“Ultraviolet bad.”
That was the core message that came out of the introduction this morning of the Surgeon General’s Call to Action to Prevent Skin Cancer at a meeting held at the National Press Club in Washington DC.
There were some other messages that now raise skin cancer awareness and prevention high on the public health awareness list, such as …
Today it’s time to say, “Ultraviolet bad”
A dozen set of eyes stared upwards. The nurses ate their pizza and glanced back and forth between me and the dry erase board that I had recently filled with incomprehensible scrawl. I had given this lecture many times and said the words over and over again. And yet the response was always surprising.
“Why do you think physicians get angry and …
Why do physicians behave badly? Maybe because they’re scared.
What can physicians learn from the Union Street Guest House?
For those who don’t know, this hotel in New York threatened to fine those who dared write a bad review. The New York Post got wind of this, and needless to say, the fallout has been ugly. The hotel has hundreds of 1-star reviews of Yelp for its efforts.
This leads to a question I commonly …
How physicians should respond to online ratings: Lessons from the Union Street Guest House
I am a solo, independent family physician and my practice is not a silo. It is not a cold, stagnant, immobile, potentially dangerous storage facility where data to be used by insurance companies and statisticians is held until it is finally purged. No, my office is a visually and emotionally comforting, innovative, healing environment where information is shared and confidence is enhanced. It is an oasis.
My practice is embedded in …
My oasis of care is being threatened
There’s at least one hidden reason the health care system is failing people who just want some face time with a doctor: too many dedicated physicians are not just overwhelmed, but burned out.
According to a 2012 JAMA Internal Medicine Mayo Clinic study, 46% of all U.S. physicians are emotionally exhausted, feel cynical about work or have lost their sense of personal accomplishment …
Americans think that most physicians have it made. They’re wrong.
The scientific literature is replete with the failure of vitamins to support diseases. Yet, the industry is booming and people’s cabinets are filled with potentially harmful, poorly studied colorful bottles that make unsubstantiated magical claims.
This year, we witnessed Dr. Mehmet Oz, a celebrity doctor who frequently extols weight loss products, supplements and vitamins on his syndicated television show come under fire from regulatory committees for false claims and poor outcomes.
The …
Vitamins are not magic. We need good science and better sense.
At the recent gubernatorial candidates forum on mental health, Martha Coakley repeated the oft-heard phrase that depression is like diabetes. Her motivation was good, the idea being to reduce the stigma of mental illness, and to offer “parity” or equal insurance coverage, for mental and physical illness. However, I am concerned that this phrase, and its companion, “ADHD is like diabetes,” will, in fact, have the exact opposite effect.
A recent New …
Stop comparing depression to diabetes
Anyone from outer space reading the news and watching TV would think that the U.S. has some of the worst health care possible. The negativity appears to be pervasive. Controversy over this, outrage over that. Whether it’s inadequate health outcomes, policy debate, or scandals with patient care, the stories and discussion abound.
As someone who grew up and went to medical school overseas and then came to the U.S. for medical residency (along …
5 things that make U.S. health care great
I knew immediately it was a problem. It was not just that Faith’s cancer had spread with innumerable masses in her liver, golf ball-like tumors in her lungs, punched out holes in her bones. It was not that the chemo, third round and toxic, had failed. Those were awful things. Rather it was her response as I began to tell her. As soon as I said, “I looked at the …
Giving terrible news to those we love
For a very long time, one of the most valuable business assets in New York City was a yellow cab taxi medallion. With recent value in the $1 million dollar range, ownership of the medallion was a virtual cash annuity, combined with equity growth (in 2004 medallion prices were in the mid $200,000 range and have increased in value 15% year over year in the 9 years since). As one …
What the Uber of health care will look like
There are few things more important than our health and our health care. Solving health care for everyone is critical to becoming a healthy, vibrant society. Because our government has controlled our health care for two generations, election realities and political rancor obscures our ability to collectively solve the problem. Allow me to use a fictitious government program, “Foodaid,” to defray the noise and illustrate how government-control of our health …
Why government cannot cure our health care
Last August I sat surrounded by 163 other ambitious, new medical students on our “introduction to the profession” week. Anxiety was high with undertones of self-doubt mixed with lofty goals. Another distinguished figure had taken the floor to introduce us to the concept of medical professionalism: commitments to patient-centered care, intellectual honesty, social responsibility and advocacy. The long list of medical virtues we were to develop, cherish, and exemplify in …
What is professionalism and wellness in medical education?
The deadly outbreak of Ebola virus in West Africa is the worst on record, with over 603 deaths reported as of July, 2014 (according to the CDC Ebola outbreak update). The virus is confirmed in Guinea, Liberia and Sierra Leone — and the crisis appears to be far from over.
The geographical complexity of the current crisis highlights one of the most crucial obstacles to …
Why is there no cure for Ebola?
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There are few jobs more chaotic than that of physician, at least based on my own experience. Yes there is a schedule of sorts: hospital rounds, procedures, office patients. Unfortunately things rarely go as planned. There is a particularly sick patient on rounds who needs a temporary pacing wire placed. There are more consults than expected. The procedure that was planned to take up to 2 hours takes 4 hours because of …
Bring order to chaos in medicine: Stick with an organizational system
Florida politicians will not change pediatrician resolve to advocate for and protect children. There’s no question that a gag order cannot halt a passionate child advocate. I’d call the recent Florida ruling a dull tool taken to a very sharp crowd. Consider this post an open letter to Florida politicians.
I live as far away from Florida as any continental American (you do the math) yet Florida politics affect pediatricians and …
A gag order cannot halt a passionate child advocate
An excerpt from The Demise of Medicine.
As with the Aesop fable, familiarity breeds contempt. The role and responsibilities of the physician are being slowly eroded by the media, the legal profession, and even other allied health professions. The tools we hone and more importantly the thought processes physicians develop to diagnose and treat are different than the tools nurses or any other …
Unify the standard to practice primary care
Inevitably, there will come a time in our medical journeys where we will have to have a difficult conversation with a family about the passing of a loved one. Sometimes, it will be an expected event after a patient has dealt with a long illness at an advanced age; other times, it will be an unexpected event in a person who looked healthy a short time before. These events can …
Honoring families in times of grief
Recent research finds that many internists do not feel comfortable or prepared to care for survivors of childhood cancer. Although the rarity of childhood cancer may explain this, the fact remains that as more and more pediatric cancer patients survive into adulthood busy internists often have some survivors in their practices. These patients would have been treated during the last decades of the 20th century or the beginning of …
5 things internists should know about treating survivors of childhood cancer
Medical errors are estimated to be the third leading cause of death in America’s hospitals. Though some of these errors are beyond physician control, many are the direct result of physician action and inaction. I spend a lot of time thinking about how to reduce these errors and I (like many of my peers) lose sleep over the mistakes I witness.
When you ask patients what quality is most important in a …
What is the most important trait in a doctor?
To improve patient care, doctors rely on research and published information.
According to an American Medical News report, professional journals are still the most popular source of up-to-date medical information among doctors.
These medical publications inform physicians on new drugs and treatments, and they contain peer-reviewed studies that both physicians and patients assume are scientifically accurate.
But all too often, research findings aren’t as scientific as they should be. And some are flat-out biased.
Research studies …
Curbing bias in medical research
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