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| Titre | Date | Durée | |
|---|---|---|---|
| Robert Kennedy Jr.’s Priorities for Making America Healthy Again With Dr. Eric Larson | 19 Nov 2024 | 01:27:14 | |
Dr. Eric Larson of the Paradocs podcast joins me to discuss what we think RFK Jr. wants to do if confirmed as head of the Health and Human Services division, what he might get done, and some priorities he ought to do to make America healthy again. q
Video - https://youtube.com/live/wt69j-XebVg
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| How to Save Over 50% on Health Care at Your Business | 20 Aug 2023 | 00:56:08 | |
Are you a decision maker at your business? If you're a CEO, CFO, the head of HR, or perhaps the owner of a small, medium or large business then you owe it to yourself to check out this fairly simple solution to save over 50% on your health care spend.
Health insurance is usually one of the biggest overhead expenses after salaries for any company and it affects the bottom line of nearly every business. Imagine what your company could do if it paid out less than 50% in its health care spend - while also maintaining a similar if not improved plan for employees.
Before you scoff and say that there is no way you can provide your employees high quality care at less than half the cost, just remember that only about 25% of every dollar spent in health care actually goes to caring for patients. There's plenty of room to cut.
Why Health Insurance Is So Expensive?The reasons for expensive insurance is obviously a complicated question. However, it's simplest to think of it in just a few ways - especially when we look for ways to bypass the rotten system to save real money for our business.
The insurance companies make money by paying out a lot in claims. This seems illogical at first glance but makes a lot of sense once you realize that the insurance companies are only allowed to use 15-20% of the total they pay out in claims towards profit and overhead. Therefore, the more in claims payouts, the higher amount they can profit.
Pharmacy benefit managers (PBMs) hang onto the rebates. Instead of passing on the volume discounts (or rebates) onto the employers and employees they keep that percentage of charges. Just like the insurance companies, the more that is paid out in charges the greater revenue they get to keep leading to ever increasing pharmaceutical prices.
Insurance brokers primarily make their money through commissions from the insurance companies. This incentive leads them to find only solutions for your company that involve large insurers. The only way you can actually save money is to bypass the traditional means of creating a health plan which most brokers are not aligned to do.
Building a Better Health Plan?What becomes readily obvious as far as solutions go is that you must create your own self-funded health plan and find transparent PBMs and rational contracting to pay for services. Very few companies are prepared to do this which is why you need to find insurance brokers and third party administrators who can set it up for you. There are plenty around, you just need to seek them out.
I've had two on in the past whom I reference in the show. Of course, they are hardly an exhaustive list of players in the field but they would be a good start for anyone investigating these solutions for their business: Katy Talento of All Better Health and David Contorno of Epowered Benefits.
show notesEpisode 176: Today's show
Episode 111: Katy Talento tells us how she saves businesses money.
Episode 150: David Contorno explains his business model.
Episode 043: How PBMs jack up drug prices.
All Better Health: Katy Talento's business where she helps others create their own health care plans.
E Powered Benefits: David Contorno's business helping others create health care solutions.
We Are Libertarians: The Paradocs is a proud partner and member of this outstanding podcast network.
Top 20 Physicians Podcasts
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Always Andy's Mom: Home of my wife, Marcy's, podcast for parents grieving or those looking to help them.
YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.
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| Surgeon Fired Over His Opinions - Mines Bitcoin Instead with Dr. Buck Parker | 30 Apr 2022 | 00:50:26 | |
What would you do if you were fired by your employer over something you had said on social media? Would you be able to survive or would you have to scramble to find work? That scenario is exactly what was faced by today's guest, general surgeon Dr. Buck Parker. And his solution was a surprising one.
Seeds of an EntrepreneurIt doesn't appear that Dr. Parker never set out to find ways to be financially secure outside of medicine. His path through medical school and his general surgery residency seemed fairly traditional. However, there were signs that he had an entrepreneurial streak about him as he began a very small online business selling gym equipment. Following that, he landed a role on a reality TV series which led to another starring role on a second show.
