Choice of Physician or Network?

My last two posts dealt with the new Health Insurance Exchange, or “Marketplace,” which opened yesterday, and I talked about some of the concerns with the limited options and a limited provider network. What will be the impact for 2014 for our patients and costs? I heard from several of you with your ideas and concerns and thought I would share them with you today.

 

Violence and Public Health

This year I have written several times about violence and its impact on the public’s health, and last week I shared our N.H. physician survey results indicating that addressing gun violence was a priority for many of you.

Carpe Diem

As many of us reflect on the recent death of Robin Williams, the gifted comedian, actor, husband and father of three, much of the focus in the media this week has been on the issues of depression, substance abuse, addiction and suicide.  It was refreshing to hear some of the commentators talk about depression as a “brain disease” and not use the term “mental illness” as much as might be expected.

Can't always sort wheat from chaff

In follow up to last week’s blog, it may be considered somewhat reflexive to speak to a confounding circumstance in the recognition and treatment of multi-substance abuse and addiction.  Mental illness is intertwined in the management of substance abuse and addiction.  Neither one of these complex conditions are adequately addressed through episodic care, whether it is rendered in an emergency department, a primary care office or from a three-day stay in a psychiatric facility.  Rarely are any of the underpinnings addressed adequately, and quite often the process can be viewed as simply inhumane.

Violence as a Public Health Issue

The violent events of the past year and my writing about them here have provoked strong feelings among our members and raised, I think, good questions like: What can I do as a physician to impact this problem? Do I even have a role?  The problem seems so big that it is very difficult for us to get our hands around.  Are there only policy solutions? Are there clinical solutions?  Are there community solutions? Or, is this just the way things are and we should accept them? 

We asked, you spoke!

"We live on an island surrounded by a sea of ignorance. As our island of knowledge grows, so does the shore of our ignorance." - John Archibald Wheeler, eminent American theoretical physicist

Earlier this year, NHMS conducted a survey to learn more about you, what is important to you, and what you think should be priorities for NHMS. We had a great response and learned the following:

We Have the Technology

On March 7, 1973, when I was 9 years old, the medical future came into my living room in Brooklyn, N.Y., via a 25-inch Zenith color television.  On that night, Steve Austin, a civilian astronaut, crashed in a test flight accident and lost his right arm, left eye and both legs.  Luckily for Colonel Austin, a Vietnam veteran who had walked on the moon, he was able to be “rebuilt” with artificial legs that allowed him to run at 60 mph, a prosthetic arm that could lift 150 pounds (and had a Geiger counter for radiation detection) and a bionic eye, complete with a 20:1 zoom lens and infrared capabilities, thanks to the generosity of the American Broadcasting Company.  Total cost?  6 million dollars.

Bullying in Health Care

Over the past few weeks, a sports story has grabbed national attention because of its implication for workplace bullying issues.  This case involves the Miami Dolphins of the National Football League, and the main players involved are Richie Incognito (the alleged bully) and Jonathan Martin (the alleged victim).

Boston Strong

This past weekend I happened to be walking up Boylston Street in Boston at night when I passed the site of the first bombing location from last year’s Boston Marathon bombing.  The building that was damaged from that explosion was being repaired, and as I looked across the street at the Boston Central Library, I thought of the horrible events from last April 15 and wondered how the victims were doing at this time, almost one year later.  It was surreal to touch a green mailbox at that site and see many parts of the metal showing damage and indentations, perhaps from the pressure-cooker bomb that damaged and forever changed so many lives.

We Need to Do Better

Last week New Hampshire lost two young university women to suspected Ecstasy or MDMA overdoses.  We offer our deepest sympathies to the families and friends of these women.  Such tragedies highlight the problems we face of drug use and addiction in New Hampshire and serve as a call to action to do all we can to prevent the physical and emotional harm that result from substance use and abuse.

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