Category: Policy

What’s wrong with crisis pregnancy centers?

Perhaps you have already heard of crisis pregnancy centers (CPCs). I see highway billboards for them on most of my long drives throughout the rural midwest. Recently, I received an email from a student interest group offering medical students to tour t…

Why is Medicaid reimbursement below sustainability?

Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim. Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area o…

Despite progress in cancer care, cost and equity challenges still must be addressed

As a physician who has spent his career taking care of people with HIV/AIDS, cancer and various blood disorders, this is an amazing time to be working in these overlapping fields of medicine. I began my training when roughly half the people diagnosed w…

An approach to prior authorization insurance denials

Patient access to care is a high priority for all neurosurgeons. Unfortunately, many of our practices are thwarted in these efforts from unwarranted insurance denials. Know, you are not alone. Take this common scenario: When Ms. Mary Smith (not the pat…

We need to change the way we talk about climate change

There was a point in my life when the words “climate change” would recall pictures of polar bears marooned on precarious chunks of ice, bobbing aimlessly in some foreign landscape of tundra and sea. While tragic, the environmental drama playing out at …

Stop shoving metrics down nurses’ throats

One time, I applied for an emergency department (ED) nurse manager position. I thought I had the job locked up until I was asked during the interview how I would “enforce metrics.” “Enforce.” My holistic, qualitative research-based response to this aut…

It’s time to study firearm morbidity and mortality as we do any other public health issue

Among modern industrialized nations, only the United States endures the current public health epidemic of firearm-assisted injury and death. In 2017, nearly 40,000 people were shot to death in the U.S., while proponents of the Second Amendment continue…

Is this cost-saving Medicare proposal doomed?

The Trump administration has proposed that insurance plans providing drug coverage to Medicare beneficiaries will no longer be forced to cover six hitherto “protected” drug classes. The classes — which include drugs for psychiatric conditio…

To do population health right, think about individuals

How do we change the way we think about taking care of patients, particularly when it comes to not the individual patient sitting in front of us, but a whole population of patients just like them (or somewhat like them)? In our practice, we have been s…

5 anomalies about compensation physicians should know about

The term “physician compensation” could be among the top phrases in health care this year. Though it’s always been a hot topic, it got hotter when the Trump administration announced a proposal that would affect nearly 40 percent of Medicare payments. T…