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I just turned 26. Here’s what I learned while buying health insurance.

Augie Lindmark

Health Policy

October 5, 2015

I cracked a Budweiser and flipped on Spotify radio for what I was told would be a challenge. On my computer screen, Minnesota’s health insurance exchange website waited expectantly, to which I submitted the Holy Trinity of health information — age, date of birth, and tobacco usage — and waited. The next page loaded slowly, evidence of the voluminous information that would soon surface. I had hoped for simplicity, instead, …

Bracing myself for racially tinged criticism, I was surprised by what happened next

Damon Tweedy, MD

Physician

October 5, 2015

An excerpt from Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine.

On a humid Tuesday morning, Chester arrived at a busy Durham emergency room. While the other patients around him made the usual requests for pain medications, diagnostic tests, and reassurance that they were not about to die, Chester gave an entirely different kind of demand.

“I don’t want no nigger doctor,” he said …

Dear health care industry: Give me what I need, not what I want

Jim Schroeder, PhD

Patient

October 4, 2015

Dear health care industry:

I think we have a serious problem, and I think we both deserve some of the blame. Over the last couple of decades, I the patient have been demanding many things of you: reduced wait times, increased access to medications and procedures, more luxurious and colorful accommodations, and numerous scheduling conveniences among other things.

Meanwhile, I have watched as an industry long-based on the revered call of service …

What will be the consequence of health care consolidation?

Peter Ubel, MD

Health Policy

October 4, 2015

The federal government is currently debating whether the big six health insurance companies in the U.S. will soon become the big four. Aetna and Humana have announced plans to merge, as have Anthem and Cigna. The American Hospital Association and the American Medical Association strongly oppose the mergers, saying they will reduce competition in consumer markets.

Meanwhile, health care provider groups continue to consolidate. Small hospitals either get swallowed up by …

The time I was a 16-year-old standardized patient

Freida McFadden, MD

Physician

October 4, 2015

An excerpt from 11 out of 10: A Collection of Humorous Medical Short Stories.

When I was 16, I got a job as a “standardized patient.” My neighbor worked for a medical school, and they needed standardized patients for their medical students to practice talking to. Because apparently you can make it through four years of undergraduate, a rigorous medical school application process, and, you know, normal life experiences, but …

Should there be limits to patient-centeredness?

Richard Young, MD

Physician

October 4, 2015

A colleague recently told me of a patient encounter he had in an emergency room. When he picked up the chart, it described the patient as a 62-year-old woman complaining of epistaxis, or a nosebleed.

He walked into the room and saw a perfectly well appearing 62-year-old woman. There was no blood on her clothes and none on her face. Her nose was not bleeding. When he asked her what could he do for her, she said …

Here’s what doctors can learn from global volunteering

Robert Pearl, MD

Physician

October 3, 2015

Resurge

In the arms of every parent who waited on the long line outside the clinic in Mexico was a child born with a facial deformity, usually a cleft lip or palate. Many of these mothers and fathers had walked long distances, carrying their child. Some families included grandparents, aunts and uncles, and others, just a mother, and her baby. Most of these …

Find a cost-effective way for drug companies to innovate

Kevin R. Campbell, MD

Medications

October 3, 2015

Recently, two significant pharmaceutical breakthroughs have resulted in a renewed debate about the costs of drug therapy. In the last year, a new drug class for the treatment of hepatitis C has been released by two different manufacturers and has been found to cure a once incurable chronic liver disease for nearly 90 percent of patients who are treated with a full course of therapy. The drug appears to be …

Who’s to blame for ICD-10?

Brian C. Joondeph, MD

Health Policy

October 3, 2015

ICD-10 is not a character in an upcoming fall TV show, but instead something far less glamorous. ICD stands for International Classification of Diseases and is a list of codes used by doctors and hospitals when billing insurance companies.

It’s been around since 1946, with the 10th iteration going into effect on October 1st. And it may be an unpleasant October surprise for doctors and hospitals. Don’t blame Obamacare. Don’t blame …

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Who’s to blame for ICD-10?

