Tag Archives: san francisco

Disciplined doc gets top rank in Google

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In SF Weekly, Ashley Harrell investigated the disconnect between a local plastic surgeon’s record of “gross negligence” which left one patient in a fatal coma and several others with burns, and the legions of glowing reviews of her practice posted all over the internet.usha-rajagopal

The reviews, she found, were connected to the astroturfing efforts of a PR agency the doctor had hired. The group also earned the doctor a top spot in Google’s PageRank algorithm at the same time that she was serving a three-year probation set by the state medical board.

Harrell’s story, Doctoring the Web, examines ways that some doctors are trying to game online ratings systems, as well as the current weakness of enforcement, both federal and local, in the arena.

Are insurers to blame for rising costs?

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The San Francisco Chronicle‘s Carolyn Lochhead and Victoria Colliver use the recent furor over insurer Anthem’s rate hikes to explore just how much of the blame for rising health care costs should be shouldered by insurers. The reporters find that, in the end, insurers are just another one of the cartels (others include device makers and providers) and operate inside the opaque world of medical pricing and snag hefty cuts for themselves. Lochead and Colliver put it thus:

While the Anthem case has raised a political storm, the underlying surge in costs gets far less scrutiny. But each sector of the health industry points fingers at the other for driving up prices, and all are raking in money.

Insurers blame hospitals and doctors, doctors blame insurers, and hospitals blame doctors and medical devicemakers in what academics call an inscrutable medical-industrial complex that rivals anything the defense industry ever invented. All these groups are combining into what many experts describe as cartels.

The reporters write that, despite their best efforts, they weren’t able to get many folks on the record. When they did find someone who was willing to talk, it was often a source we’ve seen before in other cost stories. It’s a tough theme to get quotes on, as nobody wants to burn bridges with their professional suppliers and everybody’s got some sort of skin in the game. They did, however, manage to find a local source who offered an original and illuminating anecdote:

Christina Bernstein, a medical-device engineer and independent sales representative based in San Francisco, sells disposable surgical tools made mostly out of plastic that she estimates are manufactured for about $40 each. These are marked up and sold to hospitals for as much as $350, she said, for a single use in a surgery on a patient.

“But if you were to get a detailed bill of what the hospital was charging the insurance company for the insured patient, those things get marked up to something like $1,200,” Bernstein said. “It’s ridiculous. There’s no open competition.”

(Hat tip to AHCJ Immediate Past President Trudy Lieberman, who wrote a column on CJR.org praising the Chronicle‘s story.)

Medical tourism expected to continue growth

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The San Francisco Chronicle‘s Carolyn Lochhead writes that the draw of medical tourism lies with both transparency and affordability and implies that its success shows the need for an overhaul of the U.S. medical system.plane-wing

She also notes that the reform efforts don’t seem likely to change those two central systematic problems, and thus medical tourism is likely to be here to stay, at least in the foreseeable future. The piece also explores the consumer side of medical tourism, profiling an Oklahoma surgeon who competes on price and transparency.

The article also cites an executive who advises that the economics of going overseas for treatment start making sense when the American price tag for a procedure reaches about $15,000.

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