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Why The Government Tried To Fix Primary Care And Failed
ByadminAmericans spend more per-capita on medical care than just about any other country and, yet, they often have little to show for it. Americans have worse access to care than people in other countries, and are often less likely to receive primary care services, like preventive therapies and screening tests. Determined to address these problems,…
Rural Voters Elected President Trump. Is He about to Ruin Their Local Hospitals?
ByadminIt’s not an easy time to be a small, rural hospital. Insurance companies aren’t willing to pay generously for your services, given your measly market share. You are increasingly forced to compete against large integrated healthcare systems – conglomerations of urban, suburban and rural providers armed with big marketing budgets and specialized (generously reimbursed!) services….
If We Cut Surgical Pay, Will Surgeons Cut into More People?
ByadminShutterstock Knee replacements are booming. Between 2005 and 2015, the number of knee replacement procedures in the U.S. doubled, to more than one million. Experts think the figure might rise 6-fold more in the next couple decades, because of our aging population. Since many people receiving knee replacements are elderly, Medicare picks up most of…
The Healthcare Efficiency Myth – What Really Happens When Doctors And Hospitals Join Forces
ByadminFor much of the history of U.S. medical care, hospitals and physicians have existed as separate financial entities. Physicians in the U.S. have typically been self-employed, as solo or group practitioners and not as hospital employees. An internist like me might have admitting privileges to several local hospitals. When we admit patients to one of…
Influencing Young Minds
ByadminI really like teaching Duke undergraduates. They are an ambitious and intelligent group. But sometimes their ambition and intelligence get in the way of creative thinking, especially in regards to careers. They all want to remain high achievers, so they know they must either become doctors, lawyers, investment bankers or business consultants. Not infrequently I…
Is It Fair to Reward Medicaid Patients for Receiving Flu Shots?
ByadminMy son was underperforming at school, and I was gently encouraging him to try harder (if gesticulating like an over caffeinated Italian qualifies as gentle encouragement). He could not understand why I was upset: “Dad, most of my friends are doing drugs and engaging in unprotected sex. You should be rewarding me for being such…

