The Health Care Blog

Bitter doc wants more respect for primary care

By Sarah Arnquist A primary doctor ranted anonymously this weekend on Kevin MD's blog about the lack of appreciation for primary care in his small Midwestern town and predicted its future demise. The doctor practices in a medical shortage area,...
May 16, 2008 in Physicians, Policy, reform, Sarah Arnquist | Permalink | Comments (8)

New demands of 'Millennial patients'

By THCB Staff "Millennial patients are the first generation of Americans to grow up with the Internet as a pervasive part of their lives. ... They are amazed, bewildered, and ultimately angry with the inability to access their health care...
May 15, 2008 in Health 2.0, Personalized Medicine, Physicians, Scott Shreeve, Technology | Permalink | Comments (1)

More on Physician Reimbursement, CMS, the AMA's RVS Update Committee (RUC)

by ROY POSES, MD (Note by Brian Klepper: At Health Care Renewal, Dr. Roy Poses, a Clinical Associate Professor at Brown University's School of Medicine, writes a consistently excellent blog on health care financial conflict . Both he and I...
May 12, 2008 in Brian Klepper, Economics, Physicians, Policy/Politics, The Industry | Permalink | Comments (11)

Stealth marketing: doctors and public radio

By Sarah Arnquist Over at Slate, veteran health care journalists Shannon Brownlee and Jeanne Lenzer raise tough questions about the lack of disclosure regarging four doctors' ties to the makers of antidepressants, while they told audiences of public radio stations...
May 11, 2008 in pharmaceuticals, Physicians, Sarah Arnquist | Permalink | Comments (3)

Indian docs endorse O.J. and oatmeal

By Sarah Arnquist PepsiCo maneuvered marketing genius this week by convincing the Indian Medical Association to endorse the health benefits of Tropicana fruit juice and Quaker Oats for three years. Now, when Indians reach for these products, they'll see a...
May 8, 2008 in Physicians, Sarah Arnquist | Permalink | Comments (1)

WSJ analyzes specialist pay

By Eric Novack On the front page of Today’s Wall Street Journal is an article entitled, “Medical Specialties Hit by a Growing Pay Gap”. A few passages worth thinking about: "Many in health-policy circles have focused on how the current...
May 5, 2008 in Physicians | Permalink | Comments (3)

A Hat Tip to Pediatrician Dr. Benjamin Spock

By Brian Klepper Here's one of today's entries in The Writers' Almanac, the wonderful daily newsletter sent out by Garrison Keillor on NPR. Parents of boomers like me were big fans of Dr. Spock, treating him with an almost cult-like...
May 2, 2008 in Brian Klepper, Physicians, Quality | Permalink | Comments (2)

Millennial Health Care Delivery

By Scott Shreeve Millennial (adj.) 1. Of or pertaining to the millennium, or to a thousand years 2. Generation of Americans younger than 29 in 2007 with unique social, cultural, and market identity The highlight of last month's Health 2.0...
April 17, 2008 in Physicians, Technology | Permalink | Comments (5)

Quoteable

By THCB Staff Herbert Rubin M.D. apparently did not enjoy Jane Sarahson Kahn's piece last week reporting the results of the recent Annals of Internal Medicine study examining physician attitudes towards national health insurance. Here is his email to us,...
April 14, 2008 in Physicians | Permalink | Comments (8)

The Changing of the Guard

By Jeff Goldsmith For the past 30 years, the U.S. health care system has been powered by baby boomer physicians, many of whom are now considering retirement at a younger age than prior generations due to burnout, deteriorating practice economics,...
April 14, 2008 in Physicians | Permalink | Comments (5)

As I Was Saying…

By Eric Novack As can be read in my response to Jane’s touting the wonderful results of the non-study published in the Annals of Internal Medicine recently (and well noted by the much maligned on THCB, but usually correct Greg...
April 14, 2008 in Physicians | Permalink | Comments (6)

When You Go to an ER and There's No One There to Take Care of You

By Maggie Mahar Recently, I’ve been reading less-well known health care blogs—and finding some provocative stories. Below, Edwin Leap--who is a physician and a blogger--tells a story about trying to find a specialist for a very sick child in the...
April 11, 2008 in Maggie Mahar, Physicians | Permalink | Comments (3)

Rebuilding The Medical Home: What Walgreens Surely Sees

By Brian Klepper Though it probably went mostly unnoticed in the cacophony of health care stories, last week's news that Walgreen's had bought the two largest and most well-established worksite clinic firms, iTrax and Whole Health Management, was a harbinger...
March 27, 2008 in Brian Klepper, Health 2.0, Health Plans, Physicians, The Industry | Permalink | Comments (10)

Prosecution in organ harvest case faces hurdles at trial

By Sarah Arnquist Although neither the prosecution nor defense has shown its entire case, the unusually long eight-day preliminary hearing for transplant surgeon Hootan Roozrokh revealed considerable details about what happened during Ruben Navarro’s final hours and the hurdles both...
March 25, 2008 in Organ Donation, Physicians | Permalink | Comments (1)

