Righting the Wrongs of Risk Based Algorithms

As we continue to address health inequities, understanding how algorithms impact races differently is important. One of these inequities revolves around the racial disparities in kidney disease, with Black individuals experiencing a 2-to-4-fold higher incidence of kidney failure than White individuals. Moreover, Black individuals have faced lower referral rates for pre-dialysis transplant evaluation, post-kidney failure transplants, and placement… Read More »

Diagnostic Errors in the Emergency Department

Receiving accurate care in the Emergency Department (ED) is essential because diagnostic errors can have life-threatening consequences. Let’s first examine the role of care within the Emergency Room. In emergency medicine, time is of the essence, and the focus is often on ensuring patient safety, providing follow-up care, and ruling out immediate harm. However, miscommunication and unmanaged expectations… Read More »

The Value of Funding Social Drivers of Health

As we continue to focus on delivering health in a manner that is equitable, we have come to realize the importance of social drivers of health, known as those diseases of life, that occur outside of the physiologic realm and impact an individual’s health and wellness. Presently, investments in methodologies that address these conditions have revolved around governmental… Read More »

Educational Debt Has a Greater Impact Than Meets the Eye

Educational debt is an intriguing concept; borrowing money to pay for education now that will benefit one later when their degree is earned. In essence, future earnings will compensate for the necessary debt required to achieve that degree and, consequently, those earnings. Unfortunately, the debt load of those graduating from medical schools (well into the six-digit range) is… Read More »

Evaluating Quality and Cost Between Medicare Advantage & Traditional Medicare

With enrollment in the Medicare Advantage (MA) program continuing to rise and nearly 50% of all Medicare eligible beneficiaries participating in an MA product, now is the time to evaluate the program’s benefits and possible unintended consequences. Why? A recent study by Landon et al., published in the Journal of the American Medical Association, compared the two programs… Read More »

Patient Satisfaction IS a Quality Metric

As we focus on quality, patient satisfaction continues to be a prominent measure of healthcare experience. In fact, higher patient satisfaction scores seem to correlate with desirable health outcomes. However, the issue arises concerning whether the current clinical care standard does in fact, accurately reflect clinical performance, and does it support efforts to improve the patient experience? A… Read More »

Obesity Continues to Plague our Healthcare Systems

We continue to battle the epidemic of obesity and we have tried countless tactics to impact the ever-growing issue. Unfortunately, effective treatment remains elusive, no matter what models we utilize. Whether it is diets, behavioral modification, or even bariatric surgery, we seem to continue to have a minimal impact. The idea of self-activation and engagement continues to be… Read More »

“Oh, how I remember the Review of Systems!”

Despite being out of direct patient care since 2006, I still can recite the entire review of systems (ROS) in five seconds flat. In fact, our instructors indoctrinated in us that if this documentation did not occur at every visit, one could not fulfill billing and coding requirements. Of course, this was also not the intended purpose of… Read More »

Did the Medicare Bundled Payment Model Decrease Care Quality?

As we continue to focus on value-based payment models, we must always be aware of possible unintended consequences. The Medicare Bundled Payment for Care Improvement Advanced Model (BPCI-A) is a model that has had broad participation since its inception in 2018. It has shown reductions in overall Medicare payments per episode and improvements in clinical outcomes. The question… Read More »