“Daddy, I think we have a flat tire.”
I just rolled out of the garage with my 4th grade daughter. It was Tuesday morning. Usual daily routine. Drop her off at school then go to work. A little different today as I was to lead an important meeting.
How could she possibly know what a flat tire sounds like? Now? Right now? She’s …
Chest pain and what we can learn from changing flat tires
We hear a lot about the death of the independent physician practice. But perhaps the more important discussion is about the death of practicing medicine independently. That is, the days when individual physician groups could operate their businesses and treat patients independently and without regard to the surrounding network of other physicians, nursing facilities, health networks, social workers, case managers, and other support is over.
It doesn’t matter whether the physician …
Interdependent physician practice is here to stay
If you’re a doctor, I bet you speak doctorly. You act doctorly. And dress doctorly. And spend your days in clinic with other doctorly doctors.
But life is what happens while you’re busy staring at computerized flow sheets, algorithms, and billing codes.
Real life happens outside of man-made medical institutions. Patients live in the real world. And I always wanted be a real …
Drop doctorspeak and get real with patients
When I was a medical student, I worked with an non-government organization (NGO) in Rwanda to provide medical care to women with HIV. Nearly all had witnessed their family members murdered during the genocide, and many became afflicted with HIV as a result of rape. Our initial focus was on getting antiretroviral therapy to these women, but we quickly realized that while it was important for them to have access …
Help patients by addressing the health of the community
The number of people engaging in personal health tracking is on the rise, as are the number of devices available for that purpose. By some estimates, around 15% of Americans use technology to track a health indicator for themselves or a loved one.
The availability of technology like Bluetooth LE and smartphones have made tracking an ever increasing number of health parameters possible. As we recommend these tools to patients, its …
Beware the security flaws of health tracking technology
For years, critics of Obamacare (Affordable Care Act), have predicted that it would turn out to be a “train wreck” — or something worse. But now we know that by every objective measure, the ACA is working out pretty darn well. Let’s run through the “train wreck” predictions, and what we now know to actually be the case:
Train wreck prediction #1: “Obamacare will lead to skyrocketing health care cost increases and …
Obamacare isn’t a train wreck. Here’s why.
Recently I attended a national academic conference, and while I’ll admit that, having brought my husband and son along for the trip, the balance of time spent was skewed more toward pool and beach activities than academic sessions, I did indeed attend several and overall they were of good quality. One left me somewhat disappointed, though, because although it addressed what I would consider an important topic within my field, …
Can we get more from our medical meetings?
We are at a pivotal moment in health care. It’s changing so rapidly even the people leading the change can barely keep up. One of the biggest paradigm shifts over the last decade is the focus on quality over quantity. Improving the health care experience and patient satisfaction are also being talked about in boardrooms across the country (largely due to the link with reimbursements, but still unthinkable a few …
A letter from a hospitalized patient to a hospital CEO
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Patient portals. They have great potential, but is it being met? And are we losing something in return? I ask myself these questions now that my practice offers a patient portal linked to our electronic health record (EHR). I did not expect to feel that way, …
Are patient portals a gateway or barrier to patient-centered care and communication?
There are doctors that patients see. And there are the doctors that patients almost never see.
Patients see me, an obstetrician, at prenatal visits, in the ultrasound unit, or on the labor floor. But they don’t see all the wise radiologists reviewing their imaging studies, or the educated pathologist assessing whether their biopsy is cancerous. Some of the most important doctors that our patients don’t see are the ones in the …
Recognize the doctors patients often don’t see
Today I had a very special experience, one which many of my patients have faced: I was treated like a nobody while at the hospital. Yay me.
I went to visit a patient who was admitted over the weekend to see what was going on. She was a bit upset about the confusion of the hospitalist service and how orders apparently didn’t get written for her care by the admitting physician. …
At the hospital, I’m Dr. Nobody
She’s 58, but appears maybe three days older than 42. Her eyes are sunken, tearful, worried, anxious. She tells me about her two grandchildren, and how she just visited them in Michigan. She came to the hospital, straight from the airport. She’s worried.
She’s worried because her shortness of breath hasn’t gone away for over a month now. She has had breast cancer, and opted for a more conservative approach: a …
As Americans, we love to associate with groups. More than that — we love to plant ourselves in a group, stand firmly in our decision, and then adamantly refuse to budge or to see the other party’s perspective.
Pro-life. Pro-choice. Democrat. Republican. Pro-Obamacare. Anti-Obamacare.
I suppose for all of us, myself included, it is easy to identify with our group of choice when we are sitting at home watching or reading our …
It is time for physicians to stop making the easy decisions
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An excerpt from So Long, Marcus Welby, M.D.: How Today’s Health Care Is Suffocating Independent Physicians – and How Some Changed to Thrive.
Ripley Hollister has been president of his county’s medical society in Colorado Springs, Colo., and a director of the Colorado Medical Society. He has been a unit commander of the Medical Reserve Corps of El Paso County. His practice has a world-class view of the …
The doctor who has to do the laundry
To be quite blunt about it, Ebola is a very scary disease. Among those infected, the mortality rate is, as is perhaps now widely known, an appallingly high 90%. That would seem a very good reason to keep our borders closed to this scourge — and the consequences to the poor souls who already have it be damned. That, apparently, was just the kind of thinking behind at least Read more…
Ebola in America: Stop with the hyperbole
I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration …
7 ways patients can help reduce medication errors
After more than 40 attempts to pass legislation calling for repeal or significant changes to the health law, opponents of the Affordable Care Act have moved their focus from the House floor to the courthouse. Currently at least four lawsuits are working their way through state and district court — and one case awaits a nod from the Supreme Court — that would make it illegal for the federal government …
After Halbig: What’s next for Obamacare?
Two years ago, I received my first employment contract. Not long after Match Day, I did what 115,000 physicians in training did that year and will do again this year: I signed the contract promptly and returned it. I tried to read the contract carefully, but it didn’t really matter. Unless you no longer want to be a physician, there is no other choice but to sign.
Today, as president …
Medical resident pay needs serious reform
Call it concierge, call it direct care, boutique, fee-for-service, call it what you will. I call it a solution. As physicians, we’re all solutionists, are we not? With every differential diagnosis, assessment, and plan, we are creating solutions. In accordance, one does not become a doctor for any reason other than changing the world. Perhaps this change happens one patient at a time, but working toward a greater cause and putting …
Solutionist medicine: How the concierge model can reinvent primary care
Nearly every day we read headlines about the serious prescription drug problem in America. Increasing heroin addictions and deaths from illicit drug use are taking a severe toll on far too many families and communities. While we must feel enormous sadness for the families experiencing these tragedies, we must not overlook the other major health crisis that is often associated with the opioid abuse problem: chronic pain.
The chronic pain crisis …
Intimidating doctors won’t solve the chronic pain epidemic
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