Criminal charges filed against transplant surgeon

By Sarah Arnquist Prosecutors in a small town on California’s Central Coast are making history. For the first time in the United States, they brought criminal charges against a transplant surgeon, alleging he prescribed excessive amounts of medication in an...
March 23, 2008 in Organ Donation, Physicians | Permalink | Comments (5)

A Doctor Grows in Brooklyn

By THCB staff Doctor Jay Parkinson became a media celebrity last year as word spread about his unconventional practice in Williamsburg, Brooklyn. Instead of maintaining a traditional office and paying support staff, Parkinson’s operation is entirely virtual and requires almost...
March 21, 2008 in Health 2.0, Physicians, Youtube | Permalink | Comments (33)

PHARMA: The ACP does the right thing

In 1937 marijuana was banned by Congress. The only question asked was, "what's the position of the American Medical Association?". It actually was in favor of keeping marijuana legal for medical purposes. But the response given to Congress by whoever...
February 19, 2008 in Pharma, Physicians | Permalink | Comments (2)

Let's All Ask Secretary Leavitt To Explain HHS' Schizophrenia On Medicare Physician Data - Brian Klepper

Regular readers will know that, last Sunday, I posted a column that pointed to HHS' schizophrenic behavior when it comes to the release of Medicare physician data. First they fight the consumer advocacy group Checkbook.org's lawsuit demanding the release of...
February 13, 2008 in Brian Klepper, Physician Rating, Physicians, Policy, Policy/Politics, The Industry, Transparency | Permalink | Comments (2)

PHYSICIANS: Your data is wrong!

Read this article from the Dallas Morning News called Insurers' ratings often aren't accurate, doctors complain. It's very very important, in that it explains both what's wrong with using claims data to do analytics without working a little harder than...
February 11, 2008 in Physician Rating, Physicians | Permalink | Comments (10)

Sunday Morning Post, by Brian Klepper

Here's a classical example of a federal regulatory agency holding fast to two opposing ideas at the same time. I wonder what it means? Last week the Department of Health and Human Services posted an interesting notice announcing a new...
February 10, 2008 in Brian Klepper, Physician Rating, Physicians, Policy, Policy/Politics | Permalink | Comments (1)

Concierge Medicine From A Doctor’s Perspective - David R. Donnersberger, MD, JD

Call it boutique medicine. Retainer medicine. Platinum care. Evoking the pastoral image of a sturdy black doctor’s bag and spectacles, concierge medicine is a small but growing trend among over-worked and over-booked physicians. The practice essentially offers a limited number...
January 24, 2008 in Concierge medicine, Physicians | Permalink | Comments (12)

Four Big Trends - Brian Klepper

Several events and trends emerged over the last year that will reverberate throughout the health care marketplace in 2008 and going forward. While none of these dominated the trade press like some other issues - electronic and personal health records,...
January 16, 2008 in Brian Klepper, Health 2.0, Health Plans, Hospitals, Medicare Advantage, Patient Safety, Physician Rating, Physicians, Policy/Politics, The Industry | Permalink | Comments (8)

Leveraging The Doctor As A Trusted Authority - Brian Klepper

I was on the phone with my good friend Bill Bestermann MD yesterday. Dr. B, a preventive cardiologist who is passionate about the underlying mechanics of cardiovascular disease and the horrific toll the American diet and lack of exercise is...
January 10, 2008 in Brian Klepper, Physicians | Permalink | Comments (3)

On Practical Reforms - Brian Klepper

Now that health care reform is once again an active, visible issue in state governments and the presidential campaigns, the ideas are flying fast and furious. Predictably, some ideas are better than others. Over at Health Care Policy and Marketplace...
January 9, 2008 in Brian Klepper, Health 2.0, Health Plans, Physicians, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (11)

The Politics of Publicly-Funded Health Care - Brian Klepper

Over at Health Care Policy and Marketplace Review, the always insightful Bob Laszewski walks us through the mechanics of the just-passed federal budget and its health care financing implications for SCHIP, physicians, hospitals, Medicare Advantage plans. This clear, common sense...
January 3, 2008 in Brian Klepper, Health Plans, Hospitals, Physicians, Policy/Politics, The Industry | Permalink | Comments (1)

Pilots Use Checklists. Doctors Don't. Why Not? By Maggie Mahar

Frequent THCB contributor Maggie Mahar returns today with another of her no-holds barred pieces on the practice of medicine, examining the the controversey over checklists for doctors. Many physicians are opposed to the idea on general principles, arguing that checklists...
December 29, 2007 in Physicians | Permalink | Comments (17)

My Nomination For Health Care Quote of the Year - Brian Klepper

I was reading through other peoples’ blog posts yesterday when amazingly enough, I was here on THCB and came across this straightforward statement by Paul Levy, the CEO of Beth Israel Deaconess Medical Center in Boston. Of course, many readers...
December 22, 2007 in Brian Klepper, Health 2.0, Hospitals, Physicians, Policy, Quality, The Industry, Transparency | Permalink | Comments (6)

JOB POST: Physician Advocate: Siemens Medical Solutions

Specific requirements: Medical Degree (MD) . Excellent written, verbal, and presentation skills along with strong analytical skills required. Ability to travel 70%. Demonstrates assigned products to prospective or existing clients in sales situations which include demo system operations in conjunction...
December 17, 2007 in Physicians | Permalink

