Several months ago, a post called, “Everything’s my fault: How a surgeon says I’m sorry,” appeared here on KevinMD.com. It was written by a plastic surgeon who feels that no matter goes wrong with a patient, surgeons should never blame anyone else.
She gave some examples such as the lab losing a specimen, a chest x-ray that was ordered and not done, a patient eating something when he was not to …
Surgeons can’t be responsible for every mistake
In an ironic analogy to the recent Occupy Wall Street movement publicizing the wealth gap between America’s elite and the general public, the health care world also has its own infamous 1%. According to the Agency for Healthcare Research and Quality’s 2012 report, the top 1% of health care seekers incurs nearly a third of the nation’s $1.26 trillion yearly health care expenses (and up to half of this expenditure …
The uphill climb of complex care management
Part of a series.
A common criticism of direct primary care (DPC, membership/retainer/concierge practices) is the added expense: “Isn’t it too expensive?” Ways to think about the cost are to prioritize expenditures and to consider potential savings that make it cost effective.
I gave examples of three direct primary care practices in an earlier post. Here is a recap of costs.
AtlasMD’s annual fee is $600 for a young adult and …
No, direct primary care isn’t too expensive
If you’ve ever worked in an emergency room, you’ve likely treated a victim of human trafficking.
We all have, often without knowing it.
With nearly thirty million people in modern-day slavery around the world, there are more slaves today than at any point in history.
Human trafficking is defined as “the recruitment, harboring, transportation, provision, or obtaining a person for labor or services, through the use of force, fraud, or coercion” for the …
Recognize the potential victims of human trafficking
A few weeks ago, my husband and I took my parents to dinner at one of my favorite restaurants. I was excited to go because the food is excellent and the customer service is top notch. In the past, I’d always had a great experience … until then.
That night, the restaurant was packed as they were offering half-priced desserts. My husband and I arrived first. I noticed when we ordered …
3 things a restaurant taught me about patient satisfaction
My high school graduation ceremony was your typical Californian high school graduation — the sun hovering lazily over us, a cool, ocean breeze bringing wafts from the sea. As I listened to my principal deliver his address, my attention waned in and out. The sun was too warm and the wind was too soft. When the student speaker came up to speak, I reclaimed my attention to listen to him …
Emphasize the attention a doctor pays to the patient
Direct primary care (DPC) and concierge medicine are rapidly growing models of primary care. Though the terms are used interchangeably, both are not the same. Such liberal use of terms, many times by even those within the industry, confuses those who are attempting to understand how these primary care models operate. As former concierge physician for the Pebble Beach Resorts, and subsequent founder of one of the nation’s largest direct …
Direct primary care and concierge medicine: They’re not the same
Most hospitals are strapped with a massive amount of debt. Not monetary debt, but sleep debt. Amongst both the staff and patients, sleep is severely lacking. In our busy society, we associate sleep with leisure and relaxation; a reward at the end of a long day. But sleep isn’t a luxury. Rather, it’s a medical necessity.
Sleep deprivation has widespread consequences, causing cognitive dysfunction, weakened immune system, impaired healing, increased blood …
Sleep isn’t a luxury. It’s a medical necessity.
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 59-year-old man is evaluated for a 3-month history of intermittent itching on the forearms. He describes the itch as deep, with a burning or tingling sensation. Scratching helps somewhat, but over-the-counter topical corticosteroids have not helped. Cooling the skin soothes the itch. He did not notice a rash until he started …
MKSAP: 59-year-old man with intermittent itching
I wholeheartedly support the message behind the project, What Works For Me. As health care professionals, we continually encounter human suffering and work under stressful conditions. As a family physician for the past 14 years, I have been fortunate enough to work in a variety of clinical settings, including several in general family practice.
Currently, I practice family medicine in the sexual health clinic of a community health center. …
Physician wellness: Take time to find what works for you
The big day has finally arrived. Your boss shakes your hand and wishes you well. Your colleagues gather around a cake and make small talk about landing the big fish in your retirement, or joke about what you’ll do now that you don’t have to come to the office.
A cardboard box is filled with the contents of your desk: your family pictures, desktop trinkets, snowball paperweight, and stale candy. Your …
Before you retire, see your doctor first
There are many reasons why the costs of delivering simple, uncomplicated health care in this country keep increasing while quality lags and value fails to keep pace with that of most major industrialized countries. But as a surgeon, I have a one-word answer for all that is wrong with health care: “robots.”
Surgical robots, costing an estimated 1.2 to 2.5 million dollars each with matching maintenance fees of $125,000 per year, …
Robots and health costs: Can either be tamed?
We live in a digital age. Technology has become an integral part of how we see, learn about, and interact with the world. From computers at the office, to televisions at home, to smartphones on the bus or in the grocery line, many of us spend over half of our waking lives in front of a screen.
Naturally, some of us have begun to worry about the effects this may have …
How digital media can help parents bond with their children
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Today, I saved a life.
And I wish I could tell you a story about fancy heroics — about an exploratory laparotomy, a chest thoracostomy, or a patient that coded and I was the last person to perform the chest compressions that brought them back to life. But I can’t. But I can tell you that I saved a life.
She was 16-years-old, and moved here four years ago from a different …
Today, I may have saved a life
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 21-year-old man is evaluated during a medical examination for health insurance. The patient is a weight lifter. He has no medical problems and takes no medications or illicit drugs.
On physical examination, blood pressure is 128/73 mm Hg, pulse rate is 56/min, and respiration rate is 16/min; BMI is 30. Increased skeletal …
MKSAP: 21-year-old man with a heart murmur
The New York Times had a front-page story about the growth of urgent care clinics nationwide.
These are the places that are often referred to as “minor emergency rooms,” or “doc-in-a-box” outfits. Their value proposition is simple: You don’t need an appointment. The costs are “reasonable,” and much more transparent than usual medical care at a doctor’s office, emergency room, or hospital. Best of all: They can treat a majority of acute conditions …
Like it or not, urgent care centers are here to stay
When I was a fellow, part of our training involved doing consults for patients, most of whom had just learned they had cancer or recurrence of disease. These consults were never easy, but the importance of sitting with someone who had just learned of their diagnosis was an integral part of learning the medicine and art of oncology.
Even after many …
Delivering bad news: Don’t pass the buck
I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. I recently had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind health care professionals what not to do …
Dealing with physicians who have lost empathy and compassion
In a previous post, I described how the American health care system is morphing into a system designed to service impoverished populations, and concluded that the transition “will take time, thoughtful planning, lots of innovation and a carefully cultivated disdain for human life.”
However, a new blog post from Dr. Peter Ubel makes me think that it may not take that much time after all. It seems that Dr. Ubel …
Go ahead, let’s just make poverty a disease
The unrelenting opposition by American conservatives to Obamacare may have the unintended consequence of leading the United States to a single-payer system like Canada’s.
How’s that, you say? Isn’t the whole point of conservative opposition to Obamacare to drive home the point that the government is incapable of managing people’s health care? Yes. And aren’t conservatives effective in driving home that point? Yes, polls show that confidence in government is at …
Will the attacks on Obamacare lead to a single-payer system?
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