I sat at the checkout desk in my practice last week for the first time and as always, it was a revelation. If you haven’t worked your check-in and check-out desks recently, I highly recommend it.
An insured patient that I checked out was shocked when I said the charge for her visit was $100. She said, “But he was only in …
Your 10 minute office visit needs 8 people and 45 minutes of work
One thing that many residents do not know is that there are more benefits to becoming a board certified physician than just that plaque on the wall. One of these benefits is that ability to pick up a few extra hours of work here and there doing consulting for the multitude of companies that would like the opinion or expertise of a physician.
In some cases this consulting can be about …
Why your health insurance medical appeal was rejected
I interviewed Tania Schlatter, one of the best designers I know and a guest-lecturer for Web Strategies for Health Communication, about color, imagery, and other aspects of health website design.
Lisa: How is the design of health websites different than for other types of sites?
Tania: The design of any site goes back to the goals of an organization and what people coming to a site need. Healthcare consumers can …
Secrets of good health website design
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 74-year-old man is evaluated for a 5-year history of gradually progressive dyspnea and dry cough without wheezing or hemoptysis. For the past 2 years he has had pain and occasional swelling in both knees. He has not had fever or lost weight. He smoked one pack …
MKSAP: 74-year-old man with gradually progressive dyspnea
My father, although retired, is a general and thoracic surgeon, triple boarded in critical care, who ran a trauma unit. My brother is a pretty successful lawyer. Whenever I visit them, inevitably at least one night ends with the three of us around a table, and the two of them going at it about who is to blame for the malpractice system.
My father, of course, blames the lawyers; my brother …
Doctors can reduce malpractice by being better people
There are nearly 1.5 million Americans who suffer each year from preventable mistakes. A report by the Institute of Medicine estimates that as many as 98,000 people die in U.S. hospitals each year as the result of medical errors.
Most of these errors are related to drug mistakes. That’s the bad news. The good news is that your doctors and hospitals are trying to reduce these errors by using by using …
How you can reduce preventable mistakes in your medical care
I have a patient who I will call Antonia.
Antonia is in her early 70’s. She came to the United States from Guatemala many years ago, but never learned to speak much English. This doesn’t cause her much of a problem; her community is small and tightly-knit, so she doesn’t have much need to speak English in her home or her neighborhood. And she has a large family—children and grandchildren and …
Start thinking about health literacy in a broader framework
TEDMED is a truly extraordinary conference in San Diego, a fall sibling of TED talks focused on medicine. TED talks are just 18 minutes long, chosen and designed to blow your mind. They don’t all hit that level, but many do.
True to form, the opening session was a mind-blower. 26 year old Charity Tillemann-Dick stepped out on stage and belted out a soprano aria. I thought that was it – an opening …
Patients will choose their medicine, based on their doctor’s advice
Doctors today are wary about treating chronic pain.
One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, “fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 … [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008.”
Requiring chronic pain patients to sign pain contracts is a way to mitigate this risk.
But …
Pain contracts threaten the doctor-patient relationship
Our national health status is in imminent danger from the effects of a condition that most population health experts acknowledge is out of control.
I am speaking of obesity — and, in particular, its increasing prevalence in American adolescents and children.
Almost every study that has been done concerning obesity shows a correlation with soda consumption. As a result, some states and municipalities have tried to implement initiatives that make it more …
Childhood obesity and chronic illnesses that result from being overweight
by Child of the Ocean
I recently came across an interesting article titled “Conscientious Objection Gone Awry — Restoring Selfless Professionalism in Medicine” by Julie D. Cantor, M.D., J.D., in the New England Journal of Medicine.
This article argues against a rule, the Provider Refusal Rule, from the United States Department of Health and Human Services (DHHS) that legally protects health care professionals who act based on …
Protecting health care professionals who act based on their conscience
A recent article by Pauline Chen features a group of primary care physicians at Tufts Medical Center in Boston, who have created a concierge practice that funnels income into the traditional general medical practice that sees less-advantaged patients.
Surveys (performed by the medical center itself) found that patients rated the quality of interactions with their doctors similarly regardless of their affiliation. The only significant differences in responses had to …
Medical care and airlines – should there be a difference?
Having an answering service is essential for the typical medical practice. But what about your regular call center? Do your front desk personnel answer the phone? Do you have a dedicated receptionist? Or a formal call center?
Outsourcing services seem to be on the rise and medical practices are beginning to realize some cost savings just like other businesses.
The trade-off of course can be the perception of less personalized service. Some …
An automated call center for your medical practice
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I really don’t want my children to be overweight. I know this because I see the consequences every day in my practice, consequences like high blood pressure, impending diabetes, or poor self-esteem.
At the same time, I really, really don’t want my children to have an eating disorder. I know this because I had one.
In college, I suffered from anorexia nervosa. I’m a little more than 5 feet 9 inches tall, …
Is the media responsible for childhood eating disorders?
“She just got permanent eye liner and eyebrow augmentation—looks fab,” emailed one of my closest friends last month, about her coworker. “I am seriously considering permanent liner/eyelash augmentation. Do you have any interest in doing this with me?”
I understood the appeal … I’d never have to reapply makeup after showering at the gym, save time on my morning routine and enhance features like thinning lashes and brows. Although we had …
Permanent makeup risks and dangers
Having a heart attack felt nothing like I thought it would feel. For one thing, unlike sudden cardiac arrest, in which the heart stops beating and you stop breathing, during my heart attack (myocardial infarction), my heart continued beating, and I was conscious throughout despite horrific symptoms – so how could I possibly be having a heart …
Heart attack symptoms in women, in their own words
An excerpt from More Health Less Care: How to Take Charge of Your Medical Care and Write Your Own Personal Prescription for Lifelong Health.
Bob Baker is a patient of Dr. Lisa Martin. Bob works as an engineer for a Fortune 500 company that holds major commercial and Department of Defense contracts. He’s 45 years old and happily married with two college-age children. Bob’s lifestyle is stressful. He travels …
Take responsibility for your own health
My mom doesn’t take any diabetes medicine. She keeps her blood sugars normal through a combination of common sense and careful carbohydrate consumption.
A few months ago, she had to be hospitalized for what she calls a “minor procedure.” The procedure went fine, but not the food. The first meal they brought her consisted of breaded fish (frozen), mashed potatoes (instant), corn (canned), a dinner roll (frozen), and tea (2 sugar …
Hospital meals make it difficult to control blood sugars
In a recent New England Journal of Medicine, a perspective piece on what to do with fatigued surgeons is generating debate.
The issue of work-hour restrictions has been a controversial issue when it comes to doctors in training, something that I wrote about earlier in the year in USA Today. But once doctors graduate and practice in the real world, there are no rules.
As summarized in the WSJ’s Health Blog, …
Should surgeons tell patients how much sleep they had?
I used to practice pediatrics. It has been several years since I decided to leave medicine, but people still ask me about it, and I find myself offering neat explanations between gulps of coffee. Of course, the full truth is much more complicated. The full truth has as much to do with our health care system and our culture as it does with me.
My journey in pediatrics was not entirely …
Health care economics and the relationship between doctor and patient
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