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Hospice and palliative care are bringing dying back to life

Thomas Birch, MD
Physician
May 16, 2017

My friend and neighbor died last week.  In his early eighties, wiry, opinionated, well-read, he never tolerated schooling. He built an excavating business with a perfected aesthetic for contouring soil and also built a few homes in town including mine.  When he saw the architect’s lower pitched roof framed on the garage, he had it torn off because: “It just wasn’t right. It looks like a tiny bowler hat on …

Read more…

Hospice and palliative care are bringing dying back to life

Trust your instincts, but verify them

Thomas Birch, MD
Physician
April 29, 2017

Making a diagnosis is one of my most common challenges. Families and patients are understandably more interested in the therapy to alleviate illness and suffering than exact diagnosis. We are swept along with this laudable therapeutic objective in the current of prompt empiric therapy bringing relief and hopefully confirming an empiric diagnosis and buying time before more definitive testing.

I object to this approach even as I engage in it. Necessary …

Read more…

Trust your instincts, but verify them

To fix health care, we need to examine our shared values

Thomas Birch, MD
Policy
April 21, 2017

When the political process is not working, one option is to examine the shared values of most Americans. Values are learned, clarified and even negotiated. They are the algebraic axioms from which the formulas of public policy are derived.

Examples include:

Society should care for the sick, written into the EMTALA law that prohibits turning patients away from emergency rooms.

Free enterprise is the engine of material prosperity.

The government must correct the dangers …

Read more…

To fix health care, we need to examine our shared values

A comprehensive health care redesign for the United States

Thomas Birch, MD
Policy
March 4, 2017

I can envision a comprehensive design for health care in the United States that will expand access and control costs while conforming to our shared national values of personal responsibility, care for thy neighbor and free enterprise.

After dozens of attempts to repeal, defund, delay or restrict Obamacare, the Republicans now have the opportunity to do all of the above. The problem is that it is not clear what should be …

Read more…

A comprehensive health care redesign for the United States

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  • Most Popular

  • Past Week

    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • Evidence-based medicine vs. clinical judgment: a medical student’s perspective

      Jay Pendyala | Education
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • When side effects are actually a cry for help with medication costs

      Shuchita Gupta, MD | Physician
    • The hidden math behind physician hiring costs and recruitment

      Timothy Lesaca, MD | Physician
    • Adult disability care transition: Why medicine must grow up

      Ronald L. Lindsay, MD | Conditions
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
  • Recent Posts

    • How spinal cord stimulation offers relief for chronic pain

      Kayvan Haddadan, MD | Conditions
    • Compassion fatigue in medicine: Why the brain numbs trauma

      Farid Sabet-Sharghi, MD | Physician
    • The danger of detachment: How medical training reveals character

      Ronald L. Lindsay, MD | Physician
    • The rhythm of healthy aging: Moving beyond health care metrics

      Gerald Kuo | Conditions
    • Managing acute heart failure: evidence from the DOSE trial

      Benjamin P. Geisler, MD, Jeffrey L. Greenwald, MD, and Kathy May Tran, MD | Conditions
    • The clash between defensive medicine and value-based health care

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