Aside from practicing clinically as an acute care and trauma surgeon, Dr. Parker leveraged his appearances on TV and built up a following on social media through Instagram and YouTube. And that's where the trouble began.
Losing Your JobDr. Parker's termination within his hospital system in 2020 happened a lot like the old joke in bankruptcy. "How do you go bankrupt? Gradually and then suddenly."
Parker's CMO had been very upset with his YouTube channel and social media presence for some time and when Parker published a video stating that the highest risks for COVID are those who are obese, elderly, and with medical co-morbidities, it was the final straw. Perhaps it was because the video went viral and the light it shone on an institution that didn't want any attention paid to it. No matter the reason, it was the end of the line for Dr. Parker's Salt Lake City surgical career.
Overcoming Job Loss as a MinerPerhaps by happenstance, Dr. Parker had researched and eventually took the plunge to mine bitcoin. Fortunately for him, the price of bitcoin exploded from a few thousand a coin to tens of thousands from the time he started to the time he had been let go. It more than supplemented his income lost as a surgeon and gave him the financial freedom to be able to walk away and not worry about scrambling to get another job.
It's now been almost 18 months since being let go and the CMO has been replaced and the hospital has been busy. So busy they actually asked him to return but he declined. For right now, Dr. Parker doesn't see himself going back to medicine but time will tell.
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| Emergency Episode on Fixing Michigan's Surprise Billing Problem | 04 Nov 2019 | 00:21:51 | |
Surprise billing is a nationwide problem and Michigan is not immune. Surprise billing refers to the instance where patients are expecting their insurance company to pick up the entire tab of a medical bill but they instead find a huge bill for the amount 'left over.' The worst instances of this occurring is when the patient unknowingly encounters someone who is 'out of network' with their insurance company.
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| Episode 067: What's the Over/Umbehr on Direct Primary Care Becoming the Dominant Force in Primary Care. A Discussion with Dr. Josh Umbehr of Atlas MD | 31 Oct 2019 | 01:00:38 | |
Direct primary care is just starting to really accelerate within the primary care world. And Josh Umbehr, MD has been at the forefront with his practice and line of products to service DPC doctors at Atlas MD.
In this episode, we discuss the state of DPC, how commercially there are more people looking to get involved in selling ancillary services, and the battle he and other DPC docs are having with their own professional society, the American Academy of Family Physicians.
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| Episode 066: The Fight to Dispense Medications in Doctor's Offices. A Discussion with Dr. Kris Held. | 23 Oct 2019 | 00:54:10 | |
Dr. Kris Held is the president of the AAPS and is an ophthalmologist in private practice in San Antonio, TX. She is suing the state of Texas to have the right to dispense drugs to her patients in her office. This would improve patient safety, reduce costs by over 50%, and is already being done in 44 states and the District of Columbia. We discuss her lawsuit, how she practices as a surgical specialist without insurance, and more.
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| Episode 065: Communist China & Its Crackdown on Hong Kong & Minorities with Jennifer Zeng | 18 Oct 2019 | 01:07:08 | |
My discussion with Jennifer Zeng, a Chinese woman who was persecuted by the communist government for her beliefs. She is an author and activist working to bring to light the actions of China on its own people and those in Hong Kong. We discuss growing up in China, who China tortures, their process of murdering political prisoners to sell organs for transplant, and what the struggle in Hong Kong is all about.
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| Episode 064: Solo Nurse Practitioners - What's the Controversy? | 10 Oct 2019 | 00:58:48 | |
What's the deal with nurse practitioners (NPs)? Why is there so much anger from physicians and NPs when it comes to how patients are treated? Every day on my twitter feed I hear about how nurse practitioners are "acting like doctors without the necessary training" and are "dangerous because they know nothing." Meanwhile my friends who are NPs and PAs cite studies that claim they provide better care than physicians. Both camps' arguments are hogwash.
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| Episode 063: Are Non-profit Hospitals Making a Killing? A Discussion with Dr. Richard Menger | 02 Oct 2019 | 00:52:40 | |
Today's discussion is about hospitals. Namely, what does it mean to be nonprofit? Over half of all hospitals in the United States are not for profit entities - but do they really look differently than for profit institutions? That is the question that few politicians or those debating health care speak about. In many instances, one would be hard pressed to know whether hospitals are for profit by how they run.
