According to Wikipedia, “Productivity describes various measures of the efficiency of production. A productivity measure is expressed as the ratio of output to inputs used in a production process, i.e., output per unit of input. Productivity is a crucial factor in production performance of firms and nations.”
Please tell me how this relates to being a physician or a patient. We do not produce anything. Rather we work with individuals to …
There is a 4,300-strong grassroots movement known as “Save Our Hospital” gaining notoriety in Albert Lea, Minnesota. This story is symptomatic of the fact that hospital consolidation has slowly become a national pastime. With declining revenue under the Affordable Care Act, mergers increased by 70 percent, leaving small communities scrambling for health care access. The latest casualty in the “hospital-consolidation-for-sport” trend is Albert Lea, a small …
Is the practice of medicine a different experience for male and female physicians? Two recent studies from athenahealth suggest that it is — in ways that should make us rethink what we value in health care.
The first study found that male physicians are more productive than their female counterparts. In an analysis of 47 million visits on the athenahealth network in 2016, male physicians generated 30 to 40 percent more …
A curious post popped up on my Facebook feed recently: “Another doctor running for office!” A picture of an attractive family was nestled below that exclamation, asking to show your support (in the form of dollars) for this doctor running as a Democrat for the House of Representatives. It had that sense of enthusiasm that implied I was obligated to be excited, but instead came off more like Jeb Bush’s …
For the last several weeks, I have been working as a medical volunteer on a remote island off the coast of Fiji called Batiki. Home to 234 natives, Batiki has no running water, and no electricity (other than solar generated power). The inhabitants are subsistence fishermen and farmers. They are filled with joy and a real sense of community. While on the island, I found extremely high rates of high …
One of the biggest points of contention in the ongoing discussion of burnout is that the system of health care is flawed. The endless bureaucracy, decreasing physician pay, and increasing meaningful use requirements that spawn endless clicking on an already inefficient electronic medical record platform have become unbearable by most practicing physicians today.
Furthermore, all the talk about mindfulness only riles up more anger in physicians as they feel they are …
Repealing and replacing the Affordable Care Act is on indefinite life support. The political consensus was that President Trump needed to pass health care reform to be able to move forward with his legislative agenda. While this may be true, the passing of any repeal and replacement bill without fundamental reforms has little chance of long-term success, likely defining Trump’s presidency as a failure no matter how successful he is …
It’s a health care buzzword for sure, but when we talk about quality, what do we mean? We can compare the quality of similar things and focus on its absence, but otherwise, putting the idea into words becomes complicated. Context is important. And so is perspective: One’s position within the health care system influences how he defines quality to a larger degree than it does at a restaurant, or in …
Just a year after the Supreme Court rejected a challenge to race-conscious admissions in Fisher v. University of Texas, this issue is being pushed back to the front of the room by none other than the Trump administration’s Justice Department hauling out hoary tropes about “reverse discrimination.” They are preparing cases against Harvard and the University of Pennsylvania, charging to the rescue of the multitudes of …
Anyone entering medical training is taught that medicine is an art, one that combines scientific knowledge, discovery and application with its practice. It is both art and applied science. It should never become nor has it ever been only all one or the other.
To be medicine at all, the noble vocation that so many brilliant minds sacrifice to pursue in service to their fellow humans, the practice must balance art …
This article was originally presented as student remarks at the 2015 Harvard Medical School commencement.
At the end of medical school, I always return to a musing, a zen koan of sorts from Dean Jeffrey Flier. At my white coat ceremony, a close friend and current resident, Dr. Nina Gold was chatting with the dean about the heft of our newly bestowed bright white coats. He asked her, in one beautiful …
“You’re a doctor; focus on being a doctor.”
This piece of advice was recently given to me by my own father, in regards to my multiple ambitions outside of the medical field. He himself only recently retired from a long career as a surgeon, so his opinion is the result of years of experience.
His advice got me thinking.
What makes for career longevity in our field? Statistics show that more than half …
One day a man decided to open a pizza shop. The first week he sold pizzas and collected money from his customers; the happy customers ate hot pizza, and the man made some money.
The next week many of his customers who came in had pizza insurance, and had already paid Blue Wall Insurance for their pizzas. Since so many of his customers had purchased pizza insurance, the man signed a …
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Last week a physician friend recommended watching the movie the Big Short. The description given to me was that it was a great movie that was all about a bunch of guys who saw the 2008 financial crisis coming. Sure enough, that very weekend, I planned a night in to get take out and watch it on Netflix.
And it sure didn’t disappoint. Starring Ryan Gosling, Steve Carrell, Christian Bale, and …
To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.” We purposely keep our patients in pain, or we addict them to …
I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity.
Epidemiologists debate the concept around …
Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a train wreck in progress. You may have thought about saying something, but paused and wondered, “Is this …
Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy …
Health care reform continues to make national headlines as Republican senators have failed to pass a bill in the Senate with enough support to repeal and replace the Affordable Care Act (ACA). How did we get here, and why do so many Republicans want to make the ACA go away badly? To answer this question, you have to first understand the history of health care reform in the United States …
Yesterday, we had a meeting about leakage.
No, it was not about urinary or fecal incontinence, but it was about care that could have been provided within our institution that ended up, for a multitude of reasons, happening with providers beyond the walls of our institution.
Representatives from our accountable care organization had requested a meeting to go over some issues they’ve been having with our practice, including low levels of usage …
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