Bad Medicine: How The AMA Undermined Primary Care in America - Brian Klepper

On Tuesday’s Wall Street Journal website, Dr. Benjamin Brewer describes physicians’ reactions to the 10.1% cut in Medicare physician payments that will take effect January 1. He argues that the onus will fall, once again, disproportionately on primary care physicians,...
December 13, 2007 in Brian Klepper, Physicians, Policy, Policy/Politics, The Industry | Permalink | Comments (31)

PHYSICIANS: Morrison on The Doctor Conundrum

Non-plagiarist* whatever anyone says, Ian Morrison has a great article called The Doctor Conundrum, suggesting that doctors are cranky again. Essentially Ian says it's not that we're paying doctors too much--it's that they'd make more as salesmen or futurists. *This...
December 13, 2007 in Physicians | Permalink | Comments (0)

Physicians: Can Computerized Decision Support Get Docs to Toe the Line on Quality? by Robert Wachter

Robert Wachter is widely regarded as a leading figure in the modern patient safety movement. Together with Dr. Lee Goldman, he coined the term "hospitalist" in an influential 1996 essay in The New England Journal of Medicine. His most recent...
November 29, 2007 in Physicians | Permalink | Comments (6)

Physicians: Sermo allowing docs to discuss chart errors about them! by Matthew Holt

Sermo got some press this week about a thread that's of lots of interest to all of us--medical errors and inaccurate records: Several years ago, Botney visited a specialist to check out a bothersome lump in his cheek. He took...
November 26, 2007 in Physicians | Permalink | Comments (0)

OMNI: The Oncology Metrics National Index - Brian Klepper

An innovative Ft. Worth consulting firm comprised of experienced oncology professionals, Oncology Metrics, has linked private oncology practices throughout the country in a collaborative, knowledge-sharing enterprise, called the Oncology Circle. The first round of information brought together 22 practices containing...
August 20, 2007 in Brian Klepper, Pharma, Physicians, Quality, Technology, Web/Tech | Permalink | Comments (5)

Can We Talk, Frankly? - Brian Klepper

Over at The Doctor Weighs In, Bill Bestermann literally grabs our attention and forces feeds us a highly informative, and, dare I say, USEFUL physiology lesson in If You Want To Get It Up - You've Got To Get It...
August 17, 2007 in Blogs, Brian Klepper, Physicians, Quality, THCB | Permalink | Comments (0)

Consultants to Hospitals: Prepare for Transparency - Brian Klepper

We must view and treat the community as the "owner" to whom we are fully accountable. Aggregate financial performance data, aggregate productivity performance and aggregate quality and patient satisfaction data belong in the public realm. How else can consumers make...
August 16, 2007 in Brian Klepper, Health Plans, Hospitals, Physicians, Policy, Policy/Politics, Quality, The Industry | Permalink | Comments (4)

The Presidential Candidates On Health Care

Over at the Huffington Post, Dr. Susan Blumenthal and her team at the DC-based Center for the Study of the Presidency, have released their third in a series of articles comparing the Presidential candidates positions on various aspects of health...
August 15, 2007 in Brian Klepper, Physicians, Policy, Policy/Politics, The Industry | Permalink | Comments (0)

Managed Care Redux - by Brian Klepper

Like democracy, managed care is a great idea. It's just that its rarely been tried. Even so, my guess is that its about to re-emerge in a new, improved form, and possibly with some other name. If the signs around...
August 15, 2007 in Brian Klepper, Health Plans, Hospitals, Physicians, Policy, Policy/Politics, Quality, THCB, The Industry | Permalink | Comments (7)

POLICY/PHYSICIANS: In which I criticize Uwe Reinhardt, really!

Uwe Reinhardt has written to the NY Times about What Doctors Make, and Why. It's great that they print his letter--they should be featuring a whole lot more of his stuff in comparison to their penchant for printing out of...
August 8, 2007 in Physicians, Policy | Permalink | Comments (20)

PHYSICIANS/POLICY: NY Times discovers that FFS is a bad idea

Healthcare 101 from Alex Berenson at the NY Times--Fee for service is a bad idea. Not exactly advanced stuff, but at least it's better than nothing.
July 30, 2007 in Physicians, Policy | Permalink | Comments (2)

PODCAST: Kelsey-Seybold tries to reinvent direct contracting

Kelsey-Seybold, the big multi-specialty group in Houston, TX, has plunged into direct contracting with employers in recent years. You wouldn't expect that type of activity in Texas from a physician group, so I talked to Dr Patrick Carter, the medical...
July 27, 2007 in Physicians, Podcasts | Permalink | Comments (0)

PHYSICIANS: Pou not indicted

Obvious but good news. A Louisiana grand jury refused to indict Anna Pou, the cancer surgeon accused of murdering four seriously ill patients after Hurricane Katrina. Perhaps Mr Foti will see the same fate as the DA in the Duke...
July 24, 2007 in Physicians | Permalink | Comments (0)

