Ask any physician what quality is, and you’ll get many different answers. You will hear answers such as “finding a cause for their pain,” “ruling out a life-threatening condition,” “partnering with patients to improve their health” or “offering the most evidence-based and up-to-date medical treatments.” Here’s what quality isn’t: Running a bunch of useless tests, prescribing non-evidence-based medicines, or spending hours on documentation in an EHR. Therein lies my frustration with the government’s ...

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I’m an ED physician, so I’m used to patients screaming at me — sometimes with earsplitting demands for heavy-duty painkillers, morphine drips and similar remedies that will numb or “fix” them. I can deal with this. What I can’t deal with is a health system that incentivizes physicians like me to medicate adult patients, especially those at high risk for substance abuse, with little thought given to their long-term wellbeing. As ...

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