Showing posts from July, 2017

Insufficient sleep may add more than an inch to your waist, study suggests

By now, the connection between sleep and weight gain has been well established. Numerous studies have provided evidence that sleeping too little — less than five hours — messes with your hormones, slows down your metabolism and reprograms your body to eat more. But just how serious are the consequences in terms of numbers? A new study published […]

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Medical school without the ‘sage on a stage’
Angelina Jolie said she had a rare condition. Here’s what we know about it.

CSR payments still in question after ACA repeal failures | Healthcare Dive

Cost sharing reductions, or CSRs as they are called in government circles are allocated to insurance companies as part of the Affordable Care Act.

President Donald Trump now is threatening to upset the individual market by refusing to pay cost-sharing reduction (CSR) payments to insurance companies. The White House is also pushing Congress to continue efforts to repeal the Affordable Care Act (ACA) despite three votes last week in the Senate failing to garner enough support among Republicans.
With the deadline for adjusting individual market rates a little more than two weeks away, insurance companies are pleading with the White House and Congress to make good on the CSRs and warn that premium rates would increase substantially if they are not paid.
(author) Trump may be using this as a negotiating point in his battle to repeal the ACA. It is on very short notice, most likely as Trump's effort to create even more chaos in the ACA.
Meanwhile, a bipartisan group of about 40 lawmakers have been discussing changes to the ACA that both sides of the aisle can support. They are discussing permanent CSR funding, weakening the employer mandate and repealing the medical device tax, Politico reported.

CSR payments still in question after ACA repeal failures | Healthcare Dive

Internet searches on suicide went up after '13 Reasons Why'

In the season finale of the popular Netflix TV series "13 Reasons Why," 17-year-old student Hannah Baker kills herself in a prolonged three-minute scene. Even though the entire story, much of it told through flashbacks, has been leading up to this moment, and viewers already know Hannah is dead, the graphic sequence is a torment to […]

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Medical school without the ‘sage on a stage’
Angelina Jolie said she had a rare condition. Here’s what we know about it.
Stretchy glue inspired by slugs could be the future of sutures

A doctor was killed for refusing to prescribe opioids, authorities say

An Indiana man shot and killed himself shortly after gunning down a doctor who refused to prescribe opioid medication to his wife, authorities said this week. The alleged murder and the suicide unfolded within just hours of each other Wednesday in Mishawaka in northern Indiana, a state that's been gripped by problems with opioid addiction over […]

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Medical school without the ‘sage on a stage’
FDA aims to lower nicotine in cigarettes to get smokers to quit
Angelina Jolie said she had a rare condition. Here’s what we know about it.

Medical school without the ‘sage on a stage’

Lectures are on their way out at medical schools across the United States

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End of life decisions are usually neglected. Studies reveal few have an Advanced Directive prepared.

Whenever one is admitted to hospital a standard question on admission forms is "Do you have an advanced directive? Even if you ask for a form, denial sets in and the form is firmly tucked away in a pocket or purse.....to be discovered weeks later, and then promptly put in the round file.

Why do we do this ? I am guilty of the same. Death is a frightening event for almost all. Even physicians when it comes to themselves, a wife or a child we freeze. Physicians really never become comfortable emotionally with death. We file away the emotional reaction somewhere where we hide our fear, anxiety, and grief.

After a tragic accident emotions run high and as death approaches we are paralyzed by events.

Most Americans avoid end-of-life decisions, although some people may be more likely to make them if a doctor or social worker starts the discussion. In California, the state attorney general’s office offers an end-of-life planning checklist on its website. In the past few years, other websites have encouraged those conversations, with their own suggestions on how to get started.

Rebecca Sudore, a geriatrician at the University of California-San Francisco, created prepareforyourcare.org, which provides step-by-step instructions and video stories to help people navigate the care they want at the end of their lives. She built the site in 2013 for families unsure how to broach sensitive questions. In a study published in JAMA Internal Medicine in May, she and other researchers found that the website — combined with the use of an “advance directive” form — prompted participants to plan ahead.

The study performed at a Veteran's Administration facility revealed many important points.

