“Twenty years ago, I helped save a man’s life.”
So begins this New York Times essay by Peter Bach, MD, where he talks about the inadequacy of resource use at the end of life as a policy metric. Now, I am not very fond of policy metrics, as most of you know. So, imagine my surprise when I found myself disagreeing vehemently with Peter’s argument. Well, to be fair, I did …
Turn away from interventions that merely prolong dying
Like many of my colleagues, I teach and supervise students, residents, nurses, and respiratory therapists. I’m also the medical director of a PICU. Overall, I’ve been teaching and doing administration for over 30 years. And, like most of my colleagues, I never received any formal instruction at all in how to do these things. To some extent I got help from my own mentors, primarily by watching what they did, …
Reward or punishment in medical training
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost of health care is the dominant political, social, and economic issue of our time. More than one expert called for a “jailbreak.”
“Jailbreak” for me meant either an obscure English reality television show or an expression applied to overriding the software limitations deliberately placed on computer systems for security …
Break out of the prison of the American health care delivery system
I started working with a new coaching client the other day. I’d already been following the twists and turns of her life saga for about a year, via excited emails she’d been sending me ever since reading my book Live a Life You Love.
“As you know, I’ve made all kinds of wonderful changes in my life,” she told me over the phone, “I left a job I couldn’t stand, sold …
A physician shares her anxiety management tips
Do ear surgeons perform facelifts? Absolutely!
And we perform nose surgery and throat surgery, too!
A recent article in the New York Times presented a scathing editorial on complications caused by poorly trained surgeons. However, the implication of the title “Ear surgeons performing facelifts,” is misleading and overlooks the fact that a large portion of training in the specialty of ear, nose and throat surgery includes plastic and reconstructive surgery of …
Plastic surgery is part of the ENT surgeon repertoire
Labels matter. We quickly form judgments based on them. If we hear someone called lazy, the label “lazy person” attaches in our mind even though we may not have even met the person. The same is true for labels given to various medical conditions. If the label for an illness uses language such as “fatigue,” we abstract from our experience and think we know what it’s like to suffer from …
Why we need truth in labeling of medical conditions
Losing weight can help lower your chances for cancer if you’re overweight or obese.
But not just any weight-loss plan will give your body the nutrients it needs to fight off diseases like cancer.
Below, I’ve separated out the good from the bad among popular diets.
Good nutrition is not a fast fix
Diets that make the “good list” encourage long-term change. They also give you a variety of options from all …
What you need to know about popular diets
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure it would be prudent to prescribe a blood pressure medication and order a nuclear stress test. With only a catastrophic insurance policy and a $5000 deductible it was imperative for my financial health to know the cost of both the drugs and the procedure up front.
The prescription was …
Question the price of drugs and medical procedures
If you are like most people, you have probably never heard of Morgellons disease or Morgellons. The first reason you have likely never heard if it is because it is so bizarre and uncommon. Most of what is known about it is based on rare case reports or anecdotal stories. The second reason is because it is not recognized in the medical community as a legitimate medical disease. It is …
The psychological basis of Morgellons disease
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question is, how are you using Facebook and Twitter to support your goals? Are you connecting with patients? Are you reaching out to peers and friends? It is great to have a big following, but does that turn into real, authentic meaning for you? If you are like most doctors, the answer is a …
Why doctors should embrace Google+
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who are committed to our care. We are the envy of the world for our biomedical research prowess, funded largely by the National Institutes of Health and conducted across the county in universities and medical schools. The pharmaceutical industry continuously brings forth life saving and disease altering medications. The …
America has a health care paradox
Stop what you’re doing to read this The New England Journal of Medicine perspective by Dr. Doug Diekema. It’s about vaccines, opportunities for health, and physician obligation. Written for physicians, it also speaks loudly to parents and includes a few very essential points. The whole time I read the article, my thoughts kept leaping to our imminent opportunities. Today, in 2012, we can harness the tools of social media …
We need an app for credible information on vaccines
Patient satisfaction is all the rage.
Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores.
High scores are even used by hospitals as a powerful marketing tool.
But, in the end, are patient satisfaction scores hurting patients?
I wrote about the issue previously, saying that patient …
How patient satisfaction can kill
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A few months ago I was introduced to a gentleman who had been a corporate VP for employee benefits at a Fortune 100 company for many years. I was impressed with his knowledge of health care. He shared some of his experiences with company employees, who lived all over the country.
The company had a policy that when employees were informed they had a very serious medical condition, the company paid …
Take patients away from the overtreaters
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm sandy beach vacation, new bigger home and grand Thanksgiving dinner love. Not even baby’s first words love. I mean power passion that gets us through the hard times, type of love.
Edna and Ken are 90, married and both have active cancer. They have been partners for 62 years. …
In love there is a life giving force
A guest column by the American Medical Association, exclusive to KevinMD.com.
This week, I’m joining hundreds of physicians and medical students in Washington, DC during the American Medical Association’s National Advocacy Conference to talk to our federal lawmakers about an end to what has become an annual chore of stopping drastic scheduled Medicare physician payment cuts to preserve access to health care …
AMA: Advocating for Medicare, military and fiscal responsibility
I have decided to spam for public health.
Phone calls, text messaging, and even apps have been shown to help improve health and sustain behavior change, even in people suffering from profound mental illness. But when it comes to using these tools for public health, there are two problems. The first is that each message (whether via phone call or text) costs money. The second is that it’s quite hard …
Using Twitter to deliver health improvement messages
Does your medical practice allow anybody to post links and comments on your Facebook page?
The short answer is yes. We do. Why? Because we think allowing patient to post links and commenting on our practice’s Facebook page helps us achieve these four things:
1. It encourages communication.
2. It allows us to address issues that we would otherwise have a hard time addressing.
3. Other patients will benefit by reading the discussions.
4. We …
Addressing comments on your medical practice’s Facebook page
I’ve only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case the heart had stopped beating. Death was clear.
Brain death is tougher to cope with, both clinically and psychologically. I imagine it would make anyone want to say, at some point, “Are you sure? Are you really sure? How do you know? How can you be sure?” Some times …
Why an anesthesiologist would be needed for organ donation
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis.
ABC News wonders, “How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests?”
They’re missing the point. …
5 ways to avoid a misdiagnosis
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