The Starling Curve Of Physician Productivity

As physicians, we learn about the Starling curve in the first year of medical school. It expresses the relationship between left ventricular end-diastolic volume and cardiac output. The same can be applied to the relationship between physician RVU productivity and departmental/institutional health. The physiologic relationship dictates that as end-diastolic volume increases, cardiac output also increases, […]

Do Happy Doctors Make Less Money?

I was reading over the 2016 Medscape Physician Compensation Report and was struck by some of the results. Every year, Medscape does a survey of physicians about their income, job satisfaction, demographics, etc. Last year, 19,200 physicians, responded to the survey and it unveiled some curious results. Perhaps not surprisingly, the 6 specialties with the […]

Medicaid Reduces Emergency Department Use

A couple of months ago, Ohio Senator Sherrod Brown visited our hospital to do a press announcement about legislation that he and Senator John McCain were sponsoring. After the formal event, I spent a few minutes speaking with Senator Brown. I was telling him about how we had seen a decrease in our emergency department visits […]

America’s Declining Life Expectancy?

I got on the Social Security Administration’s Life Expectancy Calculator and found out that I’m probably going to live until 83.1 years. That means that October 2041 is going to be a bad month for me. Two weeks ago, the Center for Disease Control reported that for the first time since 1993, the U.S. life expectancy decreased […]

How Many Researchers Can You Really Afford?

Academic medical centers’ reputations are rarely built on the quality of clinical care or the quality of education. Reputations are built on the volume of research grants and publications. The academic medical center becomes famous by doing research about clinical care and publishing about education. Similarly, to be promoted as a faculty member at most colleges […]

Dismantling Obamacare

After the elections of 2016, the Affordable Care Act (aka, Obamacare), will no longer exist as it is today. Many politicians have vowed to repeal it immediately. Repeal would be pretty complicated but dismantling would be considerably easier. So what’s on the chopping block? First, the ability to keep children on their parent’s health insurance […]

Penalizing Survival

There is one constant in regulations and policies… unintended consequences. Presently, Medicare seeks to improve quality of care delivered in hospitals by rewarding those hospitals that have lower mortality rates and lower 30-day readmissions. On the surface, this sounds like a great idea. But under the surface, are we penalizing hospitals that keep more patients […]