Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Licensure' Category

Can closing a hospital improve the quality of care?

The closing of St. Vincent’s Hospital in the Village in New York City at first glance would reduce access to care for New York residents living in the area.  To fill the void, however, a number of non-traditional providers have entered to fill the space.  For instance, the number of stand-alone urgent care centers are […]

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Home Births: Feminists vs. OB/GYNs

Why aren’t physicians more supportive of home births and midwifery?  The answer is that it eats into their market share and reduces their income. “[In the 1970s] feminists argued that medical care needed to be demystified and women’s lives demedicalized.  They maintained that childbirth was not a disease and normal deliveries did not require hospitalization […]

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Physician Influence on Federal Health Spending, 1950s

The 1950s was a time of unprecedented technological advances in the science of medical care.  In 1955, epidemiologists at the University of Michigan developed a polio vaccine.  These advances lead the federal government to increase funding for research.  Between 1955 and 1960, Congress increased the budget of the National Institutes of Health (NIH) from $81 million […]

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A Flexner Report on U.S. Health Care

A recent article in The New Republic examines some of the cunundrums facing today’s health care system.  Most significantly, the article mentions that ”In the war against disease, we have unwittingly created a kind of medicine that is barely affordable now and forbiddingly unaffordable in the long run.” The article offers a few suggestions of how […]

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In Support of a Fake Doctor

Recently, MSNBC reported that respected cardiologist and United Airlines captain Dr. William Hamman is in fact not a doctor at all.  ”The AP found he had no medical residency, fellowship, doctoral degree or the 15 years of clinical experience he claimed. He attended medical school for a few years but withdrew and didn’t graduate.”  As a […]

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Should health care providers be compelled to work during declared public health emergencies?

Carl Coleman say no.   Working during a pandemic is a supererogatory behavior — i.e., acts that are commendable if done voluntarily, but that go beyond what is expected.  Coleman argues that “…while health care professionals can legitimately be sanctioned for violating voluntarily-assumed employment or contractual agreements, they should not be compelled to assume life-threatening risks […]

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Physician licensure and quality: Part IIX

In The Social Transformation of American Medicine, author Paul Starr analyzes the development of modern American medicine. A large portion of the book looks at the roots of physician licensure. His analysis dates back to the colonial era. Some important turning points in the history of physician licensure before the twentieth century are: In the […]

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Physician licensure and quality: Part VII

One final example of licensure’s impact on quality is given by a 1978 study of the quality of contact lens fitting.  The study looked at 502 households who had been fitted for contacted lenses in the previous three years and were still wearing contacts.  The study was conducted with the cooperation of the American Academy […]

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Physician licensure and quality: Part VI

On February 4th, I wrote on the American Medical Association’s (AMA) role in modern medicine. Today I will give further commentary regarding the AMA by reviewing a seminal paper by Reuben Kessel (1958). The paper describing the AMA’s development in the first half of the twentieth century. The AMA has two main goals: 1) a […]

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Physician licensure and quality: Part V

During the past few days, I have written extensively on the reasoning behind why society would wish to create a licensing arrangement for some professions. Today, I will review Hayne Leland’s 1979 paper which develops a mathematical model which explicitly describes the welfare implications of licensure. Model Leland uses a Akerlof style set-up where the […]

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