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| Episode 062: How to Be Flexible Running A Different Kind of Physical Therapy Practice. A Discussion with Joe Kik. | 19 Sep 2019 | 00:55:41 | |
I haven't spoken to a lot of ancillary medical professionals in the show and explored ways that they are changing the way we deliver medical care. Today I spoke to a physical therapist who chose to run his practice unlike traditional practices. He doesn't structure therapy based on what maximizes revenue from insurers but instead on treating the patient and their injury.
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| Episode 061: Why Government Run Health Care Serves the Poor Poorly. A Discussion with Dr. Rebekah Bernard | 11 Sep 2019 | 00:48:20 | |
Serving the poor in health care is a mission that many enter medicine to do. Whether that is through medical missions, working free clinics, or in some other way - doctors are doing what they can to help the poor receive care. Some choose to work in underserved regions of the country both urban and rural that are paid in part by the federal government. These clinics are called federally qualified health centers. The question we must ask is if these clinics are the best way to serve the poor.
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| Episode 060: An Irish Doctor Compares the UK's NHS to the US Medical System. A Discussion with Dr. Clodagh Ryan | 04 Sep 2019 | 00:59:30 | |
Irish doctor Clodagh Ryan worked in the UK's NHS and US as a family doctor. She says the NHS has some advantages but they come at a cost to patient care. Among those are excessive wait times, reduced innovation, and poorer outcomes in certain treatments.
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| Episode 059: Allergist Says Direct Care Is Nothing to Sneeze At. A Discussion with Dr. Nikhila Schroeder | 20 Aug 2019 | 01:07:28 | |
Direct care is a newer way of providing care to patients. It is a cash system without insurance. Direct care is now becoming more common for specialists. My guest is an allergist who has adopted this model and practices medicine the way she wants that isn't rushed or filled with bureaucratic paperwork.
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| The Way to Build False Scientific Consensus with Dr. Jay Bhattacharya | 14 Apr 2022 | 00:55:54 | |
Dr. Jay Bhattacharya returns today to further our discussion on the dysfunction within the scientific community around COVID-19. Specifically, we discuss what exactly happened to Dr. Bhattacharya after he co-authored the Great Barrington Declaration where he and two other prominent academicians laid out a case for a more focused protection plan for the elderly than the widely adopted general lockdowns and mandates at the time. Dr. Bhattacharya was not surprised to face opposition to their plan - but the way it formed and by whom did.
A Government Bureaucratic Cabal?After the publishing of the GBD, the attack against Dr. Bhattacharya and his co-authors was blistering, numerous, and seemingly coordinated. Those on the outside, and even Dr. Bhattacharya himself, believed that the scorn from media, government, and academia was due to a general disagreement with their position - not a coordinated attack. It turns out that FOIA documents of emails from Drs. Fauci (head of NIAID) and Collins (head of NIH) prove that they worked in tandem to discredit the GBD through their contacts within the scientific, media, and government communities.
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| Episode 058: Is Self Care the Best Care? With Dr. Wayne Jonas | 09 Aug 2019 | 00:58:36 | |
Self Care is the term used to describe how patients can take care of themselves and use techniques to improve their health and healing. Utilizing self care is a component of integrative health where traditional medical services are combined with other strategies to help patients recover from illness or deal with chronic conditions.
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| Episode 057: Men Have More Heart Disease Than Women, Really They Do. A Conversation with Dr. Anish Koka | 30 Jul 2019 | 00:45:07 | |
February marks the month designated by the American Heart Association as its "Go Red for Women" campaign to raise awareness of the real risk of heart disease in women. Too often, men are seen as the victims of heart attacks and people forget that women can suffer from heart disease as well. In fact, women die more from heart disease than men, right?
Well, not exactly. And that's what we discuss in the show.
