Why Insurance Companies Suck

I prescribed Androgel (generic) for a patient with very low testosterone (total and free). He also has the accompanying symptoms. He tried to use his insurance and I needed to waste time doing a prior authorization. Here was their response: You requested the drug listed above for your late-onset (age-related) hypogonadism. A drug is covered…

Free Market Surgery

I thought I was going to read another story about evil insurance companies and why we need socialized medicine. Instead, this clinical vignette makes a great case for the free market as a way to provide good care at a reduced cost. James Schlieper drove five hours from Central Texas to a surgery center across…

A Collaborative Mess

col·lab·o·ra·tion /kəˌlabəˈrāSH(ə)n/ noun The action of working with someone to produce or create something.“he wrote on art and architecture in collaboration with John Betjeman” cooperation alliance partnership participation combination association concert teamwork joint effort working together coopetition OR Traitorous cooperation with an enemy.“he faces charges of collaboration” fraternizing fraternization colluding collusion cooperating cooperation consorting sympathizing…

Team-Based Care Saves Money?

I have ripped on the Patient-Centered Medical Home crap over and over in this blog. I just love it when articles come out as propaganda for big corporations. For example, listen to this: “The patient-centered medical home is a key foundation to how we’re building our programs and looking at how our programs are going…

Doctors Need More Nutrition Education

I hear this all the time. “Doctors need to know more about nutrition!” Every internet and fad diet guru likes to rip on doctors for knowing little about nutrition. It is time to call bullshit on this. Why? Because the information changes ALL THE TIME! No matter what side, or diet, you endorse there is…

What Are Physicians Worth to Hospitals?

We work with dozens of physicians employed by hospital systems (a radical change from my practice years, when few physicians worked for hospitals).  In almost every instance of contract renewal negotiation, the physicians are told or shown on spreadsheets just how much money the hospital loses on them. You’d think that any rational hospital administrator would…

More Anxiety Thoughts

A little while back I wrote a blog entry about a young woman going to the ER for a panic attack. I ended with these thoughts: Here are my questions: – Why are young people going to the ER for panic attacks? – Why are so many young people having panic attacks and anxiety? I…

Down the Rabbit Hole on Medicare

After getting his proposed budget cuts to Medicare stuffed in March (cuts to doctors and hospitals, of course), Pres. Trump zoomed down to hit the Florida hustings to cheer on the continued survival of this beloved program.  He hit the premier gray ghetto in The Villages, promising to protect Medicare from “socialism,’ which is akin to…