There is a growing body of evidence that hospital mergers lead to higher prices for consumers, employers, insurance and the government. It is imperative to educate patients and lawmakers as to how the consolidation of hospitals and medical practices raise costs, decrease access, eliminate jobs and, ultimately, reduce care quality as a result. Lawmakers should focus on this “first pillar” of cost control as they go back to the drawing …
Drug overdose is the leading cause of accidental death in the U.S., and opioids account for over 60 percent of those deaths. While opioids are effective pain medications when used in the proper setting, concerns arise when the patient’s condition lasts longer than three months, and prescribing more medication does not necessarily result in better pain control.
Building a strong doctor-patient rapport can help facilitate conversations with patients …
Prescribing opioids safely: How to have difficult patient conversations
The opioid epidemic has been declared loud and clear in the media over the past several years. Doctors have been demonized, and patients have been stereotyped. The statistics are alarming. However, I have yet to see anything published that focuses on the patient who lives with chronic pain. There is very little understanding for these individuals.
Let me be more specific. Society reacts empathetically towards the person who has pain related …
Where is the patient in the discussion of the opioid epidemic?
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Watching events unfold at United Airlines over the last few days have filled me with shock, awe, and horror. As a result of this public relations disaster, their motto “flying the friendly skies” has turned into “not enough seating, prepare for a beating.” America stands as a beacon of freedom from oppression. United Airlines was an iconic American company until last Sunday, with a responsibility to uphold the intent of …
United Airlines should do more than apologize profusely #BoycottUnited
“We are now contemplating, Heaven save the mark, a bill that would tax the well for the benefit of the ill.” 
Although that quote reads like it could be part of the Republican repeal-and-replace assault against the Affordable Care Act (ACA), it’s actually from a 1949 editorial in The New York State Journal of Medicine denouncing health insurance itself.
Indeed, the …
Why did the GOP health plan fail? Maybe because of medical Darwinism.
I took my dog to the vet today. You’d think this would be a straightforward sort of thing for a medical professional. You’d be wrong.
When I woke my dog up at 5:15 a.m. (my new daily start time, as it’s apparently the only way I can find time to do board questions and is also the excuse I use when I miss the majority of said questions), he seemed sleepy.
He’s …
I sometimes need to be reminded I’m not just a doctor, I’m human too
“Do you have sex with men, women or both?”
This is the way that we were taught in medical school to ask a patient about their sexual history. When we took our sample standardized patient exams, we were scored whether or not we asked this question. In my understanding, this was supposed to be a non-judgmental, non-assuming way to elicit a sexual history.
However, romantic partners generally come before sex (unless we …
Please stop asking about my wife
My mind usually starts to wander around the third or fourth hour of retracting a fat flap or holding up a leg during a long operation. I start by guessing how many times the attending has done this particular procedure. Is it his hundredth time doing it? If he was one of the older attendings, perhaps it was his thousandth one.
As a neophyte in the operating room, I still relish …
Learning surgery one stitch at a time
“For someone with your breast size, the risk of a complication is pretty high. I would recommend against the surgery.”
I smiled at the 50-year-old woman who sat in front of me wearing a pink, paper gown and a crestfallen look. She had recently been diagnosed with breast cancer and was planning on undergoing a mastectomy as part of her cancer treatment. Her breast surgeon had referred her to me to discuss …
Why doctors have a hard time talking about obesity
A keynote address to Gold Humanism Honor Society Induction Ceremony, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
As an intern, I was assigned to 9 weeks over the year on the bone marrow transplant inpatient unit. It was medically fascinating but emotionally draining and anxiety provoking. I began to get nauseated going to work because I was having such a hard time with the rotation. As I sank deeper …
Physicians can choose to nurture their human side
This happened in my first couple years of practice, but I will never forget her.
I stood at the doorway of the funeral home, a 26-year-old mother lying in the open casket was off to the side. Standing out among the crowd of mourners was a tall man holding his one-year-old daughter, her curly locks of hair bouncing as he moved.
Soon after they were married, she became pregnant. They were a …
I failed my patient, and it’s a burden I’ll carry with me
When a new doctor joined our clinic, she spent a week learning our electronic medical record. She had used two other systems before, so she was no stranger to EMRs, but that’s how different they can be.
That’s crazy!
EMRs should be like cars, which range from the likes of Smart, Mini Cooper, and Skoda to Mercedes Maybach, Rolls Royce, and Porsche. They range from simple to sophisticated, from nimble city cars …
EMRs should be like rental cars
Everyone has their abscess story. Tales of pressurized pockets of pus abound. Trust me: However far-fetched they may seem, they’re not. I had one such experience last week in which a man came to me with a painful red swollen lump on his back. It was about 2 inches in diameter, angry and fluctuant (softened) and ready to be drained, which he pleaded with me to do. So I did.
Although …
Never underestimate the power of pus
From time to time, friends, patients, and relatives ask my advice on participating in a medical experiment. My response has been no. More accurately, once I explain to them the realities of research, they don’t need to be persuaded. They back away.
Here’s the key point. When an individual volunteers to join a research project, the medical study is not designed to benefit the individual patient. This point is sorely misunderstood …
Before you join a clinical trial: Read this first
Those of us who work in pediatric intensive care have frequent encounters with the problem of suicide and attempted suicide. It has seemed to me for some years that the numbers are increasing, and this has been shown to be the case. After years of declining, the suicide rate in our country has been increasing, now at about 125 percent of the rate of several decades …
The suicide rate is increasing. Why is that?
At HIMSS, I listened carefully to payers, providers, patients, developers and researchers. Below is a distillation of what I heard from thousands of stakeholders.
It is not partisan and does not criticize the work of any person in industry, government or academia. It reflects the lessons learned from the past 20 years of health care IT implementation and policy making. Knowing where we are now and where we want to be, …
10 crucial guidelines for health care IT
Recently, the AHCA was pulled from the House floor after not enough votes could be secured in favor of its passage. A Washington Post article reported President Trump’s thoughts on the matter: “We couldn’t get one Democrat vote, not one. They [Democrats] own Obamacare. So when it explodes … we make one beautiful deal for the people.”
Journalist Robert Costa asserted “there was little evidence that either Trump or House Republicans …
Politicians must consult front-line physicians for health reform
Are you a baby boomer? Have you been tested for hepatitis C virus (HCV)? Do you know why you should be tested for hepatitis C? Do you even know what hepatitis C is?
According to research published by my colleagues from the American Cancer Society in the American Journal of Preventive Medicine, the odds are overwhelming that if you are in the boomer generation …
Baby boomer? Why aren’t you getting tested for hep C?
Thankfully, the GOP did not pass Paul Ryan’s repeal and replace bill for Obamacare. Immediately after, I saw a headline hopefully concluding, “Medicare for all may be next.” In Medicare’s current form, this would be devastating for the health of America. I am a young geriatrician; I know a heck of a lot about Medicare. Most people don’t. They just see it as a great perk of turning 65 in …
Single payer: Yes! Medicare for all: No!
A few years ago, my colleagues and I started a non-profit called Women in Anesthesiology. I started medical school late and had two children in residency (earning the delightful label of elderly primigravida or, if you prefer, geriatric pregnancy). My co-resident and I noticed few women in our department, and even fewer in leadership. We charged forward, starting a local, then national group. At the same time, a separate Facebook …
Maybe it’s time for physicians to lean out
