Category Archives: Policy

Policymakers: Put down your carrots and sticks. They will not work.

271 Shares Share Tweet Share As a family physician in the trenches, I routinely see blatantly poor medical care in the history of my new patients. Far too many people get unwarranted medications and tests, while important things go unrecognized or unaddressed. This paradox is maddening. We must do better. To this end, policymakers have … Continue reading

Patient satisfaction should not be driven by poorly-designed surveys

29 Shares Share Tweet Share A young male patient checks into the emergency department (ED) and is brought back to a room for an ankle injury he suffered the day before. He states that he twisted it while doing some indoor rock climbing and tells the triage nurse that it is swollen and tender, but … Continue reading

How Big Medicine is hurting patients and putting small practices out of business

2K Shares Share Tweet Share Recently the CEO of a large health care network stated: “Market forces don’t apply to health care.” Of course, economic and political forces apply to health care.  Big Medicine’s most powerful entities (insurers, hospitals, medical schools, pharmaceutical companies, pharmacies, and government agencies) formulate health care policy to enrich themselves at … Continue reading

Why are we hemorrhaging emergency nurses?

31K Shares Share Tweet Share I started my medical career late. Really late. By that time, I’d lived a few lives. I’d earned a boatload of initials. I’d changed husbands, languages, and continents. I’d written a useless novel, and I’d been a Mary Kay lady. One day over lunch as I was looking for something … Continue reading

Medicare for all: a campaign promise, catchy bumper sticker, or viable program?     

24 Shares Share Tweet Share With the 2020 election cycle already moving into high gear, we are hearing a lot about Medicare for all. But is it a serious campaign promise, a catchy bumper sticker or a viable national program? Supporters suggest it will be a panacea for our nation’s health insurance needs. Others are … Continue reading

A framework to understand universal health care

51 Shares Share Tweet Share One of the most popular topics in health care is the idea of universal health care coverage. You know the soundbites: “Medicare for all.” “Single-payer system.” While universal coverage sounds desirable to many, some factors must be considered. In this post, I’m going to provide an aerial view of this … Continue reading

Want to find the best doctor? Don’t rely on price tags.

5 Shares Share Tweet Share Say you want to know which baseball players provide the most value for the big dollars they’re being paid. A Google search quickly yields analytics. But suppose your primary care physician just diagnosed you with cancer. What will a search for a “high value” cancer doctor tell you? Not much. Public … Continue reading

The rent is too high in health care

1 Shares Share Tweet Share Jimmy McMillan might have been right. Mr. McMillan ran for mayor of New York City as the founder and candidate of the “Rent Is Too Damn High” Party. And while he was talking about real estate rent, he might have made a similar complaint about health care’s rent — payments … Continue reading

For future physician-activists: This is our lane

87 Shares Share Tweet Share Rudolf Virchow, a pioneering physician of the 1800s, once wrote that “politics is nothing but medicine on a large scale”. Over a century later, this nexus is as apparent as ever, and many doctors engage as practitioners of both. Twitter erupted this past fall with photos of soiled scrubs, resuscitation … Continue reading

Health care workers and administrators aren’t rowing in the same direction

306 Shares Share Tweet Share My wife and I once canoed across a glacial lake. There were twelve people in our 30-foot canoe. To reach the shore of the Mendenhall Glacier, we had to paddle two miles across a lake. All twelve of us had to paddle together to reach the shore. But what if … Continue reading