I have been blogging now for about three years, posting once or twice a week and accumulating 240 posts. I have my little flock of loyal readers and have managed to contribute a few drops in the ocean of the health care policy debate. But just this month two pieces made some bigger waves, one ending up briefly fluttering about Twitter, …
Why the chasm between doctors and patients? It’s all about money.
Doctors and patients bond over time. Information exchange, education and sharing of expertise are critical activities that add to the effective practice of medicine.
Delivering bad news is, unfortunately, an unpleasant part of a physician’s job. Honesty, empathy, and clear communication are essential to delivering news to patients and their families — even when the news is unpleasant or unexpected. While communication is an integral part of the practice of medicine, …
Doctors sometimes don’t inform patients of bad news. Why?
Life is tough for physicians in solo and small group practice. The federally mandated introduction this fall of ICD-10 requires physicians and their staffs to learn a new system of coding diseases. “Meaningful use,” another federal program, requires physicians to install and use electronic health records systems, which are complex and expensive. And PQRS, the Physician Quality Reporting System, is beginning to penalize physicians for failing to report individual data …
How can independent physicians survive the new health care climate?
An investigation is underway after a Chicago-area doctor is found dead — a suicide according to the medical examiner. What demands investigation is the callousness with which the this doctor’s death was reported by the media — and received by neighbors, many health care professionals themselves.
I’m alerted to the death initially by a Facebook friend: “Pamela, check this out!” Headline: Read more…
Doctor’s death an “inconvenience” for patients
As someone involved in both the medical and acting world, I was tremendously saddened to read about Dr. Fredric Brandt’s recent suicide, which is presumed to be in response to an impersonation of him on the Netflix’s series, The Unbreakable Kimmy Schmidt. Project Casting, a website offering free casting calls and auditions, posted a link on their website asking, “Did Netflix go too far” and I was shocked by people’s …
How far is too far? A response to Dr. Fredric Brandt’s suicide.
An excerpt from The Secret Language of Doctors: Cracking the Code of Hospital Culture.
When it comes to modern medical slang, there’s Before Shem and After Shem. Shem refers to Samuel Shem, the pen name of Dr. Stephen Bergman, psychiatrist and author of the blockbuster novel The House of God, which introduced millions of readers — and generations of doctors — to the argot that is the lingua …
The House of God brought attention to medical slang
Several months ago, Physician’s Weekly featured an article describing a bill that was introduced into the House of Representatives called H.R. 1406: The Saving Lives, Saving Costs Act. It would create a “safe harbor” for physicians who could show that they followed best practice guidelines when faced with a malpractice suit. At the end of the piece, a question was asked, “Do you think this bill will help safeguard physicians against …
Why safe harbors for medical malpractice are DOA
Years ago, as a young cardiologist in inner-city Brooklyn, I remember an elderly Spanish-speaking patient named Maria who faced the painful task of deciding whether to use her government subsidy to buy groceries or to fill the medications I had prescribed to treat her heart failure.
I wasn’t unfamiliar with this kind of poverty. I had been born into a Jewish family in Tehran, and soon after, we fled Iran to …
Is there a model out there that can narrow the care gap?
Many physicians feel burnt-out from their careers
A recent Medscape survey asked doctors of all specialties whether they experienced feelings of cynicism, loss of enthusiasm and low personal accomplishment with their work. Unfortunately, the percentage of physicians with burnout has increased since the last survey in 2013, with 46 percent overall reporting these feelings. When looking at specific specialties, the most burnt-out physicians are critical care and emergency doctors. Half of primary …
Is health reform contributing to physician burnout?
Recently, I was honored to spend a day on Capitol Hill as part of an advocacy event with the Society of Hospital Medicine. The organization, which I am proud to be a part of, held their annual meeting in Washington DC. The event involved a group of hospital physicians going to Capitol Hill to meet our congressional representatives — both in the House and Senate — to discuss the issues …
A physician spends the day on Capitol Hill. See how it went.
A pilot deliberately flying a plane full of passengers into a mountain is horrific, unbelievably sad, and, thankfully, very rare.
But suicide is far from rare. Tragically, those usually lonely acts of despair are rising. But can they be prevented?
Someone in this country dies by suicide every 12.8 minutes. The national suicide rate has increased to 12.6 suicide deaths per 100,000 and for ages 18 to 35 — the prime of one’s life — …
Businessman and maverick, Mark Cuban recently opined, “If you can afford to have your blood tested for everything available, do it quarterly so you have a baseline of your own personal health.” I’m unsure why he said quarterly, not weekly, daily or hourly. ‘
He further opined that this must be done to “create your own personal health profile and history. It …
A health care proposal for Mark Cuban
Health care in America is a perfect example of the Pareto principle, because 80 percent of our gargantuan expenditures on health care are due to only 20 percent of us who are very sick, elderly, disabled and vulnerable in many other ways.
If we genuinely wished to reduce health care expenditures, common sense dictates that we would leave the 80 percent alone and zero in on those 20 percent, trying to …
Why not turn our health care disaster into an opportunity?
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You’re 56 years old. You’re one of the 30 million people (give or take a bunch) that you hear have received health insurance in this country as a result of the Affordable Care Act. You are a positive number in the New York Times headlines the Department of Health and Human Services (HHS) have been wanting you to read. And, this is how it’s working …
People deserve real health care, not pseudo-insurance
There’s nothing like discrimination — true or imagined — to keep our airwaves humming. Recently, Indiana and then Arkansas were media fodder for laws that were proposed to protect religious freedom. Yes, I know the other side of the argument, that these religious freedom protections were veiled attempts to discriminate against the LGBT community. Both states raced to revise their original laws, although the laws’ backers deny any discriminatory intent …
Does our mission to heal transcend personal beliefs?
A recent piece in the New York Times profiled a young man with a remarkable medical history, and an equally remarkable approach to sharing it. I think it raises some profound issues regarding the self-monitoring movement and the “ownership” of patients’ health information, both of which have the potential to change our traditional practices in a big way.
The guy — Steven Keating — is not your average Joe. He is a …
Is it time to surrender control of the medical record?
How to Win Friends and Influence People by Dale Carnegie is a timeless bestseller. It is a book that’s translated into many languages globally and carries brand name recognition. People who read the book recognize common sense approach and simple lessons of courtesy that are so eloquently described by the author.
Dale Carnegie had a knack for oratory skill and displaying genuine connection with other human beings. While he tried many …
What today’s doctors can learn from Dale Carnegie
$28 million was awarded to a patient for a late diagnosis of a pelvic tumor, an osteosarcoma. This rare cancer presented as a case of low back pain and sciatica. The patient claimed that if the osteosarcoma had been caught earlier that the subsequent surgery would have been avoided.
Could doctors have done better in diagnosing more quickly?
These cases strike fear into all primary care doctors. Which patient has a …
When the back pain red flags aren’t enough
America faces a serious shortage of primary care doctors. The reasons are not hard to understand.
Lower income is the most important factor. Adult primary care doctors (general internal medicine physicians and family medicine physicians) earn on average $100,000 or so less per year than specialists do. Our income is much greater than that of the average American, and so many people have little sympathy here. But almost all people prefer …
More than lip service is needed to fix the primary care shortage
I can’t mention the physician by name, because he is currently in contract negotiations. But he lives and works in a Midwestern town of several thousand people, a town where the major social event of the year is a fall festival that features a parade down Main Street. The physician, let’s call him Dr. Smith, has been practicing there for nearly …
There’s a new hospital CEO in town
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