That damn RUC

The RVS Update Committee is one of the major reasons behind the flawed reimbursement system:

The RUC has 30 members (the chair only votes in case of a tie) with 23 of its members appointed by "national medical specialty societies." Meetings are closed to outside observation except by invitation of the chair. Only 3 of the seats rotate on a 2-year basis. Other members have no term limits.

"Seventeen ...


First, virtual hip replacement, now this. (via Dr. Wes)

"A profession dedicated to healing the sick has no place in the process of execution."

Is this true?

Nitpicking can be lucrative.

When it comes to health policy, I don't agree with Matthew Holt very often. But when it comes to John Edwards' exploitation of Nataline Sarkisyan, it is gratifying that someone from the left is calling him out on it.

As I've reiterated over and over and over again, any nationally-run, universal health care system would have to say no to some lifesaving procedures, just like ...


Scarily unhealthy. I got chest pains just from reading this. (via Ten out of Ten)

Staging a sit-in. Good idea.

NHS Blog Doctor is back

Rumored-to-be-dead Dr. Crippen returns. NHS, you're officially on notice.

John McCain on health

Joe Paduda analyzes the candidate's stand. I've mentioned before that I think that containing health care costs takes precedence over the uninsured, which is why some of McCain's ideas intrigue me.

He is one of the few candidates that talks about reforming the physician reimbursement system, although he gives few details:

We should pay a single bill for high-quality health care, not an endless series of bills for ...


Granting licensing reciprocity to out-of-state doctors for disasters seems like a no-brainer.

But Louisiana said no during Hurricane Katrina, and many physicians were not willing to risk the medicolegal implications of their bone-headed decision.

John Ford explores this issue.

How the government is treating public hospitals is shameful. Maybe the only way to send a message is to shut down.

Why I blog

From time to time, people ask me why I do this. For sure, it's a significant time commitment, in addition to managing a full-time primary care panel.

I've previously stated that I intend to "pull the curtain back", to expose what goes on behind the scenes at the physician's office and the hospital. I wrote the following on my About page: "By shining a light on ...


It'll look something like this.

A trauma story

Burns, fractures, eye penetrations, and gang activity. Another exciting read of a trauma in the ER. This time, it ends with a sad twist:

Later I found out that the guy, unfortunately didn't have insurance...and the ortho procedure he required involved a series of operations, close follow-up, and specialized equipment. And because orthopods don't work (much) for free...especially when the patient is a high risk patient (high ...


Not surprisingly, it's about the money.

Those fighting over implementing individual mandates or not are losing sight of the bigger picture.

Again, the focus on universal coverage takes attention away from cost-containment - which is the more serious problem.

Managing physicians

I'd be the first to tell you that managing physicians can be difficult, as doctors have a pretty strong independent streak. The Physician Executive is starting a new job, and getting to know his new crew.

Congress is getting into the act, wondering if Robert Jarvik is qualified to pitch Lipitor:

"In the ads, Dr. Jarvik appears to be giving medical advice, but apparently, he has never obtained a license to practice or prescribe medicine," John Dingell (D-Mich.), chairman of the committee, said in a press release.

The WSJ Health Blog asks that hard question, and gets an interesting answer.

Hospitalist Bob Wachter comments on the recent NEJM study:

. . . the study once again highlights the perpetual neglect of the med-surg patient. Even though such patients make up the biggest cohort in virtually every hospital, the fact that they are heterogeneous, often scattered around the building, bring in relatively low reimbursements, are in a comparatively low tech environment, and lack powerful advocates (namely, surgeons and proceduralists) means that ...


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