When my husband and I stopped watching television a few months after we were married, we often didn’t notice what had changed until we’d compare notes with friends. “I miss my old hobby,” a neighbor might complain, “but I just don’t have the time.” And yet we’d see his head just above the back of the couch, silhouetted against his big screen TV for hours. Not only did we regain …
How to create more primary care role models
In the past half century or so, medicine has changed the complexity of the human population as it has never been seen in the past. Think about it, there are people walking around today that fifty years ago, wouldn’t even be alive. This evolution in medicine has not only brought about transformation in the human population, but it is also changing the approach of how clinicians need to treat these complex …
Patients have changed. How do we manage them?
If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. …
Physicians must unionize. Here’s why.
Perhaps doctors should be more like the president.
After all, we also carry the ultimate responsibility for our constituents, even though we, too, have team members who do part of that work.
The way I understand things to work at the White House, those other team members collect, review and prioritize the information the president needs in order to manage his, and all …
What if the president worked like doctors today?
If you delve into the personal stories of health IT innovators, most journeys rest on their personal interaction with the health care system on behalf of themselves, a parent, a child, or perhaps a sibling. Just a few weeks ago, I had a small interaction with the health care system that confirmed many of the impressions I have developed of providers’ strengths and weaknesses.
There’s no way to start except with …
How health IT fails transgender patients
As we welcome another year, many of us make resolutions to live a better life, usually one that is healthier than the year before. As I planned my own resolutions for 2015, I was reminded of a talk given by my rabbi, David Ingber of Romemu. His sermon centered on the Torah portion about the importance of “the Shemittah” or the sabbatical year, noting how we as a society should be observing the “five Rs” …
What my rabbi taught me about being a healthier, happier physician
An excerpt from The Communication Panacea: Pediatrics and General Semantics.
If one pays attention to the language used in the context of all of these developments, it is clear we have moved into an entirely new semantic environment. Just as in the civic realm the word “citizen” has almost entirely been …
Semantics and the subversive doctor
Can primary care survive? At a time when the services of a well trained, well-supported primary care physician are needed more than ever before to help patients negotiate through the confusing health care maze, the specialty is under siege.
We are overwhelmed. Those of us in primary care are overwhelmed by the growing weight of medical, legal, financial, and clerical responsibilities placed on our shoulders. The quality of care we can …
Primary care is broken: Here are ways to fix it
The truth is, I know it’s easy to go to the Minute Clinic. I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment. Who doesn’t like convenience and a friendly smile to add? Who doesn’t like the customer service offered …
Retail clinics sound good. But if you need follow-up care, good luck.
“What do you want for dinner?” I asked my wife.
“I don’t know,” she answered. “What do you want?”
“How about hamburgers?”
“No, I don’t want hamburgers.”
“What do you want then?”
“I don’t know … pasta.”
“I’m a little sick of pasta,” I said. “How about pizza?”
“I’m really in the mood for pasta.”
Silence. Then: “OK, pasta.”
I’ve observed, both among my patients and my friends, that the issues which ultimately threaten to dismantle romantic …
The art of compromising is the key to a healthy relationship
One of my patients got admitted this past week. As a new attending, this is still an unpleasant experience. Have I failed? Is there more I could have done to prevent this? I have to say that this particular case wasn’t shocking. The patient hadn’t been doing well lately, and I wasn’t surprised when I got the message that they were on the way to the emergency room.
Due to our …
Primary care is a story of misaligned incentives
On a 12-hour shift in the hospital, I recently spent a mere hour with patients, with the rest glued to a computer screen, to the “iPatient.” When a patient comes to the hospital, speaking to them has become an afterthought to reading extensive medical records, physical exam findings from the emergency room, and synthesizing laboratory data. I, as a millennial doctor, have been on the cusp of this shift. My …
Do electronic records change the way doctors think?
Our current health care system will fail; it’s simply a matter of time. Yet the delivery of efficient, quality, and progressive health care is quite possible once we shift our thinking. A true paradigm shift in medicine begins with first establishing that each pillar in health care has an equal responsibility in making a new system work: patients, providers, and places (facilities).
This article pertains to only the provider portion.
As …
Improve the inequalities among physicians
ADVERTISEMENT
Is it medically professional for a non-profit organization to use physician testing fees to “choose wisely” a $2.3 million luxury condominium complete with a chauffeur-driven BMW 7-series town car? In my view, obviously not. To most people, such an action would conjure up images of hypocrisy, waste, and corruption.
After a review of public and tax records, it appears to me this is exactly what has happened.
Background
In 1999 for reasons that …
A physician investigates the American Board of Internal Medicine
She is a time traveler. She spends an hour with each patient, takes note of each symptom, listens to each emotional concern, takes every call from every worried patient, handles all emergency situations, fills every prescription, handles each every insurance concern, breaks bad news gently, does her hospital rounds, yet is never late to see those in the waiting room.
She treats …
Perfect Patient™, Meet Perfect Physician™
“Good afternoon officer, is there something wrong?”
I was a second-year medical resident on the way to my father’s birthday dinner. It had been a very long week and I was dressed casually in a T-shirt, shorts, and sneakers. Finally, I could kick back and be “normal” for a day. At least that’s what I had thought prior to being pulled over.
I had previously experienced the occasional purse clutching woman, a few …
Is the medical profession immune to prejudice?
He was known to the hospital as someone who would try to manipulate his caregivers. And I fell for it anyway.
Frequently admitted for pain crises associated with a chronic illness, he spent most of his hospital course avoiding eye contact with the team. So, too, were avoided answers that involved more than a few words. Providing care for him was business-like; we knew better than to expect pleasantries.
The day of …
Breaking the vicious cycles in medicine
As I sit home spending Christmas with my family this year, I look back on the past few years of my practicing medicine and realize how much of a luxury this is. While most jobs allow employees time off for particular holidays, health care is a profession where we are called on numerous occasions to sacrifice our time in order to care for others. Frequent are the calls we make …
Both patients and doctors are at the whim of uncontrolled time
It is a heart pounding, head spinning, edge of your seat page-turner; the sort of rare saga that takes your breath away as it changes you, forever. It hints at a radically different future, a completely new world a few years away, which will disrupt the lives of every man, woman, and child. Available now, from the National Coordinator for Health Information Technology (ONC), Office of the Secretary, United States …
Health IT will radically transform medicine. Is it for the better?
Dr. Mehmet Oz, also known by many as America’s doctor, is a very influential face within American medicine. An accomplished cardiac surgeon and Columbia University faculty member, Dr. Oz has impressive academic credentials.
However, in the last year, Dr. Oz has received significant criticism for claims he has made about nontraditional medical treatments on his nationally syndicated television show where he has …
Surprise! Dr. Oz’s recommendations are not supported by evidence
Get free updates delivered free to your inbox.