Easy-to-use, patient-facing ACP tools, without clinician- and/or system-level interventions, can increase planning documentation 25% to 35%. Combining the PREPARE website with an easy-to-read AD resulted in higher planning documentation than the AD alone, suggesting that PREPARE may increase planning documentation with minimal health care system resources.The website is free, and Sudore makes no money from it. It can be filled out at home from the website, Prepare for your Care

The site guides patients in drafting a “summary of wishes” to help families and other caregivers decide whether their loved ones should undergo life-sustaining medical interventions such as feeding tubes and ventilators.

Jump-Starting Hard Conversations As The End Nears | California Healthline

FDA to delay e-cigarette rules for years and explore reducing nicotine in conventional cigarettes

Scott Gottlieb, commissioner of the Food and Drug Administration, Friday announced plans to delay for years a requirement that makers of cigars and e-cigarettes get agency approval for any products marketed after February 2007. Gottlieb, in a speech to FDA employees, also said the agency plans to explore regulating the level of nicotine in conventional […]

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Her patients helped this doctor out of her dispair

How do physicians keep on going? Despite all the rhetoric in the press about physician burnout there are some who have developed a sense of purpose.

JENNIFER LYCETTE, MD , AN ONCOLOGIST DISCUSSES HER JOURNEY

Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door.

I didn’t want to head into the clinic that morning. Instead, I was filled with despair; overwhelmed with the events of the world.

How can I do it? I thought. How can I walk in there and summon the energy to see my patients?

An even worse thought: Why should I do it? What is the point in trying to heal the sick, in a broken world?

In addition to world events, I had just found out that the loved one of someone I knew had been a victim of a brutal attack: a random act of violence.

I couldn’t fathom how I would be able to walk into the clinic and face my sick, and in some cases dying, patients, and put forth to them the person they expected me to be — their doctor who believes in them, and who puts all else aside to be there for them.

As I sat there, I struggled to make some sense in my mind of recent events, but I realized, there was no sense to be made. I still didn’t feel like I would be any use to my patients, but I decided I was no good to anyone sitting in my car either.

So I went inside. I started my day, and in moments I was too busy to think about anything else. A few hours later it hit me — I was sitting with one of my patients listening to her concerns, and it was a few hours later. Without conscious thought, I had automatically stepped into my role as a physician, to put all else aside except the person behind the exam room door. And something else had happened too. The sense of despair was gone. I was filled with a sense of purpose again. The one that usually gets me through the door each morning, but I had momentarily lost.

There are many forces that can make us lose our sense of purpose, both external and internal to the world of medicine. It’s awfully hard to be a good doctor without that sense of purpose. Some might call that burnout.

Some days, it feels like it would be easier to shut down, to just stop caring. There’s too much bad out there.

But that’s exactly why we can’t stop caring.

I am often asked about my job as an oncologist, and most commonly I am asked whether it isn’t too “sad” or “depressing.” I can never quite put into words how completely opposite it is.

That morning, it was only when I briefly lost my sense of purpose, that I felt a sense of despair. The opportunity and privilege to help someone in a true time of need is about as far from despair as you can get. And I get to do it every day. As do thousands of other doctors.

"Somehow or other, that person sitting in front of me has a problem, which I may think is trivial, however in their perspective, it has caused them to disrupt their daily activity to see me. At times this overwhelms me....I am not worthy." (Author's note)

Her patients helped this doctor out of her despair

Thriving After Life-Changing Trauma, w/Dr. Pete Poullos | Incident Repor...

Tragedy and a near death experience are reported in one of the latest "Incident Report", a weekly vlog hosted by Zubin Damania, known affectionately by "ZdoggMD" Dr Z, as he is often called, and his crew consisting of Mrs Dr Zdogg (also a physician), ZPop, and the ZPups bring an entertaining yet highly relevant to the public in an easily understood format. Even doctors may understand it all.

All of us experience these incidents on a daily basis.

This episode reveals the breadth of support necessary following a serious injury

1. Financial, personal resources, health plan, family, go fund me (yes people use this mechanism for appealing for dollars.) Dr Poulos raised $ 150,000 dollars to cover extended physical therapy and non covered medical expenses
2 Social support, family, friends, fellow employees
3. Life-style changes, including future employment
4. Long term emotional support and physical rehabilitation
4. Grit ! This last one is probably the most important, to maximize the final outcome and adjust to overwhelming challenges.

Angelina Jolie said she had a rare condition. Here's what we know about it.

