High-spending hospitals can’t just start spending less while maintaining the same outcomes. Slicing spending without a plan for protecting patient health would spell disaster. To cut spending, they would need to implement strategic and complex approaches that insulate their outcomes from their expenditures – a tricky proposal.
Boozing before a procedure may impair a patient’s ability to knowingly consent to treatment, which presents liability and legal concerns.
A female ER patient cannot bear the burden of a provider’s biases. It’s crucial that providers – especially those in the emergency or urgent clinical settings – critically examine each patient, without regard for the patient’s gender. But what happens when these biases are unconscious (which they undoubtedly are in most circumstances)?
This week, I’ve been engrossed in the enthusiastic tweets coming out of the American Physical Therapy Association’s Combined Sections Meeting. And so, I wanted to take an opportunity to reflect on what’s happened in the year since I spoke at CSM in 2016.
Although women consume more pharmaceuticals than men, they comprise a minority of clinical trial test subjects and are at twice the risk for adverse drug reactions. Those who advocate for scientific accountability of sex differences in drug studies argue that the pharmaceutical industry lacks a commitment to women’s safety.
If a Medicare patient has achieved their maximum level of recovery, and additional therapy would not help them improve beyond that point, then additional treatment isn’t warranted or medically necessary. Plus, Medicare surely won’t foot the bill. You, their PT, think that additional therapy would help them from getting worse, but that’s not the standard. It’s time to discharge them, right?
So, what happens to those people in the 19 states who make too much money to be eligible for Medicaid, but who make too little money to be eligible for a subsidy? They fall into the dreaded “coverage gap” – and people in this group generally aren’t subject to the IRS penalties for their failure to purchase insurance. (Although this doesn’t address the greater problem: they don’t have insurance.)
My success in reaching 79 years of age might be attributed to moderation in the usual “abuses”–alcohol, drugs, tobacco, stress, excessive food and lots of exercise every day. Had I subscribed to this regimen when I was in my 30’s and 40’s, it would have been even more prudent — maybe leading me to tip over the century mark. But who really wants to do that?
Living in pain is horrific. Statistically, women are four times more likely to suffer from chronic pain than men. Making an awful situation worse – many of these conditions are neglected or poorly understood, causing many women to suffer intractable pain for years before they find relief. With insurance often denying coverage for these conditions, years of pain can also be financially devastating.
Where I live in Chicago, the population density is about 10,000 people per square mile. Generally, if an area has less than 1,000 people per square mile, it’s considered to be a “rural area.” Before this spring, private insurance plans in Arizona were only required to cover telehealth services rendered to those living in rural areas. But as of May 17th, they’re required to cover telehealth services statewide.
