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Navigating the health care system is as important as the care itself

Physician

October 27, 2013

The fundamentals of healthcare itself are similar in most developed countries. Evidence based guidelines are shared by international professional societies. Digital technologies have transcended cultural and geographical divides. Once someone is brought to the attention of a healthcare provider, it is the start of a rocky road, not all downhill by any means.

Navigating the healthcare landscape as a patient and caregiver has never been more difficult, even for an “insider” …

How do I stay human in a system comprised of superhuman demands?

Jenna Cottral

Medical Education

October 27, 2013

When we die, we die alone. Regardless the number of those who surround our deathbed, we experience our last breath alone. Our last feeling of pain. Our last moment of hope. Our last words, our parting gift to the sentient world as we depart the duress of consciousness. The ethereal message leaves our lips to pierce the very tangible aroma of Clorox and human excrement. The hearts of the healthy, …

Use technology to build trust with your patients

Howard Luks, MD

Health Technology

October 26, 2013

Trust: A firm belief in the reliability, truth, ability, or strength of someone or something.

Technology, technology, technology.

It is all we hear.

Ugh.

Let’s change the focus from “technology” to the useful and meaningful processes that technology enables:

knowledge
sharing
communication
trust

Technology is only an enabler, much like the social graph. They are tools, they are platforms, and if properly utilized, they may enable “disruption” or transformation. It is the few individuals, and I do mean a few, …

When do medical students lose their empathy?

Dr. Sonia Henry

Medical Education

October 26, 2013

It’s common knowledge among third year medical students that statistically a lot of us are mentally damaged in some way. Knowing these stats makes us feel better about our ongoing feelings of low self esteem, high anxiety and sometimes outright panic. In the car on the way to rotations, regular starters of conversation are statements like, “Did you know 35% of med students are depressed at any given time?”, to …

Should doctors encourage their patients to get health insurance?

Mara Gordon

Health Policy

October 26, 2013

She was a stressed-out mother of six, working a grueling job as a kitchen manager that required her to wake up at 4am every day. She came to her doctor for her headaches: searing, throbbing pain that made her vomit. She slept fewer than five hours a night. She had tried every over-the-counter pain medication I had heard of, and she had maxed out all of those doses. I met …

A not-to-do list for those with chronic pain or illness

Toni Bernhard, JD

Patient

October 26, 2013

I love to-do lists. I depended on them when I was working outside the home. I’ve depended them since my bed became my office. The one difference is that, pre-illness, I had fancy notepads and appointment books in which to keep my lists. Now I scribble them on any random piece of paper I can find.

A few weeks ago, I realized I could benefit from a not-to-do list that would …

Can I be a real man, a doctor, and a human at the same time?

Dr. Richard Cook

Physician

October 26, 2013

I am a man. Really I am. And men don’t cry, correct?

Well this one does, not very often, but when I do it is usually a good moment to pause and reflect on the circumstances. Just to check, you know, that I’m still a real man.

Shortly after the birth of our first child, I stayed up one evening to watch “Life Is Beautiful,” the wonderful Oscar winning film starring Roberto …

A lawyer provides pain management tips for doctors

George F. Indest III, JD

Conditions and Diseases

October 26, 2013

I have represented a number of physicians who have been accused of “overprescribing.” Some of these were criminal investigations by local law enforcement authorities, such as a county sheriff’s office. Some were investigations by the Drug Enforcement Administration (DEA). Some were investigations by the state licensing agency (in this case, the Florida Department of Health).

In almost every one of these cases, either the DEA, the Department of Health or the …

Let the health care battle be an all-star game

Abigail Schildcrout, MD

Physician

October 25, 2013

redsox0606

Once a Red Sox fan, always a Red Sox fan. But when you live your adult life in metro Detroit, you grow to love the Tigers. Watching the American League Championship Series caused some dissonant feelings: I was thrilled that the Red Sox won, but also a little sad that the Tigers lost. That’s baseball. Someone wins, someone loses.

Sadly, our national discussion …

The anatomy of a good doctor

Elizabeth Scarboro

Patient

October 25, 2013

I met Dr. Stulbarg when I was twenty-two, and had just moved in with my boyfriend Stephen. Stephen had cystic fibrosis, but he’d been unusually healthy until now, when his lung collapsed on the way to a party. Then, in the hospital, his lung collapsed a second time. We sat on his bed together, talking with Dr. Stulbarg about what would happen next.