In a recent interview with Vanity Fair, actress and humanitarian Angelina Jolie opened up about her personal health struggles — threats of cancer that led her to the decisions to have a preventive double mastectomy and then to have her ovaries removed. She said she developed hypertension and Bell’s palsy, a condition she said had caused her face […]

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Stretchy glue inspired by slugs could be the future of sutures

Inspired by slug slime, scientists have developed a flexible adhesive that sticks to wet surfaces. This stretchy glue can be attached to a beating, bleeding heart and could someday replace stitches in wound repair. Other commercially available glues create strong but inflexible bonds or stretchy but weak connections. The slug-inspired glue cements tightly and […]

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New debate on antibiotics: Do you really need to take the full course?

The one rule about antibiotics that has been drilled into our heads for generations is that you absolutely must take the full course — or else something very bad might happen. Is it time to reconsider that advice? In an opinion piece published in the The BMJ on Wednesday, a group of practicing physicians argues that the idea that stopping antibiotics early may […]

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These experimental treatments target brain cancer like John McCain's

When Sen. John McCain (R-Ariz.) returned to work Tuesday, he seemed his tough old self, saying it would be hard to call the Senate the “world's greatest deliberative body” with a straight face. He added he was headed home soon for treatment for the aggressive brain cancer recently discovered during surgery. McCain hasn't announced his […]

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trail running, portland & BEND!

hello, my lovelies!

you may have seen on my social media that i spent the weekend in portland & bend, oregon running a TRAIL RACE and exploring both adorable cities — and i have to say, i am in love. with all of it.

trail running included, even though the race itself was HARDER than life… probably harder for me than the full LA Marathon, but i’ll get to that!

there is so much i want to break down in this post, like my favorite spots in portland, what it was like running a half marathon in the mountains after taking a huge break from running, and how amazing it was to be in nature and reconnect to the earth in such a powerful way.

oh, and how fun it was to celebrate the love of my life’s birthday on our trip. he turned 31 yesterday, and ran 31 miles on saturday. he is a boss.

Processed with VSCO with e6 preset

let’s start with portland.

we only got to spend two nights in portland, which was not nearly enough given the amount of things i was dying to do there, but we used our time to the fullest and had such a blast.

we stayed in the CUTEST airbnb that i will definitely be staying in again & again, slightly south of the city but only about 10 minute drive into the downtown area. it makes me wish LA was not so spread out, it would make life a trillion times easier!

jonathan and i flew in on wednesday night and our friend alexi flew in thursday morning to join us — so for all the people wondering on instagram “who took that photo of you guys in bed?!?!” it was alexi, aka the best photog ever. but i have been known to self timer that shit as well, so no judgement on those who thought it was timered, lol!

thursday morning we took it nice and slow, which was SO BEYOND NEEDED. we had all been working nonstop before the trip to ensure that we could relax and take some time off while we were there, so the exhaustion was very real on thurs morning (for me, at least… i needed to take it EASY now that i was finally on vaycay!).

we hung out in our airbnb, sipped some coffee, and ventured into the city in the late morning for brunch at Harlow, which had been highly recommended to me by SO MANY OF YOU (you guys are awesome).

when we arrived at the restaurant, i immediately knew it was a place i was going to fall in love with. their menu is all vegetarian, with tons of gluten-free yumminess, smoothies, bowls, egg dishes, etc. basically my heaven.

i ended up ordering the “betty bowl” even though EVERYTHING looked so good, and i had to fight myself not to order the Harlow Latte with hazelnut-cashew milk (you guys know i am a sucker for delicious coffee drinks) but after the coffee i’d already had, i knew that would be a bad idea.

i opted for the iced earl grey latte instead (same milk, no honey), and it was delish.

i believe i said multiple times while eating that bowl, “if this was available everywhere, being plant-based would be ridiculously easy.” TRUTH, although you know i love that variety.

after we ate, we walked around the cute street we were on before making our way over to NW 23rd street to do some shopping and strolling around that street, as a bunch of people told us that was a great place to explore!

we spent the day popping into cute shops with CRYSTALS, adorable cards, quirky books and oregonian t-shirts, and i can safely say i fell in love with all of it. i bought a book on mindfulness meditation called “the things you can see only when you slow down,” which i felt was a TOTAL sign because so many people have been reminding me, ever so gently yet ever so often, to SLOW THE F DOWN.

my acupuncturist gave me a 25 minute speech about the importance of slowing down the day before i left, and then when i saw that book i knew it was placed in my hands for a reason.

portland has the CUTEST book stores, i could get lost in them for days and days on end. last time i was in portland i think i spent an entire day in Powell’s book store — the hugest i’ve ever seen, with a fiction section that bursted my heart open with it’s vastness.

