Steven Reznick, MD

Steven Reznick is an internal medicine physician and can be reached at Boca Raton Concierge Doctor.

A physician celebrates 15 years in concierge medicine

Physician

October 3, 2018

I practiced general internal medicine from June 1979 until November 2003. Immediately after training, I became an employed physician of an older internist covering my employer’s patients and building my practice for two years before embarking on my own.

I saw 20 or more patients per day in addition to providing hospital care and visiting patients as they recovered in nursing homes. As managed care made its clout felt by kidnapping …

Guidelines, multiple specialists, and the science versus the art of medicine

Steven Reznick, MD

Physician

July 16, 2018

My 80-year-old patient presented with symptoms and signs of kidney failure. I hospitalized him and asked for the assistance of a kidney specialist. We notified his heart specialist as a courtesy. A complicated evaluation led to a diagnosis of an unusual vasculitis with the patient’s immune system attacking his kidney as if it was a foreign toxic invader.

Treatment, post kidney biopsy, involved administering large doses of corticosteroids followed by a …

Do hospitalists improve patient outcomes? The answer isn’t quite clear.

Steven Reznick, MD

Physician

December 26, 2017

A study published recently in JAMA Internal Medicine looked at 650,651 Medicare patients hospitalized in 2013. It showed that when patients were cared for by their own outpatient physician, they had a slightly better outcome than when the patients were attended to by full-time hospital-based specialists who had not previously known them.

As an internal medicine physician who maintains hospital privileges, as well as caring for patients in …

When you lose someone, it takes a piece of your being with it

Steven Reznick, MD

Physician

December 19, 2017

As an internist with “added qualifications in geriatric medicine” I care for a great many elder individuals. In most cases, these are individuals I met 20 or more years ago and have been privileged to share their lives with them as they aged.

The circle of life is relentless and unforgiving, so there comes a time when these relationships end. In some cases, it comes when they can no longer care …

Why Medicare cannot stay solvent: a case study

Steven Reznick, MD

Policy

October 26, 2017

My spry, 90-year-old patient decided she had a urinary tract infection two weeks ago. She had difficulty urinating and the constant urge to void with no fever, no chills, no back pain, no bloody urine. She was advised to come in for an appointment the same morning, but this didn’t suit her. The alternative choice was to see her urologist who made time available that same day. She decided this …

This is who’s to blame for the opioid crisis

Steven Reznick, MD

Physician

October 11, 2017

“Do not get caught” seems to be the real rule of the law in South Florida, where I live.

I was trained to limit the use of controlled substances, narcotics, hypnotics and sedatives. Their use can affect consciousness, ability to drive a car and work. More severe consequences include respiratory depression and overdose from too high of a dosage or mixing too many medications and over the counter items.

The Joint Commission, …

The sad direction of hospital care

Steven Reznick, MD

Physician

August 8, 2017

My 74-year old obese, poorly controlled diabetic patient with high blood pressure, high cholesterol, coronary artery disease, asthma, obstructive sleep apnea has been difficult to motivate to improve his lifestyle and his health. He is bright, sweet and caring but just not very disciplined.

At each office visit, we review his medications, review his dietary habits and go through the check list of check-ups for diabetic complications including regular ophthalmology exams …

Read more…

The sad direction of hospital care

The elderly need hired professionals to administer their medications

Steven Reznick, MD

Meds

May 9, 2017

One of the most challenging and difficult parts of my professional day is trying to determine if my patients are actually taking their as prescribed.

I ask my patients to bring their medications to each visit in the original pill bottles, and we count pills. I ask them to bring their medication lists as well, and we go through the time-consuming practice of reviewing each medication against the prescribing date and …

End-of-life decisions aren’t any easier for a doctor

Steven Reznick, MD

Physician

December 9, 2016

As an internist and geriatrician, I deal with elderly patients all the time. We always end up talking about end-of-life issues:

“Should I be resuscitated if my heart stops and I stop breathing?”

“Do I want a feeding tube or gastrostomy tube if I stop eating and require nutrition?”

“Should I be kept alive on machines and for how long if there is no reasonable hope of recovery?”

“When should we refuse tests for …

Blood pressure in the elderly: How low is too low?

