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Medicare Is Bankrupting Doctors And Hospitals

Elderly People Street Sign by Ethan Prater via FlickrMedicare, the government insurance company for everyone over age 65 (and for the disabled), pays fees to primary care physicians that guarantee bankruptcy. Additionally, 70% of hospitals in the United States lose money on Medicare patients. That’s right … for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for primary care physician visits at its Arizona facility. Mayo gets it. Nationwide, physicians are paid 20% less from Medicare than from private payers. If you are not paid a sustainable amount, you can’t make it up in volume. It just doesn’t pencil out. Read more »

*This blog post was originally published at ACP Internist*

A Fracture Risk Calculator (FRAX) May Reduce Need For Osteoporosis Prescriptions

This post is in response to Jane Brody’s recent NY Times article on the FRAX fracture risk calculator. FRAX is a clinical decision tool devised by the World Health Organization that allows physicians to account for the myriad of risk factors, including bone density, to determine a patient’s risk for osteoporotic fracture.

Now about 20 years into the practice of medicine, I have evolved from what they call an “early adopter” of new drugs, through a time of cautious use of new drugs, to what I am now – highly skeptical of most new medications and suspicious of Big Pharma, medical thought leaders and anyone else trying to “educate” me about a disease. I am also disappointed in my medical societies for failing to cut the ties between themselves and industry, but hopeful that we are slowly but finally starting to emerge from of an era of industry-dominated health care and into a time of patient-centered medicine. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

One Physician’s Jogging Diary

Another year is done and my running log for 2009 is complete.  For two years now I’ve kept track of my jogging/running/walking that I perform in my leisure time. In 2008 I completed just over 600 miles of leisure time exercise.   The great thing about running is that it’s free.  Minus the cost of shoes and socks and a few pairs of shorts, anyone can do it.  You don’t need a GPS watch to get the job done. You don’t need a gym.  All you need are your two front feet and a little inspiration and motivation.

The Biggest Loser lost over 55% of his weight, or 239 pounds and how did he do it?  He kept moving.  There is no secret to weight loss and fitness.  Watch how much you eat.  Make smart choices about how you choose to live your life and make it happen. If you have no expectations, you’ll meet them every time.  This show is proof positive that even the super obese can lose remarkable amounts of weight with diet and exercise.

Running has become a part of my life.  Without exercise, I often feel like my day is not complete.   Seeking exercise is a state of mind that happens once you experience the benefits of feeling fit.  Here is my running log for 2009: Read more »

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

Trying To Quit Smoking? Should You Cut Down Or Go Cold Turkey?

Most specialist smoking cessation services advise patients to select a quit date and quit smoking completely on that day (usually along with medication), but many smokers prefer the idea of cutting down gradually. What are the pros and cons?

I theory, cutting down gradually might provide a “softer landing” in that it might spread out the nicotine withdrawal over a longer period, rather than giving the nicotine receptors an abrupt shock of no nicotine. It also seems to fit with common sense that it might be easier to change the behavior gradually rather than all at once. Read more »

This post, Trying To Quit Smoking? Should You Cut Down Or Go Cold Turkey?, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

New Year’s Resolution: Don’t Multi-Task

I’ve been fighting pretty hard to avoid the temptation to multitask. I plan to do so again this year. People who claim to multitask are viewed with awe. Attaining the skill is a badge of honor. In a society that is increasingly 24 /7 where demands from work, family, and friends seems endless and the opportunities to be connected are more, how can a person survive if they simply do one task at a time?

Simple. Research suggests that the person who single tasks actually does better work, focuses better, and is productive.

Oh and it might save your life. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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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