An excerpt from Private Equity in Gastroenterology: Navigating the Next Wave.
A long time ago, gastroenterologists ran solo or small group practices. Despite the myriad challenges of running a medical business, doctors enjoyed the independence that private practices offered.
But over the years, everything got too complicated. From insurance reimbursements to …
Let’s burn health insurance down. Greedy corporate bastards should burn. Big Pharma and big hospitals should probably burn too. You know who else is really, really, bad? Wall Street. Let’s burn the banks. And let’s burn Big Tech and the entire Silicon Valley cartel. Let’s also burn Big Agribusiness that’s making us fat and sick. And let’s burn the Oil companies that are destroying the planet, and let’s burn the …
The U.S. health care “system” is completely and utterly broken. According to the World Health Organization (WHO), the U.S. system ranks 37th in the world, all while spending dramatically more on health care than other wealthy countries. Tens of millions remain without any health insurance coverage. For many, medical bills can mean economic ruin — some surveys show that up to Read more…
During college and medical school, my summer employment acquainted me with members of organized crime families. Now, reflecting on my full career as a primary care clinician, geriatrician, and researcher on health care delivery improvement, I have discovered that several insights from organized crime could guide medical professionals’ responses to our country’s health care crisis.
Organized crime and the U.S. health care industry have more in common than might be immediately …
If you have worked in the hospital setting for any length of time, you likely are aware of the physicians’ lounge. It’s the protected space where the hard-working medical staff can escape to catch a break or grab a hot beverage. The physicians’ lounge is absolutely necessary. Medical staff members need a space where they can refuel and exhale the stresses that caring for the sick and dying will often …
Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …
The biggest change in medical practice that has occurred during my 25 years as a physician is the open acceptance of physician employment. Compared to this change, the ACA, EMRs, “Gorillacillins,” and the latest sepsis protocol, combined, aren’t even worth mentioning.
Physician employment was, and is, obviously an intrinsically flawed structure that was considered absolutely unacceptable for obvious reasons for the entire history of medical practice! Now, suddenly physician employment is …
Recently, I wrote about some key findings from a 2018 survey of U.S. physicians by The Physicians Foundation. It’s no surprise to anyone working in health care today that the survey found alarming levels of professional dissatisfaction, burnout, and pessimism about the future of medicine among respondent physicians. Sadly, it appears that much of that pessimism is directed toward hospitals and their leaders: 46 percent of survey respondents viewed …
Recently the CEO of a large health care network stated: “Market forces don’t apply to health care.”
Of course, economic and political forces apply to health care. Big Medicine’s most powerful entities (insurers, hospitals, medical schools, pharmaceutical companies, pharmacies, and government agencies) formulate health care policy to enrich themselves at the expense of patients and small, independent medical practices.
As an independent family doctor, my practice’s existence is in jeopardy. Small physician …
I started my medical career late. Really late. By that time, I’d lived a few lives. I’d earned a boatload of initials. I’d changed husbands, languages, and continents. I’d written a useless novel, and I’d been a Mary Kay lady.
One day over lunch as I was looking for something to do with myself, my husband suggested medicine. I spent the next nine years immersed in my medical training, feeling guilty …
Rudolf Virchow, a pioneering physician of the 1800s, once wrote that “politics is nothing but medicine on a large scale”. Over a century later, this nexus is as apparent as ever, and many doctors engage as practitioners of both.
Twitter erupted this past fall with photos of soiled scrubs, resuscitation room floors and surgically-removed bullets — all crimson with …
My wife and I once canoed across a glacial lake. There were twelve people in our 30-foot canoe. To reach the shore of the Mendenhall Glacier, we had to paddle two miles across a lake. All twelve of us had to paddle together to reach the shore. But what if we had different goals? What if the right side of the canoe wanted to paddle east and the left side …
The evolving politics of single-payer health care conflate the concepts of universal coverage, health care on demand and free health care. To the indiscriminate progressive mind, all three are part of the holy grail. The fly in the ointment is that highly attractive and altruistic politics runs into the brick wall of reality. As Thomas Sowell — a noted Stanford economist — wrote: “The first lesson of economics is scarcity: …
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This past June, California’s Department of Healthcare Services went live with the implementation of its non-medical transportation (NMT) benefit. NMT is described by the National Health Law Program as “transportation provided to access medically necessary services, which is provided by ordinary forms of transportation (public transportation, taxi, or any other forms of public or private transportation).” While transportation as a benefit has long existed under California’s Medicaid program as …
Florence Nightingale was among the first nurses who started wearing a nurse’s cap.
The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap.
Back then becoming a nurse was typically seen as a female profession, but men were allowed to become nurses too. In 1930, only one percent of RNs nationwide were male.
Growing up in the 1950s …
In a New York Post article dated January 23, 2019, the author states how Americans without health care insurance hit 13.7 percent. This 2.8 percent increase means an additional seven-million Americans lack health coverage as noted by the Gallup survey period.
This is not far behind the 18 percent recorded just before the Obamacare mandate in 2014.
Everyone is blamed in this article except the culprits. Do you think for one moment …
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Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim.
Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area of his body was covered with wounds from constant scratching. Skin that breaks easily and heals poorly can give bacteria access to other parts …
Patient access to care is a high priority for all neurosurgeons. Unfortunately, many of our practices are thwarted in these efforts from unwarranted insurance denials. Know, you are not alone. Take this common scenario:
When Ms. Mary Smith (not the patient’s real name) started her new job several years ago, she purchased the premium insurance policy that her company provided. Recently, she developed severe neck and left arm pain. Imaging of …
One time, I applied for an emergency department (ED) nurse manager position. I thought I had the job locked up until I was asked during the interview how I would “enforce metrics.”
“Enforce.”
My holistic, qualitative research-based response to this authoritarian-style question was: “I’ll find more organic ways to achieve your metrics without shoving numbers down their throats.”
I didn’t get the job. Someone told me I wasn’t “MBA enough.”
Yet, I stand by …
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I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …
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