Toni Brayer is an internal medicine physician.
I’ve taken a little writing break as I turned off news to preserve my mental health after the election. As 2024 limps to a close, I look forward to a fresh start in 2025 with a few of my own crystal ball predictions of what’s to come in American health care.
Accessing primary care will continue to be a challenge, not just in rural communities but in big cities too. Telehealth …
I tried to get a personal appointment at a large prestigious academic outpatient service. The website had a “contact us” link, which directed me to a very prolonged questionnaire wanting to know details (mainly financial) that practically included turning over my firstborn child. After spending extensive time clicking through the questionnaire, I finally came to a screen that “allowed” me to pick a time over two weeks in the future …
The news is rife with articles about younger people getting cancer, heart attacks, high blood pressure, atrial fibrillation, and arthritis. We used to think of these as diseases of aging, but now we are finding high blood pressure and atherosclerosis in people as young as 20. The guidelines for colon cancer screening have been lowered to age 45 for people at normal risk. Experts can’t explain why this is happening. …
I’m in a global private physician Facebook group, and I learn a great deal about health care, both good and bad, from other doctors. Because it is private, doctors share a lot of personal practice issues as well as challenging cases from which we all learn. The physician who posted this message from her hospital employer gave permission for me to use …
I started my day today (ironically, Martin Luther King Day) reading another tragic story about a young Black mother who hemorrhaged to death after giving birth in a large public hospital in Brooklyn.
Statistics tell a shocking story. The maternal death rate increased by 79 percent from 2018 to 2021. Women of color had even worse numbers, with the maternal mortality rate among Black women increasing from 37 per 100,000 in …
Surveys show that people are pretty unhappy with the state of health care in the United States these days. Insurance is way too expensive, and co-pays and cost-sharing are out of control, with patients paying the bulk of office visits out of their own pockets. Staffing shortages mean fewer people answer phones, and finding a primary care doctor open to new patients is darn near impossible in my neck …
Sharon Stone has publicly said that medical professionals missed a large fibroid tumor. This followed a prior incident where she reported that she was given larger breast implants without her knowledge while undergoing reconstruction surgery. We all know that Michael Jackson was killed by his personal doctor, who failed to monitor him while he was given Propofol (an anesthetic that is never used at home). Dr. Murray was on the …
As I looked around the hot, humid room at the male doctors in their white coats, I couldn’t believe I was actually participating in a medical training mission in Rwanda. After months of planning and securing equipment, I was actually in Africa. I watched as the medical residents listened intently to the lectures United States physician volunteers provided.
Forty-two Rwandan OB/GYN residents came to the University Hospital in Kigali for a …
Imagine my surprise and delight when I saw my dentist this week for a check-up and found the electronic health record (EHR) to be both informative and patient friendly. As I sat in the dental chair, the large monitor screen was swung over in front of me, and my dentist was at my side going over it. The monitor was not a barrier; it was part of my exam. The …
The Centers for Medicare and Medicaid (CMS) sets the rates all physicians get paid and insurance companies base their rates on the same formula. So who creates the formula? Well, it’s the doctors, silly! Or at least some of the doctors. Here’s how it works.
A 31-member committee formed by the American Medical Association is made up of representatives from the various specialty societies. This Relative Value Update Committee (RUC) meets …
The massive confusion about Obamacare (the Affordable Care Act) is much worse than I thought. The Kaiser Family Foundation came out with a poll that shows 42% of Americans don’t even know that Obamacare is the law. Seven percent of people think the Supreme Court struck it down and 12% think Congress repealed it.
I understand that there is confusion about the way it will work and who will be affected. …
The baby boomers are strictly identified as being born between 1946 and 1964. The boom lasted 19 years and delivered 76 million total births. “Leading edge” boomers were between 1946 and 1955. They were the generation that were the wealthiest, most active, and most physically fit generation that had ever lived. They were special and expected to have better lives than their parents.
Well, those leading edge boomers are now middle …
The United States is higher in its use of computed tomography (CT) scans than any other industrialized country. There were about 3 million scans done in the U.S. in 1980. By 2007 that number had risen to 70 million. A number of articles published in medical journals over the past few years have reported that excess radiation delivered by these scans will …
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Winter is officially here and we are in the cold and flu season. This is the time that patients get sick with viral illnesses and primary care doctors get even more frustrated as they try to do the right thing for patients. What is the right thing?
First of all we want to relieve suffering. But we also want to do that …
There are an estimated 1,638,910 new cases of the dreadful disease diagnosed in 2012 in the United States, not including non-melanoma skin cancers.
Cancer is not just one disease but is a term that represents more than 100 diseases with different causes. The basic unit of life is cells, and cancer always begins in cells. When the normal process of cell growth and division is altered, these abnormal cells divide without …
Traditionally, the patient chart stayed in the doctors office and rarely did a patient get a glimpse of anything in the record. Photocopying the chart is expensive and no physician would let a chart leave her office because the record must be held safely for a minimum of 7 years. Now more and more offices are doing away with clunky paper charts and electronic medical records are becoming the …
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There is do doubt that the way pharmaceutical companies market drugs to both doctors and consumers sways prescribing and drives up health costs. Prescription drug costs have outpaced other health care spending and are predicted to exceed the growth rates for hospital care and physician services going forward from 2010-2019.
Two researchers (Howard Brody, MD, PHD, University of Texas Medical Galveston and Donald Wright, PhD, University of Medicine and Dentistry …
When we think of osteoarthritis (OA), we think of chronic “wear and tear” on a joint that has just plain worn out. Many patients with arthritis become less and less active and that is actually the worst thing for an arthritic joint.
A study published in Arthritis and Rheumatism looked at the functional performance in 2589 adults with knee OA and found that …
Arnold Schwarzenegger’s revelation about his long-term affair with his household employee that involved a child being born is the latest in a string of powerful men with career ending flaws. Add to that the shocking arrest this week of powerful Dominique Strauss-Kahn for allegedly raping a hotel maid and we must ask, “What the heck is going on with these guys?”
I can’t count the number of heartfelt apologies that …
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“But doc, my blood pressure is always normal at home.” I wish I had a dollar for every time I have heard that line and I know it is true.
When some patients come to see me, their blood pressure is abnormally high (above 130/90) and this is known as “white coat hypertension.” Although it has been thought to be from anxiety about seeing the doctor, even long established patients who …
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