Contents tagged with end-of-life

  • Texas Family Physician - Vol. 66 No. 3, Summer 2015

    Tags: texas family physician, members, president's letter, perspective, medicare, health care reform, reform, reiner, practice management, medicaid, end-of-life, sgr, legislature, briggs, johnson, kelly, molina, icd-10

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    President’s letter



    Inside the coverage gapTexas is the only state left with at least 20 percent of its population … more

  • First do no harm? A reflection on pain and intervention at the end of life

    Tags: perspective, mandola, end-of-life

    By Vincent J. Mandola, MD

    March 25, 2015 was a day I will never forget. It was the day I watched my mother take her last breath. She was 56 years old and had battled cancer for two years. It was a surreal time stepping into the unknown for my close family, but it’s not the moment of her passing I want to write about here. It is the days leading up to that moment, as this experience has given me a new outlook on end-of-life care.

    After surgery and nearly a year and a half of chemotherapy, mom was determined to have a couple of decent weeks before what she knew was inevitable. She had just been discharged from the hospital for uncontrolled pain and sent home under hospice care.

  • Money & Medicine: Reflections on the message

    Tags: pbs, health care reform, advance directive, end-of-life, care, money, medicine

    We have known for years that the payment system for health care services provides incentives for hospitals and physicians to run more tests and perform more procedures. Debuting this week, a PBS special “Money & Medicine” examines not only runaway health care spending, but also the danger patients face from over-diagnosis and over-treatment.

    “If you add up medical errors, drug interactions, and hospital-acquired infections, medicine itself is the third leading cause of death in this country,” one expert says in the film. And another, “I’m paid more when I harm my patients; I’m paid more when I do more, even when it’s not beneficial.”

    Contributing to the estimated 30 percent of U.S. health care spending—$800 billion a year—that pays for unnecessary services, the filmmakers identify several forces at play. First, briefly, the providers:  “One person’s waste is nearly always another person’s income, and income turns into strong political defenses of areas that are classic waste.” Next, the patients: Patients’ demands are changing the behavior of providers. And particularly in end-of-life care, the family can demand “full court” care regardless of the odds.