“You know, what Mr. HD really needs is for his mom or somebody to chain herself to him …” [the ICU team laughs] … “But seriously, he needs to be watched over, he needs to be talked to. He needs someone to give him his medications, someone to take him to his appointments, someone to take care of him. With that somebody he can live for years to come. Without …
Physicians used to take care of patients at their homes.
Through the 1960s, patients would make a phone call and the doctor would arrive at the doorstep, black bag in hand, eager to serve. This changed in the mid to late-1960s as doctors developed group practices and as medical care expanded to include technology-based studies and specialty referrals, and thus became more hospital-centered. Prior to World War II, 40 percent of …
Almost every Sunday night, I walk to this one restaurant in my neighborhood for some comfort food (we’re creatures of habit aren’t we?).
I pass a church on my way where an Alcoholics Anonymous meeting is held almost every night. As I walk through the crowd of smokers, I look at them and they look at me. They don’t know that I know they’re recovering addicts. And they put a smile …
There is a critical gap in the supply of primary care physicians in the U.S., and it should come as no surprise that our existing primary care delivery and payment models are at the heart of the issue.
The traditional primary care model — medical care provided by a physician and a small support staff, often without benefit of health information technology (HIT) — was developed at a time when the …
Boston Medical Center has provided care to the underserved and Medicaid population in Boston for almost 150 years. And what’s happening to the venerable institution is gut-wrenching to read.
I trained at Boston Medical Center (BMC), completing my internal medicine residency there in 2002. A recent write-up in Boston Magazine highlights the financial trouble the hospital is going through:
Boston Medical Center is almost broke, perilously close to what …
Before he tells you how to get a straight answers from physicians, Doctor D is going to stall for time by explaining why doctors give vague answers.
Why would a good doctor give useless answers?
1. There is an answer, but your doctor doesn’t know it. Don’t be hard on doc for this one. There is no MD in the world that knows the entire breadth of medical knowledge. Some docs pretend …
One thing I have learned by being active in the obstetrics and birthing blogosphere is that there are a whole lot of people out there that think that most cesarean deliveries are unnecessary. While most of them will admit that some cesareans are medically required, its pretty rare that the ones that have had a cesarean looks at their cesarean that way.
A popular term bandied about is “Unnecesarean”, a catchy …
I like Dr. Rob, the one with the distractible mind. And although I thoroughly agree with the stance he takes in his recent post against cholesterol screening in kids, I must take issue with his opening statement:
I have a unique vantage point when it comes to the issue universal cholesterol screening in children, when compared to most pediatricians. My unique view stems from the fact that …
Doctors, both generalists and specialists, have constraints on their time. New practices and new approaches need to happen in order to maximize everyone’s time. In addition to bringing your co-payment, you should “invest” in the visit and do your part, so that by the time the visit has ended, a successful plan of care is developed.
Here are some helpful tips to make the most of your medical appointments.
Two police detectives were waiting for me near the main triage desk; one was a tall male in a sleek black suit, probably in his early forties. He was ruggedly handsome in the manner of Jean-Paul Belmondo, the French …
The Annals of Internal Medicine recently published an article by Mullan and colleagues on the social mission of medical schools. In the article, medical schools were ranked on their record of educating and training physicians …
The most visible impact of Affordable Care Act is surely the expansion of health insurance coverage to 30 million uninsured Americans, but a lesser known provision in the overhaul will have far-reaching implications as well.
The provision catapults the US Preventive Services Task Force (USPSTF) from an obscure agency that produced unenforceable guidelines about screening and preventive services into one whose recommendations directly impact reimbursement.
Radiation is emitted in various forms. Recently, CT scan radiation has preoccupied (or “absorbed”) the attention of the public and media. As explained: “X rays, γ rays, and neutron beams are considered ionizing radiation. Ionizing radiation may break molecules into pieces, creating ionic free radicals that can be very damaging to tissue.”
For this reason, it is imperative that the use of radiation is only by highly trained personnel and that …
There are things we (the providers) do to health care that are hurtful. We make protocols and rules that divide us from our patients. Protocols that sometimes make patients feel alone, distant, and disconnected from their doctors. I don’t mean algorithms of care (safe, standardized ways of how and why to treat pneumonia, for example), I mean clinic rules for helping patients schedule and get in to see doctors appropriately.
When I went into medicine, I had clear goals in mind. Helping people. A stable income to provide for a family. I grew up under the spotlight of my father, who is a neonatologist, and lived in awe of his work. I remember being in restaurants with my dad – people would come up to him reverently and sing his praises (to his obvious embarrassment).
In addition to providing those incentive dollars for meaningful use of a certified EHR, the Health Information Technology for Economic and Clinical Health Act (HITECH) significantly strengthened aspects of the HIPAA security rule, including the penalties imposed under HHS and the Office of Civil Rights.
If you are a “Covered Entity” (CE) or “Business Associate” (BA) it’s time to get serious, the deadline to be fully compliant with these final HIPAA …
I recently finished reading In Their Own Words: 12,000 Physicians Reveal their Thoughts on Medical Practice in America. It is a summary of a 2008 survey from the Physicians Foundation. I vaguely remember filling out this survey. I was interested to see what my colleagues had to say.
Many physicians describe themselves as at the breaking point.
“I am so mired in this mess that I can’t see clearly enough to give …
When I was in charge of the medical residency programs in Grand Rapids, Michigan, David Leach introduced me to the expanded Dreyfus Model of how physicians can progress from beginners to masters.
I was always struck by how master physicians freely admitted their mistakes and used them as a teaching tool. As a young surgical and cytopathologist, my sanity was saved more than once by University of …
Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.
Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics. Especially …
I can’t help but stand in awe of surgeons. I thought I was going to be one when I went to medical school, but my short attention span and my lack of true interest in the procedures spelled doom for that. Still, when I work in the ER and I have a surgical patient, I especially want to dot my i’s and cross …
