“Thank God you’re still here, Doc! It looks like they already laid off half the pharmacy department! The line is out the door!” “Don’t worry, Mr. Golati! It’s just a regular day at the VA!” I replied. October 1st at the VA Hospital was like every other day in most ways. It was still hard to find a parking space in the far-too-small lot. The hallways still bustled with white coats, smiling vets, ...

Read more...

As deliberations over how to make healthcare more cost-effective continue to play out in forums across the country -- from the U.S. Congress to state governments to health systems and hospitals -- it strikes me that we are paying insufficient attention to what should be an obvious consideration – the cost of supplies. Supplies run the gamut -- from operating tables, artificial knees, intravenous solutions, and wound dressings to bed linens, ...

Read more...

Due to ever increasing health care costs, stakeholders in the health care system rely heavily upon front-line workers to assist in containing costs to help make health care more affordable. Since nursing is the largest sector of front-line workers, the field has an opportunity to greatly impact cost containment. Currently, there are 2.7 million nurses in the workforce, with an expected growth rate of 26% over the next decade; however, ...

Read more...

shutterstock_229395838 I recently saw an article about Vanderbilt University Medical Center's nursing staff. The administration there came up with the brilliant idea of cutting back on the housekeeping staff and making nurses do some of the cleaning, though it's not specified how much. Nurses would be expected to take out the trash and linens, and mop up spot cleans on the floors, among other ...

Read more...

The anticipated and dreaded letter from my health insurance company arrived yesterday.

Dear Member: We are writing to let you know about some important changes to your individual health insurance coverage ... Your health insurance plan will no longer be available after December 31, 2013. We very much want to continue serving you and so have selected a new ACA-compliant Regence plan for you. Your new plan has more benefits and a different ...

Read more...

Healthcare markets are complex and confusing places.  But one fact is simple and straightforward:  all else equal, hospitals and emergency departments are a lot more expensive than outpatient clinics.  Which makes it all the more bewildering that so many low income patients prefer hospitals over primary care clinics. Bewildering until now.  Shreya Kangovi and colleagues at the University of Pennsylvania interviewed low income patients and discovered some fascinating reasons why they aren’t ...

Read more...

A recent post observed that the “highly charged scope-of-practice” fight between the medical and nursing professions has resulted in social media hate speech -- too often, from physicians directed at other physicians. “Like bees to nectar, a post on the topic is sure to draw dozens of anonymous, hate-filled comments” write the authors.  They propose the following “principles for civil discourse” which I believe should apply more broadly to all social media ...

Read more...

The Centers for Medicare and Medicaid (CMS) sets the rates all physicians get paid and insurance companies base their rates on the same formula. So who creates the formula? Well, it’s the doctors, silly! Or at least some of the doctors. Here’s how it works. A 31-member committee formed by the American Medical Association is made up of representatives from the various specialty societies. This Relative Value Update Committee (RUC) meets ...

Read more...

Medical science is making such remarkable progress that soon none of us will be well. -Aldous Huxley The recently completed conference, "Preventing Over Diagnosis," was easily the most important meeting I ever attended. Sponsored by the British Medical Journal, Consumer's Reports, and Dartmouth and Bond Universities, the goal was to identify the excesses in medical care and to figure out how to correct them. The evidence is compelling that we in the developed countries ...

Read more...

Soon, millions of uninsured Americans will be able to enroll in qualified private health insurance plans offered through their state marketplaces, with federal dollars to help them afford it.  The state marketplaces, created by the Affordable Care Act (Obamacare) will begin enrolling eligible people on October 1, and eligible persons will have until March 31 to sign up.   The coverage and subsidies for those who sign up will start on ...

Read more...

Most Popular

Never miss a story. Subscribe for free.