The Politics of Healthcare from the Front Lines

15 Ways You Know Mom is a Pediatrician

“If you get bit by a dog, then you will get rabies.” – 4 year old daughter “You mostly get rabies from bats.” – 7 year old son “Dogs get shots to protect them from rabies.” – 5 year old son “OK, phew.” – 4 year old daughter very relieved “Umm, how about we try to avoid getting bit by dogs?”–Mom preferring prevention strategy

2020-05-03T23:01:07+00:00July 22, 2016|Categories: Uncategorized|Tags: , , , |

Going Rogue

As the reality of MACRA (Medicare Access and CHIP Reauthorization Act of 2015) looms, the pressure is on small practices to survive. CMS plans to penalize 87% of solo physicians and reward bonuses to 81% of practices with more than 100 physicians. It is time for passive resistance, defined as protesting against a law using peaceful methods such as refusing to obey or refusing to leave a building. I vehemently refuse to leave the building.

2020-05-03T23:02:44+00:00July 20, 2016|Categories: Practice|Tags: , , , , |

Dear Mr. Slavitt, Please Come Visit My Office.

My county with a population of 260,000 has NO psychiatrist. Not one. Many states all over are experiencing the same provider shortages. Can you grow psychiatrists somewhere at an accelerated rate, like that clone army in Star Wars, and drop them randomly by plane throughout the United States? That would be a good start. They could be raised to believe indentured servitude is their destiny.

2020-05-03T23:08:20+00:00July 12, 2016|Categories: Policy, Practice|Tags: , , , , |

CMS + MIPS/APM = Death of the Private Practice Physician.

We should pay physicians for time spent engaging patients in conversation, instead of rewarding them for checking boxes on a computer screen. Physicians were trained to care and comfort people, not chase blood pressure numbers and pain scale scores. Changes masquerading as meaningful have only increased physician workload. We are widgets in the ever expanding assembly line. Do you think the MIPS will give us more time to practice medicine? If you believe it will, then I have a bridge to sell you.

Dehydration and the Need for Oral Rehydration Solution

A recent, ground breaking article in the Journal of Pediatrics studied aggressive management for children with Ebola less than 5 years of age. Mortality (death) rate in previous outbreaks was estimated at 75-80%. With this new protocol, during an outbreak in Sierra Leone, they were able to reduce mortality to 31%. That is a HUGE achievement.

2020-05-03T16:57:13+00:00June 23, 2016|Categories: Patient|Tags: , , , , , |

The Promise of a Rainbow

Throughout our careers, we are privileged to share in the overwhelming joy of others, yet bear witness to much human suffering that leaves scars on our souls. I wish these parents knew how deeply their son touched us all in the NICU that day. Rainbows are not just a collection of colors as we look out upon the horizon; they are promises for our hearts.

2020-05-03T16:58:58+00:00June 21, 2016|Categories: Patient|Tags: , , |
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