Archive for Tom Emerick

Some Cancer Experts See ‘Overdiagnosis,’ Question Emphasis on Early Detection

Thus reads a headline in a WSJ report (subscription required). Melinda Beck is the author.

She writes, “Early detection has long been seen as a powerful weapon in the battle against cancer. But some experts now see it as double-edged sword.”

Further, “…some leading cancer experts say that zealous screening and advanced diagnostic tools…” That in turn can lead to treating harmless abnormalities which can involve chemotherapy, radiation therapy, and surgery, all based on over diagnosis.

Says Laura Esserman, a breast-cancer surgeon at the University of California, San Francisco, “…We’re not finding enough of the really lethal cancers, and we’re finding too many of the slow-moving ones that probably don’t need to be found.”

This is not news to regular readers of Cracking Health Costs, but simply affirmation of the maxim, Patients Beware.

Hat’s off to Malorye Branca for the tip on this story.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

Do you want to see where some medical fraud dollars go?

Just click here.

In the case of David Nicholl, $5M want to a muscle care collection, $700k went to his girlfriend’s apartment, and $154k went to strippers, according to the Yahoo story.

Quite a guy, no? Your health dollars at work.

Even more good news: CMS reverses bad decision

In May of this year, CMS announced it would no longer publicly report certain types of adverse patient events in hospitals, a sad day for transparency.

Thanks in no small part to the rigorous efforts of the Leapfrog Group and it’s excellent leader, Leah Binder, CMS has reversed that decision.

Kudos to Leapfrog and Leah Binder for working hard to protect patients.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Great news: the launch of Care Innovations’ Validation Institute

The launch of the Care Innovations’ Validation Institute, a joint initiative between GE and Intel, is a major step forward in the world of population health management…a genuine game changer.

GE and Intel are doing what the government has failed to do, which is help employers determine which vendors actually do something — and that it is a direct challenge to the wellness industry to prove they can do anything other than overdiagnose and potentially harm employees with too much medical care. Maybe GE and Intel can ignite a wave of responsibility in corporate America, reversing the misguided mania of “playing doctor” with your employees.

The goal is to “help organizations involved in population health – from Health Plans to Employers to Vendors of solutions to the industry – adhere to the highest standards of validity, allowing them to compete on the basis of integrity and performance.”

The Institute will “impartially challenge the status quo of typical population health outcomes measurement, with the objective of impacting how the industry establishes its credibility over time. To achieve this objective, we seek cooperation from across the healthcare industry – only through cooperation can we start to move the industry to a place of trust and credibility.”

The Care innovation’s Validation Institute was founded because of the massive amount of misinformation put our by vendors in the world of population health management. Readers of Cracking Health Costs will recognize the need for this: vendors which claim impossible ROIs, make absurd interpretations of data, etc.  Examples Al Lewis and I have used are wellness vendors who claim to reduce risks of heart attacks by over 100%, or who claim to have discovered huge numbers of people with previously undetected cancer, both of which were later determined to be gross errors at best or outright fraud at worst.

If you are a population health vendor whose business is fueled by ridiculous outcomes claims, beware.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Why Doctors Are Sick of Their Profession

A recent essay in the WSJ (subscription required) discusses why doctors are sick of their profession.

The article explains that doctors:

  • have to work harder to make a living
  • don’t get the respect they they used to get
  • are in a profession “just like everybody else”
  • made sacrifices but but their work is just a job like every one else’s
  • etc.

How are they different from everyone else? Up until about 1980 or so, if you were an business school, engineering school, etc, graduate and went to work for a company, you likely:

  • had a job for life
  • were well respected
  • had a defined benefit pension
  • were treated like an asset to your company
  • worked a forty-hour week

These days MBA’s and masters level engineers at the same companies are working 50-60 hour weeks, battle every day to dodge the next 10% staff reduction, provide for their own retirement through 401k’s, will likely have to change jobs 5 times in their career, and know they are perfectly expendable.

In many high-paying big companies, the day they hire you they shoot a bullet at you. Your job is to see how long you can outrun it.

Employees, despite how hard they worked to get a good job, are stressed, dissatisfied, and fearful.

The cushy days ended years ago for most people.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

Hospital charges $9,000 to bandage cut middle finger, report says

Yes, you read that headline correctly. According to a Fox News report, a man went to the Bayonne Medical Center with a cut on his finger. Per the article, “…he was sent home after he got a tetanus shot from a nurse practitioner who also sterilized the cut, applied some antibacterial ointment to it, and put a bandage on it.”

