In 1729, a prescient Jonathan Swift wrote an essay that has a place in the health care debates of 2017. “A modest proposal for preventing the children of poor people from being a burthen to their parents or country, and for making them beneficial to the publick” reads almost like the title of a modern academic manuscript. Then, as now, it was important to look past the title before re-tweeting, ...

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Prescription opioid abuse is one of the United States’ greatest public health challenges. Approximately 97.5 million Americans consume opioids annually, and around 90 people die every day from opioid overuse. The last time in recent history a health care crisis garnered this much public attention was following the release of the 1964 “Surgeon General's Report on Smoking and Health” correlating smoking to heart disease ...

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I have no business background: zero, zilch, nada. Growing up, I was the kid who bought the lemonade, not the one who set up shop on the busy street corner. My parents bought the cookie dough, coupon book and every other school fundraiser from the kid next door instead of their own child. Job interviews? Never had them. All the jobs I've ever had I got because I knew the ...

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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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As a male medical student, I have developed a growing interest in and enthusiasm for recent efforts to raise awareness about workforce gender disparities in medicine. Though women comprise over 45 percent of resident physicians and 50 percent of medical students in the United States, research reveals deficits in key surrogate measures of successful integration. There are pay and promotion gaps, and women are much ...

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From the CMS website, October 30, 2017, “Today, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma discussed the agency’s efforts to streamline quality measures, reduce regulatory burden, and promote innovation … We need to move from fee-for-service to a system that pays for value and quality -- but how we define value and quality today is a problem. We all know it: Clinicians and hospitals have to report ...

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It has become trendy in health policy circles to believe that behavioral economic interventions are the key to health system improvement. After all, traditional economic interventions like pay per performance have generated underwhelming results, with little or no change in physician behavior. Why not try a non-financial, psychological intervention: like performance feedback! Well, a study conducted in the last couple years in Switzerland raises questions about the effectiveness of ...

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A friend recently asked me, “Where do we go from here?” The friend was referring to our impasse with health care in America. The Democrats have failed to repair the Affordable Care Act, and the Republicans have failed to repeal or replace it. With the status quo, I can understand our health care system providing lower quality care compared to its counterpart industrialized nations. I can even tolerate lack of access to ...

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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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