The Failure of “Pay for Performance”

  In my previous post, I talked about the problems with using “evidence-based” medicine to constrain patient care and avoid dealing with the complexity of health care decisions. Physicians are perfectly capable of dealing with the complexity of their patients’ medical problems, but the Centers for Medicare and Medicaid Services (CMS) believe if care can’t…

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The Flaws in “Evidence-Based” Medicine

These days the moniker “evidence-based” has been attached to almost any statement about the practice of medicine and health care reform. Since a goodly number of people are really afraid of the notion of statistics, it’s very easy for anyone to slap the label “evidence-based” on a medical decision and get away with it—very few…

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Nothing New About the Medical Home

Aaron Carroll, one of the writers for The Incidental Economist, has reviewed some of the research on whether the Medical Home is more successful in small or solo practices than in large medical organizations. The notion of the Medical Home wasn’t on the top of my list for hot topics, but my eyes caught the…

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Excuses Here, Excuses There…

It’s bad enough that the care physicians provide their patients is discounted beyond what any reasonable person would consider fair.  Unless you are a medical coder and biller, the public has no knowledge of how the insurance companies and federal and state governments further derail their payments to physicians. When a physician provides care to…

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