As I walk into the well-upholstered elevator lobby of the hospital and make my way toward the stairs for another night of covering the ICU, I am again inundated with plaques, advertisements and a six-foot-tall cardboard cutout depicting an executive in a suit reminding us that this hospital is among the best in the nation in providing “value.” As I was previously made aware during a resident education session sandwiched …
Patient care brings me enormous satisfaction. Nearly 40 years ago, when I chose medicine as a career, this was a driving force. Within moments of patients coming into my office, they often share aspects of their life history known only to their closest friends and family. Bestowing this trust is a huge honor that I cherish beyond words. I have the opportunity to help them at a time of …
Just like you, I’m trying to make sense of the world around me. But there are no templates for the bridge that health care’s building for its future.
All we can do is listen to weak signals and amplify them.
Recently (and finally), CVS bought Aetna for $69 billion. I spoke to someone intimately familiar with the deal. He called it “vertical stacking” — to expand what CVS customers can get — …
Sustainability is a bit of a buzz word these days. To be sustainable means that you only use what you need, leaving the rest to be used by you or others in the future. Sustainability is a popular topic in environmental sciences and refers to renewable agriculture, good stewardship of natural resources and recycling of waste. What about sustainability in health care?
In health care, we often describe The United States …
Sometimes it is hard for hospitals to provide expensive care to poor patients. When a low-income patient needs $20,000 of chemotherapy, a hospital loses money if that patient cannot pay for the medicine, or pays through Medicaid, with its relatively stingy reimbursement. Fortunately, the federal government created a program for hospitals that care for a disproportionate share of low-income patients, whereby they can purchase those medicines at a discount. The program …
President Trump wants $5 billion for his border wall — right now — and another $7 billion (or maybe $13 billion) later on to finish the project. What else could we do with that kind of money? Here’s an idea: with $12 billion we could cover ALL 3.9 million American children who are uninsured today, and still have a couple billion left over. Put another way: …
The movement fueling #ThisIsOurLane may fail Black Americans who endure a significant burden of gun violence. Responding to a tweet from the National Rifle Association (NRA) demanding we “stay in [our] lane” the medical community rose to the challenge. A new hashtag gained traction, thousands signed an open letter, and many shared graphic photos and stories from treating victims of gun violence.
While laudable in its medical unity, as an African-American …
Are you a media whore? Or do you worry you might be labeled one by your colleagues – if not to your face, then behind your back?
In the process of delivering hundreds of media engagement workshops, I’ve heard dozens and dozens of you express this fear, using precisely this language. You’ve made it clear that the mild put-down of “microphone hog” I was familiar with has now been replaced with …
With nearly 80 percent of internet users searching online for health-related information, it’s no wonder the catchphrase “Dr. Google” has caught on, to the delight of many searchers and the dismay of many real doctors.
What’s received little attention from physicians or the public is the company’s quiet …
In health care, we enjoy a unique opportunity to create special relationships with our work. Few enter these professions for practical reasons, and fewer still survive rigorous training without genuine belief in what they might accomplish. And cliched though they may be, the many mission statements which purport the “art of caring” do convey something real.
But to even for the naïve, spending enough time around health care produces a certain …
In medical school, we learn about Broca’s area, the region of the brain that when injured prevents a person from translating their thoughts into spoken word. When this area is damaged, from a stroke or traumatic injury, the person can hear a partner declare their love or a child cry, but are unable to vocalize a response. Silenced by their injury, their voice is trapped.
Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim.
Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area of his body was covered with wounds from constant scratching. Skin that breaks easily and heals poorly can give bacteria access to other parts …
I recently met an old friend of mine for the evening in New York City. He’s a talented young orthopedic surgeon, who has already, in the short amount of time since finishing residency, experienced so many of the problems our health care system faces.
The topic of conversation quickly turned to the current state of medical practice, the dramatic swing to corporate medicine, and the consequential loss of autonomy suffered by …
Last year, in response to a continued groundswell of criticism focused on requirements for maintenance of certification (MOC), the American Board of Medical Specialties (ABMS) formed an independent “Vision Commission” on MOC, designed to “reimagine a system of continuing certification.”
Although led by ABMS board members, many of the 27 commission members are not directly associated with ABMS. After …
As we have moved into the 21st century, we have witnessed a deterioration in our perception of our doctors of medicine. This has been a gradual, eroding process, quite possibly by the design of those in powers of authority in our government, health insurance corporations and the plethora of health care corporations. The assumption might have been to make these changes in the mode of operation gradually so that they …
It’s no secret that physician job dissatisfaction is soaring to unprecedented levels, with over 50 percent of practicing physicians reporting burnout. While many factors have contributed to this epidemic in America over the last 20 years — not least of all electronic medical records that are taking a heavy (and unacceptable) toll on physicians’ time — this is not a phenomenon unique to the United States.
I sat knee-to-knee with a nurse practitioner at a school-based clinic in rural Ohio. Choking back tears, she described a patient she couldn’t get out of her head: a middle-school girl, accompanied by her mother and a social worker. Just days prior, the girl was dropped off at her father’s home for the weekend. Before the promised Friday night football game, she discovered him unconscious on the bathroom floor. Within …
As a physician who has spent his career taking care of people with HIV/AIDS, cancer and various blood disorders, this is an amazing time to be working in these overlapping fields of medicine.
I began my training when roughly half the people diagnosed with HIV were destined to develop cancer, and nearly everyone died shortly after they progressed to AIDS. In resource-rich countries today, HIV care is often as simple as …
Patient access to care is a high priority for all neurosurgeons. Unfortunately, many of our practices are thwarted in these efforts from unwarranted insurance denials. Know, you are not alone. Take this common scenario:
When Ms. Mary Smith (not the patient’s real name) started her new job several years ago, she purchased the premium insurance policy that her company provided. Recently, she developed severe neck and left arm pain. Imaging of …
