December 12th, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
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This blog has tried to support the virtue of personal responsibility. If you smoke, don’t blame Joe Camel. If you surrender to Big Mac attacks, don’t go after Ronald McDonald. If you love donuts, and your girth is steadily expanding, is it really Krispy Kreme’s fault? And, if you suffer an adverse medical outcome, then…
Medicare aims to zoom in on hospitals, suffocating them with a variation of the absurd pay-for-performance charade that will soon torture practicing physicians. Of course, a little torture is okay, as our government contends, but pay-for-performance won’t increase medical quality, at least as it currently exists. It can be defended as a job creator as several new layers in the medical bureaucracy will be needed to collect and track medical data of questionable value.
Medical quality simply cannot be easily and reliably measured as one can do with a diamond, an athlete or a wine. Most professions resist being graded or claim that the grading scheme is a scheme. Teachers, for example, refute that testing kids is a fair means to measure their teaching performance. Conversely, any individual or profession who scores well on any quality review program will applaud the system’s worth and fairness. Shocking.
Under the government’s new program, hospitals could be financially responsible for the cost of medical care that a patient requires for up to 90 days after discharge. Read more »
*This blog post was originally published at MD Whistleblower*
December 12th, 2011 by Bryan Vartabedian, M.D. in Opinion
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I spoke to a group of academic physicians recently. Afterward I was and asked, “Shouldn’t my hospital be responsible for my digital footprint? I don’t have time to look after that sort of thing. And wouldn’t it make sense for them to promote my research?”
4 thoughts:
1. Online reputation management of academic physicians should be an individual, not institutional, responsibility. The question reflects a belief that your reputation is the job of “the marketing people.” No institution will ever be as invested in your future as you are. While there are hospitals that do a good job supporting their faculty and staff, you can’t assume it to be the case. No one looks after you like you.
2. Dig your well before you’re thirsty. That’s the name of a brilliant pre-digital book written by Harvey Mackey. He suggested that the time to invest in relationships is before you need them. Medicine is changing fast and you’ll never know how long you’ll be where you’re at. Better yet, you never know what opportunities could come your way when people find you. And if you want to experience the land before time when people used colored pencils, Rolodexes, and rotary phones, read Dig Your Well. Read more »
*This blog post was originally published at 33 Charts*
December 10th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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The primary stakeholders in the healthcare system are patients and physicians. Without patients or physicians there would not be a healthcare system.
Patients should be the drivers of the healthcare system. They are not. The primary drivers are the government and the healthcare insurance companies.
Hospital systems play the next largest role in driving up the costs of the healthcare system. Large hospital systems are constantly playing a game of chicken with the government and the healthcare care insurance industry.
Somehow, large hospital systems have been able to stay under the radar. They have been able to avoid the responsibility of the rising costs of healthcare.
Large hospital systems and large hospital chains know that insurers need them to service their network of patients. The healthcare insurance companies know that the hospital systems can hold them hostage to increased reimbursement.
When a large hospital system demands an increase in reimbursement the healthcare insurance industry simply increases premiums.
An example is the Read more »
*This blog post was originally published at Repairing the Healthcare System*
November 20th, 2011 by Linda Burke-Galloway, M.D. in Health Tips, Research
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photo from www.newscientist.com
A recent medical study by Dr. Ira J. Chasnoff of the Children’s Research Triangle asserts that Hispanic women who have assimilated to American culture have a greater risk of having children born with fetal alcohol syndrome. According to Chasnoff, pregnant Hispanic women in San Antonio had the second highest drinking rate of 29 cities in the states that were studied. I find that rather hard to believe based on my twenty-one year history of taking caring of Hispanic pregnant women. I have seen first, second and third generation Hispanic women and never encountered alcoholism among any of them. However, Chasnoff brings up an interesting point about alcohol and pregnancy. There are two schools of thought. According to Good Morning America, there are physicians such as Dr. Jacques Moritz, who think an occasional glass of wine is okay to consume during pregnancy however the U.S. Surgeon General and the American College of Obstetrician-Gynecologists advocate strict abstinence from alcohol while pregnancy.
According to medical literature, more than one-half of women of childbearing age report drinking alcohol and 1 out of 8 women report binge drinking. Alcohol appears to have negative effects throughout the entire pregnancy, not just during the first-trimester. At present, Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
November 11th, 2011 by Jessie Gruman, Ph.D. in Opinion, Research
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Our ailing economy has boosted the number of people who are unemployed, without health insurance or with minimal coverage. The popularity of high deductible health plans is soaring as employers and individuals look for affordable insurance. Twenty-nine percent of bankruptcies are said to be caused by medical bills. Many of us now choose health care services and providers carefully, trying to stay within tight budgets.
The American people, long protected from the price of health care by insurance, are now forced to act as consumers. This situation is a free marketer’s dream. According to this model, we will rationally calculate the price/quality trade-offs of each doctor visit, procedure, test and drug. We will stop overusing services. We will demand better care. And the result will be reduced health care costs for the nation while the quality of care and the health of individuals will remain the same, if not improve.
There’s nothing like a good theory.
But the theory can only be tested if a) It’s easy to find publicly reported, relevant quality information about the services we need, matched with what we would pay out of pocket; and b) We use that information as the basis of our health care decisions. Neither of these conditions can be met today.
A new Cochrane review Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
This blog has tried to support the virtue of personal responsibility. If you smoke, don’t blame Joe Camel. If you surrender to Big Mac attacks, don’t go after Ronald McDonald. If you love donuts, and your girth is steadily expanding, is it really Krispy Kreme’s fault? And, if you suffer an adverse medical outcome, then…
