The High Cost Of Observation Status

The High Cost Of Observation Status

Medicare and commercial insurance companies love observation status. When a patient has to be hospitalized but only for “less than 2 midnights hospital stay”, then that patient is classified as being in observation status rather than admitted to the hospital. This classification means that the patient is technically an outpatient and not an inpatient and […]

Age Of Physicians By Specialty

Age Of Physicians By Specialty

At this month’s American Thoracic Society meeting, it was reported that 1/3 of practicing pediatric pulmonologists in the United States are over age 60, a scary number since that indicates we are soon facing shortages of pediatric pulmonologists. It turns out that it is not the only specialty with disproportionately older physicians and these statistics […]

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 […]

Inpatient Palliative Medicine Services: Making The Right Economic Projections

Inpatient Palliative Medicine Services: Making The Right Economic Projections

The demand for inpatient palliative medicine services is very high and the supply of palliative medicine physicians is rather low. When considering bringing palliative medicine services to your hospital, the real value of palliative medicine is in what does not appear on the basic accounting pro forma. A robust palliative medicine service is a multidisciplinary […]

Dying To Reduce Hospital Readmissions

Dying To Reduce Hospital Readmissions

20% of people who get admitted to the hospital require readmission within 30 days of being discharged. Medicare has taken steps to reduce these readmissions, but the unintended consequence of these steps appears to be an increase in mortality rates. Readmissions are expensive and cost Medicare about $17 billion per year. Conventional dogma holds that […]

An Epidemic Of Endocarditis

An Epidemic Of Endocarditis

Last week, I was called about triaging a patient to the intensive care unit. A 38-year-old woman had come to a rural Ohio hospital emergency department with sepsis and chest x-ray changes that looked like septic emboli. She uses intravenous heroin. The opioid epidemic in the U.S. has primarily received a lot of press because […]