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 […]

Kicking Hepatitis C Down The Road

Hepatitis C has exposed one of the larger cracks in American healthcare financing. In particular, the drug Harvoni (ledipasvir-sofosbuvir) has shown us the inherent conflict between private health insurance (commercial insurance companies) and public health insurance (Medicare, Medicaid, etc.). Hepatitis C is an enormous problem in the United States. There are about 2.7 million Americans […]

The 2017 Medicare Readmission Penalty

We have a readmission problem in the United States. About 1 out of 5 patients admitted to our hospitals are readmitted within 30 days. Those readmissions are costly: the average cost of 1 hospitalization in the U.S. is $15,000 but the cost of 1 hospitalization plus 1 readmission is $33,000, in other words, the readmission […]

How Residents Are Paid

If your hospital has residents, someone has to pay them. Ultimately, it is the American taxpayers. For the purposes of this post, when I use the word “resident”, I’m referring to interns, residents, and fellows all bundled together. Here at the Ohio State University, a 3rd year resident gets a salary of $55,679 and has […]

The FLSA Ate My Part-Time Job

FLSA is the Fair Labor Standards Act. This is about to have a huge impact on hospital employees who work part-time or who job-share. The FLSA was originally drafted in 1932 by Senator Hugo Black. It established the 40-hour work week, designated that overtime had to be paid at time and a half, and directed […]

Where Did All The Women Physicians Go?

I’m a doctor. I look for signs and symptoms to diagnose diseases. In the past 4 months, we’ve had 6 really talented women physicians in our department resign and that is a symptom. So, what’s the disease? If they were accepting academic leadership positions elsewhere or if they were being recruited as educators or researchers then […]