The patient experience

March 26, 2009Mar 26, 2009

The following op-ed was published on March 26th, 2009 in the USA Today. As a primary care doctor, I am frequently faced with decisions where the choice is not always clear. Do the latest, more expensive drugs work better than…

The following op-ed was published on March 26th, 2009 in the USA Today.

As a primary care doctor, I am frequently faced with decisions where the choice is not always clear. Do the latest, more expensive drugs work better than the less costly, older medications? Will ordering an MRI help me treat a patient’s lower back pain? Often, the answer to these questions is, “I’m not sure.”

Because …

Is Natasha Richardson brain dead? Was an epidural bleed, or “talk and die” syndrome, to blame after her ski accident?

March 18, 2009Mar 18, 20096

Tragic news this morning regarding actress Natasha Richardson, who reportedly, suffered a head injury during a ski lesson in Canada.According to reports, she fell on a beginner's ski hill, and did not hit anyone or anything during the fall. There…

Tragic news this morning regarding actress Natasha Richardson, who reportedly, suffered a head injury during a ski lesson in Canada.

According to reports, she fell on a beginner’s ski hill, and did not hit anyone or anything during the fall. There was no obvious sign of injury, and in fact, she was “was walking around and feeling fine for an hour after her accident.”

Things then …

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Will reforming the malpractice system be a deal breaker for health reform?

March 17, 2009Mar 17, 200924

In a surprise, President Obama has signaled a willingness to discuss medical liability as part of the health reform process.Good for him for standing up to the trial lawyers, a core constituency of the left.That's a good sign, as the…

In a surprise, President Obama has signaled a willingness to discuss medical liability as part of the health reform process.

Good for him for standing up to the trial lawyers, a core constituency of the left.

That’s a good sign, as the costs of defensive medicine brought on by the broken malpractice system, should be addressed if there is any hope of reducing health care spending. …

Health policy

Will patients or doctors be the biggest obstacle impeding health care reform?

Kevin

March 10, 2009Mar 10, 200911

If both patients and doctors don't accept the changes required of their behavior, no amount of comparative effectiveness studies will cut health care spending.Two prominent medical journalists write as much in their respective blogs.First, the NY Times' Tara Parker-Pope notes…

If both patients and doctors don’t accept the changes required of their behavior, no amount of comparative effectiveness studies will cut health care spending.

Two prominent medical journalists write as much in their respective blogs.

First, the NY Times’ Tara Parker-Pope notes that patients have to realize that, yes, they should demand the best care possible. However, that means, “we will have to accept that ‘best’ …

Health policy

Relative value units, and how the RVU payment system doesn’t allow doctors to practice good medicine

Kevin

March 5, 2009Mar 5, 20096

For those who don't know, every piece of work that a doctor performs is quantified and measured.The base unit of physician work is known as the relative value unit (RVU). Most physician salaries are determined by the amount of RVUs…

For those who don’t know, every piece of work that a doctor performs is quantified and measured.

The base unit of physician work is known as the relative value unit (RVU). Most physician salaries are determined by the amount of RVUs a doctor produces in a given year, and in most cases, can range between$35 and $45 per RVU in primary care, depending on geographic location and …

Op-ed: Pads, pens, prescriptions

February 26, 2009Feb 26, 2009

The following op-ed was published on February 26, 2009 in the USA Today. Have you ever noticed the pens, coffee mugs and prescription pads at your doctor's office? Chances are, they were prominently adorned with the brand name of the…

The following op-ed was published on February 26, 2009 in the USA Today.

Have you ever noticed the pens, coffee mugs and prescription pads at your doctor’s office? Chances are, they were prominently adorned with the brand name of the prescription drug its company is touting.

The pharmaceutical industry has been giving these types of small gifts to doctors for years, in hopes of raising physician awareness of …

Op-ed: Pads, pens, prescriptions

Op-ed: More coverage requires more doctors

February 25, 2009Feb 25, 20094

The following op-ed was published on February 25th, 2009 in The New York Times' Room for Debate blog. With the number of the uninsured having risen to 48 million Americans, clearly the need for reform is dire. But President Obama…

The following op-ed was published on February 25th, 2009 in The New York Times’ Room for Debate blog.

With the number of the uninsured having risen to 48 million Americans, clearly the need for reform is dire. But President Obama made no mention of who exactly will take care of these patients, even if they get insurance under a successful health reform initiative.

As a primary care physician in southern New …

Ways you can die from having sex

Kevin

February 17, 2009Feb 17, 20094

Cosmo Magazine, that bastion of reliable medical advice, declares, "An orgasm almost killed her."Intrigued, gynecologist Amy Tuteur reads further, and finds its about case where a woman developed stroke-like symptoms after intercourse, and was diagnosed with an embolic stroke.The patient…

Cosmo Magazine, that bastion of reliable medical advice, declares, “An orgasm almost killed her.”

Intrigued, gynecologist Amy Tuteur reads further, and finds its about case where a woman developed stroke-like symptoms after intercourse, and was diagnosed with an embolic stroke.

The patient was taking the birth control pill, which can raise the risk of blood clots. In this case, it was also combined with the presence of …

Ways you can die from having sex

Her hands and feet amputated, a Brazilian model dies from Pseudomonas aeruginosa sepsis. What happened?

January 25, 2009Jan 25, 200912

Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.How can this happen? Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film,…

Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.

How can this happen?

Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film, or CT scan likely would have been done to confirm the diagnosis. I assume that a urinalysis was also performed, and if …

Op-ed: Medicare’s mistake

January 14, 2009Jan 14, 2009

The following op-ed was published on January 14th, 2009 in the USA Today. Every patient's worst nightmare is going to the hospital for a procedure only to have a surgical instrument left in his body, the wrong limb or organ…

The following op-ed was published on January 14th, 2009 in the USA Today.

Every patient’s worst nightmare is going to the hospital for a procedure only to have a surgical instrument left in his body, the wrong limb or organ operated on or, worse, dying from a medical mistake. These types of mistakes should never happen.

So when Medicare recently instituted a plan to deny hospital payments for …

Op-ed: Medicare’s mistake

Op-ed: Ease ER overload

December 3, 2008Dec 3, 20082

The following op-ed was published on December 3rd, 2008 in the USA Today. Emblematic of soaring health care costs, which are projected to reach $3 trillion by 2011,is the nationwide crisis of emergency department overcrowding. More than $18 billion is…

The following op-ed was published on December 3rd, 2008 in the USA Today.

Emblematic of soaring health care costs, which are projected to reach $3 trillion by 2011,is the nationwide crisis of emergency department overcrowding. More than $18 billion is wasted annually on unnecessary visits to the ER,with volume rising by 32% and wait times almost doubling to one hour during the past decade. Relieving this strain …

Op-ed: Ease ER overload

Op-ed: Why doctors still balk at electronic medical records

October 1, 2008Oct 1, 20084

The following op-ed was published on October 1st, 2008 in the USA Today. Despite the fact that we can complete our taxes and perform complex financial transactions digitally over the Internet, medical records have faced an impasse preventing a transition…

The following op-ed was published on October 1st, 2008 in the USA Today.

Despite the fact that we can complete our taxes and perform complex financial transactions digitally over the Internet, medical records have faced an impasse preventing a transition to the digital age. Patient charts are still paper-based in most doctors’ offices across the country.

President Bush’s goal was for every American to have an electronic medical …

Op-ed: Wasted medical dollars

September 28, 2008Sep 28, 200811

The following op-ed was published on April 23rd, 2008 in the USA Today. A recent analysis by PricewaterhouseCoopers concluded that more than half the dollars in our $2.2 trillion health care system are wasted. Medical errors, inefficient use of information…

The following op-ed was published on April 23rd, 2008 in the USA Today.

A recent analysis by PricewaterhouseCoopers concluded that more than half the dollars in our $2.2 trillion health care system are wasted.

Medical errors, inefficient use of information technology and poorly managed chronic diseases were all cited as factors. Dwarfing these reasons is a phenomenon in which doctors order tests to avoid the threat of a …

Op-ed: Wasted medical dollars

Op-ed: Doctors’ pay cuts save little in health costs

August 22, 2008Aug 22, 200823

The following op-ed was published on August 22nd, 2008 in the USA Today. "Why should I care if doctors get a pay cut?" my patient recently asked me. Therein lies the delicate dilemma physicians face today. While the common perception…

The following op-ed was published on August 22nd, 2008 in the USA Today.

“Why should I care if doctors get a pay cut?” my patient recently asked me.

Therein lies the delicate dilemma physicians face today. While the common perception is that the medical profession is well-compensated, there are serious implications in targeting physician pay to control medical spending.

Congress recently passed a bill protecting doctors from a 10.6% …

Op-ed: What we have in health care today is a failure to communicate

June 23, 2008Jun 23, 20087

The following op-ed was published on May 4th, 2008 in the Nashua Telegraph. Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure. Patients are rushed through office…

The following op-ed was published on May 4th, 2008 in the Nashua Telegraph.

Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure.

Patients are rushed through office visits and often leave without having their questions answered. Labyrinthine barriers have to be overcome before speaking with a physician. Reaching a medical provider via the …

Op-ed: Shortage of primary care threatens health care system

June 20, 2008Jun 20, 200815

The following op-ed was published on March 13th, 2008 in the USA Today. Crippling health care bills, long emergency room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face…

The following op-ed was published on March 13th, 2008 in the USA Today.

Crippling health care bills, long emergency room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face daily.

Surveys suggest that health care is a top domestic priority in the presidential election, and there is no lack of ideas on how to fix our system. …

Doctors are not gods: a surgeon on empathy with patients

Sid Schwab, MD

June 15, 2008Jun 15, 20088

There's an old joke about a guy waiting in line at the Pearly Gates, slowly working his way forward to sign in with St. Peter. Wearing a white coat, carrying a black bag and with a stethoscope slung around his…

There’s an old joke about a guy waiting in line at the Pearly Gates, slowly working his way forward to sign in with St. Peter. Wearing a white coat, carrying a black bag and with a stethoscope slung around his neck, a man walks past those in line and is waved right into Heaven. “Hey, what’s up with that?” asks the guy in line. “How come that person gets to …

Humor in medicine: why laughter helps patients open up

Rob Lamberts, MD

April 25, 2008Apr 25, 20088

The following is a reader take by Dr. Rob.I don't remember why he came to see me on that day. He was anxious on most of his office visits, so I had to spend most of my time dealing with…

The following is a reader take by Dr. Rob.

I don’t remember why he came to see me on that day. He was anxious on most of his office visits, so I had to spend most of my time dealing with his surplus of symptoms. As I walked in to see him on this day, he started rapidly hitting two fingers of against the top …

Op-ed: Cut Medicare payments for doctors, you’ll have fewer doctors