The world of health care today is much different than the one I became involved in as a physician over 35 years ago. But why should that surprise me? The world in general is so dramatically changed from that which I knew then, it would seem reasonable and totally understandable that we’ve had to make dramatic changes in how we work with the population in maintaining health. Or have we? …
Embrace the explosion of the new technologies
When DrRich decided to become an electrophysiologist over 30 years ago, it was because he wanted to help figure out how to prevent sudden death. Sudden death from cardiac arrhythmias is estimated to kill over 300,000 Americans each year, and at the time, some of the more recent victims of sudden death had been DrRich’s friends or loved ones. Because cardiac arrhythmias – even the lethal ones – can virtually …
Why sudden death is good public policy
In the fall of 2010, Atul Gawande, surgeon at Brigham and Women’s Hospital in Boston and an associate professor at Harvard Medical School, delivered a touching speech at the October New Yorker Festival. My husband attended with a friend and, because he said it so profoundly impacted the audience, I watched it myself on video the next day. It was indeed amazing. Dr. Gawande, author and national health care presence, …
4 perfect questions when facing an end of life situation
Another luminary-rich panel has been formed to make recommendations about how physician and other healthcare services should be valued and paid for.
The Society for General Internal Medicine launched the National Commission on Physician Payment Reform with funding from prominent healthcare foundations. The 13 commissioners represent a mix of perspectives: a former surgeon/senator, community physicians, academics, two healthcare mega-corporations, a think tank, a state regulator, …
Hostage to a payment method that puts the interests of patients last
An excerpt from The Take-Charge Patient: How You Can Get The Best Medical Care (Lemon Grove Press) which will be released May 15, 2012.
Here are a few suggestions that will help you make the most of your relationship with your doctor. They are for your benefit as a patient, because the more you know, the more empowered you will feel.
Remember That Doctors Are Human Beings
Almost every health care professional emphasized …
Tips to maximize the relationship with your doctor
The American Board of Internal Medicine (ABIM) and nine other professional medical societies announced that doctors should perform 45 tests and procedures less often than currently done because there is no good medical evidence that they add any value. Specifically, a xray or other imaging for low back pain in an otherwise healthy individual or an EKG as part of a routine physical, just add a lot of unnecessary cost …
Who’s responsible for bending the health care cost curve?
Physicians from all corners of the country will be receiving refund checks by mid-April totaling nearly $200 million. The checks are not a tax season windfall courtesy of the IRS. The payments resulted from a record-breaking settlement that concluded a historic court challenge led by the American Medical Association against UnitedHealth Group.
Under the terms of this landmark settlement, UnitedHealth agreed …
AMA: Physicians’ day in court has a lasting legacy
Mostly it is just terrifying.
I sat on the edge of the bed in my fleece pajamas and tried to describe the fear.
“I’m sure you’ll do great,” my husband tried to reassure me.
“But you don’t understand. Every time you induce general anesthesia, you’re basically almost killing someone. It’s … petrifying.”
“But everyone always said you were a great resident Felicity, you’re going to be a great attending too. I’m sure everything will …
I must breathe for this patient
I had a chance to “moonlight” in the internal medicine “drop-in” clinic at the Kaiser Medical Center in San Francisco while I was finishing my residency and endocrinology fellowship at UCSF. I was superbly trained in in-patient care and there was no IV or PA line that I couldn’t put in with my eyes closed. I was comfortable taking care of really sick people and thrived on complex, acute cases. I knew …
Fixing health care includes reforming medical education
As a treating physician who also serves as the Chairman of the Alliance for Safe Biologic Medicines (ASBM), I have been watching with great interest as the Food and Drug Administration (FDA) begins to unveil the approach it will take to bring “biosimilar” medications to the US. Biosimilars are attempts to replicate brand name biologic medicines. But as the name indicates, they are similar to them but not identical. Interestingly, …
Involve doctors in any drug substitution process involving biologics
How many students enter college and immediately proclaim that they are “pre-med?” Often this declaration is accompanied with an already well thought-out choice for his or her future specialty. This incredible ability to see into the future must be hereditary, as I have had 3 or 4 different parents tell me about how their kids are going to have to choose between medical school A and B, and/or how Johnny …
Use social media for MCAT help and to get into medical school
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for “feeling good”, but he did hope that it would help him avoid illness. It was worrisome when he started with some belly cramping and noticed some blood streaks in his stools. It took about a month until he could be scheduled for a colonoscopy. The news was shocking. “There’s a cancer …
End stage colon cancer becomes even more tragic without hospice
March 29, 2012
Calhoun Lecture Series
Strom Thurmond Institute, Clemson University
Thank you for the invitation to speak tonight. I’m very humbled to stand before you. And what a delight to speak to people who are neither bleeding, intoxicated nor asking for Percocet! And in a setting where no one will burst through the back door on a stretcher!
As you know, I’m an emergency physician …
The future of medicine for aspiring young doctors
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About four months ago I found myself an unlikely participant in an unlikely situation, after having endured the unlikeliest of journeys. At the end of October myself and three others from Solaris (Andy Milligan, Luke Oyler, and Robbie Surratt) boarded a plane in Dallas and made our way towards Nepal. We were traveling halfway around the world in order to help a non-profit organization called MountainChild bring medical care to …
An opportunity to serve an extraordinary purpose every day
The following column was published on April 11, 2012 in CNN.
When you visit the doctor, chances are you are given a prescription for a drug or an order for an X-ray or lab test. Before you leave, it’s important to ask whether your doctor’s recommendations are truly necessary.
Even though much of what physicians do is meant to help patients, sometimes it’s not always the case. Drugs may have harmful side …
Discussing whether tests actually help patients or cause more harm
A recent Canadian study showed that the youngest children in each grade (born in the earliest month of the Canadian grade cutoff: December) were 30% more likely to be diagnosed with ADHD than the oldest children (born in January). For girls, who overall have a lower incidence of ADHD, the difference was even more pronounced: 70%.
Interestingly, the overall rate of ADHD diagnosis in the sampling of children from this Canadian …
The conundrum between maturity and ADHD
“You can’t just let me bleed like this, Doc. I need to get out of here.” So said John, a man in his seventies, with kidney cancer spread to his Ampulla of Vater. Renal cell cancer is among those that sometimes behave in very strange ways. John had had his removed, along with his left kidney, about nine months earlier. At the time, it was thought likely to be …
The curious equilibrium between a patient and his tumor
My patient ran away from the hospital.
This ordinarily is almost common place for a hospital bordering the south side of Chicago. In the last two years at the hospital, I had first grown surprised, and then helpless and finally weary to such mysterious absconding. This time however, it struck a chord.
Long before Mr B ran away, I had an inkling the new diagnosis of HIV would be difficult for him …
Why my patient ran away from the hospital
As I pulled into the parking lot across the street from the large urban hospital where I now work, I considered the number of cars in the physician parking lot. Could there really be a physician shortage when the lot borders on full by 8am? While I fully believe that there is a maldistribution of physicians in the United States, my mind took off pondering what the parking lot would’ve …
The discussions about physician shortages are misplaced
Long relying on feedback from not only my patients but also family and friends, I try to continually improve upon how I provide care. A family member points out what they don’t like about a recent office visit and I make a mental note. A patient I referred to a specialist is less than thrilled about the way she was treated, again I make a mental note. Many of my …
Stop the Us versus Them mentality in medicine
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