The fiscal disaster of healthcare costs has a human toll

By Timothy Johnson, MD-Today, I come back to the tragedy of medical economics in this country. And I would apply that word “tragedy” in at least two ways. The first tragedy is that we are headed for fiscal disaster in this country because of healthcare costs. We now spend twice as much per person on healthcare as the average per person cost of all developed countries. During the past several decades, the inflation rate for healthcare costs has usually been two to three times the general inflation rate. Obviously, this level of healthcare cost increase cannot continue. It is, to … Continue reading

Mean doctors and nice nurses: It’s time to change our brand

  By Karen S. Sibert, MD In my hospital’s preoperative area, upright on her bed, sat an unhappy middle-aged lady who needed an operation to treat complications from her previous bariatric surgery. She hadn’t lost weight and clearly was feeling discouraged about practically everything. She was physically uncomfortable, couldn’t even keep down her own saliva because her lower esophagus was obstructed, and was in tears. As her anesthesiologist, I came to evaluate her prior to surgery. In fairly short order, I got her a tissue and a warm blanket, listened to her tale of woe, and finished my pre-anesthetic examination. … Continue reading

4 essential elements of true health reform

TIMOTHY JOHNSON, MD, MPH | POLICY | DECEMBER 8, 2012 I recently said I would describe the essential elements of “true reform.” I realize others might add or subtract from my list, but here it is – at least for today: Payment reform. I put this first because no matter what form or structure healthcare takes, without payment reform it will be doomed to failure. And by “payment reform” I mean switching from the “fee for service” model I discussed in an earlier column – which basically pays more for doing more whether or not it is needed – to … Continue reading

Making poor choices by misjudging the level of risk

by STEVEN KUSSIN, MD on August 5th, 2012 in PATIENT-   Risks are not certainties. They are the possibility that an activity will end badly. Risk is a handmaiden to almost everything we do. Life itself is risky. Every decision is associated with the possibility of harm. Risk can’t be avoided, but it can be managed. Let’s talk today about the chances we take while living our everyday lives. Risks are subject to a variety of misconceptions. What’s risky and what’s not is often a function of our personalities. Those who are risk averse put their money in the bank. … Continue reading

How the primary care shortage affects the ER

by LEANA WEN, MD on November 6th, 2012 in PHYSICIAN   Bill M. is a 22-year old college student who has had asthma and diabetes since he was a child. He comes in with trouble breathing because he has no primary care doctor and is out of his inhalers. While he’s in the ER, he also says that his diabetes hasn’t been followed for years, and now his blood sugars are out of control and he has new problems with his kidneys and his eyes. Rani K. is a 46-year old who moved from India to take a research position. … Continue reading