A Swedish sociologist Lars Tornstam describes this by asking what a 10 year old would say if we asked him what it would be like to be 20. It would be awful to him. There would be no play time. There would be no summer vacation. He would have to get a job! But at twenty he would look back at the age of 10 and say: “There’s no way …
Why do we fear old age so much?
When Rodney Peterson, a high school headmaster in Boston, assaulted his wife five weeks after she gave birth, it seemed a textbook example of the way abusive partners exploit new mothers’ vulnerability. Women are more likely to be assaulted or killed by partners while pregnant or after recently giving birth, research shows.
Traditionally, children were regarded as accidental bystanders to violence involving their parents – a view that is now being …
How children are affected by violence involving their parents
To catch you up, I received short term disability payments through my employer over the summer. After an initial denial of my claim, I appealed the decision and eventually was approved based on a suspected diagnosis (and the pulling of strings of top executives in the company). With long term disability, I have not been so lucky. My initial claim was denied because they did not see sufficient evidence in …
Receiving disability payments is more difficult than one might think
The Dartmouth Atlas Project released a study on October 30, 2012, entitled, “What Kind of Physician Will You Be? Variation in Health Care and Its Importance for Residency Training.” The data, and the conclusions of the report’s authors, bear closer examination.
The data set focuses on the differences in the intensity of services that Medicare patients receive, and highlights the academic medical centers rated by U.S. News and World Report as …
When comparing teaching hospitals, context matters
Think of a time when you’ve felt very sick, maybe a case of pneumonia, a bad bout of the flu, or a more serious illness.
You probably didn’t feel much like “engaging” with people. That’s the term health advocates use to describe what patients need to do to be effective in managing their health care.
It’s very hard to act like the CEO of your own body when you’re unbelievably tired, or …
What would your personal health checklist look like?
It is possible to both have and not have Alzheimer’s disease. Contradictory as this statement is, a study reported from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) supports it.
In a paper published in the October issue of the Annals of Neurology investigators reported the results of biomarker studies of 53 patients with dementia caused by Alzheimer’s disease. They found a notable proportion of these patients lacked one of the signature pathologies: …
It is possible to both have and not have Alzheimer’s disease
It was unfortunate – but not very surprising – to see the news recently that Groupon laid off a portion of their 10,000 employees. If ever there was a predictable bubble, it was daily deals.
But it was fun while it lasted, and you can see why there was so much overinvestment in the space. Groupon’s pitch to merchants was to ask them to take a loss by making a super compelling offer …
What Groupon has to do with severe chest pain
As healthcare costs become a bigger and bigger chuck of our Gross Domestic Product (GDP), price transparency is a subject that insurance companies and patients are talking about. The idea of knowing how much something costs, be it canned black beans in the grocery store or replacing the leaking faucet in your kitchen, seems obvious but it will be an uphill battle to enact change within the healthcare system.
The concept …
Why doctors need to care about price transparency
The art and practice of medicine is built around lessening the suffering of our fellow man. The method of doing this however, has changed dramatically throughout human history. Western medicine had its beginnings in the restoring balance to the body that was not in sync with the environment. As scientific reasoning found its way into medical practice after the dark ages, the benefits of medicine quickly became a cornerstone of …
Society must come to a conclusion on how important human suffering is
I believe that when people are in a crisis situation small things can become magnified; good and bad, and especially in the healthcare field. A perceived small rudeness may just be the tipping point that causes a patient to leave a practice or go to another hospital. On the other hand, a smile, a kind word or gesture can impact someone more than you will ever know and leave a …
There are no small jobs in any organization
We’ve all seen the data projecting a shortage of physicians in the United States, expected to reach a shortfall of more than 90,000 by 2020. The lack of nurses is equally well documented. These trends raise concern for all medical specialties, but especially for primary care.
More and more Americans are expected to need these services in the coming years, at a time when fewer and fewer students are committing to …
A spectrum of medical talent to solve the primary care shortage
Venture capitalists (VCs) … are a combination of professional gamblers and loan sharks. The secret to success is pure luck and ruthlessness, and when the combination works and the ball lands on the exact number on the spinning roulette, venture capitalists make lots of money.
-Margalit Gur-Arie, via KevinMD.com
The tone of this article, Why venture capitalists shouldn’t try to solve health care, exemplifies what is wrong with healthcare. In …
Why the VCs aren’t the bad guys
Imagine this scenario: A CEO stands in front of the board at a crucial juncture in corporate history, and says:
Members of the board, as you can see from the financial statements before you, we have had a reasonably good year. What!? You don’t have the financial statements in front of you? I have them here. I mean, I think I have them here. Where are they? Let me check with …
We need a functional health information exchange
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Healthcare innovation companies are just beginning to understand technology challenges that come with engaging patients with chronic diseases in care management and care transition. Many of healthcare IT vendors assumed that a simple access to portals with half-baked information and fragmented medical records will do the trick. Boy… were they wrong!
For the past twenty years, the HIT industry has focused on developing software solutions exclusively for healthcare providers. These companies …
Without patient participation, there is no patient engagement
“Value” is the pot of gold at the end of the rainbow that health care professionals everywhere are seeking, but which few can seem to find.
Policy makers, hospital executives, physicians, consultants – all are looking for a means to pivot away from a system that rewards volume of services provided to one that rewards quality and cost effectiveness (i.e., “value”).
How far we are from achieving this goal can be gauged …
How physician executives will drive value for hospitals
I remember, some years ago, sitting with a relative across a large wooden desk in a doctor’s private office. We discussed symptoms for half an hour during an initial consultation. On a different occasion, I recall another doctor pinning an MRI on the wall, circling an area and articulating exactly why the radiologist overlooked a diagnosis. There once was a doctor who stood bedside, outlining what was known, what was baffling and …
How entertainment has altered our desire for diagnosis
Sports fans have heard a lot about football players with Lisfranc injuries recently. Maurice Drew-Jones, running back for the Jacksonville Jaguars and Santonio Holmes, receiver for the New York Jets, have been in the news. Matt Schuab, QB for the Houston Texans missed last season from a Lisfranc injury.
Many of you may know that a Lisfranc injury is a type of foot injury and that it can sometimes be very serious …
I work at several hospitals and each uses a different electronic medical record system. When I switch from hospital one to another, I obviously have my favorite EMR systems and my not so favorite EMR systems. In the previous post, I was using the EMPOWER charting system, which I liked for its simplicity, but disliked because of the layouts of the charting interface and some of the macros it contained.
After …
More than half of my ER shift was spent on entering data
As the number of deaths from fungal meningitis mounts, many people want to know how fungal meningitis is diagnosed and treated.
As an infectious disease doctor, it is routine for me to care for patients who come in the hospital with a fever. At first glance it is impossible to tell whether the patient has meningitis, pneumonia or a urine infection.
If a patient has headache, confusion or stiff neck along with …
How is fungal meningitis diagnosed and treated?
When I was 16 my dad had a heart attack. I still recall studying in my room when my mom came in to tell me he wasn’t feeling well. At the time, I was a volunteer in the emergency room at our local hospital, located in the tiny Pacific Island of Guam. I recall asking him what he was experiencing: …
Cancer makes you realize the gift of time
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