The Ultimate Guide to Finding the Right Job After Residency

Koushik Shaw, "The Ultimate Guide to Finding the Right Job After Residency"
MgH | 2005 | ISBN: 0071461132 | 304 pages | PDF | 1,1 MB

This is a one-of-a-kind single source compendium of employment advice for residents looking for their first job and physicians looking to make career changes. For the first time, important issues such as geographic considerations, partnerships, salaries, legalities, starting an effective job search, interviewing tips, contract negotiation, are all discussed in detail by someone who's been there and lived it.

HERE

Financial Help With Diabetes Medicine

In order to obtain financial help with diabetes medicine, it's important to have health insurance or to look into government-regulated programs. Learn about drug companies that will give medication at a discounted price with help from a licensed RN in this free video on diabetes medicine.

Health Care Emergency Management: Principles and Practice

Jones & Bartlett Publishers; 1 edition (June 4, 2010) | ISBN: 0763755133 | 512 pages | PDF | 4 MB

Recent research underscores a serious lack of preparedness among hospitals nationwide and a dearth of credible educational programs and resources on hospital emergency preparedness. As the only resource of its kind, Health Care Emergency Management: Principles and Practice specifically addresses hospital and health system preparedness in the face of a large scale disaster or other emergency. Administrators, emergency preparedness coordinators, and clinical staff who are charged with managing preparedness and emergency management functions for hospitals or healthcare systems will turn to this guide as an essential reference in planning for disasters, terrorism, and public health emergencies. Health Care Emergency Management is also ideal for emergency preparedness courses in programs of health administration or public health. Through case studies and practical examples, this book engages the reader in active learning about this exciting, challenging, and rewarding field. Key Features: Chapters are contributed by leading authorities on the topic of disaster planning. The only text that focuses on disaster planning for hospitals and health systems. Each chapter offers concrete objectives for focused learning as well case studies and practical examples that help the reader understand key concepts. Downloadable resources including PowerPoints and a TestBank are available for qualified instructors.

Higher Healthcare Costs in 2011

WASHINGTON :- The amount employers spend on their workers' healthcare costs will reach a 5-year high in 2011, and employees will also face larger out-of-pocket costs for their medical care next year, according to a forecast released Monday by the consulting group Hewitt Associates.

Because of higher medical claim costs, an aging population, and changes under the new healthcare reform law, employers can expect to pay nearly 9% more toward their employees' healthcare costs than they did in 2010.

The findings are in line with a recent survey by the National Business Group on Health that asked large employers what they expected to pay for their workers' medical costs in 2011. The answer: about 9% more than in 2010.

The average total healthcare premium per employee working at a large firm will be $9,821 in 2011 -- up from $9,028 in 2010.

Employees will contribute, on average, $2,209, or 22.5% of the total premium, which is a few hundred dollars more than in 2010, when the average employee at a large firm paid 21.8% of their total premium, to total slightly less than $2,000. Once out-of-pocket costs for co-pays and deductibles are factored in, employees can expect to pay about $486 more than they paid toward their medical costs in 2010.

The authors of the Hewitt report say that the new figures mean that healthcare premiums have more than doubled in the past decade and employees' share of their medical costs will have more than tripled.

The high 2011 cost projections are based on a number of factors, the study authors said. For one, employers haven't hired many new employees in recent years, which has resulted in a slightly older work force that is more prone to expensive medical conditions.

Certain insurance market reforms contained in the Affordable Care Act (ACA) -- such as covering dependents until age 26 and eliminating lifetime and annual limits -- contributed to about 1% to 2% to the 9% increase in what employers are likely to pay in 2011.

"After 18 months of waiting for healthcare reform to play out, employers find themselves in a very challenging cost position for 2011," said Ken Sperling, Hewitt's healthcare practice leader, in a press release. "Reform creates opportunities for meaningful change in how healthcare is delivered in the U.S., but most of these positive effects won't be felt for a few years. In the meantime, employers continue to struggle to balance the significant healthcare needs of an aging work force with the economic realities of a difficult business environment."

Hewitt's data came from a database with detailed census, cost, and plan design information for 350 large U.S. employers representing 14.4 million participants and $51.9 billion in 2010 healthcare spending.

