like this. The chief culprit underlying the high-cost, low-quality American health care system is the traditional fee-for-service payment model, which rewards physicians for the volume of services they provide with no consideration for the quality of care being delivered. The answer, the story goes on to say, ...

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As part of the interview for my book, I asked about the role that mental health plays in healthcare. Responses were unequivocal: It plays a vital role. All of these doctors have patients who are depressed, anxious, traumatized, or otherwise in need of mental health services. My doctor interviewees frequently added comments about lack of access to mental health services and insurance interference. Refusal to pay is a big problem, according ...

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U.S. health care costs are high – over $3 trillion annually and about 18 percent of our GDP.  Estimates suggest that our costs are rising.  Concomitantly, we are entering an era of extreme biomedical promise, where research breakthroughs are translating into unprecedented clinical benefit. Luxturna from Spark therapeutics, for example, remarkably restores vision loss in patients with a specific eye disease.  With amazing innovations, ...

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Dr. Pramela Ganji had just finished her lunch when she was told that the appellate court had reversed and vacated her conviction.  At first, she didn’t believe it.    After all, this whole experience had been surreal.  Dr. Ganji, a 68-year-old well-respected medical doctor and married mother of 3 children, had practiced medicine for 40 years without incident.  Her patients loved her, and she had dedicated her life to helping others. ...

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I have worked with some great nurse practitioners (NPs) who I consider to be friends. They play a vital role in team-based practice. This is not about NP bashing. Nor is it a turf war; now that I'm retired, I have no turf to protect. I am a member of Physicians for Patient Protection out of real concern for the future of medicine in this country. I want there to be ...

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The state of medicine in America is a highly discussed topic today. The reports are rarely positive. Politicians battle for control over their vision for health care and predict doom and gloom if the other side “wins.” The cost of health care continues to rise for employers and employees. Physician burnout and dissatisfaction are on the rise. We hear from politicians, media outlets, and others on how to fix the ...

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On a recent trip to urgent care for my child, I began to clearly see how the changes in medicine are affecting our patients and who is benefiting from the bottom line of what is occurring in the U.S. health care system. A minor injury to my two-year-old son had me waiting patiently to be seen at a local urgent care center. Eventually, a nurse practitioner evaluated, correctly diagnosed and successfully ...

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Lots of mergers have been announced lately, but there’s still one transformative merger that will define and reshape the U.S. health care market in 2018: the CVS/Aetna $69 billion deal announced last December. CVS is best known for its 9700 retail pharmacies and 1100 walk-in clinics, but its most significant profit driver is its pharmacy benefits manager (PBM) enterprise -- a middleman between pharmaceutical manufacturers and dispensers like drugstores. The company ...

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