Dr. Rocky D. Bilhartz | Taking Back Medicine

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Accountable Care & Its Productivity Complex

November 19, 2015 / Rocky D. Bilhartz / 4 Comments

It is absolutely absurd to reward someone for being less productive.

This entire principle is befuddling to me.

But, a government think tank has decided this is the future of American medicine. “We’ve discovered a better way to muddle with the healthcare market,” they say.

The previous (and also ridiculous) system, built upon an UNKNOWN fee-for-every-service, is now being replaced by a more accountable one.

Accountability, like safety, is an easy concept on which to build support. Why? Because we need accountability in healthcare.

If the term, Accountable Care Organization (ACO), is not commonplace for you yet, it will be. In fact, you may already be receiving your medical care from one right now.

ACOs are networks of doctors, hospitals, and other medical providers that share responsibility in the care and cost of a large population’s health.

Think of them as being the It.

And, It may be caring for you.

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If You See A Study Labeled “Landmark,” Throw It In The Trash

November 12, 2015 / Rocky D. Bilhartz / 6 Comments

I’m going to tell you the real goal for a clinical trial in medicine these days.

It’s to be landmark.

It’s what the trial sponsors seek and their investigators envy.

Landmark is the ultimate goal.

In fact, trial sponsors will frequently call their own study landmark even before it gets published in a scientific journal. Kind of like getting your Super Bowl ring fitted during the preseason.

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You Can’t Take Back What You Are Giving Away

November 10, 2015 / Rocky D. Bilhartz / 2 Comments

I’ve played some basketball in my lifetime.

Just small stuff.

I’ve even coached a few games, like my sister’s co-ed basketball team, when she was eight years old. I helped my dad. One of the many things we enjoyed doing together.

I’ll never forget this one game.

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Looking For The RightCare Balance

November 3, 2015 / Rocky D. Bilhartz / 5 Comments

One of the more enjoyable writers I follow on social media is Dr. John M.

I’ve never met him personally. We only rarely exchange comments in the online environment. You know, 140 characters or less stuff. I don’t really know him.

I read his articles. Although I currently have no way of knowing this with absolute certainty, he seems to be very sincere. He may have me fooled. But, I don’t think so. He comes across as passionate about medicine, patients, and the physicians who care for them. He believes in doing the right thing.

He is an advocate for something known as RightCare. I’ll get to more about this in a minute.

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Understanding What You Pay For

October 25, 2015 / Rocky D. Bilhartz / 9 Comments

Many health insurance plans will see double-digit rate increases this year. Whether it’s Obamacare or employer-based commercial insurance, it doesn’t really matter. Your monthly premium will likely go up. Even if your employer pays it for you, your deductible will probably skyrocket yet again.

People want you to believe that YOU are finally paying for healthcare.

And, it’s a lie.

You are not.

You are paying for insurance.

And, until you understand the difference, you will never understand the problem.

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Feeling the Pressure

October 19, 2015 / Rocky D. Bilhartz / 4 Comments

It has occurred to me that this is a terrible idea.

In fact, it’s possibly the least beneficial thing for the general health of a population to have gained momentum in recent years. I’m not discussing cigarettes or e-cigarettes or low-yield cancer screening procedures. I’m not talking about diet drinks or sugary drinks.

I’m talking about home blood pressure monitoring.

It’s a terrible idea.

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All Aboard!

Overdiagnosis.

We are told this is a problem.

It occurs when the bar is lowered for what’s considered a real disease. For example, overdiagnosis presumably exists when we incidentally discover slow-growing cancers in older people. Basically, when we find a cancer that may not kill someone sooner than Father Time. And, as the story goes, we treat the cancer with lots of medicines, tests, and therapies–since the more diseases we diagnose in American medicine, the more treatments we recommend, and the more money we make, right?

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The Butterfly Effect on Me

October 6, 2015 / Rocky D. Bilhartz / 1 Comment

After reading my latest post about conflicts of interest in healthcare, my wife suggested that I write a piece about butterflies. Something pretty, she said. Natural. Peaceful.

Since hostility is never my goal, I thought I’d give it a try.

I read for an entire evening on butterflies–their life cycle, behavior, mechanisms for protection, and how different cultures view them. All I could keep thinking about was how much my grandmother liked them. She lived for nature. Flowers. Birds. Butterflies. She stayed with me once as a child when my parents were out of town. She would literally drive only 10 MPH on the road if anything remotely beautiful were visible out the window. Butterflies included. During her visit that year, I intentionally directed her down the ugliest roads in town so we could get to where we were going more quickly. I know it sounds bad, but that’s what I did.

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Emptying the Talent

October 1, 2015 / Rocky D. Bilhartz / 5 Comments

Nobody is waiting to hear your opinion.

People are not on the edge of their seat anticipating what you might say.

We often think we have an audience. But, the theater is frequently empty. People are looking for popcorn elsewhere. They are not waiting on your masterpiece.

Now, usually, this doesn’t stop us from putting on a show. People are actually hired all the time to give their opinion. All the time. Billions of dollars are spent on opinions. Some of this money comes from tax-payers. In fact, in medicine, it seems as if a degree in public health is all that’s required to provide advice.

Knowledge of time and place regarding the delivery of healthcare is not needed to wage an opinion about it. Just form a committee or an institution. Schedule a meeting. Advocate public protection or patient safety. Tell people what to fear, proclaim purity in your quest, and you’re off and running. You will probably even get funding from somebody. Maybe, it will be our government if your opinion advocates a need for more medical regulations to come from it.

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