Prior authorization — a utilization management (UM) process used by health insurance companies to determine coverage for a prescribed procedure, service, or medication — is now becoming a mandatory requirement by the vast majority of large insurance co…
There are few things in our health care system that are more unfair than surprise medical bills. Consumers think they have good coverage and are getting treatment in their health plan network only to get a huge unexpected bill in the mail because it tu…
Migrating to the U.S. as an international medical graduate, I was shocked by the health care culture of excess. Initially, it felt good to order a CT scan on everyone who had a fall or cardiac enzymes on anybody who had atypical chest pain. I felt powe…
It was the middle of winter in downtown Chicago in 1995, and I was sitting across from an apologetic alcoholic holding a slimy NG tube. Mr. Smith, an emaciated man in his sixties, had been on my service for three days with acute pancreatitis, and this …
Negotiating lower drug prices in America could possibly stifle pharmacological innovation. But it would reduce health care cost for most Americans — and that should be all that matters. If the United States began to regulate drug prices, medications wo…
The gender imbalance in nursing, our nation’s largest profession, is a slow-to-change and complex problem steeped in stereotypes, economics, unconscious bias, power, and privilege in health care and society. Along with other diversity gaps in the nursi…
Access to care, patient advocacy, health disparities: These are all buzzwords in health care now. We, as health care providers, understand that we must do the best for our patients in the hopes of providing a positive outcome. So, despite our perceptio…
The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating the five jobs we expect a health care system to do for us and then identifies which parties in the health care system (providers or in…
I have noticed a profound lack of self-esteem in our profession. I am concerned. Concerned for us, and for our patients. We are the most noble of professions. However, we have compromised our morals, values, ethics, and virtues. We are now living, oper…
“What challenges do you see yourself facing as a doctor?” I’m sitting in a suit, facing a young Asian woman with black, round glasses across a desk. On the desk in front of her is an iPad, and she sits cross-legged, hands resting on her legs. I’m in my…