Test your medicine knowledge: 58-year-old man with type 2 diabetes

mksap

Conditions and Diseases

October 3, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 58-year-old man is evaluated during a routine appointment. He is asymptomatic. He was diagnosed with type 2 diabetes mellitus 4 years ago and has hypertension, dyslipidemia, and obesity. His medications are enteric-coated low-dose aspirin, lisinopril, fluvastatin (20 mg/d), and metformin.

His calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohort Equations is …

Nurses have been my best teachers

Kay Miller Temple, MD

Physician

October 2, 2015

When the daytime soaps As The World Turns and All My Children went off the air, I stopped watching any daytime TV. So before their infamy this week, I’d never heard the name, Joy Behar. And maybe I’d heard the name Michelle Collins, but I’m thinking that name was my niece’s friend’s cousin or someone-or-other. And certainly, I’m not familiar with the …

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Nurses have been my best teachers

A pediatrician gives vaccine advice to presidential candidates

Chad Hayes, MD

Conditions and Diseases

October 2, 2015

First, I’d like to thank you for taking the time to read this; I know you’re busy fund-raising and campaigning, so I’ll try to keep this brief. It’s recently become quite apparent that several of you have some misconceptions about our immunization program. That’s unfortunate for people who are seeking such a prominent position. …

Here’s why clinicians should give shadowing a try

Peter Pronovost, MD, PhD

Medical Education

October 2, 2015

How many of our conflicts could be handled better or averted if we had the opportunity to spend some time in the shoes of the person on “the other side”? When we experience a situation through another’s eyes, and when we understand their work and world, true empathy, understanding and trust can emerge.

This is certainly true in our hospitals, where the frenzy of patient care activities involves multiple roles — …

The surprising reason behind an early refill of alprazolam

Hans Duvefelt, MD

Physician

October 2, 2015

Theresa arrived in a cloud of noise and commotion.

She had called after four o’clock the day before, but I hadn’t noticed the new message in my electronic inbox before I left the clinic.

Her almost brand new alprazolam bottle and her pain pills were missing, and Theresa was reeling. As she walked down the hall to the exam room, I heard her explain to Autumn how she had been to Walmart …

The dystopia of modern medicine

Jordan Grumet, MD

Physician

October 1, 2015

He had been educated at the finest universities. He had graduated cum laude, or whatever the term is they use nowadays to signify distinction. His pedigree was squeaky-clean.

But as he haltingly entered the dark building at the end of an otherwise unexceptional suburban street, he felt more like a criminal than a scholar. His office was drab. Each room was glowing with the artificial light provided by an incandescent bulb. …

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The dystopia of modern medicine

Want to become a doctor? Don’t be so sure.

Christopher Cai

Medical Education

October 1, 2015

Recently, my friend “Tim” told me that he no longer wished to become a doctor. He had already taken the Medical College Admissions Test (MCAT) and all his premedical course requirements. But a summer shadowing physicians whom he described as “always unhappy” convinced him to cut his losses.

“I worked hard the last three years,” he explained to me. “But I don’t want to be miserable forever.”

Medicine is a demanding and often …

Physicians must never lose their humanism

Cleveland Piggott, MD, MPH

Physician

October 1, 2015

“I’ll never forget the look in your eyes.”

Uh oh, I thought to myself.

“You had this look that you wanted to help but just didn’t know how,” said my patient.

Apparently I have very expressive eyes, and she was right. The event she was referring to was what we call a rapid response. This is when a patient’s status suddenly changes and the team wants her to be evaluated immediately. When I …

October 1, 2015: A day that will live in health care infamy

Rob Lamberts, MD

Physician

October 1, 2015

October 1, 2015 is a huge day to the medical community. It is a day that will live in infamy. It is the object of dread, of diaphoresis, of doom. October 1 is ICD-10 day. This view was further bolstered when I went to the CMS (Government Medicare) website; there was actually a doomsday countdown timer at the top of the page.

For those still unaware, ICD-10 is the 10th iteration of …

It’s time for physicians to regain their voice

Meeta Shah, MD

Physician

October 1, 2015

When was it that we stopped respecting ourselves and our profession? When did we decide that quietly smoldering or complaining to one another is better than standing up as a single entity for what we know is right? How did we allow misconceptions and distrust of physicians to grow? For outside forces to dictate what is best for our patients and take …

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