Health Reform and the Practicing Physician

When customers walk into the thousands of coffeehouse franchises here and around the world, they expect and receive a good cup of joe, no matter when and where they buy. While few would compare the selling of coffee to the delivery of medical care, many argue that the health care system is not delivering the quality of service that all patients expect and deserve. Reforms to health care finance and delivery and their impact on physicians’ ability to do their work has fueled passionate debate. This month’s issue aims to shed more light and less heat on this important national discussion.

Volume 13, Number 11: 747-845 Full Issue PDF
  • From the Editor
    Nov 2011

    Leading through Change

    Audiey Kao, MD, PhD and Faith Lagay, PhD
    Introduction to the November 2011 issue of Virtual Mentor on the topic of health care reform.
    Virtual Mentor. 2011;13(11):750-752. doi: 10.1001/virtualmentor.2011.13.11.fred1-1111.
  • Case and Commentary
    Nov 2011

    Political Discussions in the Exam Room

    Jack P. Freer, MD
    Educating patients is an important part of practicing medicine, and, especially when health care-related legislation is changing, doctors may receive political questions from patients. They may want to have brief, prepared answers to such questions, but they should protect the clinical relationship by limiting discussions that are too long or too heated.
    Virtual Mentor. 2011;13(11):753-756. doi: 10.1001/virtualmentor.2011.13.11.ccas1-1111.
  • Case and Commentary
    Nov 2011

    Physician Involvement with Politics: Obligation or Avocation? Commentary 1

    Thomas S. Huddle, MD, PhD
    What duty, if any, do individual physicians have to lobby and advocate for policy solutions that may impact the health and health care of patients and the public
    Virtual Mentor. 2011;13(11):757-761. doi: 10.1001/virtualmentor.2011.13.11.ccas2-1111.
  • Case and Commentary
    Nov 2011

    New Guidelines for Cancer Screening in Older Patients

    Lisa M. Gangarosa, MD
    For patients in their late 70s with significant comorbidities, colonoscopies provide minimal, if any, benefit and are not recommended by guidelines. Physicians are not obligated to offer tests that are not medically indicated, but they must work with the patient to reach an agreement that works for both parties.
    Virtual Mentor. 2011;13(11):765-768. doi: 10.1001/virtualmentor.2011.13.11.ccas3-1111.
  • Medical Education
    Nov 2011

    Graduate Medical Education Financing and the Role of the Volunteer Educator

    Thomas J. Nasca, MD
    Health reform did not adequately address funding for medical education. Physicians must nevertheless make sure the next generation of doctors receives a high-quality education.
    Virtual Mentor. 2011;13(11):769-774. doi: 10.1001/virtualmentor.2011.13.11.medu1-1111.
  • In the Literature
    Nov 2011

    The Effects of Congressional Budget Reconciliation on Health Care Reform

    Eugene B. Cone
    Budget reconciliation remains one of the most potent tools available to members of Congress to shape legislation, and it played a significant role in amending the Affordable Care Act.
    Virtual Mentor. 2011;13(11):777-782. doi: 10.1001/virtualmentor.2011.13.11.jdsc1-1111.
  • In the Literature
    Nov 2011

    The Physician Group Practice Demonstration: A Valuable Model for ACOs?

    Todd Ferguson, PhD
    Valuable lessons for the accountable care organization model can be gleaned from Medicare's Physician Group Practice Demonstration, but, until it proves broadly successful, other strategies to curb Medicare spending must be identified.
    Virtual Mentor. 2011;13(11):783-786. doi: 10.1001/virtualmentor.2011.13.11.jdsc2-1111.
  • Policy Forum
    Nov 2011

    Aligning Values with Value

    Audiey C. Kao, MD, PhD
    Medical stewardship is a way of describing a relatively new obligation to maximize health care resources. A professionwide conversation about its meaning and value is needed.
    Virtual Mentor. 2011;13(11):796-798. doi: 10.1001/virtualmentor.2011.13.11.pfor2-1111.
  • Medicine and Society
    Nov 2011

    Health Reform and the Future of Medical Practice

    Randy Wexler, MD, MPH
    The adoption of the accountable care organization model means that coordination of care will greatly improve, doctors will end up taking a much more active role in preventive care, and access will have to increase dramatically, perhaps with office-hour changes to accommodate patients' schedules.
    Virtual Mentor. 2011;13(11):803-807. doi: 10.1001/virtualmentor.2011.13.11.msoc1-1111.
  • Viewpoint
    Nov 2011

    The Affordable Care Act: A New Way Forward

    Vivian Ho, PhD
    The future success of the Affordable Care Act depends on doctors' willingness to take the lead in identifying reforms that will lead to high-quality, cost-effective health care.
    Virtual Mentor. 2011;13(11):817-821. doi: 10.1001/virtualmentor.2011.13.11.oped1-1111.
  • Viewpoint
    Nov 2011

    ObamaCare: The Way of the Dodo

    Michael F. Cannon, MA, JM
    The Patient Protection and Affordable Care Act's provisions will drive up premiums, increase unemployment, and spend money the government doesn't have.
    Virtual Mentor. 2011;13(11):822-829. doi: 10.1001/virtualmentor.2011.13.11.oped2-1111.
  • History of Medicine
    Nov 2011

    How Medicare and Hospitals Have Shaped American Health Care

    Robert Martensen, MD, PhD
    Medicare reimbursement practices have brought the hospital to the center of the American medical system, to the detriment of primary care.
    Virtual Mentor. 2011;13(11):808-812. doi: 10.1001/virtualmentor.2011.13.11.mhst1-1111.
  • image
    Podcast
    Nov 2011

    Ethics Talk: Reforming Health Care - Perspectives From Future Physicians

    This month, Virtual Mentor spoke with Dr. Alex Ding and Mr. Jordan VanLare, a fourth-year medical student at Columbia University College of Physicians and Surgeons, about their impressions of health reform and how it will impact the medical practice environment they will soon enter.