Rounds Online

Reconciliation on healthcare reform…that has a nice ring to it, doesn’t it?  Everyone in government will get together and seek out a consensus on what is best for the country and then “get-er-done” (that’s a new legislative phrase that has gained favor as more and more comedians join the senate). 

Ah, if only it were so.  As with so many things in Washington, “reconciliation” doesn’t mean what it means.  Reconciliation is a parliamentary procedure that a dominant party can use to prevent the other party from blocking legislation in the Senate. Invoking reconciliation would allow Senate Democrats to pass a health- care bill with a simple majority rather than the 60 votes needed to overcome stalling tactics.

Bottom line, the Democrats are going to cram healthcare reform through with or without the support of Republicans and, if necessary, without the support of all of their own troops.

Obama May Rely on Partisan Vote For Health-care Bill

Bloomberg

President Barack Obama may rely only on Democrats to push health-care legislation through the U.S. Congress if Republican resistance doesn’t eventually give way, two of the president’s top advisers said.

“Ultimately, this is not about a process, it’s about results,” David Axelrod, Obama’s senior political strategist, said during an interview yesterday in his White House office. “If we’re going to get this thing done, obviously time is a- wasting.”

Both Axelrod and White House Chief of Staff Rahm Emanuel said taking a partisan route to enacting major health-care legislation isn’t the president’s preferred choice. Yet in separate interviews, each man left that option open.  “We’d like to do it with the votes of members of both parties,” Axelrod said. “But the worst result would be to not get health-care reform done.”

Here is an article that addresses personal finance and the young doctor.  Its pretty basic but is worth reading.   When the author suggests that one can learn about wealth management by visiting the local book store he lost some credibility.  He adds as an after thought that perhaps a financial advisor might be useful.  Finding and retaining a financial advisor should be the starting point of the entire process!  You will find the entire piece reprinted below. 

Personal Financial Management and the Young Emergency Physician: The Basics

by Jesse M. Pines, MD MBA FAAEM

Vice President, Young Physicians Section, AAEM

Many physicians, especially young physicians, don’t know how to manage money. I don’t usually use stereotypes, but this one is true: doctors are not good financial managers. How do you learn about managing money? Personal finance is certainly not taught in medical school or residency. There’s so much else to learn in emergency medicine. Now you’re done with residency, and you’re out in the real world with your first job. What do you do now? You’re in a financial situation that is unique to physicians: you’re probably in your 30s or older, you may or may not have a lot of medical school debt, and now you’re making a big salary (maybe 200k or more). Some of you may have a spouse, kids, car payments, a house payment and maybe even pet insurance. How do you keep from going broke and still have a little fun with your money?

The bad news is, if you don’t know how to manage money, it’s easy to make mistakes.  And the more money you earn the bigger mistakes you can potentially make. The good news is that money management isn’t rocket science. If you can finish medical school, you can certainly learn to manage your money. But like any field, you have to know what you’re doing first. This article is intended to lay out a few easy strategies for young physicians (and maybe even some of the older ones) to ensure long-term financial health. This list of strategies is not meant to be exhaustive; it merely serves as a guide to start you on the right track. I don’t claim to be the Yoda of finance. If you’re really interested in learning about personal wealth management in depth, I would recommend either taking a course, going to your local bookstore and buying one of the many books on financial management or meeting with a professional financial counselor. (continue reading…)

NO SHORTAGE OF PATIENTS IN THIS CLINIC

Staring at my double bypass burger, I felt a bit like a coward as I glanced over to my left and saw an older man downing 4 ½ lb patties, 4 pieces of cheese, and a bun glazed in lard. I then glanced across the room and saw a 9 year old begin to work on a triple. But I had a 3 hour plane ride home that day and couldn’t risk the battle that would ensue inside me had I attempted either of those behemoths. I’ll admit though, I wish I had taken on the challenge; a burger at HAG is absolutely amazing.

Heart Attack Grill® (visit) is a restaurant out of Chandler, Arizona that makes no apologies for who and what they are. There are only 4 items on the menu: the single, double, triple, and quadruple bypass burgers. They offer an endless supply of fries, deep fried in lard (which are quite delicious). To top that all off, if you weight over 350lbs, you eat free, something I witnessed during my visit. (continue reading…)

100 Initial Priority Topics for Comparative Effectiveness Research

Institute of Medicine of the National Academies

June 30, 2009

The American Recovery and Reinvestment Act of 2009 called on the Institute of Medicine to recommend a list of priority topics to be the initial focus of a new national investment in comparative effectiveness research. The IOM’s recommendations are contained in the report, Initial National Priorities for Comparative Effectiveness Research. The list of priority topics is provided below. The topics are listed by quartile (groups of 25). The first quartile is considered the highest priority group and the fourth quartile the lowest. Within each group, however, the order of individual topics does not indicate rank.

The list provides a starting point for what the report says should be a sustained effort to conduct comparative effectiveness research. As this research initiative progresses, the priorities will evolve as well. Ultimately, research on these and future topics will not yield real improvements unless the results are adopted by health care providers and organizations and integrated into clinical practice.

PDF of The 100 Initial Priorities                         Full Report