It is tough playing man-to-man when coaches on the sideline keep insisting your team plays zone.
Such is it with health care.
For doctors, the man-to-man defense never ends. Stay with them. Glue to them. Move with them. Run with them. Defend against the bounce pass, or the dribble to avoid the admission. Hands up! Watch their waist, ignore the head fake. You shift your coverage to accommodate their needs. One on one, mana-a-mano.
But for the business of medicine, it’s all about the zone. Defend the admission basket against as many people as possible with the least number of defenders. Stay in your position. Work it 2-1-2, 2-3, or if you’re really adventurous: 1-2-2. Stick to Read more »
*This blog post was originally published at Dr. Wes*
Back when I was a young bird with type 1 diabetes, insulin cost about $70 dollars per bottle. (And I had to walk uphill both ways to the endocrinologist’s office.) I had no concept of this cost, or how it played into my family’s finances, at the time. I would just open the fridge door, grab the bottle, uncap the orange top to a 1cc syringe, and take the units my mom would yell to me from the kitchen sink.
“Two. Two of Regular should do it. Rotate to your right arm this time, okay?”
“Okay!” (And then I’d proceed to jab it into my left arm because I’m right-handed and also stubborn.)
Now, twenty-five years later, insulin has taken a bit of a price hike. I just ordered a three month supply of Humalog from Medco and the total for the insulin came to six hundred and ninety-seven dollars. For six bottles of Humalog that will be all gobbled up by early March. (And thanks to a high, but manageable-on-paper deductible, we’re responsible for the full cost this round.) Almost seven hundred dollars worth of insulin.
We’re lucky that we’re able to pay for that cost without panicking, but knowing what these bottles cost without the assistance of insurance makes me look at everything through a diabetes lens. When three days are up on my insulin pump site, I am very aware of Read more »
*This blog post was originally published at Six Until Me.*
My dad’s wife called to ask if I could see a friend of my brother’s. This 30 year old woman had been “put through the ringer” by her HMO dermatologist. He looked at her nose diagnosed a “pre cancer” and treated her with freezing. Then he put her on a cream. The “wart” is still there and she can’t get in to see the doctor (actually a physician’s assistant) for 2 months.
Welcome to capitation medicine.
This evil creation of your local managed care plan pays a doctor Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
Update: this happened 2 years ago. So, I wrote this thinking it was a new development, but it isn’t. Anyone know how this experiment has played out?
I’ve wondered for years if hospital organizations (and big organized clinics) had done the math on whether they could do without Medicare, and apparently Mayo has. More after the quote
President Obama last year praised the Mayo Clinic as a “classic example” of how a health-care provider can offer “better outcomes” at lower cost. Then what should Americans think about the famous Minnesota medical center’s decision to take fewer Medicare patients?
Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors.
Mayo says it lost Read more »
*This blog post was originally published at GruntDoc*
When lawyers talk, I listen. Two attorneys penned a piece on medical malpractice reform in the April 21st issue of The New England Journal of Medicine, the most prestigious medical journal on the planet. Here is an excerpt from their article, New Directions in Medical Liability Reform.
The best estimates are that only 2 to 3% of patients injured by negligence file claims, only about half of claimants recover money, and litigation is resolved discordantly with the merit of the claim (i.e., money is awarded in nonmeritorious cases or no money is awarded in meritorious cases) about a quarter of the time.
This is not self-serving drivel spewed forth by greedy, bitter doctors, but a view offered by attorneys, esteemed officers of the court. Apply the statistics in their quote to your profession. Would you be satisfied if your efforts were benefiting 2-3% of your customers or clients? Would this performance level give me bragging rights as a gastroenterologist? Perhaps, I should attach a new slogan to my business card.
Michael Kirsch, MD
Correct Diagnosis and Treatment in 2-3% of Cases
We would have to Read more »
*This blog post was originally published at MD Whistleblower*