PHARMA/PHYSICIANS/HOSPITALS/QUALITY: Busy busy busy

My correspondents have sent me lots of articles today. All worth a read— When Is a Pain Doctor a Drug Pusher? Basically never as far as I can tell but in the DEA’s view any time the DEA feels that...
June 22, 2007 in Hospitals, Pharma, Physicians, Quality | Permalink | Comments (7)

PHYSICIANS: A "black box" for docs by John Irvine

OB-GYN Dr. Gil Mileikowsky was forced from his position at Encino Medical Center in Los Angeles after he testified in a 2003 case involving a medical mistake at the hospital. A day after confirming in court that doctors in his...
June 21, 2007 in irvine, Physicians | Permalink | Comments (4)

PHYSICIANS/PHARMA: Klepper on oncology

Brian Klepper has an excellent piece on the mess in oncology called The cognitive dissonance of conflicted care (over at Pat Salber's blog The Doctor Weighs In).
June 20, 2007 in Pharma, Physicians | Permalink | Comments (6)

PHYSICIANS/HEALTH2.0: Sermo AMA interview

This is the transcript of my interview last month with Sermo’s Daniel Palestrant on the announcement of the deal between Sermo and the AMA Matthew Holt: This is Matthew Holt with The Health Care Blog and a quick impromptu podcast...
June 18, 2007 in Health 2.0, Physicians | Permalink | Comments (2)

HEALTH2.0: Knowledge Prostitution

The powerhouse that is Scott Shreeve, not content with jetting around the US, looking after his newest (and 4th) kid and filling my inbox with amazing stuff, is having a go at prostitutes by comparing them to doctors! Personally I’ve...
June 12, 2007 in Health 2.0, Physicians, Technology | Permalink | Comments (0)

PHYSICIANS/CONSUMERS List prices for doctors?

Healthcare Partners, the biggest physician group to emerge from the carnage of Southern California physician group implosion in the late 1990s is now putting a list price out for some procedures. Why? "It feels like the right thing to do,"...
May 29, 2007 in Consumers, Physicians | Permalink | Comments (9)

PHYSICIANS: An Open Letter to Harvard Medical School By Dr. Terry Bennett

Doctor Terry Bennett became the focus of national attention two years ago when he brusquely told an overweight patient that she was fat, warning that unless she changed her lifestyle she faced serious healthcare problems. The woman complained to the...
May 11, 2007 in Physicians | Permalink | Comments (20)

PHYSICIANS: Bennett YouTube Interview

It turns out that Dr. Bennett is also a supporter of universal healthcare. He recently attended a rally for John Edwards, where Daily Kos caught up with him.
May 11, 2007 in Physicians | Permalink | Comments (1)

PHARMA/PHYSICIANS: ESRD centers having the curtain pulled back

The NY Times shows that apparently doctors owning ESRD centers and others running chemo-infusions centers reap millions for Anemia drugs . Who knew? OK, anyone reading THCB for the past few years knows all about this, but now that it’s...
May 9, 2007 in Pharma, Physicians | Permalink | Comments (9)

PHYSICIANS/PHARMA: Fool me once-shame on you. Fool me twice.....er won't get fooled again? by The Industry Veteran

So there’s been a fair amount of fuss about a new paper by two academics, one a former drug rep, about the tricks big Pharma uses to “fool” physicians when it details them. You may not be impressed and may...
May 1, 2007 in Pharma, Physicians | Permalink | Comments (3)

PODCAST/CONSUMERS/TECH: Interview with Joseph Kvedar, Partners' Connected Health guru

Joseph Kvedar wrote a piece for THCB a couple of weeks back on Connected Health and its potential. As I'm in Boston I dropped in on him in his office at the center of the world's greatest collection of medical...
April 30, 2007 in Hospitals, Physicians, Technology | Permalink | Comments (0)

TECH/PHYSICIANS: The real state of play in eRx, by Jonathan Pearlstein

The very careful reader will have noted that I met a very smart (and, to a rapidly becoming old fogey like me, disturbingly young!) THCB reader, Jonathan Pearlstein at HIMSS. Jon works for the academic survey firm NORC and has...
April 19, 2007 in Physicians, Technology | Permalink | Comments (0)

PODCAST/PHYSICIANS/QUALITY: Interview with David Seligman, CEO of Best Doctors

Here’s the transcript of the interview earlier this week with David Seligman, CEO of Best Doctors. Pretty interesting especially for those of you thinking about how to improve health care quality on a national and perhaps nationally branded level. (By...
April 12, 2007 in Physicians, Podcasts, Quality | Permalink | Comments (4)

PODCAST/PHYSICIANS/QUALITY: Interview with David Seligman, CEO of Best Doctors

This is an interesting podcast (well aren't they all?). I interviewed the CEO of Best Doctors, David Seligman, about his network of second opinion providers and a whole lot more. They're having quite a bit of success selling the service,...
April 10, 2007 in Physicians, Podcasts, Quality | Permalink | Comments (0)

PHYSICIANS: Roy Poses--Academia and used car sales

Roy Poses at Health Care Renewal explains the economics of faculty medical practice. It's like used car sales—minus the integrity. Used care dealers have a goal (to get their sales people to sell cars) which their methods actually may work...
April 6, 2007 in Physicians | Permalink | Comments (0)

