Lee A. Resnick, MD, FAAFP Newton’s Third Law: “To every action there is always an equal and opposite reaction.” Medicine applies Newton’s Third Law liberally, from physiology to pharmacology; negative feedback loops, down-regulation, compensatory states, and medication side effects all follow its principles. The body, as we well know, is inclined to homeostasis, and any upset to this balance is met with resistance and dysfunction. Unfortunately, well-meaning healthcare regulators, policymakers—and, yes, even fellow physicians—have ignored …
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Hearing the Hoof Beats of Zebras! Facial Nerve Palsy: A Case Report
Urgent message: There is no diagnosis so “common” that it cannot be missed or mistaken for something else. A systematic approach to the history and examination are crucial to reaching the right conclusion and positive outcomes. Lee A. Resnick, MD Every now and then, medical school pearls are wrong. You remember: “When hearing hoof beats in Central Park, don’t go looking for zebras.” It may be true that zebras are infrequent visitors to New York …
Read MoreA Crisis in Quality? Lessons from History
Lee A. Resnick, MD, FAAFP If history repeats itself, then we just may be in big trouble. Many of us remember the doc-in-the-box days of the early 80s, when the first urgent care boom occurred. There was a wild proliferation of urgent care centers, driven mostly by physician entrepreneurs looking to make a quick buck. By 1985, in excess of 3,000 centers dotted the country. The following decade brought significant contraction within the industry, before …
Read MoreFunding Healthcare Reform: Tax Sugar, Not Success, Part II
Lee A. Resnick, MD, FAAFP No one has more eloquently stated the case for carving out the so-called “unnecessaries” from the capitalist code of taxation than Adam Smith. Yet, more than 230 years after the publication of arguably the most authoritative text in defense of capitalism, we continue to struggle with the concept of taxation as a socialist plot. Last month, I examined the so-called “success tax.” I suggested that a tax on earned income …
Read MoreFunding Healthcare Reform: Tax Sugar, Not Success
Lee A. Resnick, MD, FAAFP Healthcare is the ultimate paradox for democratic and capitalist ideas, an epic clash between inalienable rights and free market forces. Most everyone agrees that basic healthcare should be attainable, affordable, and non-discriminatory for all citizens. But how can we achieve this somewhat socialist-sounding goal within a free market system? Well, the free market has proven incapable of making healthcare affordable, and government coffers have proven too empty to subsidize it. …
Read MorePhysician Mentoring: Making an Impact
“We make a living by what we get, we make a life by what we give.” – Winston Churchill Physician mentoring sounds like an easy enough proposition. Who wouldn’t jump at the chance to opine and proselytize, in a position of power, to a new employee who is looking to impress his/her boss? Indeed, you can say most anything you want, with a very low risk of rebuttal or confrontation. Even well-intentioned mentors tend to …
Read MorePhysician Recruiting: Standing Out in a Crowd
Urgent care is growing by hundreds of centers each year, and available physicians are declining with equal speed. urgent care training is variable, at best, and urgent care experience is hard to find. Expanding health systems with their in-house recruiters and high visibility are tightening the squeeze. All told, it’s a recipe for unfilled positions and staff burnout. Whether you are looking to expand locations, add providers, or replace departing ones, you are bound to …
Read MoreHealthcare’s Title Bout: Free Market Economics KOs Reform
At the risk of oversimplifying, the healthcare “crisis” – and subsequent attempts to “reform” it – really boils down to a coverage crisis and a cost crisis. The two, of course, are inextricably linked. Ans every attempt to solve one seems to exacerbate the other. Our healthcare delivery system has essentially failed to manage cost and manage coverage simultaneously. The teeter-totter is perpetually imbalanced. The problem with reform efforts to date is complex. However, the …
Read MoreMinding Your E’s & M’s
Nothing hurts a business more than leaving money on the table. It is hard enough to attract business; the last thing you want to do is not get paid once services are rendered. There are a number of steps in the coding and billing process, and errors at any level can lead to bad debt, missed charges, and poor reimbursement. Let’s look at a few I would call the “low-hanging fruit.” Collection at the Time …
Read MoreHospital-owned Urgent Care Networks: Coming Soon to a Community Near You
“The whitecoats are coming, the whitecoats are coming!” if Paul Revere were running an independent urgent care network, this would be his call to arms. After years of denial and arrogance, health systems are finally waking up to the system integration benefits of urgent care. Hospitals stumbled in their response, hampered by bureaucracies, turf wars, and stifling status quo. Well, the fog was finally lifted and urgent care is on the radar. Due, in large …
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