Obamacare isn’t a train wreck. Here’s why.

Health Policy
August 13, 2014

For years, critics of Obamacare (Affordable Care Act), have predicted that it would turn out to be a “train wreck” — or something worse.  But now we know that by every objective measure, the ACA is working out pretty darn well.  Let’s run through the “train wreck” predictions, and what we now know to actually be the case:

Train wreck prediction #1: “Obamacare will lead to skyrocketing health care cost increases and …

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Obamacare isn’t a train wreck. Here’s why.

Can we get more from our medical meetings?

Medical Education
August 13, 2014

Recently I attended a national academic conference, and while I’ll admit that, having brought my husband and son along for the trip, the balance of time spent was skewed more toward pool and beach activities than academic sessions, I did indeed attend several and overall they were of good quality. One left me somewhat disappointed, though, because although it addressed what I would consider an important topic within my field, …

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Can we get more from our medical meetings?

A letter from a hospitalized patient to a hospital CEO

Physician
August 13, 2014

We are at a pivotal moment in health care. It’s changing so rapidly even the people leading the change can barely keep up. One of the biggest paradigm shifts over the last decade is the focus on quality over quantity. Improving the health care experience and patient satisfaction are also being talked about in boardrooms across the country (largely due to the link with reimbursements, but still unthinkable a few …

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A letter from a hospitalized patient to a hospital CEO

Are patient portals a gateway or barrier to patient-centered care and communication?

Health Technology
August 13, 2014

acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com.

Patient portals. They have great potential, but is it being met? And are we losing something in return? I ask myself these questions now that my practice offers a patient portal linked to our electronic health record (EHR). I did not expect to feel that way, …

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Are patient portals a gateway or barrier to patient-centered care and communication?

Recognize the doctors patients often don’t see

Physician
August 12, 2014

There are doctors that patients see. And there are the doctors that patients almost never see.

Patients see me, an obstetrician, at prenatal visits, in the ultrasound unit, or on the labor floor. But they don’t see all the wise radiologists reviewing their imaging studies, or the educated pathologist assessing whether their biopsy is cancerous. Some of the most important doctors that our patients don’t see are the ones in the …

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Recognize the doctors patients often don’t see

At the hospital, I’m Dr. Nobody

Physician
August 12, 2014

Today I had a very special experience, one which many of my patients have faced: I was treated like a nobody while at the hospital. Yay me.

I went to visit a patient who was admitted over the weekend to see what was going on.  She was a bit upset about the confusion of the hospitalist service and how orders apparently didn’t get written for her care by the admitting physician. …

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At the hospital, I’m Dr. Nobody

I am just a medical student

Medical Education
August 12, 2014

She’s 58, but appears maybe three days older than 42. Her eyes are sunken, tearful, worried, anxious.  She tells me about her two grandchildren, and how she just visited them in Michigan.  She came to the hospital, straight from the airport.  She’s worried.

She’s worried because her shortness of breath hasn’t gone away for over a month now.  She has had breast cancer, and opted for a more conservative approach: a …

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I am just a medical student

It is time for physicians to stop making the easy decisions

Health Policy
August 12, 2014

As Americans, we love to associate with groups. More than that — we love to plant ourselves in a group, stand firmly in our decision, and then adamantly refuse to budge or to see the other party’s perspective.

Pro-life. Pro-choice. Democrat. Republican. Pro-Obamacare. Anti-Obamacare.

I suppose for all of us, myself included, it is easy to identify with our group of choice when we are sitting at home watching or reading our …

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It is time for physicians to stop making the easy decisions

Ebola in America: Stop with the hyperbole

Conditions and Diseases
August 11, 2014

To be quite blunt about it, Ebola is a very scary disease. Among those infected, the mortality rate is, as is perhaps now widely known, an appallingly high 90%. That would seem a very good reason to keep our borders closed to this scourge — and the consequences to the poor souls who already have it be damned. That, apparently, was just the kind of thinking behind at least Read more…

Ebola in America: Stop with the hyperbole

7 ways patients can help reduce medication errors

Medications
August 11, 2014

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I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration …

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7 ways patients can help reduce medication errors

After Halbig: What’s next for Obamacare?