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| Episode 056: Getting Ripped Off by Health Insurance | 24 Jul 2019 | 00:35:00 | |
Everyone needs health insurance, right? Health insurance keeps you from going bankrupt, right? But what if it ends up costing you more for basic expenses?
In this episode, I recount my experience getting a 2000% markup on a laboratory test. I explain how this is a perfect example of so much that is wrong with our health care market.
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| Episode 055: Surviving the Zombie Lab Scandal with Dr. Molly Rutherford | 19 Jul 2019 | 01:00:25 | |
Zombies aren't real, but sometimes they sure seem like it. Especially when it involves medicine and the law. Health Diagnostics Laboratories (HDL) went into bankruptcy after being discovered it was ripping off patients by overcharging them and providing kickbacks to doctors and health organizations for using their services.
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| Episode 054: Abortion and Catholic Hospitals with Stephanie Slade | 09 Jul 2019 | 00:49:19 | |
The topic of abortion seems to have gained more momentum in the news cycle of late with states passing laws relaxing or loosening restrictions on the practice. It feels like the 1973 ruling of Roe v. Wade might actually come before the US Supreme Court.
As a physician and hospital, the social and ethical questions that surround abortion are both personal and professional. What is the obligation of institutions to perform abortions? How about the physicians or nursing staff?
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| Episode 053: The UK's NHS - Love It or Leave It? Dr. Philip Booth of IEA | 02 Jul 2019 | 00:40:44 | |
National health care policy is always at the forefront of the political discussion in the US. Democratic candidates are offering their visions of what the US system should look like and point to other countries in the world. One held up is the United Kingdom and its National Health Service (NHS). But is it better than what we have here?
My guest today is Philip Booth. He has written on the health care policy in the UK and is able to describe the UK system and how it differs from the US and Europe.
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| Episode 052: Bringing Joy to Medicine with Dr. Amaryllis Sanchez Wohlever | 25 Jun 2019 | 00:41:00 | |
Physician wellness has come to the forefront today as health systems deal with ever increasing numbers of physicians dealing with mental illness and even suicide. There is no shortage of explanations nor ways the health systems are trying to fix these docs. Dr. Sanchez Wohlever has personally dealt with burnout and offers her own prescription for solving the problem. Its systematic approach is both simple and personal.
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| Episode 051: Managing Your Finances as a Student with the Physician Philosopher | 19 Jun 2019 | 00:58:34 | |
One of the most important things a young student can do to help their future is to pay attention to finances when he or she is young. This means to focus on minimizing debt, living lean after you get a paying job, and investing a sizable amount of your take home pay to achieve financial independence.
Dr. James Turner, aka the Physician Philosopher, is an anesthesiologist and hosts a very popular financial website to help those in medicine to navigate the treacherous waters of finance.
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| Episode 050: Psychiatric Hope for Docs: A Discussion with Dr. Marnie McGrath | 11 Jun 2019 | 00:49:13 | |
Physician burnout and mental health problems have been well documented as has the physician suicide epidemic. Health systems implement wellness programs and have mental health awareness initiatives. However, the wellness programs do a poor job addressing the root causes of burnout and physicians have a hard time getting mental health help because of the professional stigma and inability to be sure that their treatment is truly confidential.
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| Episode 049: The Template for a Better Health Care System | 06 Jun 2019 | 00:38:05 | |
There has been no shortage of ink spilled arguing how we fix our broken US health care system so today I will use the spoken word instead. Fundamentally, we all want the same things from the system: Quality care, Affordable care, and Access to care. The real question is how do we move from here to there? Are there people who have fixed these problems even on a small scale that we can use as guides to work things out? Finally, should we look off shores for solutions to our woes?
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| Using Blockchain to Solve Health Care with Ray Dogum | 03 Apr 2022 | 00:52:38 | |
The US health care system is fraught with all sorts of problems. Many of these have to do with consolidation in the market and scores of rent-seekers (those using legislation and regulation to maintain their market share. Those issues can probably be best resolved with fundamental changes within the halls of government. However, some of these problems can be addressed with new technology which offers solutions not even dreamed possible a few years ago. And the driver of much of this innovation rests on block chain technology.
