"Hospitals Not-Profit Full"

Was Zach of 'Rage Against the Machine' implying what we're all thinking now?

How many non-profit hospitals/hospital systems truly deserve their non-profit status?

Should they be competing with the for-profit systems in the same way?

No Shows

"No Shows" are a thorn in our sides.

A recent article suggests taking the approach that the airlines take...to overbook.

Is the ideal of immediate access, no wait time, plenty of time with your physician, and quality care reasonable?

Is Primary Care Dead? And Do YOU Feel Fine?

From "Musings of a Distractible Mind":

Notice the subtle strife between internal medicine and family medicine, with the assumption that family physicians see less complex patients.

Notice that some primary care physicians are doing well...also note that this is in the Southeastern US, where reimbursement rates are higher overall.

Paging Dr. Gupta: The Anti-Vaccine Crowd is Calling

Should Dr. Gupta stimulate conversation around a controversial topic (vaccinations), or should he share what he knows (or should know) about the data?

The heated commentary sure increases hits.

Sick Visits Always Win

Even when patients come in for preventive services, their satisfaction depends on whether or not the "pain" or "illness" that they have at the same time is addressed.

So when someone comes in for a physical, many times they really have something specific they're worried about.

Do you address the preventive care, or do you address the illness?

(Or do you address both and eat the cost of one?)

If you want us to focus on wellness, you've got to pay for it....this is the bottom line.

Medicare Will Pay for "Heart Scans"! WTF?

You've got to be fucking kidding me.

Medicare has agreed to pay for heart imaging studies?

What the fuck?

Let's not pay for things for which there is clear evidence (or at least not pay adequately for them), and let's pay for cardiac imaging, for which there has been no clear impact on morbidity and mortality.

It looks like the American College of Cardiology and the American College of Radiology (along with a number of pseudo-organizations, such as the Society of Cardiovascular Computed Tomography) are our heroes here.

Of course, the rest of us know that they're behind this because it leads to more interventional cardiology procedures. One can never do enough stenting, you know...

In the meantime CVT surgeons are getting screwed, despite the fact that they've got a superior intervention....and the folks that are behind aggressive medical management are REALLY screwed.

This decision so perfectly demonstrates why complete anarchy is necessary to reform our health system. The whole fucking thing needs to be blown up:

• Incentives are skewed to benefit the high-tech proceduralists, independent of evidence.
• The average person is brainwashed to believe that they need these things.
• People get things that they don't need, and they get hurt.
• The system pays for the complications.
• There's little money left for the physicians that do the work to lower costs and improve outcomes for the system.
• Medicare's decision here leads to unnecessary testing and intervention, and thus more intervention without benefit.

How can it be possible to have true health care reform without saying 'no' to some things???

Can P4P Programs Increase Racial Disparities in Health Care?

If it meant more money for your work, would you see anyone but white men?

Racial disparities just might be enhanced by pay-for-performance (P4P) initiatives, whether or not they are intentional.

Read the article from Health Affairs.