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  • Canadian Cancer Patient Says Korean Surgery Saved His Life May 22, 2015
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  • Emergency Room Visits Increase with Obamacare May 15, 2015
    Obamacare predicted that expanding health insurance coverage for the poor would reduce costly emergency room visits. A new study has found that newly insured people are actually visiting the ER more often, 40% more often than those who are uninsured. …
  • Transparency: Changing the US Healthcare System May 13, 2015
    Ralph Weber, President and CEO of MediBid, is interviewed by David Saltzman of ShiftShapers. Mr. Weber has been in the benefits business since the mid 1990s, serving clients in the US, Canada, and around the globe. A lack of information …
  • Appalachia Sees Increased Cases of Hepatitis C May 11, 2015
    Infections of Hepatitis C, a contagious liver infection spread by blood contact, has more than tripled in Appalachia – Kentucky, Tennessee, Virginia, and West Virginia – fueled by prescription drug abuse in rural areas. About 73% of patients are under …
  • An American Response to Losing ObamaCare Subsidies May 8, 2015
    by Jane Orient, MD This summer, the U.S. Supreme Court could, in King v. Burwell, uninsure 8 million Americans by finding that subsidies are illegal outside State Exchanges. Some Republicans are saying “Let it burn.” For Democrats, it’s “ObamaCare or nothing.” Can …
  • Arthritis Awareness – May Lab Specials May 6, 2015
    Nearly 53 million adults and 300,000 children in America have arthritis. By 2030, 67% of the population will suffer from one type of arthritis.  Arthritis, joint pain or joint disease, is the leading cause of disability in the United States. …
  • American Women are Drinking More Heavily May 4, 2015
    Barbara Feder Ostrov, Kaiser Health News Whether quaffing artisanal cocktails at hipster bars or knocking back no-name beers on the couch, more Americans are drinking heavily – and engaging in episodes of binge-drinking, concludes a major study of alcohol use. …
  • Shortage of Available Surgery Causes Deaths Worldwide May 1, 2015
    Millions of people die worldwide with treatable conditions because of the lack of routine surgeries, more than from malaria, AIDS, and tuberculosis combined. Five billion of the seven billion people in the world cannot get needed surgery or pay for …
  • Cleaning Tips for a Healthy Home April 29, 2015
    Cleaning your home not only makes it look and smell better, it also can improve your family’s health.  Here are some activities you may not have thought of that will make you and your home healthy and safe: Dust Everything …
  • Using Mobile Devices at Night is Bad For Your Brain April 27, 2015
    Dr. Daniel Siegel, a psychiatrist from UCLA, states that staring into a glowing screen late at night is harmful to your brain and body. Staring at any screen at bedtime, be it computer, smartphone, or ipad, is worse than previously …
  • Few Patients Use Quality, Price Information To Make Health Decisions April 24, 2015
    by Jordan Rau, Kaiser Health News Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according to a poll released Tuesday. Prices for …
  • Shopping Tools Save Patients Cash on Medical Care April 22, 2015
    Vicki Burns of New Mexico needed a total hip replacement in 2012, but could not afford the hospital’s non-negotiable cash estimate of $79,000. Within two days of placing a patient request on MediBid, she received two bids. She chose a …
  • Hysteria’s History Episode 3 April 21, 2015
  • 20th Century Experiment Attempts to Turn Back Time April 20, 2015
    Ellen Langer, a Harvard psychologist, conducted a radical experiment in 1979 – the results of which were never published. Last fall, this study was featured in the New York Times. The study examined how aging’s effects could be altered or …
  • https://youtube.com/devicesupport April 17, 2015
  • Make Spring Cleaning a Workout April 17, 2015
    Chores you do around the house and garden can burn calories and stretch and tone muscles if done correctly. Short episodes of mild exercise can improve your fitness level if done with intensity and speed. Adding 30 minutes of chores …
  • Provisioning for the Opt Out Journey April 17, 2015
    Ophthalmologist David Richardson, MD on how to prepare for opting out of Medicare. From AAPS 70th Annual Meeting, September 2013, Denver, Colorado.
  • What America’s Decline in Economic Freedom Means for Entrepreneurship and Prosperity April 16, 2015
    The United States was once considered the land of opportunity where entrepreneurs such as Henry Ford, Ray Kroc and Steve Jobs contributed to a flourishing economy by providing new products and services at prices people were happy to pay.Today America’s …

Your Disease Can Kill You in More than One Way

by G. Keith Smith, MD

I’ve been asked a lot lately about “outcomes.”  The federal government is going to start paying physicians based on outcomes, it seems.  ”Outcome-based medicine” is a recipe for disaster.  Here’s why.

Patients are all different.  Contrary to what Washington bureaucrats believe, treatment must be individualized for individual patients.  That means that outcomes are going to be only partially under the control of the physician.  We had a patient that developed a foot infection years ago because she found that her pain was best relieved after her bunion surgery if she let her small dog lick her wounds.  Yet according to the brainiacs in D.C., this wound complication would reduce our payment for the care provided!

Now put yourself in the physician’s shoes.  He now knows that he is going to be “graded” and paid for his outcomes.  What chance does the patient with multiple system failure, someone whose likelihood of a good outcome is bleak if everything is done perfectly, have getting in to see a doctor?  If you are seeing this as a rationing tool you get a gold star!

“I’m not about to operate on that train wreck!”  ”It will kill my numbers!”  Can’t you just hear the talk in the doctor’s lounge?  Physicians employed by hospitals will be the first to run from the tough patients and the tough cases, as their loyalty is to their boss, not the patient.

Paradoxically, doctors who are doing sham surgery will be the ones with the best outcomes, as their patients, many of whom don’t need surgery in the first place, will exhibit great, basically perfect outcomes.  Physicians who don’t do unnecessary surgery will be pushed to do so to improve their “scores.”

“Pay for performance” trends in medicine are not a good idea in my opinion.  Paying based on patient outcomes will have perverse effects, not the least of which will be the complete denial of care to the very sick.



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