POLICY: Is Healthcare a right? By Eric Novack

Food for thought for the weekend… and beyond. Should the immoral in the rest of the business world be trumped by the needs of some people? Would it be ethical for an employer to require overtime and not pay employees...
March 31, 2007 in Eric Novack, Physicians | Permalink | Comments (19)

PHARMA/PYSICIANS: United is getting grumpy at the oncology-industrial complex

While I’ve been focusing on pricking egos in the HBS common room, Greg Pawelski has been keeping vigil on our friends over in the wonderful world of chemo. The main recent development is the FDA issuing a warning about overuse...
March 27, 2007 in Pharma, Physicians | Permalink | Comments (6)

PHYSICIANS/TECH/QUALITY: Tuesday's ACC report will hurt the stent market

The NY Times has an article about how stents are likely to be found to be less useful than would be indicated by the amount of use they get from cardiologists. More bad news for JNJ and BSX, but something...
March 25, 2007 in Physicians, Quality, Technology | Permalink | Comments (1)

POLICY/PHYSICIANS: Reducing waste in US health care systems, by Walter Bradley

Walter Bradley is the Chairman of the Department of Neurology at the school of Medicine at the University of Miami. Previously on TCHB he wrote a piece on how we should solve the uninsurance problem. Today he takes aim at...
March 6, 2007 in Physicians, Policy | Permalink | Comments (3)

PHYSICIANS: CYA Healthcare By Eric Novack

Dr. Eric Novack, THCB's resident orthopedic surgeon and spokesphysician is an angry man today. He is angry about people who go around blaming physicians for high healthcare costs. And he's got something to say about it. What's the real problem?...
February 19, 2007 in Physicians | Permalink | Comments (62)

PHYSICIANS/INTERNATIONAL: GPs making hay in the UK

My dad told me never to become a doctor. As I failed physics "O" Level and wandered off into social sciences that was probably sound counsel for me, but in general his advice may not have been correct. With the...
February 2, 2007 in International, Physicians | Permalink | Comments (1)

TECH/PHYSICIANS/INDUSTRY: Now the Communists have infiltrated the officer ranks!

(Speaker adopts very pompous tone) You may remember a little while back that some left wing seditious journalist criticized the sanctity of our free and opaque market system. He claimed that a leading back surgeon at the Cleveland Clinic --...
January 30, 2007 in Physicians, Technology, The Industry | Permalink | Comments (0)

PHARMA/PHYSICIANS: Big joke-Free CME: Pharmed out doesn't impress The Industry Veteran

THCB regulars will be missing the delicate tones of The Industry Veteran. But never fear, he’s back and none the less caustic for his lay-off from these hallowed electrons. Here’s his take on the new CME for doctors. No doubt...
January 25, 2007 in Pharma, Physicians | Permalink | Comments (17)

PHYSICIANS: Remember, it's a FFS world

Remember kids, almost all physicians work in a FFS world. HSC reminds us: While the proportion of physicians in group practice whose compensation is based in part on quality measures increased from 17.6 percent in 2000-01 to 20.2 percent in...
January 9, 2007 in Physicians | Permalink | Comments (0)

TECH/POLICY/PHYSICIANS:American medical care, or Larry Weed on Speed

(This one is long on links and short on explanation….sorry, but it’s all old ground here on THCB). Larry Weed was at IHI last week using the same line that he was using in 1998 and was probably using for...
December 20, 2006 in Physicians, Policy, Technology | Permalink | Comments (2)

TECH/PHYSICIANS/INDUSTRY: Communists in press stirring up trouble

So a disgruntled reporter is stirring up trouble by daring to question the way medical advances happen in this great nation. Apparently this Joel Rutchick character is suggesting that when respected surgeon Dr. Isador Lieberman and his organization the Cleveland...
December 12, 2006 in Physicians, Technology, The Industry | Permalink | Comments (12)

TECH/PHYSICIANS:Vimo--building business by doing good (or vice versa)

Vimo is donating $1 for every doctor rating posted to the Vimo site during the month of December.
December 12, 2006 in Physicians, Technology | Permalink | Comments (2)

PHYSICIANS: Barry Bonds and the AMA's still got management where they want them

The irony is quite staggering. On the same day that Barry Bonds gets the San Francisco Giants to bid against themselves--appalling the local baseball columnists--and give him $16m for one season in his tarnished chase of Hank Aaron, the Congress...
December 8, 2006 in Physicians | Permalink | Comments (19)

PHYSICIANS/POLICY: NY Times is surprised about its Ps and Qs in Prostate Cancer Therapy

So there are three treatments for prostate cancer. Medicare pays physicians a whole lot more for one (new snazzy non-invasive one that patients prefer too) than the other two. So they rush off to get the necessary equipment and staff-up...
December 4, 2006 in Physicians, Policy | Permalink | Comments (20)

PHYSICIANS: Pity the poor radiologist

They are “frustrated” by Liability and Lifestyle Issues, only 7% them are truly happy—although 70% would do it all over again if they had the chance (more than most other doctors). And only 25% of them make more than $400K...
November 27, 2006 in Physicians | Permalink | Comments (19)

