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Who Pays For Healthcare? When Doctors And Patients Don’t Care

The essence of the moral hazard experience through a nice neighborly conversation:

Neighbor: These allergies are killing me.
Happy:  That’s terrible. I hope you feel better.
Neighbor:  I tried Zyrtec but it wasn’t doing anything for me, so my doctor prescribed ‘x.’ (inaudible drug name )
Happy:  Does it start with an ‘x?’ (The drugs name is Xyzal.)
Neighbor:  Yes, it does.
Happy: Oh, that drug (Xyzal) is nothing more than Zyrtec, which the company slightly changed the formula of and now they get to sell it as a patented medication at 10 times the price for the next 10 years.
Neighbor: Oh, I didn’t know that. But you’re right. It was  $110. 
Happy:  Did it help you with your allergies?
Neighbor: Nope.
Happy: I guess you just wasted $100.
Neighbor.  I didn’t waste anything. My insurance company paid for it.
Happy:  Actually, we all paid for it with higher premiums.
Neighbor: (Walks away.)

The doctor doesn’t care — he’s not paying for it. The patient doesn’t care — she’s not paying for it. But everyone complains that their insurance rates are out of control. It’s not insurance company profits that are making healthcare too expensive, it’s patients and doctors who don’t care. 

Bundled care solves this problem because the doctor won’t prescribe a $110 medication and offer therapies with no proven benefit over less-expensive options.

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

Medical Moonlighting: How About Doctor Derby?

Medical moonlighting. That’s what you’d better be thinking about as the healthcare finance reform trap continues its destined pursuit of bankrupting America.

The only possible outcome to all of this mess is the biggest man-made healthcare recession of all time that will make the current economic implosion look like a walk in the park.

What are some possible second jobs for doctors? Every week I get offers to respond to surveys and telephone conferences by private industry asking for my opinions on up-and-coming pharmaceuticals. Just the other day I was offered $500 for a 90-minute interview. (That reminds me, I had better call them back!)

Other second jobs for doctors? Read more »

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

Healthy, Active Kids Come From Healthy, Active Adults

First RunKids are like dogs — you can train them until they’re too old to train. Then they’re going to do whatever they want.

The key to getting kids to exercise is to make it fun for them. But they aren’t going to exercise if it isn’t made a part of their normal routine. It’s up to adults to train them.

Mrs. Happy and I had the joyous opportunity of inviting our 10-year-old niece to her first-ever running event. She had never ever run in a race before. We did the two-mile race and she loved it. And amazingly, she finished without stopping — not even once.

Our nation is raising a nation of fat and lazy kids because we’re lazy adults. We drive everywhere. We sit at our desks. We get food on the run. We watch a lot of television. We surf the Net a bunch. And we have stopped moving. We have literally stopped moving. Read more »

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

An Earful And A Mouthful: Insulted Woman Bites Off Man’s Ear

So I’m listening to the radio [yesterday] when I hear a story about a woman who was called “fat” by a 24-year-old man at a party. What does she do?

The Omaha World Herald is reporting that she bit off more than she could chew by literally biting off his ear.

Police at a Lincoln, Nebraska hospital responded to a call in the emergency room at 3:25AM on April 28th when the unnamed, one-eared man claimed 21-year-old Anna Godfrey bit off his ear for calling her “fat” at a party. The ear chunk is missing in action. Read more »

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

Should Doctors Retire At A Certain Age?

Many people like to make a comparison between the airline industry and the medical industry when it comes to protocols.

Is there a maximum age restriction for commercial pilots in the United States? Yes, there is. In 2007, Congress raised the age of forced retirement for commercial pilots from 60 to 65 years old.

In light of that, should physicians be forced to retire after a certain age as well? Should we trust our health to the abilities of a physician who is 70, 75, 80 years or older? 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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