Block Chains to the Rescue?
The basics of block chains have been discussed on this show where we explained the basic concept of what it is and how it works (here and here). We also looked at some helpful business applications such as decentralized finance and how that could unlock capital and make for opportunities for small medical practices. However, the real allure of block chain is whether it can solve some of the bigger problems in health care and bring about real structural change to the problems that plague doctors and patients alike: information sharing, supply chains, and payment processing.
Patient Information Sharing and Storage
Big Data is big money and there is no more valuable data set than patient health information. Companies pay millions of dollars for this data to develop health processes and businesses to manipulate the data to change patient behavior, physician behavior, and new businesses. However, the biggest problem is that the patient has no ownership of their information meaning that they cannot decide if the data is used or be compensated if it is. The possibilities of the block chain allow for patients to control their information and dictate those to companies - not the other way around.
Additionally, patients owning and securing their own data would allow for more accurate and safer transfer of their personal medical information when traveling between medical systems, EHRs, or even health providers within the same system. In essence, a patient could only transfer the information they want and deem important to a particular provider and no more. A quick example would be to just provide personal demographic information to an imaging center and not all their health history.
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| Episode 048: Bringing Markets to Medicine with Health Sharing Ministries. A Discussion with Matt Bellis of Liberty Health Share | 21 May 2019 | 00:48:41 | |
This podcast has been dedicated to bringing you disruptors to the health care market and today's show features a discussion about health sharing ministries. The ministries work as a substitute to carrying health insurance allowing for people to use the service to pay their medical bills. Individuals pay a "sharing amount" each month which is then aggregated by the ministry amongst its members and sent to those with medical bills.
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| Episode 047: Making Direct Care Work as a Gynecologist with Dr. Deborah Herchelroath | 15 May 2019 | 01:01:02 | |
Today, we continue our journey discussing physicians who are using direct patient care through a membership model as disruptors in the health care field. Direct primary care is one of the most disruptive and innovative models to emerge in recent years and more and more specialties are looking for ways to adopt the insurance-free notion of providing care to patients. Now we can add an OB/GYN to the ever growing lists of physician specialties as I discover the practice of Deborah Herchelroath, DO.
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| Episode 046: Using Midwives to Lower the C/Section Rate with Dr. John LaGrand | 08 May 2019 | 01:04:11 | |
For women, a very scary and anxious time of their life is pregnancy. C/sections are a very common procedure in the US for women constituting 33% of all live births.
However, my guest Dr. John LaGrand's practice, in which he works collaboratively with four certified nurse midwives (CNMs), he believes is a different way to practice obstetrics and has led to a c/section rate of only 5%.
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| Episode 045: Why Carrots & Sticks Won't Work with Doctors. A Discussion with Dr. Ryan Neuhofel | 23 Apr 2019 | 01:00:49 | |
One of the great challenges to those paying for our health care today is determining who is high quality, who is truly expensive , and who is doing the right thing. Unfortunately, the payers in medicine are not the patients but third parties like Medicare. Since the person receiving the care is not directly paying for the service, administrators in an office have to make the determination of how to pay without experiencing the care and knowing whether the physician was providing the right care.
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| Episode 044: Physicians as Leaders with Dr. Jack Cochran | 17 Apr 2019 | 01:13:52 | |
Physicians today need to be more than healers. They need to also be leaders for their patients and partner with the patients throughout all aspects of care. Until we as physicians take an active role in finding solutions to every problem encountered by our patients, we aren't doing our job. This includes being mindful of the cost of tests, procedures, and pharmaceuticals and doing something to lower those costs to make getting the necessary care affordable.
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| Episode 043: How PBMs Jack Up Drug Prices with Dr. Madelaine Feldman | 10 Apr 2019 | 00:59:26 | |
How do PBMs (pharmacy benefit managers) pass on savings to themselves and leave patients and insurance companies holding the bill? It's hard to answer that question without first understanding what a PBM is, how they work, and what their role is in the pharmaceutical market. Unfortunately, the PBMs intentionally cloud what they really do in order to continue ripping off patients and insurance companies with unnecessarily high drug prices.