PHYSICIANS: The New York Times--desperate to fill column inches

When I think about all the problems in American health care, many of them the result of the political and clinical choices made by “older and middle-aged physicians (like myself)” (“Myself” being the author of the piece, Dr Erin Marcus...
November 23, 2006 in Physicians | Permalink | Comments (5)

QUALITY/PHYSICIANS: OBGYNs are scientists, scientists I tell you

Interesting long article in the New Yorker by Atul Gawande about How childbirth went industrial. Briefly it’s about how we stopped using all kinds of techniques for getting kids out that required a lot of skill because we started measuring...
November 9, 2006 in Physicians, Quality | Permalink | Comments (2)

PHYSICIANS: I don't think Eric Novack will like this much!

Medicare Cut for Doctors Now Official
November 2, 2006 in Physicians | Permalink | Comments (13)

PHYSICIANS/PHARMA: The New England Journal gets a local examination

Boston Magazine has interesting article about the NEJM. Not the least of the issue is how the local medical society uses it as a cash cow. Well worth a read.
November 1, 2006 in Pharma, Physicians | Permalink | Comments (1)

The Great Balance Billing Scandal By Eric Novack

In California, the possibility exists that the unelected department of insurance, under pressure from the insurance industry and patient advocacy groups, may fundamentally alter the way medicine is practiced. In an effort to get a work around the disgraceful- yet...
October 5, 2006 in Physicians | Permalink | Comments (64)

PHYSICIANS/PHARMA: The oncologists' chemo junket flies above the radar

You may have heard just a few things on THCB from Greg Pawelski, Matt Quinn, me and others about the oncologist prescribing franchise, and how it might just change physicians’ behavior a tad. Well Greg informs me that last Thursday...
September 25, 2006 in Pharma, Physicians | Permalink | Comments (16)

PHYSICIANS/QUALITY: Getting the Cedars-Sinai docs to change behavior

Pretty interesting article from the Freakonomics guys about the large efforts it took to get docs at Cedars Sinai to change a relatively simple behavior with a big impact on patient safety— washing their hands. One gets the impression the...
September 25, 2006 in Physicians, Quality | Permalink | Comments (1)

PHYSICIANS: Dr. Mom sounds off

Angela Heider is no longer practicing as an OBGYN, and has written a book about why not, called The Rise and Fall of Dr. Mom: Women, the Health Care Crisis, and the Future. What went wrong? Well she starts to...
September 22, 2006 in Physicians | Permalink | Comments (13)

PHYSICIANS: Venting about the AMA, just a bit

I'm up at Spot-on trying to put the AMA's current push polling in perspective. Don't expect me to be too nice. Cruel, but fair.
September 14, 2006 in Physicians | Permalink | Comments (11)

PHYSICIANS/PHARMA/TECH: A take on the news, sort of

Things we already knew: Doctors are poor at judging their own abilities. It’s a bit like everyone says they’re a good driver, but that 75% of drivers are terrible. Merck earnestly believes that it was as pure as the driven...
September 7, 2006 in Pharma, Physicians, Technology | Permalink | Comments (1)

QUALITY/PHYSICIANS/POLICY/POLITICS: Hmm...."questiions" about those chemo payments

Chemotherapy; Part B "reforms"; bribes to doctors; taxpayer and Medicare patients bilked. Have we heard any of this before? (I’m sure we’ll hear from Greg soon!)
August 30, 2006 in Physicians, Policy, Policy/Politics, Quality | Permalink | Comments (5)

PHYSICIANS: More on the problems of primary care

Robin Cook has the solution for the woes of primary care physicians in the New York Times! They should write best-selling novels…or perhaps he means join mutli-specialty group practices.
August 29, 2006 in Physicians | Permalink | Comments (2)

PHYSICIANS/HOSPITALS/POLICY: Explaining practice variation to the masses

I'm up over at Spot-on trying to explain practice variation to the masses. Let me know how I did back here.
August 24, 2006 in Hospitals, Physicians, Policy | Permalink | Comments (31)

PHYSICIANS: Ed Goldman podcast transcript

This is the transcript from the interview/podcast I did with Ed Goldman from MDVIP a week or so back. (The transcript was done very well and very affordably by castingwords. I just gave it a light readability edit) Matthew Holt:...
August 23, 2006 in Physicians, Podcasts | Permalink | Comments (1)

PHYSICIANS: Patient comments on overuse

The NY Times asked. Have you ever suspected that a physician had financial incentives for recommending a medical treatment to you? One day later they have 236 comments from readers. almost all uniformly going after doctors and dentists for overtreatment....
August 22, 2006 in Physicians | Permalink | Comments (8)

PHYSICIANS/POLICY: Concierge Medicine-Interview with Ed Goldman MDVIP

Does primary care have a future? And is that future a version of concierge medicine? It's very early days, but yesterday I had a great conversation with Ed Goldman, CEO of MDVIP, a franchise concierge medicine company. He has some...
August 16, 2006 in Concierge medicine, Physicians, Podcasts | Permalink | Comments (74)