Steven Reznick, MD

Conditions

July 15, 2016

A recent publication in a fine peer-reviewed medical journal of the SPRINT study proved that lowering our blood pressure to the old target of 120/80 or less led to fewer heart attacks, strokes, and kidney failure. There was no question on what to do with younger people but to lower their blood pressure more aggressively to these levels. Debates arose in the medical community about the ability to lower it …

Failure to communicate is a patient safety issue

Steven Reznick, MD

Physician

November 6, 2015

My 66-year-old professional athletic patient had a history of a scar tissue related small bowel obstruction seven years ago related to a previous appendectomy. He now had similar symptoms with cramping, lower abdominal pain, and some nausea.

Since his office was next door to his longtime friend and gastroenterologist, he called over there. He was given an appointment with the junior partner since his buddy was out of town. Thirty years …

Is the crusade against pill mills turning into a witch hunt?

Steven Reznick, MD

Meds

August 16, 2015

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I care for a 65-year-old woman suffering from sarcoidosis affecting her lungs, her skin, her bones, her nerves, her blood chemistries, her kidneys, her colon and her mind. She has gone from an active spouse, mother, grandmother, tearing up the dance floors with her husband, to a home recluse calling friends to drive her to medical and care appointments while ambulating with …

I temporarily went back to paper records. And it wasn’t so bad.

Steven Reznick, MD

Tech

April 29, 2015

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On Monday March 30, 2015 our Greenway PrimeSuite electronic health record had a system-wide failure at the level of the Edgemed Computer service center in New York State. It meant that I was back to using pencil and paper to interview patients and record the answers and physical findings.

With much trepidation, I began seeing patients with two sheets of white blank …

Physicians don’t take the time to communicate with their colleagues

Steven Reznick, MD

Physician

October 4, 2014

I was finishing tying my shoes as I got dressed to take my lovely wife out to dinner for our 41st wedding anniversary. It was 7:30 p.m. after a hectic day at work and we had a wonderful dinner planned at a local restaurant.

The telephone rang with the caller ID identifying a call on my office work line.

“Hello this is the emergency department, please hold on for Dr. S.” …

The pressure to admit patients from the ER will only grow

Steven Reznick, MD

Physician

September 21, 2014

Once again government regulators have put in place well-meaning rules without anticipating the consequences. We all hate sitting around in the emergency department waiting to be seen and to be treated. On October 15, 2014 as part of the new Affordable Health Care Act and the patient satisfaction portion, hospital ERs will have about 180 minutes from the time you arrive and sign in to evaluate you , treat you …

Discussing financial issues before medical issues: Be more thoughtful

Steven Reznick, MD

Physician

March 19, 2014

Well over a year ago, I advised my 80-year-old patient and her children that due to progression of her Parkinson’s disease. Because of her frail nature, she needed a higher level of assistance and care if she wished to remain in her home. She was extremely unsteady walking and several courses of physical therapy had not improved the situation. The patient was feisty and would only allow help to come …

After attending a medical graduation, a new sense of optimism

Steven Reznick, MD

Education

July 16, 2013

I recently attended the University of Miami Miller School of Medicine graduation for the class of 2013. It had special meaning for me since this was the last group of students at the University of Miami Miller School of Medicine-Charles M. Schmidt Florida Atlantic University (FAU) joint venture to pass through my tutelage prior to the Boca Raton program becoming solely an FAU program.

One of the graduates visited my office …

Why we cannot keep the costs of end of life care in a reasonable range

Steven Reznick, MD

Physician

May 21, 2013

“J.T.” is 92 and clearly a soul who lives to the beat of a different drummer. She has no children and her closest relative is a niece who she despises. Despite this the niece oversees her care, sending in a full time aide and her personnel assistant to run the household. J.T. will not come to the office for a visit. If I call and make an appointment to see …

Human nature prevents any cost savings at the end of the life

Steven Reznick, MD

Policy

April 25, 2013

We are frequently reminded by the General Accounting Office and CMS that a great proportion of Medicare health costs are incurred in the last three months of a patient’s life. Health care policy experts have tried to reduce these costs by encouraging end of life planning. Living wills, health care directives and the availability of hospice and palliative services will not put a dent in these costs because of human …

A doctor for the elderly: What to look for

Steven Reznick, MD

Physician

December 30, 2012

My elderly and infirm parents live 15 minutes south of my home in an assisted living facility. They moved there after it became apparent that they could not manage their affairs in their own home, have some degree of independence and socialization with friends and receive the care and supervision they needed to stay out of the hospital. Their cognitive impairment …

Steven Reznick, MD

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