Should Men Be Screened For Prostate Cancer With PSA?

Should Men Be Screened For Prostate Cancer With PSA?

Identification of cancers in early stages when they are surgically curable has resulted in an overall reduction in cancer death rates in the past 20 years. Where cancer screening has been most effective is in colorectal cancer, cervical cancer, and breast cancer. Prostate cancer screening has been much more controversial with several recent studies suggesting […]

Why U.S. Health Care Is So Expensive

Why U.S. Health Care Is So Expensive

This month, an article in JAMA gives us some ideas of why American medical costs are so high. The authors analyzed data from the OECD (Organisation for Economic Co-operation and Development). The OECD maintains a huge database of economic information from most of the world’s developed countries. Their healthcare database is particularly useful to anyone […]

Making Your Inpatient Practice More Efficient

Making Your Inpatient Practice More Efficient

In my last post, I showed how Medicare reimburses at $36 per work RVU but most physicians get paid $45 – 70 per wRVU. In order to get from $36 to, say, $55 per wRVU, the physician has to either find ways to supplement their income from non-clinical revenue sources or they have to increase […]

Making Your Outpatient Practice More Efficient

Making Your Outpatient Practice More Efficient

It is hard to make a huge salary with a purely outpatient medical practice, in fact, it is hard to just break even without support from a hospital or some other institution. American medical financing is structured in order to preferentially reward physicians who do procedures, who have high-volume inpatient practices, or who are subsidized […]

Choosing Academic Medical Leaders

Choosing Academic Medical Leaders

I think that every search committee assembled for nominating academic medical center leaders should be required to watch the movie The Replacements before starting their search. In the movie, Gene Hackman is the coach of the Washington Sentinels, a fictitious professional football team. In the midst of a player’s strike, the team has been repopulated with […]

Leadership Means Listening

Leadership Means Listening

Whether you are a hospital medical director, an army major, a corporate CEO, or the President of the United States, you never have enough resources to do everything that you really want to do. Consequently, you can’t give everyone everything that they want. But you can listen and sometimes just listening is your most valuable […]

How To Be A Medical Malpractice Expert Witness

How To Be A Medical Malpractice Expert Witness

25 years ago, I got a call from an attorney representing a physician in an academic medical center in another state. The physician was being sued by the family of a patient who had died from a condition mimicking acute eosinophilic pneumonia, a disease that I had published some articles about, and the attorney asked […]

Deciphering The Medicare Hospital Star Rating System

Deciphering The Medicare Hospital Star Rating System

CMS just released its newest star ratings for U.S. hospitals. The ratings were supposed to come out last summer but there was a delay because of problems with the methodology Medicare was using. The rating system attempts to compare hospitals’ performance with common conditions. Hospitals are rated with 1 – 5 stars, with 5 stars […]