Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Head Size - Infants

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The infant's head is enlarging, but the doctor observes that the fontanelles are not bulging, and the infant is intact, neurologically speaking; s/he has no symptoms, i.e., is neither irritable, nor unusually sleepy -- then, follow carefully.   In the Case of Macrocephally, How Is The Diagnosis of Hydrocephalus Typically Made? Presentation "The various types of hydrocephalus can present differently in different age groups."

Shut That Damnable Drip: Controlling Healthcare Waste

To make health care reasonably profitable for private payers and more affordable for patients, those who manage health care must focus on reducing cost, which is far easier than increasing the health benefit or medical loss ratio. See: "How the U.S. Health-Care System Wastes $750 Billion Annually," by Brian Fung, pub. Atlantic Mobile, 9/7/12

Not Just an Apple a Day...

Complementary and Alternative Medicine (CAM) is inviting and has such promise but it is unproved and it can be dangerous. As Paul Offit (Chief Infectious Diseases, Children’s Hospital of Philadelphia) states, “There’s no such thing as alternative medicine. There’s only medicine that works and medicine that doesn’t.” Offit PA. “Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine.”

Hunched Backs (Kyphosis)

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Exercises Can Help Kyphosis, But.... Certain exercises may prevent or delay the progression of hyper-kyphosis or hunched back, but that cannot completely correct it; it normally progresses with age. For example, here's a YOGA pose that is recommended by Dr. Loren Fishman, a Physiatrist who is well-published on this and related topics. Locust Pose – Shalabasana: How to do it by Ann Pizer []

Healthcare Reform in the U.S.

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The United States is the only wealthy, industrialized country that does not ensure that all of its citizens have healthcare coverage. Insuring America's Health: Principles and Recommendations, Institute of Medicine at the National Academies of Science, January 14, 2004, last accessed Tuesday, February 2, 2010

The Incentive in Piecework is....

This article is posted in: generate pieces (Dr. Caldwell Esselstyne, circa mid '60's).  Specialists even more than primary care practitioners fractionalize care; that's costly; In the medical home, primary care treats the whole patient.  To explain the drastic shift needed to encourage primary care and discourage a further and unjustified overabundance of specialists, know that: 35% of visits for circulatory conditions are to family physicians, 27% of visits for musculoskeletal problems are to family physicians

Specialist Surfeit--Unaffordable!

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Do we pay too much for health care here in the US? Is there a plethora of specialists? And, what about the waste in the system? Yes, of course to all, but if you are the person who needs treatment, maybe the answer is "not really." If you can't get the medical help you need when you need it, maybe the fact that it is theoretically free doesn't mean anything.   We're going to discuss global payment and hit upon both sides--reducing inappropriate access and improving appropriate access.