Tag Archives: money

Aim your BS Detector at the Turduckens in Healthcare

Aim your baloney detector at the BS in health care – STAT – by Lawton R. Burns and Mark V. Pauly – May 2019

BS, what Princeton philosopher Harry Frankfurt once called a “lack of connection to a concern with truth — this indifference to how things really are,” has probably been around since the beginning of language.

We’ve noticed an influx of BS in health care. You don’t have to look far to spot it. Just think of Theranos and IBM Watson.

We are wondering if several new corporate “turduckens

I thought this was a made-up word, but no, it’s real and it’s not for the squeamish:  Continue reading

Scant Evidence Gabapentin Works for Pain

Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works. – The New York TimesBy Jane E. Brody – May 20, 2019

There is very little data to justify how these drugs are being used and why they should be in the top 10 in sales,” a researcher said.

One of the most widely prescribed prescription drugs, gabapentin, is being taken by millions of patients despite little or no evidence that it can relieve their pain.

In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes. [that article is posted below]    Continue reading

Understanding the money trail in medicine

It’s important to understand the money trail in medicine – Smart Money, MD | Finance | April 9

There was a recent news brief stating that the average internist generates about $2.4 million annually for the hospitals that they work for.

See also: Physicians Keep Increasing Revenue for Hospitals and The demise of medicine when profit reigns supreme

While it’s no surprise that doctors help others make money, seeing a figure to your worth hammers home how much we sustain the health care system, often at our own expense.   Continue reading

The demise of medicine when profit reigns supreme

The demise of medicine: A neurologist advocates for patients and is silenced – by Virginia Thornley, MD – Aug 2018

Our doctors have it almost as bad as we do, as more and more small practices are being bought up by huge corporations (with the moral imperative to make a profit).

Now they are only employees valued for their RVUs (Relative value units (RVUs) are a measure of value used in the United States Medicare reimbursement formula for physician services).

Physicians are overwhelmed by

  • patient loads, 
  • 10-minute visits,
  • the wealth of documentation dictated by health insurance requirements and
  • the overwhelming overtaking of medicine by non-physician personnel.

As medicine changed from patient to profit-centered, it marked the beginning of the end. Continue reading

The Industrialization of Medicine

I found this slide from a powerpoint presentation on Twitter, and I lost the original link, but it was clearly presented by the EMC, a corporation that sells databases and EMRs used in healthcare these days.

The presentation is titled “A New Era in Healthcare” (ripe for profiteering) and from this slide, we can see they are talking about money, not patient care.

Death by 1,000 Clicks in Electronic Health Records

Death By 1,000 Clicks: Where Electronic Health Records Went Wrong

The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief.

Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death.

Monachelli’s husband sued Stowe, the federally qualified health center the physician worked for. Owen Foster, a newly hired assistant U.S. attorney with the District of Vermont, was assigned to defend the government.   Continue reading

Voice-recognition to automate doctors’ data entry

Voice-recognition system aims to automate data entry by doctors – STATBy Casey Ross @caseymrossMarch 4, 2019

I think artificial intelligence (AI) in healthcare simply must happen with so many people’s care sprawling over so many healthcare services (and billing companies). Using AI learning systems in healthcare makes a mockery of any kind of patient or doctor privacy. Even worse, they are dangerously prone to undetectable errors (people have died).

Still, we need these systems to cope with the ever-increasing amounts of data and knowledge, but we need them to serve humans, not to replace them.

Hands down, the one task doctors complain about most is filling out the electronic health record during and after patient visits. It is disruptive and time-consuming, and patients don’t like being talked to over the doctor’s shoulder.    Continue reading

Physicians Keep Increasing Revenue for Hospitals

Physicians Keep Increasing Revenue for Hospitals – Ken Terry – February 27, 2019

This is an ugly look at what’s really running our healthcare. Our critical medical care is just a cost center to be minimized while shareholder profits and pay to the hospital’s C-suite executives soar.

The average amount that physicians generate for hospitals has jumped significantly since 2016, according to new survey results released by Merritt Hawkins, a leading physician search firm.

The survey shows that independent and employed physicians generated an average of $2.38 million each for their affiliated hospitals, a 52% increase from the $1.56 million they generated when the firm last conducted its survey in 2016. Continue reading

The fallacy of patient-centered care

The fallacy of patient-centered care– KevinMD.com – by – Mar 2019

According to NEJM CatalystPatient-and family-centered care encourages the active collaboration and shared decision-making between patients, families, and providers to design and manage a customized and comprehensive care plan

Under patient-centered care, care focuses more on the patient’s problem than on his or her diagnosis. Patients have a trusted, personal relationship with their doctors …”

Historically, patients have had better relationships with their physicians than they do today.    Continue reading

Parenteral Opioid Shortage Curtails Pain Control

Implications of the Parenteral Opioid Shortage for Prescription Patterns and Pain Control Among Hospitalized Patients With Cancer Referred to Palliative Care. | Clinical Pharmacy and Pharmacology | JAMA Oncology | JAMA NetworkMar 2019

In a cohort study of 386 patients with cancer referred to a palliative care team for pain management before and after the announcement of parenteral opioid shortages, the referring oncology and palliative care teams prescribed significantly fewer parenteral opioids after the announced shortages and more nonparenteral opioids.

Now even cancer pain care is compromised by the “drug-war” misdirected at a prescribed medication instead of increasingly deadly illicit drugs.

After parenteral opioid shortages, significantly fewer patients had achieved clinically improved pain by follow-up day 1.   Continue reading