Category Archives: Policy

Why has respect for Medicine and Physicians largely evaporated?

Most, physicians choose to enter Medicine for more than “just” income opportunities. They are also motivated by altruism, and a desire to do good for the communities in which they served[i]. Physicians anticipated respect, which came from appropriately applying their … Continue reading

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Cook County’s Sweetened Beverage Tax of November 2016 – It’s A Matter of Choice!

The Cook County of Illinois Board enacted a Sweetened Beverage Tax. The purpose of the tax was twofold. Every tax is is intended to increase revenue. This is no exception. However, the tax is a “choice tax”, that people can choose not to pay, by not buying drinks with added sweeteners. If people don’t add sugar to their diet, every expectation is that obesity and its complications will become less prominent. This will be associated with reduced health care costs. Continue reading

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Some thoughts on Health Care Legislation 2010 to 2017.

Legislation to overcome some of the flaws of the Patient Protection and Affordable Care Act (Obamacare) is flawed. The Senate and House bills are not as different as had been originally hoped. Insurance reforms may be overcome with “waivers” and Medicaid is being drastically changed. The individual mandate appears to have been continued, under different guises, in both bills. Continue reading

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What is Quality in Medicine? – It Isn’t Easy!

The definition of Quality in Medicine is in the eye of the beholder. There are several good paradigms, but they all look at different components of the overall concept. Continue reading

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We have “Information Overload” in Clinical Guidelines.

Guidelines should be useful to the provider of health care. However, there are more guidelines than can be digested by these providers. This may make guidelines less useful than intended. Continue reading

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General Shineski Needn’t Have Been Ousted – He Was Betrayed

At the end of May, after a series of exposés and congressional hearings, General Eric Shinseki, was pressured to resign as Secretary of the Department of Veterans’ Affairs… Could the VA scandal have been prevented? – In all likelihood yes. Would it have been easy to prevent? – No. Continue reading

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Diagnosis may be the Achilles Heel of Incentive Based Payment.

“Diagnosis is the mental act of selecting the one explanation most compatible with all the facts of clinical observation”.  – Raymond Adams in Harrison’s Principles of Internal Medicine – 4th edition In almost all instances, Government and other third party … Continue reading

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Providers, Patient Care Delivery and Policy: Hospitalist story

There are often perverse incentives in health care. These incentives can, at times, create competing drives where providers are encouraged to do things that directly increase the costs of care.  Consider the reaction to the mandate to cut down hours … Continue reading

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We should work to Identify Problems rather than try to Fix Blame in Medical Service delivery.

Recently there have been stories of inappropriate cardiac procedures being. There are at least four glaring examples of instances in which cardiologists have acted in a way that was not consistent with what others would have considered optimal patient care. … Continue reading

Posted in CV, Peer Review, Policy, Quality, treatment options | 3 Comments

Who is responsible? Is there Enough Accountability in Medicine?

The Alligator Allegory reads: “ The objective of all dedicated employees should be: To thoroughly analyze all situations, Anticipate all problems prior to their occurrence, Have answers for these problems, And Move swiftly to solve these problems when called upon. … Continue reading

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