The Sunshine Act is part of the Patient Protection and Affordable Care Act passed in 2010.  This act went into effect in August of 2013 and requires the full disclosure of any payments (or transfers of value, i.e., lunches and dinners) made to physicians from pharmaceutical and medical device manufacturers. The spirit of the act is to have more transparency with regards to potential conflicts of interest created when physicians receive ...

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As physicians, our patients generally look up to us as people who make a great impact on their lives and sometimes even save them. But over the last year, I’d have to say that it’s my patients who have repeatedly saved me, starting with a four-month-old baby girl on November 9th, 2016. The morning after election day, I walked into my first patient’s room at 9 a.m. Like most of the ...

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Years ago, our government had a problem with health care. Medicare and other health care costs were spiraling out of control. It was clear that the problem was rapidly advancing technology and pressure to provide that technology to everyone who was demanding it. But the government, as usual, choose a politically motivated solution. They went after the one group involved who was the most disorganized, least clear on its desires and ...

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The United States of America, home of the free and land of the great. So many have died attempting to flee from war, dictatorships, and poverty to gain access. Once a country with such strong influence, it's now divided by bipartisan views and gridlocked actions. As a nation, we struggle to find solutions for our poor outcomes. Why does such a great country rank so poorly in education and health ...

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When I found out my patient was in the hospital again for the third time in six months, I wondered why her asthma had flared. Was the cold weather bothering her? Was her treatment regimen inadequate? When I spoke with her, I discovered the heartbreaking truth: she had been limiting her albuterol inhaler use because she simply could not afford to take it as much as she needed. For many of ...

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I love my doctors. I have an undiagnosable autoimmune disease. It's mostly manageable, my lab work is perfect, and I rarely get sick. I get allergy shots and take blood pressure medication. I always have at least low level, mostly familiar, physical symptoms. Occasionally a new one appears. Sometimes it is scary. I could have sued any or all of my doctors over the last decade-plus. I could be "livin' large." They ...

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It may be hard to believe, but there is a bigger problem than repealing or saving the Affordable Care Act. And that problem is: Why are we so sick to need it in the first place? Health insurance has become the sine qua non for life in America. Without it, the Fates sever the thread of life with ease. For those escaping the scissors of death, you might be beleaguered with ...

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Every patient eventually asks the same question: “How can I find the best hospitals and doctors?” The solution might seem easy, since we live in a world where information is readily available on the Internet. In a few clicks we can shop for goods, review consumer products, market ourselves on social media, and complete financial transactions instantly. You would think that health care, which accounts for 17 percent of the GDP, ...

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A friend of mine recently underwent a total knee replacement. Although he did well and was pain-free, he did say that he felt he was on an assembly line. I asked him what he meant. As he was talking, I flashed back 30 years, back to a time when by today's standards I would be considered a “good old country orthopedist.” Thirty years ago, I moved to a small community to ...

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During a 15-minute recess, the elementary school students trooped from the playground toward nurse Catherin Crofton’s office — one with a bloody nose, a second with a scraped knee and a third with a headache. Kids quickly filled a row of chairs. Staffers brought paper towels for the bleeders and tried to comfort the crying. “We’re here for first aid, emergency, counseling,” said Crofton of the Mount Diablo Unified School District. “There ...

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