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Variations in Hospital Pricing

1
April 21, 2014

There is more evidence that a large source of wasteful spending in the U.S. healthcare system comes from hospitals. The National Institute for Health Care Reform worked with the Center for Studying Health System Change to look at the variation of hospital pricing across the country. Their recent report focused exclusively on private sector...
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The Harms of Patient Satisfaction

1
April 14, 2014

Patient-Centered. It sounds so right, doesn’t it? Right up there with mothers and apple pie. If only family medicine were so simple. A report by ABC news told the story of a doctor at a VA hospital in Kansas City who claims she was forced to leave her job because she tried to limit...
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Obamacare — Now That Enrollment is Closed

1
April 7, 2014

I confess that I haven’t paid that much attention to the horse race politics of insurance enrollment under the PPACA (Obamacare). Overall, even if 7.1 million signed up, pay their premiums, and weren’t previously insured, it still means that only a small fraction of the 50 million uninsured now have coverage. Several people have...
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I Still Get Butterflies on Match Day

1
March 24, 2014

I am on the teaching staff at the John Peter Smith Hospital Family Medicine Residency in Fort Worth. The editor of the Primary Care Progress blog asked me and some other faculty and residents across the country to write about the match process. The “match” is the system where we rank all of the...
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More Evidence on the Limits of the PCMH

3
March 17, 2014

A recent article in JAMA showed the disappointing results of a 3-year study of over 100 certified patient-centered medical homes in southeast Pennsylvania. Basically, it showed only 1 of 11 quality measures improved and utilization and costs were not reduced. In one of the most narrow-minded statements by the AAFP ever, its current president...
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A Visit to Britain’s National Health Service

6
March 9, 2014

I had the great privilege and excitement of seeing Britain’s National Health Service up close and personal this past fall. My primary guide was Dr. Helen Stokes-Lampard, who is the honorary Treasurer of the Royal College of General Practitioners. She is very unlike her stuffy title. She is very down to earth and very...
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The Country Family Physician is In

1
February 24, 2014

I know some of you have seen this already, but I thought I’d broadcast this piece one more time. This is a link to a post I wrote for Primary Care Progress. In it, I talk about examples of how family physicians are still faithfully serving the needs of nearly 70 million rural Americans....
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Mammography 2014

2
February 16, 2014

I assume many of you have heard by now of the Canadian randomized controlled mammography study that found that 25 years later, there was no difference in breast cancer death rates between 40-59 year-old women who had mammograms vs. those who did not. I won’t go into a lot of further details and analysis,...
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RUC and the Special Deal of the Ologists

4
February 10, 2014

This article received some notice when it was first published in August. Haley Edwards writing for Washington Monthly does a great job exposing the insider deals and duplicity of the AMA’s Relative Value Update Committee, or RUC (commonly pronounced “ruck”). This is the AMA’s committee that advices Congress on updates to physician fees. Here...
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CTs and Cancer

2
February 2, 2014

In a wonderfully strongly-worded piece in the New York Times, Drs. Rita Redberg and Rebecca Smith-Bindman talk about the future physical harms of excessive CT scans now. They state that 1 in 10 Americans undergo a CT scan each year. A study by the National Cancer Institute estimated that CT scans conducted in 2007...
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