As I explained to my medical student this morning that I was ordering an ultrasound on a patient first because the insurance company wouldn’t authorize a CT scan without it, it occurred to me that medicine derailed from its true purpose. Shortly later, I found myself again pointing out why I was prescribing a certain medicine rather than the one I wanted because it was not on the formulary of ...

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We’ve all been through difficult times. It may be the death of someone we love or suffering abuse with no one to help. In life, many events fly at us that are hard to manage. Many of us just suffer silently through the pain, not allowing anyone in. And even while we do that, we also know that is not the healthiest response. Many patients come to me struggling with anxiety ...

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The health care system has never been so complex as it is today. As doctors, we’ve seen the struggles that happen just trying to help patients get the medical care they need. Patients are now ladened with high deductibles and often are the victims of baseless denied coverage for diagnostic tests and medication. Insurance companies insist that they are not practicing medicine, merely making coverage determinations and that the patient is ...

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Many people seem to believe that the Z-pak possesses magical qualities. Patients come in requesting it for the common cold, because it worked for them in the past. Not only do many believe it cures the common cold, but they think it can treat any infection. Have a urinary tract infection? Just ask your doctor to prescribe a Z-pak! Sniffles got you under the weather? Do the same! Anyone who believes ...

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On June 10, 1963, the Equal Pay Act was signed into law by President John F. Kennedy, amending the previous Fair Labor Standards Act.  Under this law, pay disparities between men and women were clearly prohibited. More than fifty-five years later, women are still fighting to be paid the same as men holding the same jobs. Gender pay disparities exist among all professions. Not only does a pay gap exist ...

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We’ve all seen the news and heard the stories about children being separated from their parents as they cross over the U.S. border. The pictures of human beings, including very young children, behind wire mesh (some argue that they are not really cages) is simply horrifying. Over the past decades, we have seen atrocities happening in many other countries around the world. And we sit and wonder why the citizens ...

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When we go to the deli, we expect to take a number and wait in line. Accomplishing any task at the department of motor vehicles can be an ordeal of waiting and then being herded out the door. This is part of life in American society. However, it should not be part of your health care. Patients need personalized attention and they need a health care team that listens to them, ...

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Where I practice, the process of referring a patient suffering a mental illness is quite infuriating. The wait to get in to see a psychiatrist or psychologist can be months all the while patients are suffering. Worse yet, with certain insurances, there are just no mental health providers available for any of their covered patients. The failure of treating mental health disease in the U.S. is glaring. In the U.S., approximately ...

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He looked tired and worn down, more so than many of the other patients I had seen that day. He didn’t speak English and I did not speak his language, but I could feel his anxiety as it filled the exam room. One of my employees translated, in fact, what his “boss” was telling us. The boss was worried that he was more tired than usual, and not getting his ...

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Doing a simple internet search, you can find a plethora of information about well-being and health. Being happy and well is a goal everyone should aim to achieve. However, I  find many of the tips out there are simply unattainable. It may be that I am just a fail at true inner peace and that my inner tsunami doesn’t let me rest. Or it may be that the tips just ...

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While our elected officials in Washington spin political rhetoric and quote scary statistics around the opioid epidemic, New Jersey was one of the first states to take actual action. In February of this year,  New Jersey Attorney General Gurbir Grewal declared its plan of combat: a 24-hour response team, improvements to the prescription monitoring program, and over a million dollars in federal grants. In fact, the Office of ...

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As he sat in the driver’s seat and started to whistle that dreaded Willie Nelson song, my heart started racing, and my world started to spin. While most kids may be annoyed hearing their father whistling that toneless noise, terror started seeping into my very bones. I knew what that sound meant and it was no Pavlovian response, but rather a foretelling of the horror coming. Simply put, it meant ...

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Few people can argue that health care is a business these days. Medical services are attached a price tag and patients are now customers. However, intrinsic to health care is a very high ethical code that doesn’t exist in other sectors. For example, if a patient shows up in the ER, they cannot be denied service, whether they are wearing shoes or not. While McDonald’s and other top companies are ...

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You go to your doctor because you are suffering pain, fatigue, or some equally debilitating ailment. Your doctor examines you and is worried there may be a serious underlying medical reason for your symptoms and orders a test. But, before you can have that test done to determine the cause of your symptoms, the insurance company must agree that you need it in order for them to cover the cost ...

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Americans witnessed the many failed attempts of our elected officials to reform our broken health care system over the past year. Some call for repealing and replacing the Affordable Care Act (ACA) while others think it is the cure-all for what ails our system. The simple fact that politicians fail to consider is the fact that having health care coverage does equate to actually receiving health care services. In fact, the ...

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I often see patients for follow-up and learn they are not taking the medications either I or another health care provider prescribed. Sometimes the reason is obvious, and other times the patient is reluctant to give up the information. Patients have the right to take or not take medication that was prescribed. But, sometimes by not doing so, they are putting their health at risk. As a doctor, I want my ...

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Measuring metrics is a common catch-phrase in health care. The goal of capturing certain data is to improve patient outcomes. But, as doctors, we were taught to treat the patient and not the numbers. While optimizing clinical outcomes is a needed goal with all the complexities in medical treatment currently, the system seems to have gone too far in its quest for targeted numbers. If, for example, a patient suffers metastatic ...

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The Office of the Surgeon General existed since 1871 when Dr. John Woodworth was appointed the first supervising surgeon of the national hospital system. In the previous year, the Marine Hospital was reorganized into the national hospital system. On January 4, 1889, Congress formally recognized the new personnel system as the Commissioned Corps. The Corps was established along military lines and initially consisted of only ...

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It is not enough to know that a patient’s medical condition warrants an MRI. For most insurance companies, a diagnostic test of this sort requires what is known as a prior-authorization. But, the doctor saying the patient needs this test often fails. The insurance company has a certain guideline the patient must travel first before they will consider the test. For example, a patient with back pain and numbness in one ...

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According to the National Institute of Mental Health (NIMH), about 9.8 million adults (or 4 percent of all adults) over the age of 18 years suffered a serious mental illness in 2015. A serious mental illness is one that affects a patient’s daily functioning. Considering all mental illness in adults in the same time period, 43.4 million adults (or 17.9 percent) who met the criteria for a ...

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