tag:blogger.com,1999:blog-7323692122514281455.post5105435019865749812..comments2024-03-18T17:51:23.018-04:00Comments on MD Whistleblower: Free Drug Samples and Hospital Hotels: Which is the Greater Evil?Michael Kirsch, M.D.http://www.blogger.com/profile/07555280388086931097noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-7323692122514281455.post-1413682831049979392011-05-28T10:29:07.558-04:002011-05-28T10:29:07.558-04:00Throughout this blog, my own profession and my own...Throughout this blog, my own profession and my own specialty have not been spared. No protected special interests here. Thanks for your comment.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-48580514845189305132011-05-28T07:41:58.154-04:002011-05-28T07:41:58.154-04:00Our great American healthcare system encourages &q...Our great American healthcare system encourages "competition". Since healthcare consumers are not equipped (nor is medicine itself) to understand the relative quality of the services they are buying, they are influenced by fancy rooms and lobbies and the like. I would agree that competition for hospitals-whether inter-hospital or with physicians, has yet to reduce healthcare costs. We merely add more infrastructure, and our medical widget piece-work system simply insures that everyone will continue to make a living by overusing the unnecessary diagnostic and therapeutic capabilities. Before you are critical of the hospitals, you should understand the incentives with which they are presented. Are you as critical of your physician colleagues who open up their own office-cum-MRI? Colonoscopy center? Mohs surgery facility? We have way too many hospitals and doctors in so many locations--but competition remains the favored model by many. There is not enough healthcare consumer information in the world to think that "competition" will make a dent in our healthcare costs.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-48085449857125948432011-03-13T18:01:37.433-04:002011-03-13T18:01:37.433-04:00@jb, thanks for you thoughtful views. Of course, ...@jb, thanks for you thoughtful views. Of course, I recognize that the well off will live better and have a higher standard of living than others. It just seems jarring to me that new hospitals are now equipped with 'cruise line' amenities, while we have a health care system starved for resources. I uunderstand your point, but am merely suggesting there is great irony here.<br /><br />I celebrate the advances that the drug companies have made, and have expressed this repeatedly in this blog. Respectfully, I believe that you could take care of most patients reasonably well with only a small number of medicines available.<br /><br />Thanks again for commenting. I look forward to reading your views on future posts.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-29927479598624796512011-03-12T17:11:58.983-05:002011-03-12T17:11:58.983-05:001- concern that reimbursement will be linked to pa...1- concern that reimbursement will be linked to patient satisfaction (CMS surveys, HCAPS scores here in NY)<br />2 - wealthy patients pay their bills and/or are insured. For elective procedures, they'll commute from another state/country... And wealthy patients want to be comfy.<br /><br />Not sure why you wouldnt understand why there's more attention being paid to patient amenities!!LifeOnMulberryhttp://twitter.com/LifeOnMulberrynoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-35670243884095902011-03-05T07:39:05.046-05:002011-03-05T07:39:05.046-05:00@healthy living, is a posh hospital suite a prereq...@healthy living, is a posh hospital suite a prerequisite for excellent care?Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-14526404299749611122011-03-04T22:28:17.434-05:002011-03-04T22:28:17.434-05:00Ask the patients in third world countries. If you ...Ask the patients in third world countries. If you have experienced being admitted to a provincial hospital just to share beds with 2 other patients, then you would dream of staying in a hospital suite. These wards are cheap but it worsens your condition. On the other hand, although you pay $$$$ in hospital suites, at least you can recover quickly and you can just work for the expensive bills later.healthy livinghttp://www.drjoetoday.comnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-6342417730215771002011-03-01T07:23:47.914-05:002011-03-01T07:23:47.914-05:00I suspect that most physicians could treat most pa...I suspect that most physicians could treat most patients quite will with only 20 or so old fashioned generic medicines available. A PPI, beta blocker, few antibiotics, prednisone, digitalis, diuretics, etc. <br /><br />@Toni, yeah, there's somthing obscene about creating palatial hospitals when the system and many individuals need health care resources so desperately.