Articles

We now begin the magazine’s second calendar year. We shall summarize what was reviewed in the early part of the magazine. The US spends $4.5 trillion/year on healthcare or $13,493/person(2022) each year, the highest cost per capita of any developed country in the...

The principal goal of this magazine is to promote cost reduction while maintaining or more ideally improving the quality of medical care. The discussion in the first year of OMRUM’s existence has largely focused on the “big strokes” of difficulties with medical care...

In the previous article, the term “siloed physician care” was introduced. Physicians who practice in this manner see their roles as narrow in their patients’ care. Often, they don’t see themselves as obligated to any greater purpose in a patient’s management. For any...

As an internist (a PCP for adults), one of my greatest challenges was finding a good specialist pool when referral was necessary. A specialist should be well-trained, judicious in use of resources, and at least reasonable in bedside manner. Interestingly enough, the...

Few issues affect society at so many levels as does the current controlled substance debacle and arguably the opioid crisis in particular. It disproportionately exists within poorer and less educated communities. It draws resources from law enforcement at the federal...

So, we will now resume development of how best to measure factors influencing the future cost of care for a patient. In Part I, the idea was brought up of measuring patient fitness as a good surrogate of future cost of care for the patient. A simple starting point for...

In order for the patient population to benefit best from any medical system and especially a universal healthcare system, the care team ministering to the patient must be, ideally, headed by a PCP (primary care physician). Specifically, I believe that every patient in...

An important question to ask at this point in what positive behaviors might a patient engage to stay healthier and reduce costs (as opposed to avoiding negative behaviors such as smoking, excess drinking, etc.) Allow me the following story after which I will develop...

The Curse of the Medical Record As always, the goal of this magazine is to increase efficiency of medical processes and to lower costs. One process in need of fundamental improvement is the timely recording into and retrieval of medical records. To make the point, I...

The concept of universal healthcare in the United States raises, in many, their hackles. However, it really need not do so. The most important part of this article to remember is that in the US, we already have universal healthcare. Yes, you read that right, the US...

At this point, it is worth saying, once more, that the purpose of this magazine is to reduce the cost of medical care while maintaining or improving its quality. Initial groundwork for this goal has been made in previous articles. The full quote heading this section...

Let us now pick up our discussion regarding progressive disease states in a Markovian framework. In part I, we discussed a number of issues many of which are fairly intuitive: Preventing a disease is the best-case scenario (state 1) Intervening early in a disease...

To reduce medical costs, I submit that, one should decrease both the need for services and the cost of services. To help ourselves preserve health, we should all know our personal values for the following 4 items (obviously, this list is not exhaustive): BMI Body Mass...

The backbone (including nomenclature) of the following discussion will be organized according to so-called Markov processes. This allows the use of a common-sense framework. One of the most important goals in a medical system is to intervene early and effectively for...

Purchasing prescription medication is something that many of us have done and nearly all of us will do. Because every day Americans buy many million prescriptions, one would normally think that market forces would push prices down by strong, open competition. This is...