Dr. Niran Al-Agba

Free-market Medicine: Can Independent Practices Stay Viable Using Price Transparency?

I need a light, a stethoscope, and a pen to heal and comfort human beings; the rest is basically nonessential. This Mexican physician and I fundamentally do the same thing every day; except he has no receptionist, no billing personnel, no manager, no administrator, no care coordinator, and definitely NO EMR in his emergency clinic. He documented the visit in less than 3 minutes (like I do), signed it, and handed me the top page for my records. His care was good, his skills were solid, and his decision-making sound; I would have treated any other child the same way.

Niran Al-Agba2020-05-14T03:25:58+00:00February 10, 2017|Categories: Policy, Practice|Tags: Burnout, Free Market, Independent Practice, Physician Autonomy|

Inseparable: The Physician and The Mother

As physicians, we do our best to set patients up for successful futures. This instruction can begin when a person is a few days old and may continue for a lifetime. In primary care, we observe children grow into adults, finish their educations, and embark on families of their very own. The single greatest aspect of medicine for me has been to realize the impact our lasting relationships can have; something that was facilitated by being a female physician.

Niran Al-Agba2020-05-14T03:24:45+00:00February 3, 2017|Categories: Patient, Physician|Tags: Parenting, Patient Physician Relationship, Physician Mother|

Mylan May Have Been “The Shot Heard Round the World”

U.S. Healthcare needs a revolution; ‘the shot heard round the world’ frequently refers to the opening shots of the American Revolution in 1775. The Big Pharma lobby is holding the American people hostage with their exorbitant ransom demands. Last summer, Mylan Pharmaceuticals, led by CEO Heather Bresch, overplayed their hand. Mylan came under fire for a 400% price increase in the EpiPen two-pack. This device is considered life-saving for children and adults with anaphylactic reactions to various food, insect, or environmental insults. Ms. Bresch insisted the significant price increase ($600-$700 for a medication which costs pennies) was justified due to the more ergonomic appearance of the delivery device and improved safety profile.

Niran Al-Agba2020-05-14T03:23:39+00:00January 27, 2017|Categories: Patient, Policy|Tags: Affordable Care, Corporatization, Corruption, Epi Pen, Health Policy, Mylan, Transparency|

Taking Our Seat at the Table: The Practicing Physicians of America

Physicians must stand up and be counted. Our time is now. Practicing physicians can deliver valuable insight and novel perspective on how to enact change. We must give the power to make healthcare decisions back to the patient and their doctor, rather than to the insurance and pharmaceutical industries.

Niran Al-Agba2020-05-14T03:22:03+00:00January 26, 2017|Categories: Physician|Tags: Anti-MOC, Burnout, MOC, MOC Reform, Patient Physician Relationship, Physician Advocacy, Physician Autonomy, PPA ACA|

Meaningful Use: A Bird’s Eye View from the Penalty Box

Welcome to the penalty box, with no term limit. Every single visit, procedure, counseling session, or medical intervention will have 2% shaved off the top. The average family physician receives about $100,000 a year in Medicare reimbursements, so a 2% penalty for 2017 will become 3% in 2018, and increase to 4% in 2019—a combined three-year total of $9,000.

Niran Al-Agba2020-05-04T01:54:53+00:00January 24, 2017|Categories: Policy, Practice|Tags: Burnout, EHR, EMR, MACRA, Meaningful Use, MIPS, Penalty|

The Greatest Blessing

I often wonder who has been the greatest blessing to whom. A physician bears witness to the direct impact we have on the lives of other human beings. What a rare treasure to behold! As physicians, our journey is riddled with successes and failures. Yet, my love and dedication to this noble and rewarding profession is instantaneously revitalized when a young person wanders into my office and reminds me of a time when we overcame such insurmountable odds together.

Niran Al-Agba2020-05-04T01:51:40+00:00January 17, 2017|Categories: Patient|Tags: Child Death, DIC, Mononucleosis, Patient Physician Relationship|

Let’s Make Vaccines Great Again!

How far should a medical director of a large scientific institution be allowed to veer off the path of mainstream medical science? A medical doctor employed at a large, prestigious medical institution has an obligation to his patients, his colleagues, and the general public at large.

Niran Al-Agba2020-05-04T01:48:51+00:00January 11, 2017|Categories: Patient, Policy|Tags: Anti-Vax, Immunizations, Vaccination|

Mumps, Cheek Bumps, and Testicle Lumps

So what does this mean exactly? Most likely the mumps portion of the MMR vaccine is less effective in the Marshallese population in particular due to some genetic difference in their immune response. It is also possible this virus is “drifting” by changing a protein here or there or an H or N molecule as similar to the influenza virus. So all in all, there are likely small changes in the natural mumps virus altering the landscape for everyone; however those with Marshallese background are naturally more susceptible.

Niran Al-Agba2020-05-04T01:42:27+00:00January 4, 2017|Categories: Patient|Tags: Immunizations, Measles, MMR, Mumps, Rubella, Vaccinations|

Does Life Expectancy Matter?

Health policy experts, IT executives, and politicians jumped on the ACA, HITECH, and MACRA bandwagon while clinging tightly to their misguided belief that more electronic records, ACO’s, care coordinators, administrators, pay for performance schemes, and other fads or gimmicks would improve health outcomes; it turns out one of the most fundamental measures of healthcare quality, our life expectancy, is no better than before.

Niran Al-Agba2020-05-04T01:38:47+00:00December 20, 2016|Categories: Patient, Policy|Tags: Government Medicine, Health Policy, Life Expectancy, Metrics|

The Price is Basically Right

Choice for all of us has evaporated from the system in many small rural areas suffering from physician shortages already. Frustration at the overwhelming increases in insurance premiums is palpable everywhere in this country. Maybe it is time to give Dr. Price and Seema Verma a chance. There will be many compromises as in all things, but allowing physicians and patients more control over their lives and livelihoods is a revolution worth celebrating.

Niran Al-Agba2020-05-04T01:34:33+00:00December 9, 2016|Categories: Policy|Tags: Health Policy, Tom Price|

Niran

About Niran Al-Agba