When a physician prescribes medication I always ask if there is a generic and I watch carefully when a brand name drug becomes available generically, often changing a $50+ co-pay to $5 or less. But if we fill prescriptions on cruise control that is without asking the right questions, we can wind up with much
Recently a friend was told by his doctor he needed an MRI and said that he could get it at the hospital on the campus where the doctor’s office was located, or at a private imaging center two blocks away. This reminded me of the mystery of the Claustrophobia Cluster about twenty years ago, in
Recently I visited a medical specialist I have known for twenty five years. Back then I was a new hospital President and he was a junior attending. About ten years later I became his patient. And hadn’t seen him in two years. When he saw me he said “hello Dr. Metsch” and I responded “hello
With the guidance of an experienced and thoughtful physician I just made a decision to end a course of diagnostic testing after slowly getting to that decision point. But I have family members and friends who have gone through a full “best practices” diagnostic regimen only to wind up in an ambiguous situation, then having
You may have wondered how Obamacare pays for medical care for the 20 million+ newly insured. If you don’t understand the incentives and disincentives to hospitals and physicians and get caught in the regulatory quagmire, then you will be the payor! Using Medicare, here’s an example of how three related concepts determine whether or not
Sounds great! But with the transformation of health care more and more physicians are “employed” and not in “private practice.” The Medical Group Management Association reports that more than 50 percent of physicians are now employed by organizations affiliated with health systems. In some specialties, like cardiology, that is closer to 75 percent. Discussion of
Over the past five years teaching in a health care MBA program, I had a number of students who were physical therapists. They had DPT (Doctor of Physical Therapy) degrees, worked at prestigious academic medical centers in NYC, but did not want to be, or were not called Doctor at work. At one of the