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Two recent pieces alerted me again to the misleading information that is often disseminated about dementia detection and treatment, sometimes by doctors themselves, more often in the press. Dementia is a horrible disease with no known cause or cure. Very few of Medicare’s resources are devoted to helping demented people and their families in ways that are sensible and effective, from exercise programs, to daycare centers, to custodial help. However, Medicare will be pay for any number of tests, specialist visits, and drugs, none of which have ever been demonstrated to improve the plight of those with dementia, but which cost the taxpayer money and resources better utilized elsewhere, a
I am thrilled to announce that Curing Medicare has been accepted for publication by Cornell University Press. After a successful run as a self-published manuscript, and a lot of very positive reviews, the book has found a worthy home at Cornell. We expect the book and its message to reach an even wider audience now, which is so signficant in light of the upcoming presidential election and all the changes occuring in Medicare. It is expected to be republished in 2016 and will again be available at that time. With the help of an outstanding and accomplished editor at Cornell, Suzanne Gordon, I have reworked much of the book to reflect new challenges that doctors and patients face under Medi
Cancer screening is perceived to be a very effective way to prevent serious illness. Pap smears, mammograms, colonoscopies, and even PSA blood tests can detect cancer early and lead to improved outcome. But just how effective are these tests at detecting early cancers and helping patients to live longer and better? Are there any dangers of getting these tests, which on the surface seem harmless? I talk a great deal about this topic in my book, and in many cases, especially in the elderly, screening tests are more harmful than helpful. While this seems counter-intuitive, it is based on ample research. Many such tests are endorsed by Medicare’s quality indicators, and the failure of our
In the Universe that Medicare is scripting, one that is designed to reshape and reform medical care, doctors will be paid for the quality of their work, not just the quantity of their visits and procedures. Our Accountable Care Organization recently laid out the 2015 Medicare clinical guidelines to which we need to comply in order to prove that we practice high quality care. Ultimately much of our salary will be tied to our adherence to such guidelines. One particular guideline stated that every patient with a blood pressure over 120 must be monitored and be offered advice and treatment. Any pressure under 120 is considered by Medicare to be optimal. Once pressure exceeds 140, then even
In the Washington Post on August 4th an article entitled “Health inspectors alerted to blood-thinner dangers” discussed the dangers of blood thinners like Coumadin in nursing home residents. The article makes the point that many nursing home residents using blood thinners suffer harm, even death, when their doses are not closely monitored, essentially blaming the nursing homes for not following blood levels of the drug closely enough. High doses of blood thinners can cause severe bleeds. In fact, Coumadin has been used as a rat poison for years because it will kill rats by causing them to bleed out and die. But it is not simply the failure of nursing homes to monitor levels that causes p
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