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Deception about Dementia: Why Early Detection can be Dangerous
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


Curing Medicare to be republished by Cornell University Press in 2016
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 wi


Cancer screening: how conventional wisdom, quality indicators, and payment incentive equals poor ou
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, especiall


Quality indicators that kill: high blood pressure in the elderly
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 guid


Rat Poison in the Nursing Home
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
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