I’m continuing my series on the reasons there are so few family physicians in the U.S. and why the Center for Medicare and Medicaid Services (CMS) is a root cause of this deficit. My conclusions are based on recent research on the topic. In my last post, I showed how the...
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For the next several weeks, I’ll try to explain to non-physician readers why the Center for Medicare and Medicaid Services (CMS) billing rules create the horrid lack of primary care patients experience when they simply want to find a personal physician. My conclusions are based on recent research on the topic....
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OK, I’m back. (I had several weeks of intense work and family obligations). And OK, I’m going to go for it with the payment reform stuff. I will spend the next several weeks trying to explain to a general audience why the payment system for physicians is extremely rigged in favor...
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I know some of you have seen this already, but I thought I’d broadcast this piece one more time. This is a link to a post I wrote for Primary Care Progress. In it, I talk about examples of how family physicians are still faithfully serving the needs of nearly 70...
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Here we go again. There is yet another round of evidence of how the physician workforce hole we’ve dug for ourselves keeps getting deeper, but there has been still no substantive payment reform on the government side (Medicare/Medicaid) or the private payer side. One recent study appeared in the journal Academic...
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I’m re-posting a piece I wrote 3 years ago. It still applies today. I realize I’ve griped a lot in my previous posts, though I don’t see myself as a nattering nabob of negativism. For problems to be fixed they first must be identified, and our healthcare system has lots of...
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Yet another study has documented the obvious: that the Medicare fee schedule is heavily weighted to favor procedural services. Sinsky and Dugdale added to the previous documentation of this institutional bigotry by being sure to capture the other demands on physician time besides the procedure itself. This includes time spent talking...
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To finish out my complaining about Dr. Oz for this cycle, I want to go back to the New Yorker article on him that appeared earlier this year. A quote from the article: “As Oz likes to say, Marcus Welby—the kindly, accessible, but straight-talking television doctor—is dead.” Assuming he really said...
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Continuing my discussion of the findings in our recently published study on the ways family physicians deliver better care at a lower cost than a multi-ologist model, today I will talk about how family physicians deliver care at lower cost facilities. I think I’ll make this post on the cost-effectiveness of...
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Continuing my discussion of the findings in our recently published study on the ways family physicians deliver better care at a lower cost than a multi-ologist model, today I will talk about how family physicians actually talk their patients out of expensive wasteful tests and treatments. I saw this occur multiple...
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