First, a bit of old business. A friend asked me if the Medicare benefits and taxes figures I quoted last weak were adjusted for net present value. The dollar amounts quoted were in 2010 dollars adjusting for inflation, so yes, they were adjusted for net present value. The link to the...
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It’s been interesting watching the political maneuvering since Newt Gingrich criticized the plan to reduce the federal budget deficit proposed by the House Budget Committee Chair Paul Ryan of Wisconsin. After receiving push back from fellow Republicans, Gingrich spent the week backpedaling from his earlier remarks. Many pundits have recognized Ryan...
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When the quality improvement movement first started in medicine, I was all for it. The principle that you can’t fix what you can’t measure resonated with me. I felt that individual physicians and systems should be accountable to the people paying the freight and our patients. Doubt should have started creeping...
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Happy Mother’s Day to all the moms. In honor of this day, let’s talk about raising young family physicians. Though the match in family medicine for residency slots was a little better this year than last year, it is still miles from where it needs to be. Only a little over...
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My local newspaper prints the You Docs column 3 days a week and I’ve been reading it for over two years. I can’t say I’ve read every column in that time, but I can say most of them. There is a clear pattern to their writing and thinking. In the column...
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A colleague in private practice, Dr. S of Plano, TX, sent me the following note he gave me permission to share: Since the beginning of 2011, we’ve observed a disturbing trend among our patients’ new insurance plans. At least two major payors (Aetna and Cigna) are now offering $0 or reduced...
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A study in the New England Journal of Medicine several months ago presented findings on a new medicine to prevent a deep vein thrombosis, which is a blood clot in one of the larger veins of the leg. These clots are usually more of an annoyance than dangerous, though the worst...
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An article in Health Affairs documented well what all of us know in front-line medicine: patients who don’t feel well go the emergeny room. The study looked at data from a national survey and found that a minority of patients see their primary physicians (42%) for first-contact care, with visits to...
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This means your children and grandchildren are now saddled with even more of the financial burden of the excesses of this generation. It came as no surprise that Medicare approved the  new prostate cancer drug Provenge. It had to. The laws governing Medicare say it has to cover all therapies that...
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There have been 10 controlled trials of mammograms and not all of them were randomized controlled trials. We need another. Treatment for breast cancer has improved since the advent of mammography. Drugs like tamoxifen and trastuzumab have improved survival in selected patients (though trastuzumab costs a fortune, but it actually helps)....
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