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| Episode 042: How to Fix US Health Care and Other Simple Questions | 30 Mar 2019 | 01:25:57 | |
This week's episode is a longer interview I did as a guest on the Gray Matters Radio Podcast with Mike DeVine. He had me appear in February as part of his series exploring the US health care system and its many dysfunctions. In this episode we explored the problems with the pricing system, group purchasing, economic scarcity, and why things are just so darn expensive. Of course they all get answered and wrapped into a nice little bow at the end of the interview.
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| Episode 041: An Otolaryngologist Sticks Her Neck Out and Actually Discusses Prices Ahead of Time. A Discussion with Dr. Elaina George | 19 Mar 2019 | 00:53:01 | |
Only in medicine is discussing prices before providing care a revolutionary concept. Prices serve as an important signal to both providers and patients as to the relative scarcity of care. Whether that is time with a physician, time in the operating room, the cost of equipment necessary for procedures, or medications the price signal is important for both sides to understand the real cost of using resources.
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| Episode 040: How Prior Authorization Delays Care and Frustrates both Patients and Physicians with Dr. Mark Lopatin | 12 Mar 2019 | 00:52:10 | |
How would you feel if someone who didn't know, was unfamiliar with your symptoms and story, and had never examined you dictated the way you were treated? Would you be upset if the people making those decisions were not specialists or maybe even had the same training as a physician? Unfortunately, this practice is very common today in every doctor's office in America and it is called prior authorization.
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| Episode 039: Is Mental Health Broken? A Discussion with Counselor Michael DeVine | 06 Mar 2019 | 00:55:54 | |
If there were a conventional treatment for a disease in a traditional medical practice that worked only 10% of the time or less - would anyone feel comfortable claiming it was a fantastic cure? I suspect not, yet those abysmal successful treatment numbers are present in some areas of the mental health arena when it comes to addiction treatment. However, you almost never hear about the failure of the 12 step programs or outpatient treatment plans and their high failure rate. Why is that?
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| Episode 164: Medical Education Credentialing Boards - Follow the Money with Charles Kroll and Elizabeth Tremblay | 11 Mar 2022 | 00:45:32 | |
There's no shortage of an alphabet soup of government agencies but the same exists within the nebulous public-private sphere of medical education and credentialing. These non-profit organizations were created to ensure a baseline within medical education institutions across the entire country for medical students, foreign medical graduates and residencies. However old and established these institutions are, they are still staffed by people who make decisions and are charged with maintaining the organizations financial stability.
But, since they don't have any real competition, they can make financial decisions that are not always the best for the long term viability of the organization which can lead to problems in the future. Sometimes those futures become the present and people paying for their services, ie, medical students, residents, and foreign medical graduates take the brunt of their poor fiduciary planning.
The real financial risk to many of these organizations is similar to what threatens governments at the local, state, and federal level: pensions.
The Sorry State of NBME's Pension ProgramCharles Kroll is a forensic accountant which means he is adept at parsing financial reports and determining where money is flowing and where the inherent financial risks are to organizations. With the help of analyst Elizabeth Tremblay, they have analyzed the financial data from the National Board of Medical Examiners (NBME) - which conducts the testing for medical students - and have found troubling signs. Foremost is that the NBME has a retirement fund that is worth almost $300 million which is twice the value of the organization. On top of this, the retirement fund is still underfunded which means it is at some risk for default with an organization that clearly could not meet those extra payments since it is dwarfed by the size of the retirement fund.
Of course, the great risk is to medical students which would probably be on the hook to make up for the financial offset if the retirement fund becomes grossly underfunded. The only real source of revenue for the NBME is its examination fees. And for medical students, they are forced to pay whatever fee the NBME comes up with since there is no competition and alternative testing organization in the United States. The financial mismanagement of this and other organizations will fall hardest on those with no choice and the least ability to pay.
