Category Archives: General Interest

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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Rolf McMillan Gunnar, MD, MACP, MACC 1/22/1926 – 3/18/2017 – An Appreciation.

Dr. Rolf M. Gunnar died after a battle with Cancer. The Chicago medical community and the world lost a compassionate, and brilliant man. I met Dr. Gunnar when I was an intern at Cook County Hospital in 1966. My resident, … 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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How Can We Align Incentives As We Move From Volume to Value?

Changing payment for health care from volume to value will be facilitated if the stakeholders keep a close eye on “What’s in it for me” Continue reading

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How Do We Use Statistics?

How we utilize Statistical Inference is indeed a critical piece in the evaluation of new information in the Biomedical Literature. Continue reading

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What Happens to my medical information? Where is it?

In this week’s MedPage, a medical information website, there is a post, by Dr. Leonard Lichtenfeld, about sharing personal health data. He was asked to sign a consent for information sharing that may have essentially taken away from him any … Continue reading

Posted in General Interest, Health Informtion Exchange, Medical Records, Personal Health Record | 1 Comment

Helping our Patients and Ourselves Navigate the Internet for Reliable Health Information.

In June 2015 Dr. Arthur Caplan opined on Medscape that physicians should be prepared to help patients in some way as they try to navigate the morass of medical information that is available on the Internet[i]. One oft quoted study … Continue reading

Posted in General Interest, Health Information, Health Informtion Exchange, Literature | 11 Comments

Dr. Gawande has done it again – almost – a review of “Being Mortal”; Gawande, Atul; Metropolitan Books; New York; 2014

This book is almost on track to be a potential game changer. The title is engaging. However, on my first reading, I found the book a little difficult to follow. Dr. Gawande has essentially written about two distinct components of … 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

Posted in General Interest, Leadership, Policy | 2 Comments

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

Posted in General Interest, Policy, Quality, treatment options | 2 Comments