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.
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.
On November 8th America elected a President who ran on the promise to restore government of the people, by the people, for the people (among other things). However, we cannot expect such (continue reading →)
The world is not going to end. We witnessed a revolution earlier this week. The people have spoken and they chose the anti-establishment, street smart, government shrinking candidate who bucks the status (continue reading →)
Should patients fire their doctors if they suspect burnout? In a recent PBS interview, Dr. Noseworthy suggested patients should “change physicians” when faced with non-empathetic doctors suffering from burnout. His cavalier resolution (continue reading →)
Whether applied to policymaking for individuals, large populations, or administration of health services nationwide, it is imperative regulatory decisions be anchored to empirical evidence. The official MACRA rule has now been released. (continue reading →)
Independent physicians are at the beginning of a challenging movement as we fight to stay relevant and solvent during the transition of health care from independence to “regulation without representation”. In 1773, (continue reading →)
Recently I wrote about empowerment and the importance of letting patients make their own health care decisions. Our job is to make sure patients are given information and then allowed to choose (continue reading →)
Over the last century, health care has morphed from a system valuing individual responsibility to one grounded in physician dependency. Patients are viewed as clients who ravenously consume scarce resources, while physicians dispense answers and guidance for a price deemed too high by bureaucrats to be sustainable. Knowing how invested patients are in understanding their conditions and their willingness to take responsibility for their good or bad choices are metrics worth tracking. It is important to remember physicians make recommendations, educate their patients, and would do best by engaging in shared decision making with those patients. That entire process saves money and improves how patients view their quality of care.
I recently contacted her mother to inquire if she wanted her daughters’ medical chart. She said it was a gift to see her daughter through the eyes of her physician, who was there every step of the way. Medical records are more than metadata on a computer screen; they are a sacred chronicle of our enduring connection with our patients in life, and even in death. When an EMR can do that, I will be thrilled to embark on a digital journey. Until then, give me paper or give me death.