Increased Medical Student Debt

The average medical school debt today, according to the Association of American Medical Colleges(AAMC), is $156,456. USA is the only country in the world were future doctors have to bear such a financial burden of their education. That places significant strain on any relationship involving an American medical student.
Student debt statistics
•  $156,456 – According to the Association of American Medical Colleges (AAMC), the average educational debt of indebted graduates of the class of 2009.
•  79 percent of graduates have debt of at least $100,000.
•  58 precent of graduates have debt of at least $150,000.
Why medical education debt has increased
Medical education debt is driven by rising tuition. AAMC data show that median private medical school tuition and fees increased by 50 percent (in real dollars) in the 20 years between 1984 and 2004. Median public medical school tuition and fees increased by 133 percent over the same time period. Other recent 20-year periods show similar trends. Tuition is just one source of increasing debt burdens. Other causes include:
•  Interest accrued on loans over time significantly adds to the total cost of student debt.
•  Students are now entering medical school with more education debt from undergraduate education.
•  Increasing numbers of “non-traditional” students who have children to support.

Is Evidence-Based Medicine a Barrier to Cost-Effective Care?

August 29, 2007 presentation by Alan Garber for the Stanford School of Medicine Medcast lecture series.

Alan Garber, MD, PhD, professor of medicine and the director of the Center for Health Policy and of the Center for Primary Care and Outcomes Research at Stanford University, discusses the importance of distinguishing between a treatment's effectiveness and its value, and in turn what role evidence-based medicine should play in today's coverage decisions.

Health insurance

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Health Care Payments in U.S.

In 2008, the federal government spent $782 billion on health care through the Medicare and Medicaid program. Below is a breakdown of the expenditures incurred by service product.

Cancer Treatment Costs Nearly Double (Exceed $48 Billion, Patients' Out-of-Pocket Payments Decrease)

May 10, 2010 -- The cost of treating cancer in the U.S. has nearly doubled in the past 20 years, according to a new analysis.

The analysis also found that outpatient care has become a trend and out-of-pocket costs to patients have declined.

Researchers from the CDC and other institutions looked at data from the 1987 National Medical Care Expenditure Survey and compared the information with data from the 2001 through 2005 Medical Expenditures Panel Survey. The report is published online in the journal Cancer, a journal of the American Cancer Society.

Among the findings:

* The total medical cost of cancer in 1987 was $24.7 billion, expressed in 2007 dollars.
* The total medical cost of cancer increased to $48.1 billion during 2001-2005.
* The increase is the result of new cases in the aging population as well as an increase in the prevalence of cancer.
* As a share of overall medical expenses, cancer costs remained fairly constant, accounting for about 5% each time period.
* Outpatient care became more common, with the expenses for inpatient care for cancer falling from 64.4% to 27.5% of total cancer treatment costs.
* The share of cancer costs paid for by private insurance increased from 42% to 50%, and the share of out-of-pocket costs fell from 17% to 8%. In 1987, Medicare paid for 33% of costs; by 2001-2005, it paid for 34%.

The researchers note limitations of the study, such as the tendency for cancer patients with advanced disease not to participate in surveys, which may translate to an underestimate of costs. The data don't include some information on the "true burden" of cancer, such as the nonmedical costs for child care, travel, caretakers, and lost productivity.

Even so, the data ''enhances our understanding of the burden of cancer on specific payers and how this burden may change as a result of healthcare reform measures or other changes to healthcare financing and delivery,'' the authors write.

Good Film on COPD and it`s health care costs ($42.6 billion)

Chronic obstructive pulmonary disease (COPD) refers to chronic bronchitis and emphysema, a pair of two commonly co-existing diseases of the lungs in which the airways become narrowed. This leads to a limitation of the flow of air to and from the lungs causing shortness of breath. In contrast to asthma, the limitation of airflow is poorly reversible and usually gets progressively worse over time.

COPD is caused by noxious particles or gases, most commonly from smoking, which trigger an abnormal inflammatory response in the lung. The inflammatory response in the larger airways is known as chronic bronchitis, which is diagnosed clinically when people regularly cough up sputum. In the alveoli, the inflammatory response causes destruction of the tissues of the lung, a process known as emphysema. The natural course of COPD is characterized by occasional sudden worsenings of symptoms called acute exacerbations, most of which are caused by infections or air pollution.

The diagnosis of COPD requires lung function tests. Important management strategies are smoking cessation, vaccinations, rehabilitation, and drug therapy (often using inhalers). Some patients go on to requiring long-term oxygen therapy or lung transplantation.

Worldwide, COPD ranked 6th as the cause of death in 1990. It is projected to be the third leading cause of death worldwide by 2020 due to an increase in smoking rates and demographic changes in many countries.[2] COPD is the 4th leading cause of death in the U.S., and the economic burden of COPD in the U.S. in 2007 was $42.6 billion in health care costs and lost productivity.

