Wes Fisher is a cardiologist.
Atul Gawande, MD is a brilliant writer, no-doubt an excellent surgeon, and many would say a physician-visionary for all that ails America’s health care system. He speaks first-hand of the changes that have occurred in American health care and recently offered his perspective for fixing our health care system to the fertile minds of Harvard’s recent graduating class of 2011.
In his graduation speech, published front and center (yet again) …
Recently I was asked to serve as a consultant on a medical matter. Interestingly, they requested my hourly price for my services. I thought about this and wondered, “What am I worth per hour in the open market?”
It is an interesting question to ponder.
I have decided to ask the blog-o-sphere. Call it a bit of “free market economics.” For the record, 100% of my hourly wage for my services will …
It’s impossible to watch the news these days. Whether you’re conservative, liberal, independent or non-committed, it’s impossible to avoid the political bickering these days as the US Presidential campaign enters its final countdown. As a physician, seeing the video of Granny being pushed off a cliff is about all I can handle.
Seriously?
No politician I know has to deal directly with Granny, but I do. I have to look …
There is a moment in everyone’s life, for oneself or a loved one, when one receives the “diagnosis.” In that moment, eyes meet across the desk and the shell-shocked individual looks up and asks, “Doctor, what should I do?” In that instant, the patient is putting all of their trust in another human being who is trying nothing less than to save a life.
A good doctor has always been a …
If you want to succeed in academic cardiology, get a federal grant for research.
Better yet: get a few well-paid industry grants, too.
These days lower-paid academic cardiologists are finding it tougher to find protected time for research and speaking because grants are harder to come by and money from their academic center is getting tight. For instance, the National Heart, Lung and Blood Institute (NHLBI) of the NIH no longer accepts investigator-initiated innovative …
“The plural of anecdote is not data.”
A recent lead editorial in the Sunday edition of the New York Times was entitled “A Formula for Cutting Health Costs” and contained the byline “Alaska natives have something to teach doctors and patients in the rest of the world.”
I read the editorial with interest, hoping that a new perspective, vision, idea, or insight would be mentioned that would provide a sustainable cost solution …
“Dr. Fisher, can you teach our residents EKG lecture series?”
Naively, I said “Sure!”
What I didn’t realize is how hard this is to do today.
Much of this is not residents’ fault. They only have so many hours in so many days to attend lectures while caring for patients. Thanks to residency work-hour restrictions, those hours have become even fewer. To make matters much worse, through the year residents are torn to …
June in the United States heralds the month when residencies end and new ones begin. While much will be written soon about the dangers of entering hospitals this time of year (this story never seems to tire with mainstream media), I would like to step back and reflect on why doctors should consider attending residency graduations. I had the pleasure of doing so recently.
Excitement. With all of the dreary news of …
In our rush to establish a national electronic medical record (EMR) system as part of the American Recovery and Reinvestment Act of 2009, powerful silos of independent EMR systems have sprung up nationwide. While most systems are being developed responsibly, like the Wild, Wild West, many have been developed without an objective eye toward quality and the potential harm they may be causing our patients.
As most readers of this blog are aware, …
“I estimate these changes to your charting work flow will take only five minutes.”
Five minutes is fine if it happens for only one patient. But when it is multiplied by as many as forty patients in a day, the multiples get impressive. Five minutes x forty patients = 200 minutes (more than 1.5 hours a day).
Minor five-minute changes to administrative charting requirements aren’t so minor, especially when you add more …
Not everything that counts can be measured.
Not everything that can be measured counts.
-Albert Einstein
Recently, a disturbing trend of monitoring physician quality and accountability has taken another ominous turn: tracking physician’s movements at scientific conferences (so called “tag and release”) using RFID tags embedded in attendees name badges at national scientific sessions. Having had personal experience with the American College of Cardiology meeting, this technology was also embedded in the …
Recently, an editorial from a plastic surgeon Lloyd Kreiger, MD, appeared in the Wall Street Journal entitled “ObamaCare Is Already Damaging Health Care.”
While I’m not sure I’m ready to concede that Obamacare has already damaged health care in America, I will agree the law is certainly is changing health care, aligning health care corporate interests with political interests, with …
With the explosion of social media, I am amazed at how many doctors I encounter who know little to nothing about blogs, Twitter, Facebook, Google Buzz and the like. “I’m too busy.” “Who has time for that stuff?” “I wouldn’t have time for anything else.” “How can I possibly keep up?”
And yet today, as more and more patients reach out to the web to find medical information or, more importantly, …
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What we’re learning from the 21% Medicare pay cut to physicians that occurred today:
* There really must be a cost-control crisis with Medicare and the only politically-acceptable way to implement those cost controls are by cutting working physicians’ payments.
* There’s was widespread political support for blocking the scheduled pay cuts to doctors, but central government control moves very slowly. That’s because doing so is expensive. For now, doctors have been …
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