This blog is about freedom and personal responsibility. I have opined that cigarette smokers should not be permitted to transfer total responsibility for the consequences of their choices to the tobacco companies, even if this industry has committed legal and ethical improprieties. I do not support the politically correct beverage ban in New York City, sure to spread elsewhere, where the …
The folly of breasts and politics
Suppose 20 children and 6 adults died at a school in a very short time period. And suppose there were clusters of similar deaths, many of young healthy people, around the country: at a movie theater, a shopping mall, a high school, a house of worship. Would you expect the Center for Disease Control to get involved in trying to figure out why these people died and how to prevent …
Did any doctor ask Nancy Lanza about guns?
American Medical News featured an article with the disturbing title, “Massive health job losses expected if Medicare sequester prevails.”
I wasn’t entirely sure what a “sequester” was, since I thought it was a verb. Sequestration, I thought, was the noun. (I hear a loud knock. It must be the grammar police.) The story, as I understand it, is that when our government decided to pull together and raise the debt ceiling, …
Why across the board Medicare cuts are a bad idea
What will health insurance cost in 2014?
Will the new health insurance exchanges be ready on time or will the law have to be delayed?
There will be sticker shock
First, get ready for some startling rate increases in the individual and small group health insurance marketplace due to the changes the law dictates.
In a November 2009 report, the CBO estimated that premiums in the individual market would increase 10% to 13% …
The cost of health insurance in 2014: Get ready for sticker shock
As a doctor, I have never really believed in any type of significant mind-body connection. Of course stress is related to depression or even heart disease. But I never really thought that we as humans were capable of controlling our bodies responses to disease. I don’t think I’ll ever believe that it is possible to heal yourself from a serious disease like cancer from thoughts.
But recently, I have had a …
Patients who pass quickly once they have given up on life
The AP alert flashed over my phone, its words chilling — gun shooter — elementary school-Connecticut — then the report: 27 killed, 20 of them young children. Killed by a young adult not old enough to legally buy a drink, but able to get his hands on a fearsome amount of firepower, and old enough to have developed a hatred of others that nobody will ever comprehend.
Struggling with this since, I …
How technology can exacerbate mental health problems
Gun rights advocates are correct: a well armed principal might have reduced the death toll from the tragic elementary school shootings in Connecticut last week. Gun carrying citizens might also have been able to take down the shooters in Aurora and Virginia Tech. To most people, after all, guns are about self-defense, not about committing crimes. As the old saying goes: “There has never been a mass shooting at a …
Jumping to quick conclusions after Newtown would be a tragic mistake
“I kissed my daughter as she left for school today and realized it might be the last time I would ever see her.”
-New Jersey mom, three days after the Sandy Hook, CT shootings
On December 14, 2012, twenty school children died of the Gun Disease, shot making gingerbread houses. As guns beget guns, firearm injury and death spread like a virus. Doctors, the healthcare system, have failed to protect the most …
Stop the proliferation of guns by ending the fear
On Friday morning I was seeing a patient, chatting about the holidays. She had given me a gingerbread house making kit for my kids — which she had done annually since I had become her doctor.
“You are doing so well,” I declared, “Have a very Merry Christmas!”
“You too!” she said as we hugged and she left the examination room.
At 12pm …
As an oncologist, I thought I had the words to console the survivors
Is the medical profession doing enough about gun violence?
Are any of us? This is the question that we all must ask ourselves, in the wake of the incalculably sad massacre of little school children in Newtown, Connecticut.
I have struggled for days now to find the right words—how can I, or anyone else for that matter, find the words to describe the indescribable shared grief we have about the indescribable horror …
Are the healing professions doing enough to curb gun violence?
I remember the first gunshot wound I treated in the emergency department at Jacobi Hospital in the South Bronx 35 years ago. Only one of two I saw that month in the second busiest trauma ER in the country. Gang fight. Troubled youths. In the middle of the night. Hand guns.
We couldn’t save him. I was devastated. My chief resident, an aspiring trauma surgeon, took me aside and matter of …
Did I shoot them? Am I bleeding? And does all bleeding stop?
Winter is officially here and we are in the cold and flu season. This is the time that patients get sick with viral illnesses and primary care doctors get even more frustrated as they try to do the right thing for patients. What is the right thing?
First of all we want to relieve suffering. But we also want to do that …
Antibiotics for your viral cold: Why it’s hard to do the right thing
Gunman. Elementary school. Death toll rising.
The news of Sandy Hook was paralyzing. Anger, sadness, and confusion bubbled into my mouth until I could not speak. I wanted to scream. I wanted to cry. I wanted to leave work – to grab my kids – to be home.
As the tragedy of the moment continued to stream across my computer, like a horrific movie script impossibly true, a stinging email from the …
Light will help us to heal from Sandy Hook
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The patient had arrived for a urology procedure with a blood glucose in the 400’s. He suffered from a recent stomach bug and had gotten off schedule with administration of his meds. While his GI symptoms had subsided, he was feeling crappy overall. I decided to cancel his case and went about initiating treatment to get his blood sugar under control. When I informed the urologist of my findings and …
The transition from resident to attending physician
I haven’t give much thought about gun control, but since the horrific unspeakable tragedy which occurred in Sandy Hook, Connecticut where 20 children and 6 adults were killed, I like many others are. Increasingly, crime scenes are now including movie theaters, malls, and schools, places where people escape reality, find gifts, goods or services for themselves, loved ones, or friends, and …
Mental illness and gun violence are a doctor’s responsibility
I’ve been getting emails about the New York Times piece and my quotation that the penalties for readmissions are “crazy.” It’s worth thinking about why the ACA gets hospital penalties on readmissions wrong, what we might do to fix it—and where our priorities should be.
A year ago, on a Saturday morning, I saw Mr. “Johnson,” who was in the hospital with a pneumonia. He was still breathing …
Reducing medical errors should take priority over readmissions
Costs and revenue: This is the oxygen of any business, any organization. What are your revenue streams? How much does it cost you to produce them? Life is not just about breathing, but, if you don’t get that in-out equation right, there is nothing else life can be about.
Right now this enormous sector is turning itself inside out. It has turned the “transmogrification” setting to “warp.” Why? It’s all about …
Why cost and revenue will kill independent hospitals
It is no news a lot of doctors like to stick up a rather snotty nose to EMR. The defenders of the EMR tend to label such doctors as archetypal Luddites, sticking to their archaic ways and unbecoming of change and the new times. But as is usually the case with any two heated but opposite arguments, the truth likely lies …
Explaining the epic failure of EMRs
Since the massacre of innocent school children and those that gave their lives educating and trying to protect them this past Friday at Newtown Connecticut’s Sandy Hook Elementary School, I’ve struggled to make sense of this calamity as much as much as anyone.
As a physician who has worked to save the lives of sick and injured children, and as a father of children the same age as those massacred in …
The only words that explain Sandy Hook: Pure evil
A patient of mine was seeing a local specialist. The parents wondered if it would be appropriate to get another opinion. Contrary to what patients might think, most physicians are absolutely fine with this and some even encourage it. However, patients often want to know if seeking another opinion is justified. It is my job as a primary care provider to help families decide when or how to obtain that …
How do you know if a second medical opinion is justified?
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