COPD is also known as chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD), chronic airflow limitation (CAL) and chronic obstructive respiratory disease.

Money-Driven Medicine

Money-Driven Medicine provides the essential introduction Americans need to become knowledgeable and vigorous participants in healthcare reform.

Endoscopy of Acute Bleeding from a Peptic Ulcer :important implications for health care costs

Acute upper gastrointestinal hemorrhage, which is defined as bleeding proximal to the ligament of Treitz, is a prevalent and clinically significant condition with important implications for health care costs worldwide. Negative outcomes include rebleeding and death, and many of the deaths are associated with decompensation of coexisting medical conditions precipitated by the acute bleeding event. This video focuses specifically on endoscopic management of acute bleeding from a peptic ulcer.

Medicare enrollment problems,Medicare payments

A 3-physician, family medicine practice in Lexington, Va., recently found itself with roughly $40,000 in unpaid Medicare claims -- practice revenue that was in limbo because of a cascade of blunders in Medicare's physician enrollment process.

Brenda Harlow, office manager for Lexington Family Practice since 1981 and, thus, no newcomer to the Medicare game, commented she'd never seen anything like the mess in which the practice found itself recently.

The nightmare started with the completion of Medicare enrollment forms in January. A series of events, including Medicare contractor mailroom mishaps and a lack of clarity about what information the contractor needed from the practice, stretched on for nearly two months, according to Harlow.

Then the hammer came down.
"Payments from Medicare were stopped on March 12," said Harlow. Subsequently, the practice was notified that, as of May 25, all three physicians in the practice could be "barred from Medicare for a year."

Robert Pickral, M.D., has been serving Medicare patients at the Lexington practice since 1981. "What is the message to the physicians of America when this kind of disruption happens?" he asked.
"We operate a small practice in a small community. Revenue is way down, and federal quarterly taxes are due," said Pickral, adding that Medicare patients account for nearly 25 percent of the practice's patient panel.

As of June 2, the practice still had no resolution regarding the Medicare enrollment problems, and it still has not received any Medicare payments.

According to Kent Moore, the AAFP's manager of health care financing and delivery systems, there is no way to know for sure how many other Academy members are experiencing similar problems with Medicare. But "I do know that Pickral's practice is not alone," he said.

"I have exchanged e-mails and phone calls with other AAFP members who have run afoul of Medicare's physician enrollment process," said Moore, adding "in some cases, physicians have had their Medicare billing privileges revoked as a consequence."


Avoiding Medicare Mishaps
Medicare's Provider Enrollment, Chain and Ownership System, or PECOS, may be the source of many problems, including those experienced by Pickral's practice, according to Cynthia Hughes, C.P.C., an AAFP coding expert who works with Moore in the AAFP's Practice Support Division.

The Internet-based PECOS was established in 2003, and physicians who have not submitted an enrollment application since it went operational need to re-enroll, said Hughes.

She also cited physician revalidation rules laid out in the Medicare Program Integrity Manual (275-page PDF; About PDFs). According to the manual, Medicare providers and suppliers "must resubmit and recertify the accuracy of their enrollment information every five years in order to maintain Medicare billing privileges."

According to Hughes and Moore, physicians can be proactive to prevent problems with Medicare. For example, physicians should

* log in to PECOS to see if they are registered there and to ensure that their information is complete and accurate;
* respond to Medicare requests for revalidation of enrollment in a timely manner, so if issues crop up, there is ample time to resolve them; and
* report any provider changes, such as a change of address, promptly.

"Physicians may think Medicare is picking on them, but the real issue is that there are lots of new rules that everyone is trying to follow," said Hughes.

She suggested that physicians who are rushing to beat a Medicare enrollment deadline and who are not already established in PECOS should submit a paper application. "Approval for PECOS registration can take some time," said Hughes.

lawyers opinion :risky business tweeting the symptoms of social media

"To date there are at least 540 hospitals in the United States utilizing social media tools: Hospitals account for 247 YouTube channels, 316 Facebook pages, 419 Twitter accounts, and 67 blogs.

The number of individual and independent medbloggers is in the thousands.

In December of 2009, a hospital employee was forced to resign because of a single tweet.

On October 29, 2008, a patient provided what is believed to be the first live tweet from the operating room. “Bad bad stick. Ow ow ow ow ow.”

In response to online physician rating websites, like Yelp, RateMD, and others, a company now offers physicians an antidefamation service, including contract provisions restricting a patient’s right to make negative comments on rating websites.