J & i took a yoga class at Yoga Pearl in the late afternoon, which was so freaking nice after siting on the plane and also getting our bodies ready for the race. it’s always hard for me to take yoga at places i’ve never been before because i am such a creature of habit with my studios, but Yoga Pearl is beautiful and the experience of being in the space alone made me feel very oregon-esque.

then the three of us went to Bamboo Sushi for dinner (huge winner) and next-door to Salt & Straw for ice cream afterward!

i am not the hugest ice cream person, but holy shit that ice cream was good. i had chocolate gooey brownie and almond brittle, because if i’m going to have ice cream… i’m going to go all out.

thennnn we headed to bend!

i told you our time in portland was way too short! we woke up the next morning to meet our friends (electric flight crew!!!) at the airport to head to Bend, and admittedly i was a stress basket for a multitude of reasons.

ONE, i had found out that morning that someone very dear to me had passed away. my next post will be about her, so you guys will learn more soon. secondly, i do not like waking up and scrambling to get to the airport without time to eat breakfast or get all my stuff together. we were pretty rushed, we didn’t know a whole lot about where we could get healthy food in a pinch before our 3 and a half hour drive to Bend, and we were walking around downtown trying to agree on a place with ALL of our luggage and bags.

i went into Kure Juice because i recognized it from my last trip to portland and had probably the best oatmeal of my LIFE. J & alexi decided on whole foods, where we met some people who drove us to the airport in their cross-country road trip van (great story, new friends hehe), arriving at the bus with plenty of time (and me thinking i left my purse and laptop in the road trip van which thankfully i did not, but there was a minor panic attack that’s for sure), and then driving to Bend.

we stopped in the super cute yet totally not wellness friendly town of Governor’s Camp on the way, had some less than decent Mexican food, and eventually made it to Bend 4 hours later. it was a BEAUTIFUL drive, with rolling green hills and tons of lush, gorgeous mountain scenery that we simply do not get in LA or anywhere near.

THE RACE!

i will skip our welcome dinner with Under Armour and my scramble to try to get to sleep early which really didn’t happen because i was starting to get so nervous about the half in the mountains, once i officially heard how insane the elevation and the hills were… BUT with jonathan running the full 50k, i felt a lot better about my own *short in comparison* 13.1 mile distance.

it had been a while since i had woken up for a race. over a year, in fact. the last race i ran was the Vine, Body, Sole Half Marathon in Napa LAST May! i took a long running break after my Panchakarma and during my teacher training in favor of slower, more low-intensity exercise, but a few months ago i knew i was ready to dive back into more running. because i love it, even though that ish is hard.

running is like a moving meditation for me. it’s certainly not easy for me the way it comes naturally to some people, but i think that’s one of the things i love most about it. running is a huge challenge for me. even when i am very well trained for a race, it takes my body several miles to warm up and to feel up to speed (literally).

but once i get into my groove, it becomes a true out-of-my-head, reflective, meditative experience. this time was no different, even though… the entire half marathon was on a TRAIL, so way high up in the mountains. to give you an idea of the elevation and incline, it looked a little something like this:

intense, right?! and yes, that downhill from about mile 2 – mile 5 felt like pretty much the best thing of my entire life. that’s when i really got into my groove and felt like the race would be a piece of cake after my MAJOR uphill “warmup.”

the first hill was freakishly hard. it was one of those hills that is so steep, there is zero point in trying to run it because you’d burn yourself out in .2 seconds. my mind was doing crazy things during that uphill climb… including convincing myself that the race was going to be my demise and that i’d never be able to finish it if the entire thing was as hard as that first massive hill.

of course, as all things do, it got easier after my body was warm and my mind started to calm down. plus, i kept thinking about jonathan who was in the middle of his 50k while we were doing the half — and that inspired me more than words can even begin to say. (50k is 31 MILES!)

after mile 6 or so when the incline started to get really steep again, i decided to be easy on myself and walk as much as i needed to. this made the race super enjoyable, because there was no pressure to keep moving fast the whole time — it was a slow and steady, enjoy the scenery, take in the mountains, and give love to the growing tightness in my hip flexors and calves by walking it out kind of race, and just jogging when it felt right.