Defined Benefits are the ProblemRetirement benefits are usually of two main types, defined benefits and define contributions. It effectively shifts the risk either on the employer or the employee. In the private sector, defined benefits (guaranteed payouts over the length of your retirement) haven't really existed for 35 to 40 years. Nowadays, private companies and most non-profit organizations offer 401Ks which are specified contributions but do not guarantee your future payouts - they are whatever they returns are.
What is so unusual is that all of these medical education boards use defined benefits as their retirement structure which puts their organizations and, by definition, their clients at risk for covering the gap of underfunding their benefits. According to Kroll, unless the organizations kill their defined benefits plans they will be at increasing risk for insolvency or at a minimum, jacking up fees to students.
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| Episode 038: The Causes of Physician Burnout, Depression, & Suicide with Dr. Cory Fawcett | 26 Feb 2019 | 01:07:24 | |
Today, the topic physician burnout and looking at the numbers at who is suffering and what the causes are. Medscape published its 2019 Survey of Physician Burnout, Depression, & Suicide that dives deep into the demographics and causes of the phenomena. However, what was notably absent from the possible causes for burnout was financial matters. What effect does a high personal debt have on physician well being? And if it is a problem, how can you find your out of debt to improve your psyche as a physician?
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| Episode 037: A Rheumatologist Says No to the Joint Commission. Leaving the Third Party Pay System with Dr. Ellen McKnight. | 20 Feb 2019 | 01:02:45 | |
I have spent a lot of time discussing innovative ways of delivering medical care on this show and it has primarily been based around primary care. However, those who are specialists who traditionally practiced using third party payors (Medicare, Medicaid, commercial) are also beginning to strike out on their own and switch to cash pay. The reason for this is that the cost of using insurance and the lack of access allows these specialists to find a market for the type of medicine they want to practice.
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| Episode 036: Markets and Med Students with Dr. Beth Haynes | 14 Feb 2019 | 00:52:37 | |
What is the difference between a first year medical student and a senior in college? A lot of debt and neither knows anything about medicine. Contrary to popular belief, medical students don't know the first thing about the health care system, how it is delivered in the United States, or what challenges face physicians in caring for their patients. So all of the popular opinions floating around in the general undergraduate student population are present upon their training.
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| Episode 035: Changing the Emergency Room with Real Price Transparency. A Discussion with Dr. Christion Rice | 06 Feb 2019 | 00:58:22 | |
For those who have encountered the health care system - the emergency room is the greatest mystery for charges. Although little of emergency care is truly emergency life threatening care (est. ~3%) the care is some of the most expensive in the hospital. Whether that it is imaging, laboratory, or professional services - patients and insurers are expected to pay the inflated costs. So how do we control costs and not break the bank for all of our patients when they are possibly at their most vulnerable?
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| Episode 034: Is Direct Primary Care the Future of Medicine? A Discussion with Dr. Lee Gross of Docs 4 Patient Care | 29 Jan 2019 | 01:00:15 | |
If there is one thing patients and doctors agree about when it comes to primary care it's that it isn't properly working for either one. Doctors have too little time to spend with patients, can only address one or two problems at a time, and spend most of the little face time they get staring at a computer screen than at their patient.
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| Episode 033: Walking Away From It All. The FIRE Movement with Dr. Leif Dahleen | 22 Jan 2019 | 00:57:40 | |
When it comes to working, we all have different goals on what to accomplish during our careers. However, almost everyone anticipates on retirement as the way they end their professional life. The FIRE movement is one which emphasizes achieving your financial independence and retirement at a younger than traditional age. With careful planning and goals in place at a young age, you can achieve the goal of financial independence with more time to control your life without worrying about financing living.
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| Episode 032: Is Dead, Dead? Is Brain Death, Death? A Discussion With Dr. Alan Shewmon | 12 Jan 2019 | 00:50:47 | |
One of the tasks assigned to physicians, and certainly not a task one thinks of when entering medical school, is to verify death. The first time you declare someone dead - for me, it was as a first year resident in the ICU - is a weird feeling because of the finality of it. As with anything you do as a physician for the first time there is some uncertainty that you aren't "messing up." But you don't need to be a doctor to declare someone dead because anyone can tell when someone or something is dead, right?