Stephen had told me about Dr. Stulbarg already. …

Read more…

The anatomy of a good doctor

Does board recertification do more harm than good?

Wes Fisher, MD

Medical Education

October 25, 2013

I continue to study for my third ABIM recertifications in both cardiovascular disease and cardiac electrophysiology. In preparation for the examinations, I purchased the review materials offered by the American College of Cardiology called ACCSAP-8 and took a surprisingly expensive cardiac electrophysiology board review course held in Chicago recently. I find I have little time to study all of this material while delivering patient care, so I’ve been getting up at 4:30-5:00am each day when …

Self-preservation: Why I abandoned clinical practice

Diane W. Shannon, MD, MPH

Physician

October 25, 2013

When I introduce myself as a physician who left clinical practice, non-physicians ask me why I left. They’re generally intrigued that someone who sacrificed many years and many dollars for medical training would then change her mind. But physicians, almost universally, never ask me why I left. Instead, they ask me how. They call and email me with logistical questions, wanting to learn the secret of how I managed the …

HealthCare.gov doesn’t need a tech surge, it needs better primary care

Kevin Pho, MD

KevinMD

October 25, 2013

The Affordable Care Act is off to a rocky start, to say the least.

Attention has been focused on HealthCare.gov, where those without employer-provided insurance can shop for health plans. Finger pointing abounds, with the Centers for Medicare & Medicaid Services and contractors blaming each other.

A story in the Wall Street Journal chronicles the debacle:

The contractors said each of their pieces worked more …

Read more…

HealthCare.gov doesn’t need a tech surge, it needs better primary care

Our children will be living a growing number of zombie years

David L. Katz, MD

Physician

October 25, 2013

For reasons I confess I don’t quite understand, zombies are in these days. They populate blockbuster movies, TV shows, and even commercials. There are the classic, grisly, menacing variety, and even some new-age variants that seem almost cuddly, in a creepy sort of way.

But whatever explains the fascination with zombies, they seem to belong to that same taxonomic category of interest as purple cows of silly poem fame: People …

Obamacare covers screening colonoscopies, with a catch

Stephen C. Schimpff, MD

Conditions and Diseases

October 25, 2013

“An ounce of prevention” we all know is good medicine. An example is colonoscopy. It was time for mine so after some lengthy procrastination I called and set up an appointment which I soon found a perfectly good reason to postpone for a few weeks. A common occurrence. The government wants me (and you) to not procrastinate, at least not because of the cost. The Affordable Care Act (or Obamacare) …

We need to move beyond the DSM paradigm

Claudia M. Gold, MD

Conditions and Diseases

October 24, 2013

A paradigm is a way of thinking about things. For the past 60 or so years, our thinking about mental health and illness has been dominated by what can be referred to as the “DSM (Diagnostic and Statistical Manual of Mental Disorders) paradigm.” What this looks like in everyday practice is that when a child is referred to my behavioral pediatrics practice for say, anxiety, the questions that parents, referring …

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We need to move beyond the DSM paradigm

The balance between cost control and drug innovation

Peter Ubel, MD

Medications

October 24, 2013

To almost every claim that the American healthcare system is overpriced, defenders of the United States can point to the comparison problem — it is not fair to compare American surgeons, or hospitals, to our peers in Europe when American surgeons and hospitals are not the same as in those other countries. Our surgeons are better trained, the defenders retort, and our hospitals offer higher quality care. When quality measures …

A strategy to approach patients who don’t believe in vaccines

Christopher Johnson, MD

Physician

October 24, 2013

Childhood vaccination remains controversial among some non-physicians, in spite of being nearly universally recommended by physicians. If you spend some time on Google you will discover a whole world of websites where the issue, long settled in the medical community, is vigorously debated among non-experts. Of course a large component of this controversy is fallout from the now thoroughly debunked claims by Andrew …

The degradation prison life can hold for psychiatric patients

Allen Frances, MD

Physician

October 24, 2013

Sexual abuse is shockingly common in the U.S. prison system. A recent survey conducted by the Bureau of Justice Statistics concluded that each year about 200,000 prisoners are victims of coercive sex.

Most of the those abused are psychiatric patients misplaced in prison. They make vulnerable targets — less able to defend themselves and less likely to be believed if they report infractions.

Prisons are clearly not an appropriate or safe place …

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