There are a number of other scenarios that could lead to liability. For example, what happens if an “off-duty” physician responds to a health question by a neighbor while doing yard work? Suppose the same exchange occurs through online “messages” between a physician and one of the physician’s “friends” on Facebook, creating an electronic record of the exchange that could potentially support the existence of a physician-patient relationship, thereby creating certain liability arising therefrom (e.g., HIPAA, medical malpractice, patient abandonment, etc.).

The authors of a National Law Journal article warn that bosses who “friend” are begging to be sued."

BP is facing a bill of up to $34bn from the Gulf of Mexico disaster

BP is facing a bill of up to $34bn from the Gulf of Mexico disaster after US senators demanded the oil company deposited $20bn into a ring-fenced account to meet escalating compensation costs.

The sum dwarfs many analysts' previous estimates, shared by BP, that put the cost of the clean-up effort and payment of damages to affected communities, such as fishermen, closer to a total of $5bn.

Shares in BP nose-dived by more than nine per cent today as investors took fright at the demand by the 54 Democratic senators, who represent a majority in the US upper house. The company is now worth almost half what it was before the accident of just under two months ago.

BP already faces up to $14bn in civil penalties, payable under US environmental law, assuming the leak is plugged in August. These punitive damages are directly linked to the size of the spill – already estimated at being up to eight times worse than the Exxon Valdez disaster in 1989 – with BP liable for up to $4,300 for each barrel-worth spilt.

Senate leaders insisted the $20bn ring-fenced account should be exclusively for "payment of economic damages and clean-up costs" and should not be seen as a cap on BP's other legal liabilities. With punitive damages pending too, the theoretical total of $34bn is equivalent to more than half the corporation tax paid by all British companies last year.

Tony Hayward, chief executive of BP, and other directors of the company, will meet Barack Obama at the White House on Wednesday prepared to offer concessions in the hope of taking the sting out of mounting political attacks on the company.

BP will be in "listening mode", willing to cut its next dividend, worth about $2.5bn, possibly paying the cash into the clean-up fund. It will also reiterate its commitment to paying all legitimate claims arising from the disaster. But the company does not believe that the demand by the senators to stump up $20bn is justified.

Executives were also alarmed by the White House's insistence last week that BP must pay the wages of rig workers laid off by other firms because of the six-month moratorium on deepwater drilling in the gulf. If pursued, the company fears it would be exposed to potentially limitless claims from anyone affected by the disaster, which would eventually bankrupt the company. The company hopes that President Obama's statement, following the meeting with BP, will draw back from the demand.
Hayward, who was in Houston today overseeing the spill response, hosted a conference call with his board to discuss BP's next move. The company had indicated that it would wait as usual until close to its next results announcement, on 27 July, to decide whether or not to pay its next quarterly dividend. But it is now set to announce its intentions sooner, perhaps as early as Thursday. It is understood BP could use the dividend as a bargaining chip in its talks with the White House.

Obama today risked the wrath of families of 9/11 victims by comparing the gulf spill to the 2001 terrorist attacks, as pressure intensified on the White House to show greater urgency over the crisis.

Ahead of a trip to Louisiana and a televised address to the nation tomorrow, Obama said the spill, the worst environmental disaster in US history, would, like the 2001 terror plots, continue to influence the country for decades to come. Some people who lost relatives in the 9/11 attacks rejected the comparison. "I think he's off-base," said Jim Riches, a former New York fire department deputy chief, whose son died at the World Trade Centre. "These were 9/11 murders … not something caused by people trying to make money."

Bad aspects in American health care system

1. Most physicians do not set their own fees. Medicare, Medicaid, and private health plans set these fees, which often have little to do with the costs of doing business.

2. Congress each year sets Medicare fees through a formula called SGR (Sustainable Growth Rate), which this year calls for a 20% reduction in overall physician fees.

3. If SGR were to go through as to proposed, surveys indicate at many at 30% of physicians will not accept new Medicare patients because new Medicare fees will not cover expenses.

4. The next political crisis will be limited access to doctors; this is already occurring in Boston, where waiting times to see doctors are 2 to 3 times the national average for comparable cities.

5. Medicare on average pays 80% of what it costs to provide care: hospitals and doctors make up the difference by negotiating higher payments from the much maligned private plans.

6. An estimated 10% of health costs are due to the practice of “defensive medicine,” whereby doctors order extra tests and procedures in anticipation of defending themselves again future malpractice lawsuits.

