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Latest Posts

New Medical Drama “21” And The Evil SGR Conspiracy To Cut Medicare

Name: “21” (% to be cut from Medicare)

Protagonist: Dr. Rob and a cast of thousands of physicians (Kiefer Sutherland wouldn’t work for such small payment.)

Villain: Evil SGR (Sustainable Growth Rate) conspiracy to cut Medicare by 21% across the board.

Victim: The elderly population depending on Medicare for payment of their medical care.

Plot:  A follow-up to the popular drama “Lost” where members of congress were stranded in Washington D.C. with the task of reforming healthcare without any contact or communication from doctors and patients. This new drama “21″ tells the tragic tale of an industry under siege and a population facing possible disaster.

Already stretched to the limit by the paltry reimbursement from Medicare for primary care office visits, Dr. Rob and his band of physicians is hit by the evil conspiracy of SGR, a secret society whose goal is to harm the elderly people in the country by driving away all people willing to give them care. The congress, tired out from haggling over the healthcare reform bill, allows evil SGR to exert its power in the name of “fiscal responsibility.” Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Does Your Parent Need Nursing Home Care?

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One of the great blessings of my life is that my 91-year-old father, whom I dearly love, lives in the apartment building next door.  After sixty-six years of marriage, he’s been living alone since my mother’s death last March. He is still sharp as a tack, as he might say.   Read more »

The Elderly Versus Healthcare Reform

One of the storylines in the health reform debate is how the Medicare population is fighting the current reform efforts.

It’s ironic, in a way, since if the status quo continues, fiscally sustaining current Medicare benefits will be a near-impossibility.

In his regular column, The New York Times’ Ross Douthat provides some insight as to the mindset of the Medicare recipient. He says, rightly, that, “At present, Medicare gives its recipients all the benefits of socialized medicine, with few of the drawbacks. Once you hit 65, the system pays and pays, without regard for efficiency or cost-effectiveness.”

When reformers talk about savings, it “sound[s] a lot like ‘cuts’” to the elderly, and hence, their apprehension. Arguments that many of the tests and treatments can be reduced without sacrificing quality of care will not resonate. With the prevailing mentality equating better care with more care, any attempt to introduce serious cost-saving measures will meet a determined resistance from the American public.

*This blog post was originally published at*

Real Cost Drivers In Healthcare: Prolonging The Lives Of The Elderly

Reducing health spending, as Congress is finding out, is difficult.

Some health economists have pointed to medicalization of common complaints, like erectile dysfunction and attention deficit hyperactivity disorder, as one reason. Indeed, Dartmouth researchers, who are cited as favorites of the current administration, feel that an “epidemic of diagnoses” is what’s making us sick.

But, Darshak Sanghavi writes in Slate that this may be a red herring, and clouds what’s really driving up costs, namely, the amount we spend prolonging the lives of the elderly. He points to David Cutler, an adviser to President Obama, and his analysis that “it costs far more to prolong the lives of the elderly ($145,000 per year gained) than the young ($31,600), and the rate of spending on the oldest Americans has grown the fastest.”

None of the current health reform proposals target this, understandably, because it would be politically difficult to tell elderly voters that we need to spend less on their care.

And because of that, Dr. Sanghavi rightly concludes that, no matter what gets passed, “we’re just putting off the day of fiscal reckoning.”

*This blog post was originally published at*

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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