the last 4-ish miles were when it started to feel particularly painful & hard. because of all of the inclines, my iPhone “Health App” now told me i had gone 17 miles. that’s 4 miles more than a half… and i knew i had several miles to go! it was starting to get really frustrating not knowing where i was, or how much further i had to go, but when i finally past the “Mile 9” marker i knew i had it in me to go 4.1 further.

and also because of the inclines, going 0.5 of a mile felt like a full 4 miles in itself. it was killing me! but i tapped into my breath, took in the serenity of the total silence around me, and kept going. i knew i was so close to finishing! my hips and calves were screaming, but my lungs felt 100% fine which was nice considering the major elevation and altitude!

i also had a moment out there talking to the person who passed away this weekend that i was close to — i’ll get more into that in my post about her, but it was very special and oh so calming.

because i allowed myself to walk so much throughout the race, the final half mile was really not so bad at all. i knew i was SO close to the finish, so after the last big hill i jogged through to the finish line and found our EFC crew.

i foam rolled it out, watched alexi finish her 5k (she sprained her ankle last month or else she would have been in the half with me!), and all of us anxiously awaited jonathan crossing the finish line of his 50k… ahhh!!

watching him finish was hands down one of the coolest, most memorable experiences i’ve ever had. he texted us when he was 45 minutes out, and my anxiety level was WAY TOO HIGH to not go right down there to start waiting at the finish line so i rallied everyone down there to get our beers & cameras ready and… wait.

the giddiness was way too much fun. every single one of us got to soak in the excitement of his massive accomplishment because it is just so freaking amazing to know someone who is finishing such a huge, challenging race — let alone be madly in love with that person.

he came through pretty much right when we thought he would (a full hour earlier than his goal time!!!) like a TOTAL champ, and by far the best part of my entire day was giving him a huge, beer-soaked hug and kiss at the finish line.

it’s an incredible feeling to be with someone who motivates you to be the best version of yourself, huge physical challenges and all, but that’s a blog post for another day.

not to mention, he ran this race for his BIRTHDAY which is just incredibly cool and inspirational.

then we celebrated the night away in Bend, checking out some super adorable spots like Bend Brew Co, a cute little pub that i didn’t catch the name of, and a hilarious but AWESOME “night club” called Seven.

safe to say, we had a really freaking amazing time. i even had two cocktails AND a shot, and you guys know for me… that is a LOT.

all in all, the trip was incredibly fun. it was so awesome to be somewhere new surrounded by so many good people that we love, to push ourselves and do something VERY HARD but very awesome, and ultimately — to watch J finish his 50k and totally crush it.

now i am dying to go back to portland AND to bend to hit up all the cute, healthy, yogi spots that we didn’t have time for on this trip!!! do you have any oregon faves that i missed?! any trail racing or half marathon / 50k experiences of your own?! i’d love to hear!! XO

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The quality of sperm from men in North America, Europe and Australia has declined dramatically over the past 40 years with a 52.4 percent drop in sperm concentration, according to a study published Tuesday. The research — the largest and most comprehensive look at the topic, involving data from 185 studies and 42,000 men around the world between 1973 and 2011 — […]

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A Buddhist yogi taught others to live a meaningful life. He died with fentanyl in his system.

Photo credit: Caitlin Strom http://ift.tt/2vELLpl Posted by Michael Stone on Wednesday, November 23, 2016 When the Buddhist and yoga teacher left his home in British Columbia's Gulf Islands last week and didn't return, his family became concerned. Michael Stone, a well-known author and social activist, had suffered quietly from bipolar disorder, they said, and several months ago “his mania […]

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Monthly shot could be the ‘next revolution’ in HIV therapy, replacing daily pills

HIV/AIDS is no longer the death sentence it once was, but maintaining the strict regimen required to keep the virus at bay — one or more pills daily — still poses a major challenge to many people who are infected. Adherence is low among some populations, given the effort that is required to obtain, keep and store […]

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New Zika testing recommendation issued for pregnant women

Federal health officials are changing their testing recommendations for pregnant women who may be exposed to the Zika virus through travel or sex or because of where they live. In updated guidance released Monday, the Centers for Disease Control and Prevention is no longer recommending routine testing for pregnant women without any Zika symptoms but […]

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New Therapies in Alzheimer's Disease: A Review of the Similarities and Differences

Alzheimer's disease continues to increase as the population ages and expected life span increases. The disease has profound effects on resources to care for this end of life phenomenon. The emotional and financial impacts are catastrophic on family, loved ones, caregivers and the social network as well as government funded long term care. Many new "memory centers" are emerging as well.

