The New York Times Health section has a new columnist that wants to discuss the fact that many Americans are losing faith in their doctors. And get this, the columnist is…a doctor. Dr. Pauline Chen, a liver transplant and cancer surgeon, has seen first-hand the growing struggle to find open communication and trust on both sides of the doctor-patient relationship, and she’s ready to talk about it. Dr. Chen says, “We all want the same thing: the best care possible, but we have lost the ability to converse thoughtfully with one another. My hope is that we can revive that …read more

Even George Clooney can’t save what some in the press have nicknamed “The Republican E. R. Plan.” (This post is a follow-up to one I wrote yesterday about McCain’s top health care advisor, John Goodman, who thinks that access to the ER is the same thing as having health insurance.)
For someone with a PhD in economics, you would think that Goodman realizes that the emergency department is the most expensive way to access health care in this country. Moreover, treatment for a disease is almost always more expensive at later stages, and is definitely more expensive than preventing the disease …read more

In an interview yesterday, McCain’s top health care advisor, John Goodman (he also calls himself “The Father of Health Savings Accounts” — something I wouldn’t brag about) said that the term “uninsured” is a misnomer because Americans can access health care through the emergency room.
As an expert in cancer care and how that care is delivered to patients, I can categorically say that access to an emergency room is not the same as “access to health care.” If you’re a cancer patient, what you need is access to expensive pharmaceuticals, experienced physicians, and expert oncology nurses who will actually hook …read more

The New York Times reports on a study that family doctors are making an awful lot of mistakes when it comes to routine lab tests such as blood draws. The study, published originally in the journal Quality and Safety in Health Care, was conducted by physicians in the American Academy of Family Physicians (AAFP) research network. It found that errors in testing can happen at any point along the way, from ordering a test to failing to notify a patient when the test results return.
These results aren’t that surprising, but what concerns me the most is the cost-saving potential of …read more

Dr. Peter Bach, who practices at Memorial Sloan-Kettering Cancer Center in New York and who advised Medicare and Medicaid (CMS) from 2005 to 2006, penned an editorial with this same title – “Paying Doctors to Ignore Patients” – in today’s New York Times. As bad as is sounds, Bach is right.
Physicians who are paid on a fee-for-service (FFS) basis are paid per service they provide, whether this service is a surgical procedure , a PET/CT scan, or an office visit. The more expensive services are reimbursed more handsomely. (This scheme does not apply to physicians who are reimbursed by capitation …read more

As reported by the Washington Post, CMS is attempting to jump-start the adoption of electronic health records/electronic medical records (EHR/EMR) and e-prescribing with a new program that will pay physicians and practices a bonus for using electronic prescribing tools. Practices that move to electronic prescribing methods will receive bonuses of 2% in 2009 and 2010, bonuses of 1% in 2011 and 2012, and bonuses of 1/2 % in 2013.
At the same time, the New York Times is reporting on Philadelphia area insurers that are offering bonus payments or increased payments to physicians for using tools such as telephone visits, e-mail “visits,” …read more

Hillary Clinton spoke out Friday in opposition to a Bush administration proposal that would cut federal funding to hospitals offering contraception such as birth control pills and other pregnancy prevention methods by more or less rebranding these contraceptives as abortion. The proposed law would also back health care providers who believe it is their right to not provide contraception if they have a moral opposition to doing so.

Image by seiu_international on Flickr
The proposal in question relates to a Dept. of Health and Human Services (HHS) memo that defines abortion as any measures, including prescription drugs such as birth control pills, …read more

The WSJ reports that patients aren’t the only ones stung by pricesfor Avastin and other expensive cancer drugs. Physicians are also getting burnt. While most drugs are prescribed directly to patients and picked up at a pharmacy, leaving the patient and/or insurance company with the bill (and the pharmacy with the overhead), most cancer drugs are delivered IV, and physicians must purchase them up front before a patient arrives for an infusion. As it may take up to 90 days (or occasionally more) for reimbursement to come through from a patient’s insurer for a drug, physicians are left footing the …read more

Kings County Hospital Center in Brooklyn, a hospital that’s Web page claims is “staunchly committed to patient-centered care”, left a woman who had collapsed on the floor unattended for over an hour. She died on the floor before anyone assisted her.
According to the video below, she had been waiting in the ER for over 24 hours before she collapsed. This is not the first time that this particular hospital has failed to properly treat its patients, and according to a number of sources, this incident is just one in a long line of sad cases that will become more …read more

The American Medical Association isn’t too thrilled by the planned expansion of Medicare’s “No-Pay” List. Starting in October 2008, CMS will no longer reimburse for care for the following: pressure ulcers, catheter-associated urinary tract infections, Stephylococcus aureus septicemia, air embolism, blood incompatibility, and an object left behind in a surgical patient.
I agree with the first one (pressure ulcers) for the most part, and definitely with the last three — these three items are sometimes called “never events” because they should never, ever happen (and rarely happen when a hospital has good procedures for staff communication and safety double-checks). However, denying …read more