A recent Wall Street Journal article about narrow networks described it as new pressure on insurers. Sorry, WSJ, not new. Employers have pressured insurers about access to their employees’ providers for years. What is new is the increased willingness of some buyers (read that as insurers including Medicare) to accept an insurer’s narrow network in…
Read more
The Unintended Consequences of Today’s Health Delivery Model
Efforts in the name of efficiency and cost reduction have unintended consequences. When I was in practice, I admitted, or at least followed, all my patients in the hospital. There were no issues of aftercare, because I discharged them with appointments to see me within a day or two (rarely more). I knew what medications…
Read more
Health Information Exchange-a 21st Century Upgrade Opinion
Not long ago, I injured my knee and discovered something else in the process: a severe sprain in the medical information system. Here’s the story: The emergency room took X-rays and an MRI and referred me to an orthopedist. He reviewed the tests and sent me to a specialist. But my specialist—an expert in his field—suddenly…
Read more
Why the fuss over observation status? A typical conundrum
This post was originally published on 8/14/2013 This is an example of why observation status has caused such headaches for physicians and patients. You’re a hospitalist at Joe Smith County Health System. At 5 p.m. Monday, you hear this from an ER doc: “Hi, this is Gus in the ER. I’ve got a patient for…
Read more