Health Affairs has published a study that demonstrates little impact of Medicare’s mortality data on improving outcomes. No surprise here. Once again, we learn that data without context have modest motivational effects. While the data imply an urgent message, too often the response generates two questions that lack obvious answers: “So what?” and “Now... »

Providing effective chronic care management for a panel of patients is a challenge that is often under valued intellectually and financially. As a result, large numbers of internists have left office-based practice for hospitalist medicine or other pursuits, and the nation faces a profound shortfall in primary care providers, especially with the passage of... »

Recently, I was consulted about Medicaid coverage for nurse anesthesia services for procedures provided in a physician’s office. As I did a little research, it became apparent that my state had no standards for an office to provide procedures involving intravenous sedation other than a requirement by the department of health that such care be provided only... »

Improved, but very expensive, treatments for hepatitis C may result in a broadening of the current HCV screening recommendations, necessitating that patients of a certain age be screened for the viral infection. A recent study, funded by the Centers for Disease Control and Prevention, demonstrates the cost effectiveness of screening baby boomers for HCV... »

Long considered a potentially dangerous medication, over-the-counter Primatene Mist will no longer be sold in the U.S. after the first of the year. Many physicians consider OTC inhaled epinephrine as an inadequate treatment for asthma. And, they say that its availability could lead to fatal asthma events by... »

After nearly a decade of effort and billions of dollars, the British National Health Service has scrapped its efforts to implement a national health information exchange.

Granted, some of the announcement contained political posturings of Labour versus the Tories, but all in all, the failure of this ambitious effort reflects the gap... »

The current issue of the Journal of General Internal Medicine features an editorial by Michael Wilkes that discusses an unusual incentive offered to physicians engaged by the national concierge medicine company, MDVIP.

It describes how a third of MDVIP physicians accepted a free genetics profile worth $999 from a genetics testing firm Navigenics and that... »