Even I am not immune to influenza. In Northeastern Ohio, there have been more hospitalizations and school closings this year from influenza. And, let me tell you, as a family physician who also sees patients in the hospital and the office, we have seen a lot more respiratory illnesses versus last year.
No, I’m not one of those Dr. Oz hypocrites who skip the influenza vaccine. …
A doctor’s first-hand account of the flu
Sometime while I was still in high school, my mom began to have trouble breathing. She had never had asthma before; an albuterol inhaler helped for a while. Still, cold season was a nightmare, and later, so was allergy season, and every year seemed to get worse.
After college, I moved back in with my parents. She fought her way through the cold season, dutifully driving 20 miles (and later 40, …
Fighting high health costs. Because I can.
I recently dug up a copy of the personal statement I wrote when I was applying for residency. I’ve said before that I think these personal statements aren’t worth much. But somehow, I now feel compelled to prove it by ripping apart my own personal statement.
So here we go:
It was the same situation that I had been in dozens of times.
Well, not really. I mean, I was only a third-year …
A medical student’s personal statement: Deconstructed
Dear Internal Medicine Community:
ABIM clearly got it wrong. We launched programs that weren’t ready and we didn’t deliver an MOC program that physicians found meaningful. We want to change that.
Nearly 80 years ago, the American Medical Association and the American College of Physicians founded the American Board of Internal Medicine (ABIM). ABIM was charged with distinguishing the discipline of internal medicine from other forms of practice by creating uniform standards …
ABIM announces immediate changes to MOC program
The quality-measurement enterprise in U.S. health care is troubled. Physicians, hospitals, and health plans view measurement as burdensome, expensive, inaccurate, and indifferent to the complexity of care delivery. Patients and their caregivers believe that performance reporting misses what matters most to them and fails to deliver the information they need to make good decisions.
Thus begins a recent editorial in the New England Journal of Medicine. It was accompanied by …
Quality measures are going through growing pains
Dr. Richard Gunderman published an article that shared the story of Melissa Chen, a 35-year-old radiology resident in her final year at the University of Texas San Antonio. While her road to medical school was somewhat unconventional (it is great story, I highly suggest reading it), Chen is not your typical medical school student — one whom has persistently endured a rather standard, run-of-the-mill path through graduate school and …
Solving the problem of medical student debt
It seems everywhere you look in health care today; some consultant is telling you that “less” is actually “more.” Less care leads to more quality. Less expense brings better outcomes. Nurse practitioners with less training are more cost effective. Fewer work hours for residents builds a safer hospital environment.
Never in our entire history have we gotten so much for so little.
Arshya …
Pay for a doctor and get a plumber instead
I am looking out of my window on a cold and cloudy Boston afternoon and find myself pondering about life: How unpredictable it is, and how one minute can hold no assurance for what happens after. Before I left for vacation, I saw Joan.* She has been under my care for a number of years, living with and thriving despite …
A patient reminds a doctor: How unpredictable life is
Meaningful. Having a serious, important, or useful quality.
You know this word because you want it to define your life. Nearly all of us, at some point, will seek a more meaningful existence. Most wish our jobs were that way too.
Meaningless. Having no purpose or reason. Ouch. We don’t want anything to do with that. Meaningless makes us question what in the …
The sad, tragic road to meaningful use
We all know that the U.S. system of paying for health care is tremendously complex and inefficient: a multitude of insurers, thousands of insurance plans, innumerable medical bills, countless incorrect and denied claims.
But just how much do we waste on this administrative morass?
I led a research team that recently reviewed all the available evidence and published our findings. The resulting numbers are staggering.
Compared with countries that have a single health …
The financial sinkhole of health insurance complexity
I just deposited a check into my bank account by photographing the check with my iPhone and zapping it through cyberspace. I realize this is ho hum to the under 35 crowd. Soon, there won’t be any paper checks as the entire transaction will occur electronically. As a member of the over 35 crowd (plus 20 years), I am wowed by this process. I remember being astonished when my kids …
Mobile health: Just because we can do it doesn’t mean we should
There’s been a lot in the press lately about the flu shot not being effective this year. This provides an excellent opportunity to educate about what the flu vaccine is and why it is important.
First, a review of basic biology and immunology. Antigens are proteins on the surface of organisms that trigger an immune response. Recognition of these antigens is how your body …
Why getting your yearly flu shot matters, even if it’s not 100 percent effective
Dear anti-vax parents,
In the wake of the Disneyland measles outbreak, there’s been a lot of heated talk about parents who choose not to vaccinate their children. It seems like the medical community is now protesting even louder than the anti-vax groups were a couple years ago. But I want to take a moment and apologize for the harsh tone some of …
Dear anti-vax parents: It’s not your fault
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This past week I spoke with a patient who noted that since his wife’s death six months ago, he had lost 40 pounds, slept a maximum of four hours nightly, and stopped enjoying activities he used to take pleasure in. He found it difficult to concentrate at work, and getting out of bed each morning was described as his greatest struggle. While relaying this story, the man was on the …
Psychiatry is devalued: And patients suffer because of it
Ever since we are children, our parents and society teach us how to play together with others. What we don’t realize is that this lays the groundwork for developing important teamwork skills — the same skills that enable success and positive outcomes in the workplace. My own experiences in hospital medicine practice throughout the last decade continue to increase my appreciation for these seemingly simple yet invaluable techniques.
Like many young …
How to build a great hospitalist team
A woman told me she saw her physician recently and, when she told him all the things she was doing to help herself, naturally he told her he practices Western medicine and that he does not believe in that stuff.
Not a good conversation.
A number of research studies have found that one in three patients routinely use alternative treatments, but …
How to talk to your patients about alternative medicine
Some people who know what I do don’t really know what I do.
They picture me floating through the hospital extinguishing lives, blowing them out one by one like candles down an endless corridor. They think I practice euthanasia, that my presence alone hastens death — that I consume hope and happiness like a black hole, compressing it all into nothingness. Some call me the Grim Reaper, others the Death Doctor. …
I’m a palliative care doctor. This is what I do.
Although the Affordable Care Act’s second enrollment period is nearly over, politicians, medical professionals, and the public still debate its implications. According to David Houle and Jonathan Fleece, one-third of all hospitals in the United States will close or be reorganized into another kind of health care provider by 2020. What will differentiate the winners from the losers? Simply put, it will be high patient satisfaction.
In consumer terms what …
Improve patient satisfaction from the eyes of the consumer
Many physicians I know are struggling to make ends meet while making several hundred thousand dollars per year. Despite growing incomes, their savings rates remain extremely low due to ever increasing expenses. What they do manage to save, they turn over to professional money managers.
How does this happen? Why are some of the smartest, hardest-working and most responsible members of our society unable to create real wealth? The answer is …
Most doctors are financially illiterate
An excerpt from The Freedom Formula for Physicians.
Get the last copy of your pay stub. What is your year-to-date compensation? What is your annualized compensation?
Hint: Take your current compensation and multiple it by 12, divided by the number of months already compensated. For example, using an end-of-the-month May check, multiply the amount by 12 divided by 5.
Get the last copy …
Physicians: How to gain insight into your tax situation
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