November 12th, 2009 by Dr. Val Jones in Health Policy, Opinion
Tags: Caps, Costs, DC, Finance, Healthcare reform, Medical Malpractice Insurance, Medmal, Tort Reform, VA, Virginia
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There hasn’t been much discussion about serious tort reform in the current healthcare reform debate. That’s probably because most policy experts don’t believe it will make a significant dent in healthcare costs. I happen to believe that tort reform would be a huge boon for healthcare (just ask Ob/Gyns in Texas) and save a lot in defensive medicine practices and unnecessary testing, but even if I’m wrong and it wouldn’t result in cost-savings, there’s another issue at play: access to primary care physicians.
We all agree that we’re in the midst of a major shortage in primary care physicians. Many different solutions have been proposed – everything from “let the nurses do it” to forgiving medical school loans to physicians who choose primary care as a career. However, solving the PCP shortage isn’t just about recruitment, it’s about retention. And with up to a half of PCPs saying that practice conditions are so unbearable they’re planning to quit in the next 2 years – Houston, we have a problem. Read more »
November 11th, 2009 by Richard Cooper, M.D. in Better Health Network, Health Policy, Opinion
Tags: Costs, Finance, Healthcare reform, Inequality, IOM, Poverty, Public Health
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The Institute of Medicine (IOM) has addressed seven key health care reform questions and offered answers that capture today’s consensus. No surprises, but good clear analyses. But what if the underlying conceptual framework is not an excessive use of services by wrongly incentivized providers but the tragic over-use of services by the poor? Here are seven “what ifs” plus an eighth question.
1. Is health care too expensive?
What if health care is the economy, the major source of jobs and the basis for America’s worker productivity? And what if the problem is an unfair insurance system and inequitable distribution of fiscal responsibility?
2. How much too expensive is it?
What if regional variation is not a manifestation of excessive spending but of income inequality and the intersection of wealth and poverty? And what if differences in price and economic development, rather than waste and inefficiency, differentiate costs among countries? Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
November 10th, 2009 by Happy Hospitalist in Better Health Network, Opinion
Tags: Against Medical Advice, AMA, Internal Medicine, Internist, Lawsuit, Legal, Physician, Responsibility, What To Do
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When a patient decides they are leaving against medical advice what responsibility does the physician have to their care? When I was a resident in training, and even early on in my position as a hospitalist, I would get a call from the nurse that Mrs Smith was demanding to leave the hospital against medical advice. I would tell the nurse “Fine. Let her go. I’m not her father.” I would tell the nurse to discharge Mrs Smith with no medications and leave it up to them to find follow up.
I would suspect this is a prevalent attitude for many hospital and emergency based physicians. I’ve seen it over and over again. And I still see it today. Many doctors and nurses feel obliged to let grown men and women make poor decisions. However, being a grown man or woman able to make poor decisions is apparently not enough to keep a doctor for being sued and losing that lawsuit because a patient chose to make poor decisions. Read more »
*This blog post was originally published at A Happy Hospitalist*
November 9th, 2009 by Nancy Brown, Ph.D. in Better Health Network, Opinion
Tags: Above Average, Anxiety, Depression, Mean, Over Achievement, Pressure, Psychology, Teen, Test Scores
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My heart is going out to teens these days, especially in my high-achieving community. It seems school districts and parents alike have lost the sense that “average” is really OK, and in some cases, much healthier than “above average.”
An emotional goal of adolescence is to answer the question “who am I” acquiring self-certainty as opposed to self-consciousness and self-doubt. Most teens approach life expecting to succeed and achieve their goals rather than being paralyzed by feelings of inferiority. On a normal path, adolescents seek out people who inspire them and gradually develop a set of ideals and goals for their future. This is all perfectly normal, and if all goes well, teens become young women and young men who believe they can do whatever they set their minds to and are willing to work hard enough for. This process gets stunted if the expectations set for them are unreasonable. Read more »
This post, All Teens Under Pressure To Be Above Average, was originally published on
Healthine.com by Nancy Brown, Ph.D..
November 9th, 2009 by Hsien-Hsien Lei, Ph.D. in Better Health Network, Opinion
Tags: Exercise, Francis Collins, Genes, Genetic Testing, Genetics, Gym, NIH
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A little over two years ago, I confessed that I was “just a little scared of genetic testing.” I have two young children and almost every day I see traits in them that I’m pretty sure they inherited from me whether via genes or behavior. If you’re a parent, I’m sure you can imagine that there’s a lot of self-blame going on in our house.
So when it comes to genetic testing, I should want to know but I don’t. At least not right this minute. Haven’t I got enough to worry about?
From Middletown Journal’s month-long series on the battle against cancer – Many with cancer gene don’t want to know. Read more »
*This blog post was originally published at Eye on DNA*
