I have been writing a bit lately on the need for health care providers to talk with their patients about health care costs, if for no other reason than to enable patients to determine whether they can afford to pay for the healthcare that their doctors are recommending them to receive. I have been criticized for this position, on the grounds that I am rationing care from people with …
A health research company just released a list of the 100 top drugs in America according to sales. 29th on the list, with sales of over $1.8 billion, is the cholesterol lowering drug ezetimibe, brand name Zetia.
This drug was released over 10 years ago because it worked really well in combination with statin drugs such as Zocor (simvastatin) to lower LDL cholesterol levels. It was released as a single agent and combined …
During my third year of residency I trained for and completed an Ironman triathlon. I’ve discovered, despite its growing popularity, many people have no idea what a triathlon is and often nod at me in hesitant approval when I talk about this particular passion of mine. An Ironman triathlon is a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run, completed in succession, all in one day.
And it happens …
Imagine this: You are sick. You are the sickest you’ve ever been. You want to die. You almost did die. You want to bury your head in your cozy bed for the next two years.
But you’re not in your bed. This bed has plastic for covers and sandpaper for sheets. You need to throw up every thirty minutes but you have to share a bathroom with someone you don’t know, …
For days, I have been trying to get long-term patient, Stan, on the phone; his blood work came back abnormal, and we need to repeat it. I called the number in our file a bunch of times. The odd thing is that sometimes it rings without stopping, sometimes it is answered by a machine, which immediately beeps and disconnects, and at …
I met Madelyn for the first time last month in clinic. Six months prior, she was an otherwise healthy 14-year-old girl. One afternoon, Madelyn’s phys ed teacher led a gym class aimed at completing fitness and health assessments on all of the children in the grade. One at a time, each child was asked to step up and onto a scale …
In his commencement address at Sarah Lawrence College, international affairs journalist and author Fareed Zakaria defended the value of a liberal arts education. “At its essence,” explained Zakaria, “a liberal education is an education to free the mind from dogma, from controls, from constraints. It is an exercise in freedom.” His speech, I imagine, was well received and much appreciated by the over 400 graduates earning liberal arts degrees that day …
Here’s a doctor’s health tip for patients that I’ll bet you haven’t heard before.
If you’re a patient who walks into a hospital for an elective procedure of any kind — surgery, or a diagnostic test — and you find out that Joint Commission reviewers are on site, reschedule your procedure and leave. Come back another day, after the reviewers have left.
Why? …
Taking call is the worst thing about being a doctor. There, I said it. But wait! What about medical malpractice lawsuits? What about dealing with patients’ suffering or dying either from their illness, or far worse, relating to decisions you made or procedures your performed? Certainly these are far worse events than being on call.
Granted. However, these awful events are part of …
I was on the cusp of my first year in medical school, and time was running out. Classes started in two weeks. I needed a place to live: Ideally someplace cheap, not too far from school.
There was an opening at Phi Chi medical fraternity, a large brick house of faded elegance located less than a block from my classes at the University of Minnesota. At $75 a month for a …
I got a letter the other day from a local urologist requesting clearance for a patient of mine to have surgery. The doctor wanted to know whether there were any contraindications, from the standpoint of the patient’s cancer, such as bleeding, infection or poor wound healing, which would preclude local anesthesia, bilateral incisions, sharp separation, ligation, and electrocauterization of the vasa …
Nearly all physicians are now subject to patient satisfaction ratings. In my case, and many thousands of my colleagues across the country, it is via the survey tool sold to health care facilities by the Press Ganey Company. There are also many, many online sources that rate physicians.
The idea is a good one: Physicians should be subject to feedback from patients about patient perceptions of how good a job the doctors …
As a medical student I was in awe when a professor looked at a patient’s hands or nail beds and described their medical condition without taking a history. I was also enthralled by a TED talk by the best selling author, Abraham Verghese, where he described a lesson that Arthur Conan Doyle, author of Sherlock Holmes, learned as a medical student at the medical school in Edinburgh, Scotland from the famous physician …
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When I first met Ralph, he was 82-years-old. He suffered from shortness of breath which started when his wife of 56 years was diagnosed with a rare bone cancer. Upon further investigation, I diagnosed him with a weak heart and a very tight aortic valve which required immediate surgery. Ralph made it; his wife died. Today, twelve years later, he brings me treasures from his metal detecting hobby on the …
In an effort to save on human resources costs, some hospitals have decided to make locum tenens* doctors and nurses line items in a supply list. Next to IV tubing, liquid nutritional supplements and anti-bacterial wipes you’ll find slots for nurses, surgeons, and hospitalist positions.
This depressing commoditization of professional staffing is a new trend in health care promoted by software companies promising to solve staffing shortages with vendor management systems (VMS). In …
The technology industry has been buzzing of late because of the big players entering the wearable sensor market. We are very familiar with Misfit and Nike’s Fitbit for some time. Others investing into the sector include Intel, Microsoft, Apple and Samsung.
There is no doubt that the inertia for fitness trackers is undergoing modulation. This is a result of both a dampening of the initial “wow” factor by consumers and a maturation of the market. Recalls of …
I have long been a fan of the Case Records of the Massachusetts General Hospital, which is published weekly in the New England Journal of Medicine. For many years, I made a point of recommending them to medical students and internal medicine residents as a model of concise yet comprehensive case presentations.
No wasted words, no missing information, and none of the filler that trainees often added when they presented cases, such …
Painful wait times at the doctor’s office. It’s an old story with few exceptions.
As a dad, I have to deal with many of the same issues of parenting that you deal with: sleepless nights , fevers and holding my kids down for shots (my wife did it once, I think, then she promptly retired from this job). However, waiting at the pediatrician is not something I have to do. So, I can’t truly empathize …
I recently read the New York Times article on the ridiculous amount that insurance company executives and hospital administrators make. So the reason that American health care is so expensive is not because doctors earn too much, or drug companies charge too much or device manufacturers are making ever more expensive devices with ever expanded indications. Except that it is all of that and more.
Hospital administrators and insurance company executives do …
The very basic definition of a hospital is a place of healing and recovery. Health care is in a tumultuous state of flux at the moment, with the universal drive for quality improvement and the need to reign in costs. These issues, along with the desire to enhance our patients’ satisfaction and overall health care experience, were barely even talked about a decade ago. Now, they are all the buzz …
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