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The Big Short in health care: What happens after the bubble bursts

Policy

August 30, 2017

Last week a physician friend recommended watching the movie the Big Short. The description given to me was that it was a great movie that was all about a bunch of guys who saw the 2008 financial crisis coming. Sure enough, that very weekend, I planned a night in to get take out and watch it on Netflix.

And it sure didn’t disappoint. Starring Ryan Gosling, Steve Carrell, Christian Bale, and …

9 reasons the “golden age of medicine” was golden

Thomas D. Guastavino, MD

Physician

August 29, 2017

To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.” We purposely keep our patients in pain, or we addict them to …

15 tips for working with women

Sasha K. Shillcutt, MD

Physician

August 28, 2017

I work in a male-dominated field. As a cardiac anesthesiologist, I work with mostly male cardiac surgeons in a department where the majority of my fellow anesthesiologists are male. I work with some fantastic male colleagues. They are caring, skilled doctors, and I consider many of them to be friends.

While most of them know how to handle emergencies, trauma and difficult work situations, many times they clam up when we …

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15 tips for working with women

The mythical unicorn of vaccine denialists

Christopher Johnson, MD

Conditions

August 28, 2017

I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity.

Epidemiologists debate the concept around …

5 ways virtual doctors can help during a natural disaster

Latisha Rowe, MD, MBA

Physician

August 28, 2017

In Houston, all of my colleague’s offices are closed, and there is limited access to the Texas Medical Center due to Hurricane Harvey. As a virtual medical doctor, there was only one thought on my mind this entire weekend, “How can I help?”

As a Floridian, I have certainly faced my share of natural disasters beginning with Hurricane Andrew, a category 5 hurricane in 1992. Living through Hurricane Andrew gave me …

Physicians: Use your voice to make the difference

Vineet Arora, MD

Physician

August 28, 2017

Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a train wreck in progress. You may have thought about saying something, but paused and wondered, “Is this …

The white coat symbolizes 2 important commitments

Efrain Talamantes, MD

Education

August 27, 2017

A white coat ceremony address to the University of California, Riverside School of Medicine, August 4, 2017.

“It takes a village” is one of my favorite proverbs, an African proverb, that resonates with each of us on this monumental day. There is without a doubt that every one of you worked very hard to get into medical school. However, this difficult journey was supported by dozens of important individuals: teachers, …

Fix the pay imbalance between specialists and primary care physicians

Zachary Janowski

Policy

August 27, 2017

Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy …

Good clinical care takes more than medical acumen

David Edelbaum, MD

Physician

August 25, 2017

When I finished my medical training almost sixty years ago, I was like many new graduates: I thought I knew it all.

I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s …

4 reasons to choose emergency medicine

Mitchel Schwindt, MD

Physician

August 25, 2017

There is a definite finality to the decision of which specialty a physician pursues. The reasons are as vast as they are individual. Hopefully, the med student has done due diligence and has a solid grasp on what their future entails, at least for the future as far as anyone can confidently foresee. Here is my story.

1. Challenge. No day is quite like another, and life as an emergency medicine (EM) …

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4 reasons to choose emergency medicine

A surgeon makes a mistake, and couldn’t stop crying

Caitlin Smith, MD

Physician

August 25, 2017

“F*ck!”

I pried my eyes open and had the realization of exactly what time it was. I was going to be late — again. I jumped out of bed as fast as my stiff and weary body would allow, threw scrubs on I was mostly sure were clean, ran a brush through my hair so I didn’t look totally disheveled when I had to look like professional in a few minutes …

48 hours in the life of an on-call gynecologist

Andrea Eisenberg, MD

Physician

August 25, 2017

An on-call weekend: 48 hours of being at any moment “on,” of being edgy, of being exhausted. This weekend included a full house of patients to see in the hospital, a patient list of three pages to be exact. As I went from patient to patient, room to room, each held its own unique story filled with the yin and yang of life. I realize too, this may be a …

This resident’s childhood friend inspired him to help other children as a physician

Admin

Video

August 24, 2017

“You find joy that people are doing better because of what you did for them.” #BornToHeal

Courtesy of the American Medical Association (AMA).

This resident’s childhood friend inspired him to help other children as a physician

Help me help doctors in recovery

Stephen F. Chambers, MD

Physician

August 24, 2017

Approximately 12 years ago, I hired my first physician in recovery. He had temporarily lost his license following a bout with alcohol. After a stint in a rehabilitation clinic, he was ultimately reinstated. My journey to hire this physician was arduous at best. During the interviewing process, I narrowed the field down to two candidates: one with a past and one without. I wrestled with the “in recovery” situation and …

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Help me help doctors in recovery

A history of health care reform

Behrouz Zand, MD

Policy

August 24, 2017

Health care reform continues to make national headlines as Republican senators have failed to pass a bill in the Senate with enough support to repeal and replace the Affordable Care Act (ACA). How did we get here, and why do so many Republicans want to make the ACA go away badly? To answer this question, you have to first understand the history of health care reform in the United States …

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A history of health care reform

Stop the patient leakage in primary care practices

Fred N. Pelzman, MD

Physician

August 24, 2017

Yesterday, we had a meeting about leakage.

No, it was not about urinary or fecal incontinence, but it was about care that could have been provided within our institution that ended up, for a multitude of reasons, happening with providers beyond the walls of our institution.

Representatives from our accountable care organization had requested a meeting to go over some issues they’ve been having with our practice, including low levels of usage …

This doctor sings to her patients. And the results are beautiful.

Jessica Jameson, MD

Physician

August 22, 2017

I am an interventional pain physician. I spend most of my days doing spine injections with a fair amount of kyphoplasties and spinal cord stimulators thrown in as well. It seems to me that these are minor procedures that shouldn’t evoke anxiety in patients, but they do. Patients get nervous. They get anxious.

I am also a singer. I had the privilege of being classically trained through my college years. Like …

A letter from a parent to her child’s pediatrician

Tracy Asamoah, MD

Physician

August 21, 2017

I am a child psychiatrist who is also a patient, a mother of patients and the wife of a patient. I have lived all sides of health care and appreciate the complexity that is our American health care system. After a recent move to a different part of town, we decided to find a new pediatrician for our daughters.

I knew that we had several good options near our home. When …

Online physician reviews: Patients are the ones who will suffer

Kaci Durbin, MD

Physician

August 20, 2017

The rise of the Internet has changed many things in the world of the customer. Now, in the age of the online consumer, a person can search for not only the exact item or service he or she wants, but read hundreds of reviews on that particular item or service. Thanks to Yelp and a host of other online rating sites, a person can find a reputable painter or contractor …