Although my team, the New England Patriots lost Super Bowl XLVI to the New York Giants in one of the most exciting and tense games in recent memory, reviewing both the pre and post game coverage provided even more learning for doctors and healthcare than my prior post. One can demand excellence and still fall short. When one fails to achieve the intended goals, the learnings can be as …
What health care can learn from a Super Bowl loss
Doctor, do you know a lot about human nutrition? You said “yes?”
Congratulations, if that is true. But I suspect that South Carolina Congressman Joe Wilson’s infamous quote “you lie” is applicable.
American medical schools traditionally have done a horrible job with their curricular treatment of clinical nutrition. University curricula are controlled by the faculty and, when the faculty don’t know or care much about a topic, it often gets short shrift.
I …
Should medical schools be mandated to teach nutrition?
Pain is the result of a physiological series of electrical and chemical events that occur in the body. The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”
Pain receptors are bare nerve endings that are widely distributed throughout the body in the skin and mucous membranes. When pain receptors are …
Cancer pain is often undertreated
In a bid to save money, health insurers are coming out with what’s known as “focused networks,” which typically exclude the highest cost hospitals.
In the Boston area, one such plan comes from health insurer Harvard Pilgrim Health Care, whose plan excludes Partner’s Health Care institutions. That’s significant, since Partners includes the famed Massachusetts General Hospital as well as Brigham and …
Will patients accept focused networks in today’s economy?
Very few are as starkly aware of the transience of life as those working in the healthcare profession. We are expected to be, for want of a better word, immune to it; as if each death we face is somehow a vaccine that will eventually, with regular booster doses, provide us with enough immunity to be resistant to the Grim Reaper.
We spend years studying, arming ourselves with pages and pages …
When medical students first deal with death
Most physicians went into the practice of medicine motivated (at least in part) by the reward that comes from that human-to-human connection. The reward that comes from helping people. It was true of my generation of physicians, it was true of those before me, and is true of newer generations of physicians who grew up in a more interconnected, digitized world.
We are now at a time in medicine where an …
Is the patient experience enhanced by modern technology?
Today and for the next few years the weather of this industry will be dominated by pervasive, discontinuous change. Structures, revenue streams, relationships of every level: All are shifting in fundamental ways. Specifically, the weather will be driven by:
i) invention and propagation of new business models;
ii) shifting risk onto both the provider and the patient, accompanied by building of new risk-based relationships, contracts and alliances;
iii) smart primary care coming to …
10 strategic questions to ask yourself about the future of health care
Your doctor’s exam room is getting overcrowded. Modern US health care means that, like it or not, you and your physician are sharing that once private space with an insurance executive constantly hissing in your doctor’s ears to move it along. You are also sharing it with pharmaceutical marketers, lobbyists from the food industry … special interest groups of every stripe.
Now move over and make room for one more interested …
How political agendas erode the doctor-patient relationship
The BBC had a story recently about general practitioners (GPs) in the UK prescribing health apps to patients. The idea is that prescribed apps would be free to patients, even if they had a cost associated with them, so I’m assuming that the NHS would pick of the tab for such apps.
The story has gotten a lot of attention, and I think with good reason. I’ve written before and …
Why doctors aren’t prescribing health apps to patients
It’s cool. So cool, that President Obama used one. So cool, it’s been on the cover of Newsweek. It’s been in multiple television commercials, radio advertisements, highway billboards, and was even coined one of the top 14 medical breakthroughs of 2011 by Boston Magazine, a city teeming with medical innovation. Yet surgeons and health economists are unable to explain the fascinating rise of robotic-assisted surgery.
Currently, a single company manufactures and …
Why isn’t everyone excited about robotic assisted surgery?
I aspire to be Betty White when I grow up; she’s witty, funny, brilliant, and beautiful. I can’t wait to coo, “My eyes are up here,” to the hot guy who’s just busted down my door, when I’m 90 years old.
“What’s the secret to her vivaciousness?” I wonder. She is probably genetically gifted a la George Burns, but I bet she has done more to preserve her looks and her …
How to be like Betty White when you get older
Every day physicians and other healthcare professionals are engaged in an invisible battle at work.
In one corner is our desire to help other people, make a difference and practice the skills we worked so hard to perfect.
In the opposite corner is burnout and it’s entire gang. Most of us don’t recognize burnout has a whole team on its side. We are outnumbered at least ten to one. I call this …
Physician burnout: Why it’s not a fair fight
In advance of their annual User Conference, the social media team at athenahealth was able to talk about modern medicine with the event’s keynote speaker, Dr. Abraham Verghese. A physician and Stanford professor, Verghese has also authored several books, including the New York Times bestseller, “Cutting for Stone.” Here he talks about the importance of being present during the exam, in an era with so many distractions threatening to …
Neglecting the patient in the era of health IT and EMR
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Despite remarkable changes in technology, only 20% of patients who could benefit from hearing aids actually wear them. Reasons vary, but include a lack of awareness among patients and physicians, fear of stigmatization, and failure to recognize the immense value of hearing aids on social life and productivity.
Hearing loss affects 36 million Americans according to the National Institute on Deafness and other Communication Disorders (NIDCD). One third of people …
Hearing loss affects more people than you think
A heretic essay in JAMA by Vinay Prasad (Northwestern of Chicago), Adam Cifu (U. of Chicago) and John Ioannidis (Stanford) should be required reading for every medical student and resident and to pass any board certification exam in any specialty … in my humble opinion.
John Ioannidis became one of my personal heroes with the publication of his great paper in PLoS Medicine, “Why Most Published Research Findings Are False,” and its …
Bias and error are rampant in medical literature
The latest supplement toxic alert thankfully involves only two young soldiers who died suddenly, both reported to have the unregulated amphetamine-like dimethylamylamine, DMAA, aka “Jack3d” and “OxyelitePro,” as the suspected death-dealing toxicant.
Who knows how many other unexplained deaths and near-deaths can be attributed to the vast experiment foisted upon an unwary American populace by such drugs — I mean, “supplements”?
Thanks to 1994’s Hatch Act, the Dietary Supplement Health …
Unregulated supplements are a tragedy in waiting
Author of the new book “The Future of Health Care Delivery” and the former CEO of the University of Maryland Medical Center, Stephen C. Schimpff, MD, FACP, says effective care coordination, especially for patients with chronic illness, requires technology, more involvement of primary-care physicians and a health-care system – not a medical-care system.
A physician, educator and cancer researcher for more than 40 years, Dr. Schimpff shares his …
Care coordination is key to fixing health care
There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine. I don’t know that any one of them is more important than the other (it really just depends on which day you ask me). One that stands out for me though as a universal problem shared by millions is Managed Health Care, and the imposition it has posed on …
Why this pediatrician quit medicine
The manner in which a physician communicates information to a patient is as important as the information being communicated. Patients who understand their doctors are more likely to acknowledge health problems, understand their treatment options, modify their behavior accordingly, and follow their medication schedules. In fact, research has shown that effective patient-physician communication can improve a patient’s health as quantifiably as many drugs—perhaps providing a partial explanation for the powerful placebo …
Essential patient communication tips for physicians
The United States Preventive Services Task Force (USPSTF) is a federal committee composed of private sector experts in prevention and primary care. Its mandate is to make recommendations as to which preventive services are beneficial, which are useless and which are harmful. Disconcertingly, there is a small but vocal opposition to the USPSTF as embodied by an op-ed piece in the Wall Street Journal by Dr. Scott Gottlieb.
Dr. Gottlieb’s main argument against the USPSTF is …
The USPSTF should stay independent from politics
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