For years, many physicians have complained about the onerous nature of government-certified Electronic Medical Records. However, thanks to the HITECH Act, the rush to digitize medical records has continued. Due to the impetus provided by the ACA and subsequently by MACRA, the mad rush has progressed into a frenzy of data-collecting and reporting activity, all in the name of … [Read more...]
My Professional Thanksgiving
Yesterday, I received a thank you note from a patient that prompted me to write this post. The note started with "Dearest Dr. Cavale!!!" and continued "I just wanted to say thanks for your kindness. Even though you keep wanting me to stop smoking...(your) professionalism and warmth is very soothing". It ended with "Your way makes having diabetes not so frightening". I was … [Read more...]
Why MACRA Might Make SGR Look Good
Just recently, our beloved Congress repealed the dreaded Medicare sustainable growth rate (SGR) formula and passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), with huge bipartisan support and much fanfare. The President gleefully signed it into law. Hurrah! In this summary in JAMA, Prof. Robert Steinbrook gives an unvarnished quick look at MACRA. The … [Read more...]
Doctor, Fix Thyself
Government run medicine started in the U.S. with Medicare fifty years ago. The Medicare promise of 1965 bears little resemblance to the Medicare reality of today. Five years ago Obamacare was signed into law, and American medicine today is barely recognizable. I have spent the last six years fighting the moral inversion of government-run medicine and the incremental … [Read more...]
Games Medicare Plays – Why are Physicians Still Playing?
Kaiser Health News published a report recently on Medicare's "incentive" program payments to hospitals. The most obvious observation is that most hospitals will not see any meaningful incentive payments, due to the carrot-and-stick methods employed by Medicare. A very telling statement comes from consultant Eric Fontana, a Washington-based analyst at The Advisory Board Company- … [Read more...]