7. Passing federal laws permitting patients to enroll in plans and “portability” of plans across state lines would make a public option unnecessary and would render private plans “competitive.”

8. Ending “community ratings,” which force the young to pay the same premiums as older individuals, and reducing “standard benefit plans, “ which often include unnecessary benefits, would reduce premiums for the young and decrease the number of uninsured.

9. The primary care shortage is real and growing because medical students are smart and are not choosing to work twice as long as specialists at 1/2 the pay; doubling Medicare pay for primary office visits would be a good start for relieving the crisis.

10. The surest way to reduce costs is having patients spend more of their own money and making them more responsible for their health, which is the premise of lower-premium health savings accounts and high deductible plans.

Why does a CT scan cost so much in USA? (billions dollars on Defensive Medicine)

It started as a simple stomach ache, but Alexandra Varipapa, a sophomore at the University of Richmond, decided to go to the emergency room.

There, doctors ordered a full CT scan, a radiation imaging test, which found a harmless ovarian cyst. She never questioned the CT scan, CBS News correspondent Wyatt Andrews reports.

But her father did - when he got the $8,500 bill, $6,500 of which was that CT scan.

“I was pretty flabbergasted,” said Robert Varipapa, himself a physician.

Varipapa says his daughter's pain could have been diagnosed far more easily and cheaply with a $1,400 ultrasound.

“A history, a pelvic examination and probably an ultrasound,” he said. And he would have started with the ultrasound.

But the hospital defends the CT scan, saying an ultrasound might have missed something more serious.

“It would not have ruled out appendicitis obviously, it would not have ruled, necessarily, out a kidney stone,” said Dr. Bob Powell, ER medical director of Bon Secours St. Mary’s Hospital.

Varipapa agrees, but asks why not start simple - and do the CT scan only if necessary?

“Well it's my opinion this is defensive medicine,” Varipapa said.

Defensive medicine is what happens when doctors order too many tests because they are afraid of missing a diagnosis and later losing a multi-million dollar lawsuit for malpractice. Defensive medicine these days is so pervasive, some estimate its yearly cost at more than $100 billion.

Dr. Kevin Pho runs the popular medical blog, Kevin M.D., where doctors routinely confess exactly how they run up costs by practicing defensive medicine.

“Defensive medicine is bad medicine,” Pho said.

In a post, one ER doctor says he's just admitted two patients to the hospital - when he was sure "neither was having cardiac (problems), but what am I to do?"

Another admits that in his practice, “every patient with a headache gets a (CT) scan.”

“It's much easier to defend the fact that you ordered a test than it is to not order the test at all,” Pho said.

And the costs of defensive medicine today are increasingly paid by patients, even those with insurance - because of rising deductibles and co-payments.

“There’s no doubt in my mind this is a significant driver in health care costs today,” Pho said.

Source : CBS News

Not the Best, Only the Most Expensive

Money-Driven Medicine provides the essential introduction you need to become knowledgeable and vigorous participants in healthcare reform.Americans spend two times more per capita for healthcare than the average rich country, one-sixth of the GDP.
"Money-Driven Medicine" reveals that the profit-driven "medical-industrial complex" has over-built the healthcare sector producing a powerful, distorting incentive for billions of dollars of pointless, even risky, tests, prescriptions and surgeries. This pay-per-service system drives doctors into lucrative specialities, while primary care physicians have become an endangered species. Million dollar diagnostic machines stand idle while emergency rooms overflow.

Medical malpractice from both a doctor and lawyer perspective,and Payment receiving

Medical malpractice is a major issue that divides doctors and lawyers — with patients often left in the middle. reform is sorely needed, mainly to help injured patients be compensated more quickly and fairly than they currently are:

Researchers from the New England Journal of Medicine found that nearly one in six cases involving patients injured from medical errors received no payment. For patients who did receive compensation, they waited an average of five years before their case was decided, with one-third of claims requiring six years or more to resolve. These are long waits for patients and their families, who are forced to endure the uncertainty of whether they will be compensated or not.

And with 54 cents of every dollar injured patients receive used to pay legal and administrative fees, the overhead costs clearly do not justify this level of inefficiency.

In this clip, perspectives from both sides are given, and it’s easy to see why this contentious issue isn’t going to be resolved anytime soon.

Financial Help With Diabetes Medicine

In order to obtain financial help with diabetes medicine, it's important to have health insurance or to look into government-regulated programs. Learn about drug companies that will give medication at a discounted price with help from a licensed RN in this free video on diabetes medicine.