He bill was nearly $9,000. Sounds like the hospital “mugged” the patient.

The CEO of the hospital, Mark Spektor, gave an absolutely hilarious response when questioned about the charge, He said the patient’s “… visit cost so much because his insurance carrier United Healthcare refuses to offer fair reimbursement rates.” (Emphasis mine.)

The CEO’s comment is the ultimate non sequitur. So the hospital charged an outrageous fee to an innocent patient because…what?…Bayonne Medical Center doesn’t like United’s fees? How absurd.

I’ve written about cowboy doctors who are wasting hundreds of billions in healthcare dollars.  There are cowboy hospitals too.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Get off the fence and chose sides

It is time to get off the fence and choose sides. Corporate benefit managers, listen up.

This is part 2 of a recent post about Dr. Sandeep Jauhar’s welcome expose’ of poor healthcare in America, in his book, “Doctored: The Disillusionment of an American Physician”

His book is an important one, but on key issues he wants to have it both ways.

On the one hand he laments physicians who order expensive, invasive, and futile care for patients even when the patients clearly don’t want it. On the other hand he complains about his frustration with having to get authorization from insurance companies for care he wants to deliver to his patients. Those two notions are mutually exclusive.

Equivocation on important healthcare problems has created the healthcare chaos we have today. Concerned parties need to choose sides, especially corporate benefit managers.

BWT: “Medical school applications have risen by 38% from 2003 to 2013,” according to an article in the WSJ by Thomas Stossel.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Cardiologist Speaks From The Heart About America’s Medical System

This is the headline in an NPR story about Dr. Sandeep Jauhar. It is a truly sad story about what is wrong with the practice of medicine in America.

Jauhar wrote a memoir about his career and a cardiologist, called “Doctored: The Disillusionment of an American Physician”. The picture he paints is not a pretty one, but the themes he explores will be familiar to regular readers of Cracking Health Costs.

According to Jauhar, doctors are increasingly unhappy with their work. [That] growing discontent has serious consequences for patients.”

Of so-called “defensive medicine”, e.g., ordering excessive tests, etc., he says some is associated with fear of litigation, but much is simply convenient and profitable.

He writes if you have a rare and dread disease you’re lucky to live in America.  “But if you have run-of-the-mill chronic diseases like congestive heart failure or diabetes, the system is not designed to find you the best possible care.”

One of the most dangerous aspects of care in America is “uncoordinated care by multiple specialists”. Further, “Today if you go to a hospital, it’s rare that you won’t have multiple specialists on your case.”  Lack of genuine coordination among specialists leads to misdiagnoses and poor treatment plans.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Pioneering new injection to cure heart failure without need for major surgery

So reads a headline in a good article in The Telegraph, a UK newspaper.

Per the article, “The technique, which involves a simple injection, could aid the recovery of hundreds of thousands of heart failure patients – and could even consign heart transplants to history.”

Great news, yes?  Not so fast…

But before anyone goes GaGa over this news they need to consider this: if this technique proves out, it will have a small impact in the US. The problem here is that many of the invasive heart procedures in the US now have safer, effective, and less expensive medical alternatives, but “cowboy” doctors in the US disregard such alternatives in a wholesale way.

Why do so many US doctors ignore effective, proven, medical alternatives to surgery? Because they get rich doing so. That’s why.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

‘Cowboy’ Doctors Could Be A Half-A-Trillion-Dollar American Problem

That is the title of a terrific article published in Common Health—Reform and Reality.  The author is Carey Goldberg.

“Cowboy” doctors are defined as ones who “…who deviate from professional guidelines, often providing more aggressive care than is recommended — are responsible for a surprisingly big portion of America’s skyrocketing health costs. The paper concludes that ’36 percent of end-of-life spending, and 17 percent of U.S. health care spending, are associated with physician beliefs unsupported by clinical evidence.’ ”

Oddly, some of the more elementary doctor rating systems tend to be biased in favor of Cowboy doctors in their methods by giving higher ratings to specialists who do comparatively more surgery that their peers, the very ones who may well may be the Cowboys this article describes. My advice about doctor quality ratings: caveat emptor.

EdisonHealth carefully screens to ensure the doctors in it’s Centers of Excellence programs are not, repeat not, Cowboys.

Many of the worst Cowboy doctors are in cardiology and orthopedic surgery, but Cowboys are even doing a load of transplants that are clearly contraindicated for the patients at an average five-year cost of about $1.5 million.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price. Click here: Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of EdisonHealth. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.