Every time I turn on the television, there’s another commercial for a new drug treating a condition I’ve never even heard of.
It’s constant. And honestly, it’s exhausting.
I can’t help but wonder: What happened to real care?
I remember a time, 35, maybe 40 years ago, when doctors knew your name. They looked you in the eye. They read your chart. They listened to what you had to say before deciding. They …
An excerpt from Dr. Koop: The Many Lives of the Surgeon General.
“I was the salesman for pediatric surgery. I have the knack of talking to an audience and convincing [them] about what I’m saying is true.”
– CEK
The early 1950s witnessed an extraordinary burst of professional activity on the part of the young surgeon, still in his 30s, as the American Academy of Pediatrics (AAP) …
The recent focus on the Canada-U.S. border has led to frequent confusion between human smuggling and human trafficking. Smuggling involves people moving across international borders. In most cases, irregular migrants who are smuggled into the country consent to assistance. Human trafficking, on the other hand, involves the exploitation of people for sex or labor through coercion, regardless of geographic movement.
Continued conflation of these terms will undoubtedly harm anti-human trafficking efforts …
The term “core competency” was coined by management experts C.K. Prahalad and Gary Hamel in their influential 1990 article titled “The core competence of the corporation,” published in the Harvard Business Review. Prahalad and Hamel defined core competencies as the unique capabilities or advantages that a company possesses, which are critical to its ability to achieve competitive advantage and long-term success. These competencies are not just about the skills or …
A familiar ding echoes from blue scrub pants. My conditioned frontal cortex reflexively shoots my hand to the back pocket. Fingers encircle a black smartphone. A ricochet of notification vibration still tickles my right buttock. Several semi-autonomous thumb swipes ensue. The joy of Microsoft Outlook’s blue glow reveals a new email—one of nearly a hundred emails jostling for self-importance that day. But this one is different. The ominous phrase “Effective …
An excerpt from Dr. Koop: The Many Lives of the Surgeon General.
“I have learned that, when an idea’s time has come—and it is on your watch—you must seize the moment.”
– CEK, Glasgow speech
It would take C. Everett Koop, M.D., Sc.D., just an hour—one very well-prepared hour—to overturn nine months of obloquy and ridicule. In the process, he re-ordered the public face of …
Blockbuster was once a dominant force in the video entertainment industry, with thousands of stores and near-total market control. However, when digital streaming services emerged, Blockbuster was slow to respond, dismissing Netflix as a passing trend. By the time it recognized the shift in consumer preferences, it was too late – the company collapsed, unable to compete in the new era of on-demand entertainment.
Health care, particularly primary …
In past decades, physicians practiced medicine. The majority were dedicated to patient well-being. They were paternalistic and decided what was in their patients’ best interests, and patients generally trusted their judgments. In the 1970s, ethicists concluded that patients and clinicians should make treatment decisions jointly. This position has been championed since then, despite multiple surveys demonstrating that more than 50 percent of patients prefer their physicians to be the decision-makers. …
Before a discussion of entitlements and welfare programs is started, a primer on the fiscal situation of the country seems appropriate. Service on the national debt is now second only to Social Security as a government expenditure. The debt is now about $36 trillion. Government revenues are 18 percent of GDP. Spending is 25 percent of GDP. Seventy-six percent of spending has been mandatory, leaving 24 percent as discretionary. The …
As I have written elsewhere, the United States is now embroiled in a highly contentious debate concerning the causes of the so-called “opioid crisis.” Prescribing guidelines updated in 2022 by the Centers for Disease Control and Prevention (CDC) and Veterans Administration (VA) have become the basis for continuing scientifically unsupported restrictions on patient access to long-term prescription opioid therapy. Doctors …
As a former health care executive, I have witnessed many leaders at all levels sabotage their own success. Most of it was unintentional but rather the result of a failure to learn from those who have gone before. Many in the health care industry are promoted into leadership roles without the benefit of leadership or management training and are then left to their own devices to learn “on the job,” …
Health care systems worldwide are grappling with access, efficiency, and sustainability challenges. In Canada, the debate over public versus private care is especially charged, and nowhere is this more evident than in Quebec. The province has the highest number of physicians practicing outside the public system in the country—yet they still account for only 2 percent of all doctors. Instead of vilifying these professionals, policymakers should be asking: What lessons …
We heard of Hurricane Irma only a handful of days before it smacked straight through 5th Avenue in my hometown. The predicted storm paths sent the hurricane sweeping through Miami—across the coast. When the storm path shifted, it was almost too late for my family to evacuate. Its 180 mph winds and 10–15 foot storm surge were catastrophic, costing the lives of 84 people.
It was the coordinated response of the …
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As first-year medical students, we are taught to always prioritize patients over politics. However, our research in maternal health has shown us that the two are dangerously intertwined, with political decisions directly impacting the provision of health care not just domestically but around the globe.
On January 24, only four days into his second term, President Trump reinstated “Protecting Life in Global …
Federal downsizing, while touted as a means to streamline operations and eliminate bureaucratic waste, has significant and often detrimental consequences for the U.S. health care system. Two documents shed light on this issue from complementary perspectives. The first, a U.S. Office of Management and Budget-Office of Personnel Management (OMB-OPM) memorandum outlines an aggressive workforce optimization initiative designed to reduce federal staffing and cut costs. The …
The United States health care system is plagued by inefficiencies that drive up costs and limit access to care. The Department of Government Efficiency has a crucial role to play in addressing this challenge. As a physician, I often strive to practice cost-conscious care whenever possible. Three common-sense broad reforms—repealing Certificate of Need (CON) laws, implementing universal physician licensing, and advocating for site-neutral payment reform—offer significant opportunities to reduce health …
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A nurse practitioner (NP) in urgent care saw a patient with a severe headache following a fall. Initial testing and symptoms suggested a concussion, leading to discharge. However, when the patient’s worsening condition later revealed an elevated white blood cell count, they were rushed for further evaluation—but it was too late. The patient succumbed to bacterial meningitis. …
Introduction
It is no secret that the U.S. medical system fails to treat all patients equally. Those with Medicaid often lack access to the same primary care and subspecialty clinics as those with Medicare or private insurance and face longer wait times. Medicaid is jointly funded by the states and federal government. The solution is to increase Medicaid reimbursement. Of course, in my home state, Texas, …
With the murder of the UnitedHealthcare CEO, many have expressed vitriol towards the insurance industry.
Having worked in non-profit health care all my life, I decided in 2018 to switch to the “dark side,” or the insurance industry, out of curiosity. What is it that they do, and how are they doing it? I thought knowing would make me a better health care worker when I returned.
As a registered nurse case …
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January
In a blistering commentary, the American Medical Association’s flagship journal, JAMA, condemns the corrosive effect on patient care of the profit-seeking practices of health insurers. Separately, the organization announces that it’s selling the 13 journals in its JAMA Network to a private equity firm for $375 million “in order to enhance our mission of promoting the betterment of public health.”
February
Quickly following up on a campaign pledge to slash the federal …
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