PHYSICIANS: The sky is falling

Mark McClellan says that Medicare payments to physicians are going down 5%. This of course is leading to political pressure, with the President of the AMA writing op-eds showing that the sky is indeed falling on the heads of seniors....
August 9, 2006 in Physicians | Permalink | Comments (46)

PHYSICIANS/POLICY: Where's the outrage? by Eric Novack

Eric Novack is a bitter, twisted physician (just kidding Eric!)in fact he's outraged! Why? Apparently he wants to be paid on time and doesn't want to work for free! Read on: Where is the outrage? Where are the NY Times...
August 2, 2006 in Physicians, Policy | Permalink | Comments (8)

HEALTH PLANS/PHYSICIANS/TECH:Health care, the way it should be (or How to stop worrying and learn to love the bomb), by Pat Salber

Pat Salber writes The Doctor Weighs In. She is a doc, an ex-med director at California blue shield, and a Kaiser Permanente member. And she loves them. This is why, and it’s quite an advertorial for Kaiser and an indictment...
July 28, 2006 in Health Plans, Physicians, Technology | Permalink | Comments (26)

QUALIY/PHYSICIANS: P4P in the United Kingdom

The biggest P4P scheme in the world is going on in the UK, one that I first wrote about in early 2004. (For more on the wider ramifications of reform in the UK ,see yet another article in this weeks...
July 27, 2006 in Physicians, Quality | Permalink | Comments (2)

TECH/QUALITY/PHYSICIANS: Healthcare and The Long Tail - Searching for help when you’re on the wrong-end of the curve by Jim Walker

Two things have got my attention recently. The first is the concept of the long tail in medicine, which I've thought about alot since my fiancee got an odd condition (shortness of breath) that didn’t match any of the symptoms...
July 26, 2006 in Physicians, Quality, Technology | Permalink | Comments (5)

QUALITY/PHYSICIANS: Just what we need now, another grandstanding politician on end of life issues

I’ve been having a backchat email with the people from the Tenet Shareholders Committee. They are enjoying the legal attack on the Louisiana physician who is supposed to have performed a mercy killing or provided ample pain medication at Tenet’s...
July 20, 2006 in Physicians, Quality | Permalink | Comments (6)

PHYSICIANS/INDUSTRY: Retail clinics

I recently met Michael Howe who is CEO of MinuteClinic, and he had the good graces to call me back and talk on the day that they sold out to CVS. Very classy as it would have been easy to...
July 19, 2006 in Physicians, The Industry | Permalink | Comments (6)

PHARMA/CONSUMERS: Med Solutions

This is more of a public service announcement, but Med Solutions offers a service which can put you in touch with all the patient assistance programs from big Pharma. It looks to be well worth checking out if you need...
July 19, 2006 in Physicians | Permalink | Comments (0)

QUALITY/PHYSICIANS: Klein on malpractice

Ezra Klein has written a pretty good state of play about Medical Malpractice over at Slate. As you know I’m all for putting the solution for malpractice within the context of an overall medical error/practice guideline/EBM policy. Of course, politically...
July 11, 2006 in Physicians, Quality | Permalink | Comments (0)

POLICY/PHYSICIANS: Too many doctors

Dartmouth worthy David Goodman has an op-ed in the NY Times called Too Many Doctors in the House. It makes the arguments that you all know well, but it does contain this lovely zinger. The association of medical colleges has...
July 10, 2006 in Physicians, Quality | Permalink | Comments (3)

PHARMA/PHYSICIANS: Yet more on Rx data sales

The NEJM has a perspective about the sale of Rx data of physicians prescribing patterns, which caused a lot of fuss on THCB a while back. In my view this is problem about number 728 on the docket of what's...
June 29, 2006 in Pharma, Physicians | Permalink | Comments (2)

PHYSICIANS/POLICY: Brian Klepper on the end of life as we know it, or something like that

Brian Klepper was recently up at Medscape bemoaning the lack of physician leadership in righting the troubled ship of our health care system, and challenging physicians to do better. He got lots of feedback, not all of it as negative...
June 23, 2006 in Physicians, Policy | Permalink | Comments (4)

PHYSICIANS/TECH/POLICY/POLITICS: Hard to generate savings when you spend more, eh?

The real medical story of the day is of course Michael Owen’s torn ACL, which leaves the idiot Swede’s decision to take only one fully fit striker plus a kid he won’t play to Germany as dumb as they come....
June 21, 2006 in Physicians, Policy/Politics, Technology | Permalink | Comments (1)

PHYSICIANS/POLICY: Physician Shortage Looms--hold onto your wallet

Quoting a bunch of head hunters and a rural doc who can't find anyone willing to move to Ukiah, the Los Angeles Times says this: A looming doctor shortage threatens to create a national healthcare crisis by further limiting access...
June 5, 2006 in Physicians, Policy | Permalink | Comments (10)

PHYSICIANS/PHARMA/POLICY: More Friday fun

I was checking out potential book titles when I cam across this site, Health Care for Dummies. Given that I’ve spent some of the week beating up on the AMA, and spent some of yesterday touching on why the health...
May 26, 2006 in Pharma, Physicians, Policy, Policy/Politics | Permalink | Comments (5)

TECH/HEALTH PLANS/PHYSICIANS: Let's hire this PR firm!

