Steven R. Peskin, MD, MBA, FACP

Three days of a severe headache that would not respond to the ibuprofen, naproxen, or acetaminophen. "I never get headaches" is what I said multiple times to my wife and to colleagues. The morning of day three, a rash started to appear on my forehead, in the left eyebrow, in the scalp, with swelling around the left eye and swollen lymph nodes at the angle of the jaw on the left. My wife mentioned "shingles". Poor early diagnosis on my part, and, I said "Oh !*#%! that is what I have".

Paul E. Terry, PhD

Recently a Minnesota school was evacuated after 10 students got sick during choir practice. A carbon monoxide leak was the presumed cause, given the similarity of student’s symptoms and the rapid spread of complaints. Thirty students in all were taken to the hospital and the school was closed for the day. Tests proved negative, recovery was quick, and the Minnesota Department of Health (MDH) now reports that the likely cause was psychogenic illness.


The state spokesman said that when people in a group become ill at the same time with subjective complaints, “It is no less real.”

Steven R. Peskin, MD, MBA, FACP

"Welcome to Moe's"  is the warm and friendly greeting of the staff at one of my favorite cantinas — Moe's Southwest Grill, where a rice bowl and iced tea set me back just $9 and change. But for one woman who underwent Mohs surgery for a very minor lesion that may not have required the Mohs procedure and the subsequent plastic surgery repair, her bill for the day was over $25,000, as reported in a January 18, 2014 New York Times article titled "Patients' Costs Skyrocket; Specialists' Incomes Soar".

Steven R. Peskin, MD, MBA, FACP

The memory tape of the golden oldie from Lovin' Spoonful was playing in my head before watching Dr. Eric Topol’s interview with Dr. Paul Offit about his recently published book, Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine

Paul E. Terry, PhD

January 1, 2014 marks the most monumental day in the history of American health policy. The individual insurance mandate, the sunsetting of underwriting as we know it, and the planned obsolescence of the term “pre-existing conditions” in insurance all presage a fundamentally different era for access to health care.

Jessica Cherian, PharmD, RPh

Nowadays, every turn of a newspaper page, click of a media page on the Internet, or flip to a news channel brings us to an update, or more likely a criticism, of the public exchanges. With all of the attention on this side of the exchanges, we might be forgetting about the private exchange.   The private exchange serves as a channel for individuals and employers to purchase health insurance that is separate from the newly opened public exchanges developed under the Patient Protection and Affordable Care Act.

 The biggest difference between the two stems from the fact that government subsidies aren’t available to those choosing to purchase health insurance from the private exchange. This explains why much of the news regarding private exchanges focuses on the group market, as employers that choose to participate in a private exchange provide employees with an subsidy to be used toward the purchase of health insurance, a method also known as defined contribution.

Paul E. Terry, PhD

The recent Health and Productivity Conference sponsored by the National Business Group on Health (NBGH) signaled the arrival of what social scientists have long held as vital to the success of wellness: a balance between personal and organizational engagement in health.

Jessica Cherian, PharmD, RPh

The Pioneer Accountable Care Organization (ACO) was an additional ACO model offered by Medicare, designed for groups that were already experienced in coordinating patient care across the care continuum. The shared-savings payment policy in this case is aligned with higher levels of both sharing and risk than that of the basic Shared Savings Program. Many had high hopes for the Pioneer groups and anticipated positive results when it came time for reporting in 2013.

Steven R. Peskin, MD, MBA, FACP

In doing research for a Grand Rounds needs assessment on humanism in medicine, I re-acquainted myself with a classic lecture by Dr. Francis Peabody, "The Care of the Patient" published in the Journal of the American Medical Association. (Peabody, FW: The Care of the Patient. JAMA 1927; 88:877–882.)

The words that Peabody spoke to his students in 1927, as Peabody himself faced his own mortality, having been diagnosed with cancer at age 45, are resonant and worthy of daily reminder for any of us involved in caring for patients, designing care models, influencing benefit plans, organizing systems of care, integrating technology into patient care, or serving in adminstrative leadership.

“Medicine is not a trade to be learned, but a profession to be entered,” he told his students. “The treatment of a disease may be entirely impersonal; the care of a patient must be completely personal.... the secret of the care of the patient is in caring for the patient.”

Steven R. Peskin, MD, MBA, FACP, is associate clinical professor of medicine at the University of Medicine and Dentistry of New Jersey – Robert Wood Johnson Medical School, and is governor of the American College of Physicians, New Jersey South.

Princeton’s Uwe Reinhardt, PhD, renowned health care economist, sits down with Managing Editor Frank Diamond to discuss the economic effects of the Affordable Care Act, wellness programs, and the state of health care in the United States in general.

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