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Latest Posts

Medicare’s Use Of Claims Data: Finding The Outliers

I have opposed Medicare’s use of claims data to evaluate the quality of medical care. Quality medical care is the goal that must be achieved. However, no one has described the measurement of quality medical care adequately.

Physicians recognize when other physicians are not performing quality medical care. Physicians recognize when another physician is just testing and performing procedures to increase revenue.

These over testing physicians are a small minority of physicians in practice.

Quality medical care is not about doing quarterly HbA1c’s on patients with Diabetes Mellitus. Quality medical care is about helping patients control their blood sugars so their HbA1c becomes normalized. It is about the clinical and financial results of treatment.

The clinical and financial results depend on both patients and physicians. Patients must be responsible for Read more »

*This blog post was originally published at Repairing the Healthcare System*

Medicaid Thieves And The Future Of Healthcare

Are you wondering about a glaring unintended consequence of  healthcare reform? Read on to learn how everyone becomes a criminal.

By now you’ve all heard of the government reports of Medicare fraud being three times higher than 17 billion dollars a year  previously thought. How you ask? Because an illegible doctor signature is considered fraud and Obama is out to make things right and transparent and accurate. You can pretty much count on every physician in this country being a fraudster.

But what about Medicaid? Does the same fraud problem exist with the Medicaid system? Probably, but you also have to worry about the patient abuse aspect as well. Here’s an angle of  unintended consequences you may not have considered with healthcare reform by making pre-existing conditions a thing of the past.

I have been told Happy’s hospital has a handful of repeat offenders using their family member’s Medicaid card to get free healthcare services in the ER. Why is that possible and why would anyone let their family member use their insurance card? The question you should ask is not “why,” but “why not?” Why wouldn’t every family with Medicaid share their card? Read more »

*This blog post was originally published at The Happy Hospitalist*

High-Tech Scans Of Fruits And Vegetables?

Medical Pastiche blogger Peter Zavislak, whom I can always count on to point out the unusual and interesting sides of medicine, sent me to a website that has nothing but pictures and videos of food in an MRI scanner.
Here’s a series of images from their site of a cantaloupe as viewed from an MRI: 


I just find myself thinking that these MRI machines aren’t cheap to run and maintain. Doctors and nurses used to be able to get “freebies” by buddying up with the X-ray, CT or MRI technologist and running a scan for free.
Some hospitals allow their employees to test the machines after being set up or maintained to get images for testing purposes. I’m sure more than a technologist or radiologist or two have found incidentalomas from this practice. Read more »

*This blog post was originally published at The Happy Hospitalist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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