August 22nd, 2008 by Dr. Val Jones in Uncategorized
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My friend and fellow blogger Dr. Kevin Pho just published an op-ed in USA Today explaining why cutting physician salaries will not reduce healthcare spending. Here is an excerpt:
The number of physicians who do not accept new Medicare patients is dramatic; in states like Texas, this number can exceed 40%. No wonder, as Medicare pays less than half of doctors’ fees. This scenario comes as a record number of Boomers approach Medicare age.
Those without Medicare are not spared the consequences. Seniors sometimes delay their care, leading to expensive treatment in the emergency department. Doctors who lose money seeing Medicare patients could pass on the costs to the privately insured.
According to the Kaiser Family Foundation, there are more significant drivers of health costs, including new prescription drugs, technology and administrative needs. Princeton economist Uwe Reinhardt estimates that physicians’ take-home pay represents roughly 10% of national health care spending. Cutting physician pay by 20% would only reduce spending by 2%.
I’ve also blogged about the plight of primary care physicians – as their salaries do not allow them to meet their high overhead costs.
As decreases in Medicare reimbursements begin to make it impossible for small practices to afford their supplies, rent, and coding and billing staff, more physicians will simply stop accepting Medicare patients. This means that the taxes that Baby Boomers have been paying all their lives will essentially not result in a guarantee of good medical coverage in their retirement. They may need to pay out-of-pocket to purchase additional insurance or to have a good primary care physician available to them 24-7.
Concierge practices like Alan Dappen’s may fill a gap in care. With full price transparency, availability via email and phone 24 hours a day, 7 days a week, house calls, and affordable fees – savvy patients will realize that his services are well worth the small out-of-pocket expense (on average, his patients spend $300/year on his services).
What’s my bottom line? I think we all need to save as much as we can of our own personal funds in case government programs do not provide us with adequate health coverage in our futures. At least if we grow our own healthcare nest egg, we’ll have more care choices in the future. And those choices may one day be a matter of life and death.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 21st, 2008 by Dr. Val Jones in Uncategorized
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This is the new blog site for Dr. Val and the Voice of Reason. Please stay tuned as I’m working to improve this new site over the next week or so. Thank goodness I have help.
August 20th, 2008 by Dr. Val Jones in Medblogger Shout Outs
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Usually I prepare a weekly (or bi-weekly) feature called “Heard Around The Blogosphere” but this time I’d like to devote my list to images – things SEEN around the medblogosphere. Here’s my top 10 list:
1. Paul Levy’s feet (he is the CEO of Beth Israel/Deaconess Hospital in Boston – and he has some pretty impressive bunions)
2. Doggie scuba gear – I doubt the dogs enjoy it
3. Prosthetic limbs inspired by “retro” furniture – from Medgadget.com
4. TV sunglasses for use at the dentist’s office – now that will keep your mind off things!
5. A fake necktie is actually a cooling device – anesthesiologist Joe found this interesting Japanese invention for men.
6. Beer goggles from the Happy Hospitalist
7. Bizarre bread sculptures that resemble human body parts – from Boing Boing
8. Too many fingers – art by Street Anatomy
9. A skeleton necklace – found by Happy Hospitalist
10. Margarine ad with something lost in translation – Fail BlogThis post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 19th, 2008 by Dr. Val Jones in News
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A small research study suggests a link between depression and poorer driving test scores. In fact, there also seemed to be a dose-response relationship with anti-depressants. In other words, the study subjects on the highest doses of anti-depressents got the lowest driving test scores.
Since depression can impair one’s concentration – the link is certainly plausible. I thought it was interesting that anti-depressants seemed to increase the risk for low scores. One would hope that those on anti-depressants were less symptomatic, but it’s also possible that the dosage correlated somewhat with the severity of the disease.
Drivers with conditions that could impact their driving abilities (such as epilepsy or stroke) should report their impairments to the DMV. Will the list of reportable impairments eventually include depression? I doubt it, but it is reportable to the Vehicle Licensing Agency in England.
On the spectrum of risk factors for sloppy driving, I wonder where depression stands?
- Cell phone usage
- Advanced age
- Driving in a foreign country
- Driving while eating/drinking
- Driving while intoxicated
It would be neat to see these risk factors compared to one another on a graph. Has anyone seen such a thing?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 17th, 2008 by Dr. Val Jones in Medblogger Shout Outs
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I’m a big fan of GruntDoc (Texas ER physician Allen Roberts), one of the first medical bloggers on the Internet. To show my appreciation, I’ve decided to plagiarize repost this classic “rant” of his (in case you missed it in 2004):
I work in an Emergency Department, and have noticed that there is one common denominator in the majority of the assaulted patients I treat: they were all assaulted by “Some Dude“. (Also, they were all assaulted for “…no reason…”, but that’s the topic of another rant). This is true no matter where I work, the time of day or day of the week.
“Some Dude” has in the last two weeks shot my patients, sucker-punched, struck with bottles, beaten them with fists and a golf club (or perhaps the entire set), and pushed my patients down stairs.
Additionally, “Some Dude” has ’slipped drugs’ into the drinks of, transmitted sexual diseases to, and stolen the medications of my patients.
I have no idea how “Some Dude” is everywhere at once. I suspect he’s an evil superhero, though in the current times I cannot completely exclude an AlQuaeda conspiracy.
I advocate a vigorous police and public-health effort to locate and confine “Some Dude” due to the clear and present danger he represents to the health and welfare of our republic.
If you encounter “Some Dude,” please turn him in to the appropriate authorities. 
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