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| Episode 031: Direct Primary Care for Pediatrics with Dr. Nitin Gupta | 11 Dec 2018 | 01:01:02 | |
Direct Primary Care (DPC) is starting to gain some steam and popularity with established physicians, residents, and medical students. Patients are also beginning to learn about this alternative to traditional insurance based care. Instead of copays, deductibles, and limited visits and times with the physicians - DPC works as a monthly fee with unlimited access to the physician.
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| Episode 030: The Epidemic of Physician Suicide with Dr. Pam Wible | 05 Dec 2018 | 01:05:22 | |
Physician suicide is an epidemic. How else do you describe 400 physicians per year ending their own lives which is over twice the national average? Why do so many doctors feel that the only escape from their pain is suicide? How do we end this epidemic and begin to heal the healers?
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| Episode 029: Overcharged - Why American Health Care is So Expensive with Prof. David Hyman | 21 Nov 2018 | 00:55:17 | |
We can all agree - outside of a few overpaid pharma CEOs - that the American Health Care system is too expensive. In fact, one could argue that the system of delivering health care in America is designed to cost the most possible without any parts that can check its growth. If you were to try and design a more costly and inefficient system I dare say you would be unsuccessful.
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| Episode 163: How We Reformed State Government to Save Billions with Christin Deacon | 04 Mar 2022 | 00:47:08 | |
It's easy to become despondent about controlling spending or eliminating waste through reform on government expenditures. We've all seen the headlines about the $1 million hammer or toilet seat and governments losing track of money. Also, with all the people who have been elected on the platform of 'transforming' government or making it efficient, there has been almost nothing but the exact opposite happen. It's why the joke about death and taxes not only funny but very true.
To make matters worse, imagine government getting involved in the purchase of a product that is incredibly expensive and wasteful - US health care. This is a recipe for budget overruns, poor health outcomes, and a bottomless pit of spending. The opportunities for wasteful spending is so great and the lobbyists to keep the gravy train of spending so powerful that tackling it at the state level seems hopeless.
Yet that is exactly what Christin Deacon did.
Reforming New Jersey's Health and Benefits Plan
Maybe it's because Christin Deacon didn't know any better but she looked at the amount of money being spent on New Jersey's health and benefits and actually thought she could find some meaningful savings for taxpayers. To her credit, she asked the questions that no one had asked and pursued solutions that no one had seriously tried before. Through her persistence, Deacon helped save New Jersey citizens over $500 million per year for years. Those billions of dollars have been used to fill other gaps in the state budget and most importantly, haven't been thrown away on poor contracts or inflated pricing.
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| Episode 028: A Deep Dive Into Who Today's Doctors Are | 14 Nov 2018 | 00:59:21 | |
Who is that man or woman in the white coat? What is he/she thinking as you are being examined or operated on? Is that physician burned out? Suicidal? Feeling optimistic about his/her profession? The future? There is a lot going on between the ears of that physician that isn't devoted to healing people. Today, I take a deep dive solo-style into the results of the comprehensive 2018 Survey of American Physicians by the Physician's Foundation.
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| Episode 027: The Opioid Crisis and Who's to Blame with Dr. Howard Grattan | 08 Nov 2018 | 01:00:18 | |
The opioid crisis has been in the news for a few years now and those to blame for it are many. Is it pharmaceutical companies who made easy to prescribe formulations of powerful pain killers? Is it physicians for over prescribing pain medicine for simple aches and pains? How about federal guidelines that encouraged the over treatment of pain? Or the creation of the fifth vital sign in the late 90's that treated pain as important as heart rate.
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| Episode 026: Making Social Media Work for Docs with Dr. Corriel | 01 Nov 2018 | 00:49:37 | |
Social media is ubiquitous in our lives and doctors have a less than average presence within that sphere. The reasons are many but probably partly related to concerns about medical liability, their employers, and reputations as physicians. Dr. Dana Corriel set out to change that. She created the #SoMeDocs which encourages physicians to engage the world more and bring their unique perspectives to patients and the public through the use of social media.
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