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April 21, 2014

Andrew Silow-Carroll: Passoverkill? Suggestions to make next year's seders even more culturally sensitive

Sara Israelsen Hartley: Seeking the Divine: An ancient connection in a new context

Christine M. Flowers: Priest's execution in Syria should be call to action

Courtnie Erickson: How to help kids accept the poor decisions of others

Lizette Borreli: A Glass Of Milk A Day Keeps Knee Arthritis At Bay

Lizette Borreli: 5 Health Conditions Your Breath Knows Before You Do

The Kosher Gourmet by Betty Rosbottom Coconut Walnut Bars' golden brown morsels are a beautifully balanced delectable delight

April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review Jan. 9, 2013/ 28 Teves, 5773

More of our doctors are losing independence

By Nat Hentoff




http://www.JewishWorldReview.com | Recently, as usual, I was anticipating an appointment with one of my favorite doctors. Unlike some of my past physicians, he doesn't rush through a session. He listens carefully to my concerns, responding with lucid helpfulness.

But this time, he seemed somewhat depressed. He explained, "I am no longer independent." He has long practiced independently while also having an office at a major New York City hospital, to which several of my other doctors are similarly connected and where I am a patient when necessary.

"I can no longer be here at the hospital," he told me, "unless I become an employee of this hospital and accept their rules of procedure."


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And when his patients need hospital care at this noted teaching and research institute, they may feel they have to go elsewhere if he ultimately decides to leave. Or, if he chooses to stay, his patients' care may significantly decrease.

The growing pressure on the president and Congress to make the cost of our health care less of a rising cause of our national deficit is affecting many of our doctors, including mine. And the result of this historic change in our country's doctor-patient relationship has been largely ignored by the media and, thus, is not yet fully recognized by many of us.

But The New York Times' Robert Pear, a leading reporter on health issues, has been a clear exception. This recent piece of his was submerged in the paper's back pages on Dec. 27, 2012: "Doctors Warned on 'Divided Loyalty.'"

What "Divided Loyalty"? Pear immediately explains: "With hospitals buying up medical practices around the country and seeking to make the most of their investment ..."

In other words, less income and authority for doctors, more for their bosses at the hospitals.

But wait. Pear continues with a stern reminder from the American Medical Association to doctors with these new employers: "Patient welfare must always come first and not be overridden by the economic interests of hospitals that now employ doctors in ever-growing numbers."

Adds Dr. Ardis Dee Hoven, a Kentucky internist who is president-elect of the AMA: "We never want patients to worry or wonder if a decision is being made in their best interest." Emphasizing that commitment, the AMA sharply declares that doctors should have an "'unfettered right to exercise independent professional judgment' in caring for and advocating for patients."

So when We The People need medical help, there's supposedly nothing to worry about in the new arrangement. But as Pear reports, there is a darkening cloud over what happens in some hospitals around the country.

He writes: "Dr. Jerry D. Kennett, a leader of the American College of Cardiology, said he was aware of cases in which a hospital had told doctors not to place defibrillators in Medicaid (low-income) patients because 'it's a money-losing proposition' for the hospital.

"In other cases, he said, hospitals have told doctors they must use the (employer) hospital for laboratory work and certain imaging procedures, even if doctors found that they got better results or better service elsewhere."

This is "'independent professional judgment' in caring for and advocating for patients"? Pear presents another possible reason my doctor is not compliant with losing his independence: "Hospitals often set a goal for doctors (in their employ) that can result in a bonus, but if the doctors fall short, their salary may be reduced the next year."

Fall short in doing what the hospital orders them to do? And the patients have nothing to say about it?

There's always the possibility, of course, that some doctors -- even at the prospect of losing a steady hospital job in this hazardous economy -- may finally decide to be true to themselves and regain their independence. Pear shows us the result of this decision under the rule of some hard-lined hospital administrators:

"Hospitals frequently seek agreements to ensure that physician employees will not work for competitors if they leave the hospital staff. Such agreements typically prohibit a doctor from practicing medicine in a certain geographic area for several years after the doctor's employment ends."

In this land of the free and home of brave?

Even the AMA balks at this imposition of such a restriction on doctors whose crime is yearning to be independent again. As Pear writes: "The medical association discouraged doctors from entering into such agreements, and it said that 'patients should be given the choice to continue to be seen by the physician in his or her new practice setting.'"

The one in which he or she is his or her own boss?

Meanwhile, how will a hospital rule over doctors on its payroll when, as Jane E. Brody of the Times reports: "The number of Americans 65 and older is expected to double to 80 million in the next three decades. People 85 and older are the fastest-growing age group; by 2020, there will be 6.6 million people in that age bracket, when rates of debilitating ailments soar" ("With Help Here and There, Preserving Independence in Old Age," The New York Times, Dec. 25, 2012).

How many of these Americans will be welcome in some of our hospitals under their rules of cost-efficiency? There is a move to care for them at home, but will there be enough support under Obamacare for their independent doctors?

Barack Obama and future presidents, along with members of Congress, are already well taken care of with lifelong medical insurance and pensions.

As for the rest of us, we still have the First Amendment -- if we dare to use it at the polls by protesting the end of our doctors' independence.

Every weekday JewishWorldReview.com publishes what many in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.


Nat Hentoff is a nationally renowned authority on the First Amendment and the Bill of Rights and author of several books, including his current work, "The War on the Bill of Rights and the Gathering Resistance". Comment by clicking here.

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