Last week, after dinner, as I was rinsing the dishes, I casually mentioned to my wife, “I spoke with the volunteers at Doctors Without Borders today, and they need help.”
This was before the first case of Ebola was diagnosed on U.S. soil. A pregnant silence fell in the kitchen except for the clattering of dishes and the boiling of water as …
As Ebola spreads, what can we do to help?
If an ill patient, who unexpectedly has Ebola, landed in Memphis, it is likely that my partner or I would see him. We work as infectious disease doctors at the hospital closest to the airport.
The Ebola patient would present with fever, nausea and vomiting, indistinguishable from a flu or a viral illness that hundreds of patients present with each day at our hospitals. But over a few days of the illness, …
Ebola in the United States: A reason not to panic
As I walk into the hospital each day, I notice patients and families sitting outside on benches that are surrounded by large signs prohibiting smoking on hospital grounds. For over five years, a collaborative and concerted effort by Memphis hospitals has successfully made all the hospital campuses smoke-free.
Now, in other states, hospital systems like Cleveland Clinic and Baylor Health Care have taken another bold step forward. They have stopped hiring …
Should hospitals discriminate against smokers?
Lying in a hospital bed, my seriously obese patient can barely see her swollen and odorous right foot over her abdominal fat. The foot is soon to be amputated, the result of an untreatable infection exacerbated by diabetes and kidney failure, which developed in part because of obesity.
Her two children, ages 6 and 12, hover from the hospital bed to the couch. In between, the bedside table is strewed with …
Doctors struggle to treat childhood obesity
The day after the temperature dipped from 60 degrees to 25 degrees, I mistakenly left for work without a winter jacket. Rushing 50 yards to the hospital doors with my arms clung to my chest in the blistering cold, my tie flew over my shoulders, my teeth chattered, and my fingers went numb.
That evening I began to sniffle. The next morning I had a sore throat, and the following day …
Do cold temperatures cause colds?
The night before I was leaving for a three-week medical mission trip, I was called urgently to the ICU to see Rachel (name altered), a previously healthy woman in her late 40s, slightly overweight with dirty blonde hair. She had started a new job as a customer service agent. Rachel was the sickest patient I had seen in months, and I could not figure out what was going on.
A week …
Influenza can make you critically ill
Some years ago, driving through an end of town where pawn shops and boarded up homes are common, I saw a small placard sign nailed on a telephone pole. “Buy Health Insurance,” it touted with premiums as low as $25 a month. I was tempted.
Health insurance, for me and for most Americans, is a necessary part of life, similar to home rent or mortgage, grocery bills and gasoline. Insurance is …
The difficult transition from substandard to standardized coverage
Recently, I was among a dozen people who sat privately to talk about the Affordable Care Act (ACA), aka Obamacare, with the embattled Health and Human Services Secretary, Kathleen Sebelius. Dressed in a light green blazer, sitting alongside Memphis Mayor AC Wharton and Congressman Steve Cohen, who had nudged her to visit Memphis, Secretary Sebelius listened to our feedback and shared her insights.
First and foremost, addressing the issue of the …
A meeting with Kathleen Sebelius about Obamacare
Standing in the dimly-lit cave-like radiology reading room, I was looking at a CT scan which was done in the emergency room on a man in his 40s who had a testicular mass — likely a cancer — which had spread through out his body. It wasn’t that the man did not know the mass was present — earlier CT scans from the emergency room clearly showed the mass in …
Getting health insurance is not about your ideology
Lying in a hospital bed, my seriously obese patient could barely see her swollen and odorous right foot over her abdominal fat. The foot was soon to be amputated, the result of an untreatable infection exacerbated by diabetes and kidney failure, which developed in part because of obesity.Her two children, ages 6 and 12, hovered from the hospital bed to the couch. In between, the bedside table was strewn with …
Obesity in children: What is the responsibility of doctors?
In 2007, I published a story in my local paper in which I confessed to having made a medical error years earlier. I’d mistakenly prescribed an antibiotic for a patient whose chart indicated an allergy to the drug.
Thankfully, the story had a happy ending. My patient recovered and took no legal action after I explained to her what had happened. I ended my article vowing to take greater care to prevent errors …
Urging doctors to take responsibility for their mistakes
We have done it. We have decreased the increase in the cost of health care. Let us explain. For three decades (1980-2009), the cost of health care has been increasing each year at an average rate of 7.4 percent — double the rate of inflation. However, over the past three years, the increase in health care expenditure has remained at a low 3.1 percent.
Is this decline …
The blueprint for decreasing the cost of health care
If you drink coffee, I have some bad news and some good news. The bad news is that the more cups of coffee you drink, the higher your risk of dying early. The good news is that if you “risk adjust,” then the more cups of coffee you drink, the lower your risk of dying early. Let me explain.
According to a Read more…
Can coffee help you live longer?
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Two weeks before the Newtown, Conn, shooting I was at my doctor’s office for an annual physical exam answering questions on an intake survey. Questions like “Do you smoke? How much?” and ” Do you wear the seat beat?”
And then one question stuck out: “Do you have any firearms in the house? Are they stored in a locked area?” What business …
Firearms violence is a public health safety issue
Four years ago, as I was making rounds on the oncology floor, one of my patients with leukemia asked, out of the blue, “Hey, Doc, who you gonna vote for?” He had an Obama T-shirt by his bedside.
Chuckling politely, I asked him why he wanted to know. “I’m curious, Doc,” he said. “It tells me your worldview.” He said that if we agreed on who should be the next president, …
The problem with discussing politics in the exam room
Recently, a medical student confided in me a thought that few in our profession would dare say aloud: “We may have come to medical school to help people, but we choose our specialty careers based on potential salaries.”
This in part explains why the most-prized residencies are in fields such as dermatology and radiology, whose procedures generate high fees. According to a physician survey by the Medical Group Management Association, the …
Income inequality among physicians should matter to patients
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?
Thirty percent of health care spending — amounting to $750 billion a year — is wasted, according to a recent report by the Institute of Medicine.
I know. As a doctor, I am party to this waste, and I think doctors can play a major role in recovering it.
In a private conversation, a cardiologist tells me about his partners — “loose guns” he calls them. “At the hint of chest pain …
Doctors can play a major role to reduce waste
As I approach my 50th birthday, I worry about Medicare not being there for me when I become eligible. I have some inside knowledge about Medicare. My parents and in-laws are patients on Medicare. As a doctor, I am a provider for Medicare, and as a public health educator I am a consultant for a Medicare quality improvement organization.
Everyone, including the leaders of both Democratic and Republican parties, agrees that …
Fixing Medicare: Both providers and patients need skin in the game
I once thought that only the federal government in Washington could effect changes that would impact the cost of health care in the United States, especially with so much attention on the recent Supreme Court decision on the 2010 health care reform law. But now I think differently.
Now I believe that emboldened employers in places like Memphis can use their clout. They can influence insurers and work directly with doctors …
Align employers with doctors, hospitals and insurance companies
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