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-74938448163368554202011-02-28T08:39:22.279-05:002011-02-28T08:39:22.279-05:00The only solution I can think of for this conundru...The only solution I can think of for this conundrum is massive amounts of new Federal legislation. <br /><br />@anonymous (why don't you use your name?) - the impetus to use "tweaked" drugs is usually consumer-driven. With the economic profiling that doctors are subjected to, it's in our financial interest to prescribe the least expensive drug, not the new expensive stuff.A. Baileynoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-31051364970359941512011-02-28T07:37:40.236-05:002011-02-28T07:37:40.236-05:00Last time I looked, you couldn't buy a tube TV...Last time I looked, you couldn't buy a tube TV if you tried. This is the competitive model in action, fellas. Last time I looked, most docs don't like to think about a single-payer alternative. Also, what about all the docs who prescribe the samples of some tweaked drug otherwise going off patent instead of a generic? That's real money....Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-10039178338396374822011-02-27T15:56:57.833-05:002011-02-27T15:56:57.833-05:00Michael Kirsch, MD: Great post. While I had a bit...Michael Kirsch, MD: Great post. While I had a bit of trouble finding the connection between taj hospital suites and free drug samples, you did tie them together (kindof)<br /><br />I agree with you about this new trend of 5 star concierge hospitals. They are clearly aimed at the wealthy patient who has choices. The problem is, there aren't enough of those patients out there to fill them and as Medicare/Medicaid becomes the prime payor, these marketing efforts may prove to be a big mistake. Private rooms-yes. Flat screen TVs and atriums and marble bathrooms are an extra cost that we should not have to bear as a population. We should not be building hospitals that cost more than some small countries annual budget. We are building a $1.5 billion dollar hospital in SF.Toni Brayer, MDhttps://www.blogger.com/profile/15258759363309666629noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-30859645891468714652011-02-27T15:09:14.566-05:002011-02-27T15:09:14.566-05:00Comments appreciated. Just seems vulgar to have &...Comments appreciated. Just seems vulgar to have 'Club Med' hospital care when we have working folks who can't afford medical insurance. Those who argue so vociferously for raising taxes on high earners are mute on this issue.<br /><br />James, delighted to have you on the blog and expect regular offerings of your erudite input.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-631110520067550542011-02-27T12:23:45.158-05:002011-02-27T12:23:45.158-05:00Great site--just added MDWB to my blog roll.Great site--just added MDWB to my blog roll.James P. Pinkertonhttps://www.blogger.com/profile/06914344842339708576noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-66039128100870909802011-02-27T07:55:27.424-05:002011-02-27T07:55:27.424-05:00Michael,
There have been a boat load of articles i...Michael,<br />There have been a boat load of articles in lay newspapers on this subject, and within the last 6 months, a terrific review in NEJM.<br /><br />Lots of folks are questioning the wisdom of 5-star amenities in the hospital realm.<br /><br />Not really clear on your questioning reformers and picketing though? So many issues to discuss, not the least of which is Medicare, FFS vs caps, etc. This is not an 'A' list quagmire by any means, but certainly one that gets discussed, and needs vetting.<br /><br />I cant knock you though for citing it as a problem. You are 100% correct.<br /><br />BradAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-32571862072785170982011-02-27T06:22:00.721-05:002011-02-27T06:22:00.721-05:00Nice picture of the Taj, Michael. I don't have...Nice picture of the Taj, Michael. I don't have a problem with fancy hospital rooms if they're paid for by individuals, privately. But if you have a for-profit hospital, where the idea is to draw in higher-paying patients, and doctors might be motivated to do more procedures for those patients with dollars in hand...that's another story.Elaine Schattner, MDhttp://www.medicallessons.netnoreply@blogger.com