It’s well known that coding changes drive provider behavior, and billing behavior drives provider decisions. For the last 30 years, little has changed in health insurance billing, which is why the standard of care within the payer system has rema…
Category: Public Health & Policy
The U.S. doesn’t have enough faculty to train the next generation of nurses
Despite a national nursing shortage in the United States, over 80,000 qualified applications were not accepted at U.S. nursing schools in 2020, according to the American Association of Colleges of Nursing. This was due primarily to a shortage of nursin…
Climate change through the lens of an emergency physician [PODCAST]
“The worst part of the climate crisis is that our kids, my kids, may never get to witness the most beautiful parts of our world because they may, and will, cease to exist without our action and power. As I watch my own kids looking out over the o…
Emotional epidemiology of disease is as critical as clinical epidemiology
At this point in the COVID vaccination campaign, nearly all American adults who want the vaccine have gotten it, and are gratefully snapping up their boosters. Those who decline vaccination are largely impervious to public service announcements, commun…
Why health care delivery is an exceptionally different industry: Why does it matter?
Second in a series. Please read part 1 and part 2. We expect that most readers have noticed the differences we cite and have also noticed that these differences are negative, not positive differences. The big question is, why these structural and strat…
High deductible health insurance is bankrupting Americans
Two decades ago, high deductible health plans barely existed. Today, more than half of the U.S. workforce is on one, which are plans with deductibles greater than $1300 per individual or $2,600 for a family. It’s a growing, undiscussed problem for publ…
Medical debt is the enemy of everyone [PODCAST]
“Medical debt is the mortal enemy of the patient, the physician, the hospital, the community, the state, and the nation. When we think of others’ debts, we tend to think such debts are their personal responsibility. If they’re unable to pay the d…
The goal of health care is in peril
Introduction and background As an emergency department medical director and physician, a busy emergency department can be a thing of beauty to me. We work hard to set up systems that will provide the care our patients need. Despite our best efforts, al…
Life along the railway lines in Bangladesh during Bishwa Ijtema: a physician’s photojournal
The Bishwa Ijtema meaning “global congregation” is an annual gathering of millions of Muslims in Tongi, by the banks of the Turag river, just north of Dhaka, in Bangladesh. Bangladesh is predominantly a Muslim nation. This yearly “BI&…
Why health care delivery is an exceptionally different industry: health system infrastructure and health system operations and execution
Second in a series. Please read part 1. The business of health care delivery differs markedly from other consumer and service industries in many ways. First and foremost, the economics differ. Specifically, the payers of medical care are often differen…