Health Policy
August 11, 2014

After more than 40 attempts to pass legislation calling for repeal or significant changes to the health law, opponents of the Affordable Care Act have moved their focus from the House floor to the courthouse. Currently at least four lawsuits are working their way through state and district court — and one case awaits a nod from the Supreme Court — that would make it illegal for the federal government …

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After Halbig: What’s next for Obamacare?

Medical resident pay needs serious reform

Medical Education
August 11, 2014

Two years ago, I received my first employment contract. Not long after Match Day, I did what 115,000 physicians in training did that year and will do again this year: I signed the contract promptly and returned it. I tried to read the contract carefully, but it didn’t really matter. Unless you no longer want to be a physician, there is no other choice but to sign.

Today, as president …

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Medical resident pay needs serious reform

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Solutionist medicine: How the concierge model can reinvent primary care

Physician
August 11, 2014

Call it concierge, call it direct care, boutique, fee-for-service, call it what you will. I call it a solution. As physicians, we’re all solutionists, are we not? With every differential diagnosis, assessment, and plan, we are creating solutions.  In accordance, one does not become a doctor for any reason other than changing the world. Perhaps this change happens one patient at a time, but working toward a greater cause and putting …

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Solutionist medicine: How the concierge model can reinvent primary care

Intimidating doctors won’t solve the chronic pain epidemic

Physician
August 11, 2014

Nearly every day we read headlines about the serious prescription drug problem in America.  Increasing heroin addictions and deaths from illicit drug use are taking a severe toll on far too many families and communities. While we must feel enormous sadness for the families experiencing these tragedies, we must not overlook the other major health crisis that is often associated with the opioid abuse problem: chronic pain.

The chronic pain crisis …

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Intimidating doctors won’t solve the chronic pain epidemic

The evolving physician role in end of life decision making

Physician
August 10, 2014

I was taught in medical school (some 50 years ago) that doctors had a special duty to protect the patient.  That seemed self evident and logical.  “Do no harm” was a first principle dating back to Hippocrates. However the teaching I received extended the concept to also protect the patient from bad news, and to make “the right” decision for them — not necessarily including them in the conversation or …

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The evolving physician role in end of life decision making

Bringing the two Americans back home with Ebola: Is it worth it?

Conditions and Diseases
August 10, 2014

Ebola is a hemorrhagic fever that causes death by what seems like a virally induced stigmata. That statement could be even shorter. With a fatality rate that can reach 80 to 90% we could just say that Ebola is death.

The World Health Organization (WHO) says this most recent outbreak is “moving faster than our efforts to control it” and the CDC is calling this “The biggest and most complex …

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Bringing the two Americans back home with Ebola: Is it worth it?

What can medicine admissions learn from Google?

Medical Education
August 10, 2014

In a New York Times column, Thomas Friedman recent wrote about what Google values and seeks in its new employees. Striking to me was the fact that overall intelligence ranks lower on their values totem pole than several traditionally more important attributes.

So, what can medicine learn from Google and how can we apply it to our admissions process? Here are five key points from the article, adapted to our admissions process:

1. …

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What can medicine admissions learn from Google?

A primer on the anesthesia care team model

Physician
August 10, 2014

american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Daily, and often several times a day, I am asked by patients about my role as a physician anesthesiologist.  Occasionally the answer involves reiterating to patients that an anesthesiologist is a physician.  Once we get into the discussion, patients are also surprised to learn that …

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A primer on the anesthesia care team model

10 potential benefits of robot caregivers

Health Technology
August 10, 2014

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My recent New York Times op-ed on robot caregivers for older adults has elicited curiosity, enthusiasm and controversy.

I have to admit that my own first reaction to the topic was captured in the Times’ letter from Sherry Turkle whom I mention in the piece. I was in a meeting and turned to a colleague, clumsily patted her on the back and said, “It … is …

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10 potential benefits of robot caregivers

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