December 5th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
Tags: CMS, Cost cutting, Healthcare Costs, Medicare, Obamacare, Physician Salaries, SGR
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In reviewing Ezekiel Emanuel’s New York Times article I thought of an interesting question. In Dr. Emanuel’s view it is not worth having tort reform or healthcare care insurance reform. He claims these reforms are an insignificant burden to the cost of the healthcare system.
I have demonstrated that the evidence for tort reform and reform of the healthcare insurance industry proves him wrong.
The question then is where is the $2.5 trillion dollars the U.S. healthcare system spends going?
President Obama and Dr. Emanuel think it is going to physicians. President Obama’s idea to control healthcare costs is to reduce physician reimbursement.
Physicians have the weakest expression of its vested interests among all the stakeholders because of lack of effective leadership.
Simple arithmetic reveals that reducing physician reimbursement will yield an insignificant reduction in healthcare costs.
Never the less on January 1st Medicare is going to decrease physicians’ reimbursement by 27%. This decrease is the result of the application of the government’s Sustainable Growth Rate (SGR).
The Sustainable Growth Rate (SGR) is a complicated and defective formula intended to contain the overall growth of Medicare spending for physicians’ services. The intent was to keep physicians’ reimbursement in line with the nation’s ability to pay for that medical care. The SGR formula uses the gross domestic product per capita in a complicated and inaccurate way. Read more »
*This blog post was originally published at Repairing the Healthcare System*
December 5th, 2011 by ErikDavis in Opinion, Quackery Exposed, Research
Tags: Alternative Medicine, Andrew Wakefield, Autism, Chicken Pox, Chickenpox, Measles, Parents, Pediatrics, Pox Parties, Pseudoscience, Rubella, Skepticism, Statistics, Vaccines
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There has been much abuzz about “pox parties” – the practice of parents getting a bunch of unvaccinated kids together with an infected one (pick one, really, though chicken pox is the focus of the recent article in Time) in the hope that their little sweethearts become ill and therefore “naturally” immune to the disease. This deliberate infection involves things as seemingly innocent as breathing the same air as the infected to the stomach-turning sharing of bodily fluids (Saliva lemonade, anyone?). To compound the issue, it seems that parents aren’t always taking into account how the viruses are transmitted, and end up trying oral transmission to transmit a disease that is transmitted through the air. And yes, the whole thing is as stupid as it seems.
Given that the people partaking in these events have likely not vaccinated their children against anything else, these parties could be a source point for multiple highly contagious infections. Most of us have had chicken pox as children and don’t remember it fondly – now imagine having chicken pox with mumps, mono, and maybe a little hepatitis A to top it off. It is also easy to forget in Western luxury that these innocuous childhood illnesses are actually lethal. Just measles? Well, one death per 3000 measles infections might not seem like much, until you consider the fact that in 2008, 164,000 people died of the measles worldwide – approximately the same number of civilians that have died in the entire length of the current Iraq war. That’s an annual number, and it’s gone down by almost 80% over 10 years. How? Read more »
*This blog post was originally published at Skeptic North*
December 5th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
Tags: ABEM, ABIM, Board Certification, Board Exams, Certification, Competency, Education, Emergency Medicine, Exams, Medical Education
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Here’s my column in this month’s Emergency Medicine News.
In 1994 I was thrilled to become certified by the American Board of Emergency Medicine. I had worked very hard. I studied and read, I practiced oral board scenarios and even took an oral board preparatory course. It was, I believed, the pinnacle of my medical education. Indeed, if you counted the ACT, the MCAT, the three part board exams along the way and the in-service exams, it was my ultimate test. The one that I had been striving for throughout my higher education experience.
I am now disappointed to find that my certification was inadequate. In fact, all of us who worked so hard for our ABEM certification find ourselves facing ever more stringent rules to maintain that status. And it isn’t only emergency medicine. All medical specialties are facing the same crunch. Our certifying bodies expect more…and more…and more.
And the attitude is all predicated on the subtle but obvious assumption that those of us in practice are not competent to maintain our own knowledge base. Despite spending decades in education that we are not to be trusted. That we are not interested in learning. That we do not attempt to learn and that our practices are not, in fact, the endless learning experiences they actually are. They assume we need more supervision, despite demonstrating (by our continued practice) that we are willing to do hard work, in hard settings, and do the right thing.
Unfortunately, the rank and file Read more »
*This blog post was originally published at edwinleap.com*
December 5th, 2011 by ChristopherChangMD in Opinion
Tags: Diagnosis, Dr, Drug Abuse, House, M.D., Physician, Popularity, TV, TV Show, Wrong
2 Comments »
Would YOU as the patient see a doctor who is a well-known jerk, abuses drugs, gives the wrong diagnosis more often than not, and is known to like ordering very invasive tests??? Be honest…
The other week, a patient with a chronic cough exclaimed to me that she wished the fictional character Dr. House of TV fame actually existed in real life, because he was somebody who can diagnose anything.
I looked her straight in the eye and told her that somebody like Dr. House in the real world would be a physician nobody would want to see for many reasons:
- In the real world, patients expect doctors to have the correct diagnosis from the beginning (might forgive one wrong diagnosis). Dr. House seems to always get things wrong multiple times before he gets it right. I seriously doubt most patients would have stuck around as long as they do on the TV shows before going elsewhere. Read more »
*This blog post was originally published at Fauquier ENT Blog*
December 4th, 2011 by DrWes in News, Opinion
Tags: Age, Chicago Tribune, Cost, Cost-effectiveness, Elderly, health care, Health Care Reform, Malpractice, Old, Palliative Care, Rationing, Refusal, Seniors, The Hastings Center
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A sure-to-be controversial article appears in the Chicago Tribune earlier this asking the sensitive question of ‘Health care at any age, any cost?:’
“If you want to save all lives, you’re in trouble,” said Callahan, co-founder of The Hastings Center, a bioethics research institute in New York, and a faculty member at Harvard Medical School, in an interview. “And if you want to save all lives at any cost, you’re really in trouble.”
Callahan and co-author Nuland, a retired professor of surgery at Yale School of Medicine who wrote the best-selling “How We Die,” were both 80 when the article was published.
“We need to stop thinking of medicine as an all-out war against death, because death always wins,” said Callahan.
The article goes on the make some bold demands of doctors: Read more »
*This blog post was originally published at Dr. Wes*