Early diagnosis is suspected by cognitive changes, behavioral changes and observation. Confirmation studies such as fMRi and CT scans can confirm changes such as amyloid plaques, and cerebral atrophy. However Alzheimer's disease can be mimicked by other degenerative disorders.

In an outstanding professional continuing medical education course the author gives an complete story for those interested in Alzheimer's Disease. He also elaborates on new treatments to ameliorate and slows down progress. For those interested in the pathology and biochemical changes his lecture extends to that domain as well.

Marwan Sabbagh, MD

Karsten Solheim Chair for Dementia; Professor of Neurology; Director of the Alzheimer's and Memory Disorders Division, Barrow Neurological Institute; Research Professor of Neurology, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona

The video and transcript are available separately. There is also a slide deck

Currently there is no treatment that will roll back the effects of AD. Current treatments will extend the time period for progressive decline.

New Therapies in Alzheimer's Disease: A Review of the Similarities and Differences (Transcript)

Choosing-Wisely-Medical Associations have Awakened.

"Choosing Wisely" is a compendium of one hundred and eighty pages of quality medical recommendations.

The list was compiled by specialty organizations in each field and generated by peer reviewed scientific journals. This is the premier source of verified and credible information.

This is an extensive list of do's and don't for physicians developed by the American Board of Internal Medicine, and it's subspecialty organizations.

It is available in this post below. There are a few surprises in the document, which many physicians will not know. Some patients who read it will be ahead of their own physician. Always question why the test is necessary. It is your right to refuse a test or treatment.

Almost all don'ts revolve around unnecessary diagnostic and/or preventive measures that show no real value. Many of these tests, or preventive measures are done for anecdotal or fear of legal liability by omission.

All of these pseudo-treatments increase the cost of health care without proof of effectiveness.

Choosing-Wisely-Recommendations.pdf

He thought he just had blisters from a hike. He had flesh-eating bacteria and nearly died.

Wayne Atkins thought little of the blisters he had gotten while hiking. He was trekking up and down the 4,500-foot-high Mount Garfield in New Hampshire — a 10-mile round trip — and blisters were no surprise. He was in the Granite State for a family member's early June wedding, which went off without a hitch, even […]

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Is Medicare's Readmission Penalty Counterproductive? |

Physicians are always very skeptical and suspicious that new Health Care Policy is set without vetting of their overall effects on the quality/quantity of outcomes.

Elevator and doctor lounge conversation often turns to this subject. It has been several years for the affordable care act to impact some of health outcomes.

One study from Yale looked at the effects . of the regulation regarding Hospital Readmission Rates in the first thirty days following discharge from the hospital.

Investigators at Yale University ,F. Perry Wilson MD, MSCE compared the incidence of certain events since the new regulation went into effect. He points out how regulations can have unintended consequences.
1. Are longer hospital stays reducing readmission rates?2. Do longer stays increase the cost of hospital care ? (Doctors delay discharges to avoid readmission rates)

"I'm showing you the data for heart failure here, but the results were pretty similar for acute MI and pneumonia. Basically, each dot represents a hospital, and you're seeing the relationship between a hospital's change in readmission rate, and change in 30-day mortality rate. The statistics suggest that hospitals that reduced readmission had a slight reduction in 30-day mortality too, but the signal was pretty small – visible only to statistical software and not the human eye. There were other factors not considered in the study, such as:

They did not examine the relationships between length of stay, readmission rate, and mortality, they did examine inpatient mortality in a secondary analysis and again found no increased risk among hospitals with better readmission rates. So even if hospitals are keeping patients longer, it doesn't seem like this is killing them.

In this case, we have no evidence of unintended consequences from the HRRP. But this is but one policy of many, and in a health system as complicated as ours, prediction of the effects of policy will never be a match for measurement of those effects."

The results of the study come at an important time as legislators try to determine fixes to the ACA.

F. Perry Wilson, MD, MSCE, is an assistant professor of medicine.

Is Medicare's Readmission Penalty Counterproductive? | Medpage Today