Physicians are the building blocks of value-based care, yet the cumulative human and financial cost of our decisions are mostly hidden from us. Instead, our reality is analogous to being on a diet and a budget at a restaurant that doesn’t put prices or calorie counts on the menu. We need and want cost transparency. A survey from Deloitte University discovered cost is a part of ...

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Let me warn you — I own guns. I love to shoot. And I’m a strong supporter of the Second Amendment. This may seem hypocritical coming from a doctor, but don’t shoot me figuratively speaking, of course — before I make my case. Any mass killing is a horrifying event. Any senseless death is riveting. Obviously, this goes without saying, but as a doctor whose purpose is to save lives, ...

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Shortly after the publication of "Independent practice: Both nurse practitioners and physicians should be outraged," the nurse practitioner (NP) leadership responded with a press release, denouncing the concerns that were cited, calling them “rhetoric.” But in contrast to this criticism from the political end of the NP spectrum, I was inundated by emails from working NPs across the country in support ...

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It is well known that smoking cigarettes negatively impacts health and leads to an increased risk of stroke, heart disease, lung cancer and death. No one debates this anymore. But it wasn’t always this way, and it didn’t come easily. In the 1940s, almost half of the population in the United States smoked, and the tobacco industry was subsequently incredibly powerful and politically active. It spent millions of ...

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Why is U.S. health care so costly compared to other developed countries? A recently published report provides some insights. In a study of 11 countries, Harvard researchers found that while the United States has the highest health costs relative to its GDP, its use of services is average. More specifically, the U.S. ranks lower than nearly every other country in doctors’ visits, hospitalizations, hospital days, and consultative services. The difference is ...

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Hospitals serve as the economic lifeblood of their communities. They are the second-largest source of private-sector jobs in the United States, employing 5.4 million Americans who, together, embrace a virtuous mission to heal and help others in need. And yet, every year, more and more of them are forced to shut their doors. With soaring costs, eroding margins and mounting pressure from competing providers, the American hospital industry is on life ...

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Now that the children have shouldered their muskets and taken aim -- figuratively speaking, of course -- against the gun lobby, maybe we can interest them in another partisan conflict that’s even more sweepingly about their survival: climate change. Not to minimize the horrific consequences of school shootings, but there are many more lives at stake from climate calamities. Threats from sea level rise, flooding, wildfires, and storms are multiplying ...

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Eye surgery is a delicate business. It involves operating within an orb the size of a large marble to remove a cataract or repair a retinal detachment. Not only is superb eye-hand coordination a must, but also an awareness of the myriad other medical issues in the elderly population most in need of eye surgery. Traditionally, patients undergoing cataract surgery had a preoperative medical evaluation, including blood work, chest X-ray, and EKG, ...

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A hundred years ago, the practice of medicine was just that: the practice of professionals specially trained to alleviate suffering and heal the sick. Doctors had a fiduciary responsibility to put the needs of their patients before their own. A small town doctor might be paid for his efforts in chickens — living or cooked. Flash forward. Medicine is big business. Trillions of dollars are spent every year in the health care ...

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Medical practices with risk-adjusted contracts must sharpen their diagnosis coding. Practices that are part of accountable care organizations (ACOs) or that have risk-adjusted contracts with commercial payers have an economic incentive to accurately report the disease burden of their patients. In fee-for-service medicine, physicians are paid based on the fee schedule associated with a CPT code, and any modifier attached to that code. The diagnosis code establishes the medical necessity ...

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