Public Health & Policy

On the front lines, America's emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19.  Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our ...

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Here in the U.S., we slip and slide around the reality of rationing. We like to believe we can have it all, do it all, that there are no bounds. And if you have money in the U.S., that is more or less true. Until now.

Personal protective equipment and test kits for COVID-19 are in short supply. I won't explore the myriad of reasons of why ...

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As medical trainees, we will shape the rapidly changing health care environment in this country. We are fiercely advocating for our disadvantaged patients, debating the price of life-saving medications, and carefully considering how the upcoming elections will shape the health care system in which we both provide and receive care. All the while, we handle our responsibilities and prepare to care for critically ill patients during a seemingly inevitable pandemic. ...

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In 2009, when more than $35 billion was invested in expanding national electronic health record (EHR) uptake, one of many advantages touted was its value as a tool for managing population health. This promise has failed to materialize due to a chaotic rollout of non-communicating systems. Today, as we confront COVID-19, the coronavirus wreaking international havoc, the need for such a tool is exquisitely evident. How could ...

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Obesity is a topic that literally hits home for me.  For the past two years, the website WalletHub has voted the McAllen-Edinburg-Mission TX metroplex as the “fattest city in America.”  As a health care provider, this is deeply disturbing because it puts my community at high risk for a wide variety of health problems, including but not limited to coronary artery disease, diabetes, stroke, and several cancers such as liver, kidney, breast, ...

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The year 2020 might bear witness to a significant shift in control of health care from the providers, insurers, and the government to actual health care consumers. First, it was the politicians, then the tech conferences and promises of 5G, and now global pandemic scares are all signaling the demand for remote health care. The delivery of health care has been in the hands of hospitals and physicians for nearly a century. ...

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Over the last few years, there has been a slew of articles about patients receiving surprise bills after ER visits. One woman was charged $5,751 for an ice pack and a bandage. An infant was charged $937 for an antibiotic ointment. Who sends bills like that? Is it the ER doctors? No. It's large corporations. ER docs want to help you regardless of ...

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A guest column by the American College of Physicians, exclusive to KevinMD. Although I work for the American College of Physicians, I’m writing this as a general internist who has practiced both primary care and hospital-based medicine for over 25 years. Hopefully by now, you are aware of Better is Possible: The American College of Physicians’ ...

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I became a physician to help people. So isn't fighting for issues that help protect my patients such as racial equality, LGBTQ rights, gender pay equity, access to health care, and education all part of patient care? Don't my patients want to have a doctor who is fighting for them both in the office and outside it? When I started working as a resident physician and later went on to my attending ...

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February is a short month. Even this year with leap day. So short. Maybe that is why I am so mad at what Company X did to me. My health insurance company stole eight hours and six minutes from me in February. I will never get it back. This is my story of trying to get Company X to pay its part of two drugs I take for seizures. Very important drugs. ...

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Does anyone really want health care for all? I promise this is not a political rant. Americans, of any political persuasion, should not be misled by the implications of health care for all: It does not mean medical care for all. Providing a card stating you have health insurance is only a nominal solution, provided by politicians, who are looking for a superficial fix. Our problems are more complex than such ...

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109. This is the number of people who died each day from firearms in the U.S. in 2017, the most recent year for which the CDC has published data. It is a staggering number, one that deeply damages the fabric of communities and tears families apart. What's perhaps most disconcerting is that this number – 109 – may not come as a shock. We have become so numb ...

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Readers of my articles know that no one has been more critical of Obamacare's flaws––particularly over the impact the program has had on middle-class consumers in the individual health insurance market. And, readers already know that no one has been more supportive of the Medicaid expansion from the very beginning. Now, the Trump administration wants to give states the option to abolish the open-ended federal funding of Medicaid ...

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 Working in urgent care, I've started supervising some of the other providers at sites other than my own -- 19 sites in all in Pennsylvania and Delaware -- so I hear about a lot of patient situations.

The urgent care site where I work is in an affluent area.  Most of our patients are employed or retired and have health insurance, though I have certainly encountered a number of patients ...

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Gun violence has become a public health epidemic. Despite countless deaths in mass shootings over the last two decades, the Dickey Amendment—a provision inserted into the 1996 spending bill which blocked federal funding for research on gun violence—remains on the books. While every politician, media pundit, and policy expert “know” the solution, the answers are not that simple. In reality, the factors which have fueled the rise in gun violence across ...

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Spiraling costs, poor quality outcomes, and inequities in access to care are driving significant and long overdue changes to the way health care is administered and managed in the United States. And while the U.S. spends more on health care per person than other wealthy countries, its health outcomes are no better than those in other developed countries. In fact, it performs worse in several health metrics, including life expectancy, infant ...

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Legislators have found a new way to insert themselves into the physician-patient relationship. In October and November 2019, news stories regarding a parental dispute over the treatment of a transgender child prompted legislators in Texas, Kentucky, and Georgia to announce plans to introduce bills that would prohibit medical and surgical treatment of transgender children under age 18. Since then, Read more...

Ever since the publication of the infamous 2016 BMJ opinion piece claiming medical error should be considered the third leading cause of death in the U.S., the debate on the true incidence of deaths caused by medical error has been raging. Many, including me, felt the estimate of 251,000 deaths per year from medical error was grossly inflated. For example, the paper extrapolated the number of deaths from ...

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Our local newspaper recently ran an article on the top of its front page, stating that our monopoly health system is now “expanding health care cost discounts.”  The article was actually a press release - free advertising on the front page. As a primary care physician who refers patients to this health system, I wanted to know what these discounts really meant. So, I asked the newspaper in an editorial, “what ...

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