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Part 2 of the ACA Series: The new unpleasant face of primary care.
The increased regulatory burdens placed on primary care practices by HIPAA, the ACA, Medicare regulation/reforms, meaningful use, and novel modes of care (e.g., medical homes, ACO’s, chronic care notes, ect.) have pushed many doctors out of traditional primary care arrangements and into affiliations with hospitals. I am part of a 5 provider practice (2 doctors, 3 nurse practitioners) that is autonomous and has sufficiently reduced overhead to allow us to have small patient p


The CDC and diseases of the elderly: Less factual than advertised
The following is part of a report that I wrote for the Lown Institute website. You can access the report by clicking the link: LOWN ARTICLE While the CDC should be lauded for its efforts to curb the spread of disease, its recent announcements about pneumonia vaccine and Tamiflu have raised suspicions about its motives and its accuracy. The following article summarizes some of what has transpired. When CDC director Tom Frieden stated unequivocally that neuraminidase inhibit


The Impact of the ACA on Primary Care Part One: what we know now.
In the next several blogs I will explore how the ACA has impacted primary care as of 2015. In my book and my previous blogs I have talked about how quality indicators and electronic medical records, in their current forms, can detract from the ability of primary care physicians to provide optimal health care to their patients, can disrupt the doctor-patient relationship to the detriment of both doctor and patient, can squander physician time with meaningless tasks that do no


ACA Reform and the Medical Home: The Newest Primary Care Initiative
Part of the ACA’s success hinges on its ability to reduce the cost of medical care by better managing chronic illness and by averting hospitalization. Ten billion dollars has been invested in new projects through Medicare’s Innovation Center, much of the money flowing through hospitals and large organizations. In a previous blog we discussed how an expensive program financed by the Innovation Center, designed to reduced hospital readmissions, has not shown any progress afte
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