To those of you who’ve been paying attention, this may not exactly be news. Apparently, health insurers don’t pay claims immediately and deny some of them. But it is news because practice management/billing company AthenaHealth has quantified the numbers across...
May 25, 2006 in Health Plans, Physicians, Technology | Permalink | Comments (5) | TrackBack

POLICY/PHYSICIANS: More on the AMA

So why did I get so grumpy with the secretary of the AMA and his talk at TEPR. I actually stood up and asked a long question which he interrupted to tell a bunch of lies about Canada, ignoring that...
May 25, 2006 in Physicians, Policy | Permalink | Comments (11) | TrackBack

PHYSICIANS/TECH: The intransigence of the AMA knows no bounds

Here’s what I wrote for FierceHealthcare today. Attendees at the 22nd annual TEPR meeting could be forgiven for being a little anxious about the future. Conference organizer and Medical Records Institute Peter Waegemann put out a call for action, noting...
May 23, 2006 in Physicians, Technology | Permalink | Comments (11) | TrackBack

HOSPITALS/PHYSICIANS: E-mail leads to doc lawsuit in Jefferson Health System

Dig into this story -- It's a juicy one "E-mail leads to doc lawsuit in Jefferson Health System" Sounds like there's a little war over patient ownership going on...just in case you forgot your hospital econ 101.
May 17, 2006 in Hospitals, Physicians | Permalink | Comments (0) | TrackBack

PHYSICIANS/BLOGS: Disheartened? Maybe

I love people commenting on THCB, and 99% of the comments are very, very thoughtful. But I am a little dismayed that while only one person wants to comment on my long piece on the individual insurance market, one other...
May 11, 2006 in Blogs, Physicians | Permalink | Comments (8) | TrackBack

PHYSICIANS/POLICY/POLITICS: Malpractice insurance--much cheaper than 1986

This one will get some “discussion” going. Health Affairs has an article showing that malpractice premiums are much lower as a share of physician practice revenues than they were 20 years ago!
May 8, 2006 in Physicians, Policy, Policy/Politics | Permalink | Comments (30) | TrackBack

PHARMA/PHYSICIANS: Attacking the Rx data stream

So perhaps this is getting serious. Doctors Object to Gathering of Drug Data If the A.M.A effort succeeds, "legislators will turn their attention elsewhere, and the industry can hang on to one of its most valuable data sources," according to...
May 4, 2006 in Pharma, Physicians | Permalink | Comments (60) | TrackBack

POLICY/PHARMA/TECH/PHYSICIANS: The Industry Veteran thinks Uwe and McLellan are missing the point

It’s been a while since we heard from The Industry Veteran, but the dialogue between Mark McClellan and Uwe Reinhardt I reported on at WHCC last week did raise his hackles. I love Uwe’s analysis and think McLellan is very...
April 26, 2006 in Physicians, Policy, Policy/Politics, Technology | Permalink | Comments (21) | TrackBack

HOSPITAL/PHYSICIANS/POLICY/POLITICS: Hubbard, transparency, clarity, earth & water, mixed

Today, direct your attention over to Spot-on, where I’m up with my summary over Hubbard’s arguments with providers over price transparency—it’s called Clear as Mud. As ever you can come back here to comment. Somehow this topic tends to get...
April 21, 2006 in Hospitals, Physicians, Policy, Policy/Politics | Permalink | Comments (36)

TECH: Just another EMR puff piece....on Cerner?

Anyone who's ever read Fast Company won't be surprised at the slightly breathless tones used in one of their typical "business gets new process, struggles a little at first, then succeeds beyond its wildest dreams" plot line. After all this...
April 18, 2006 in Physicians, Technology | Permalink | Comments (1)

POLICY/PHYSICIANS: Another crazy doc in favor of single payer

Yet another crazy doctor decides that the hassle of dealing with 301 separate insurers is just too much and that he, was well as everyone else but the insurance industry, would be better off with a national single payer system....
April 18, 2006 in Physicians, Policy | Permalink | Comments (0)

POLICY/PHYSICIANS: Mother of all comment threads

If you haven’t been reading, there are now some 46 long detailed and excellent comments in the article called Can the real HSA fan, please stand, please stand up?. Speaking as someone who’s been through the academic mill, this comment...
April 13, 2006 in Physicians, Policy, Policy/Politics | Permalink | Comments (0)

PHYSICIANS: Doctors In Demand

Now given that 30% of activity in health care is waste motion, this shouldn’t be the case, but apparently it is and doctors are in high demand. So the next time you catch one pissing and moaning about their life/income,...
April 3, 2006 in Physicians | Permalink | Comments (37)

POLICY/PHYSICIANS: Mystery Pollster The AMA Spring Break Survey

For those of you curious about the AMA’s recent “Girls Gone Wild” survey, some interesting stuff from Mystery Pollster. Here’s Part 1 and here’s Part 2. If you look deep in the comments about Part 2 you’ll see my cynical...
March 31, 2006 in Physicians, Policy | Permalink | Comments (1)