A few months ago, the father of one of my best friends was diagnosed with cancer. He had to have surgery to remove the tumor. His father, being someone I’d known since childhood was like an uncle to me. After the surgery, I sat across from him in an otherwise empty hospital room on a sunny day in beautiful San Diego. It ...
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People can wear what they want in America. Whether you want to debut the latest vogue or your midriff rife with adiposity, you are free to do so. But just because you can, doesn’t mean you should. In the span of one week, I found two people -- on two separate occasions -- wearing white coats, each ...
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When report cards of performance became available, cardiac surgeons in New York and Pennsylvania avoided high risk patients. Could something similar happen, nationally, after the forthcoming revolution in transparency inspired by ProPublica’s data release?
Take two fictional orthopedic surgeons, Cherry Picker, MD and Morbidity Hunter, MD.
Cherry Picker lives in the Upper East Side of New York. His patients give ...
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The drug test came back abnormal. There was THC present. I walked back to Mrs. Johnson and raised my eyebrows.
"What's wrong?" she asked, not used to whatever kind of look I was giving her.
"Uh, you forgot to mention to me that you smoke weed."
She blushed and then smirked. "Well, yes, I guess I forgot to put that down on the sheet. I don't ...
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1. Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse.
Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to ...
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Years ago, I owned a lawn service. I ran the company.
Actually, I was the company. The only worker. Then, a buddy of mine joined up. It became our summer gig for many years.
We prided ourselves on quality. We were good at what we did. And, we were fast, too.
Jump ahead a few years. OK, more than a few.
I now work in ...
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With much hype and fanfare, the independent investigative journalism outfit, ProPublica recently released their Surgeon Scorecard, assessing individual specialist surgeons who perform elective knee and hip replacements, spinal surgery, prostate surgery, and gallbladder removal surgery.
I had blogged about the impending release. My trepidation about the idea of a non-medical, non-scientific organization analyzing complex surgical data concerned issues such as ...
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Part of a series.
I put down my blogging pen last fall to focus on two things. One was completing a new book: Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor. The second was preparing to move to a retirement community.
We live in a pleasant neighborhood with nice ...
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Before I was a doctor, I was a dad. My oldest daughter was two years old when I started medical school, so I did a little bit of parenting without the benefit of any medical knowledge at all. I remember her 2-month visit well. It was one of the few visits that I was able to make, and my baby girl ...
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One of the ghosts in every exam room is the institution that pays many private doctors over ten million dollars, the authority that determines that you can order a BNP (brain natriuretic peptide) to look for heart failure in patients with shortness of breath but not when they have leg edema. You know who I’m talking about: Medicare.
Medicare is not only ...
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As I have said before, when done correctly, doctoring is an act of love.
It is founded on the most basic of human interactions, intimacy. Patients open their doors and closets revealing a treasure trove of brutal humanity. Physicians dedicate themselves to healing, to upholding a sacred covenant born of tears and blood. It is a partnership, a carefully rehearsed ...
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Consider, for a moment, that you are a new physician. A patient, who is a lifelong smoker, comes to your clinic complaining of shortness of breath, and after conducting several tests you diagnose him with chronic obstructive pulmonary disease (COPD). Relying on your training, you prescribe medications, arrange for follow-up visits and describe activities that can help him better manage his breathing ...
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Natural language processing might seem a bit arcane and technical -- the type of thing that software engineers talk about deep into the night, but of limited usefulness for practicing docs and their patients.
Yet software that can “read” physicians’ and nurses’ notes may prove to be one of the seminal breakthroughs in digital medicine. Exhibit A, from the world of medical ...
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The long-awaited Finnish randomized controlled trial of antibiotics vs. surgery for appendicitis was just published in JAMA. Depending on your perspective, 73 percent of patients were successfully treated with antibiotics or 27 percent of patients failed antibiotics and needed surgery.
The good news is that it was a large multicenter study involving 273 patients randomized to surgery and 257 to ...
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I love that patients have so many more tools to learn about their health. Between Google, TV, magazines and the thousand-word warning that comes with every prescription, it’s almost like you don’t need a doctor. This is especially true if you do the two most important things for your health: eat less and exercise more.
Except it’s not really that simple. There’s a reason it takes at least seven years to ...
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Recently, I wrote a piece on developing the state of connection within a medical family. In it, I highlighted the fact that everyone has a role in growing this connection and that everyone’s time, energy and effort is important. I also touched on the importance of parents presenting a unified front as the parental team. This piece focuses more specifically on developing that unified team approach.
It can be ...
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Anti-Obamacare critics often claim that “every” physician they know hates Obamacare. For instance, pediatric neurosurgeon and GOP Presidential candidate Dr. Ben Carson told Fox News that “he's spoken to hundreds of doctors throughout the country about the Affordable Care Act, and not one of them ‘liked’ President Barack Obama's signature health care law.”
Doctors hate Obamacare, it’s alleged, because it ...
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In the news recently has been a complaint filed by over 60 Asian-American groups, alleging discrimination in admissions at Harvard. They point to such statistics as this: in 2009, among accepted applicants to the Ivy League, the average SAT score on a 1600 point scale for Caucasians was 310 points higher than Hispanics ...
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As I previously documented in a series of posts, the road to the U.S. Preventive Service Task Force's 2012 "don't do it" recommendation on PSA-based screening for prostate cancer was long, arduous, and full of political pitfalls. It led to me leaving my position at the Agency for Healthcare Research and Quality. Later, the USPSTF ...
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Past 6 Months
A patient secretly records his colonoscopy. It cost this doctor her job.
Admin | VideoDoctor’s death an “inconvenience” for patients
Pamela Wible, MD | PhysicianHealth care or abuse: Which are you receiving?
Pamela Wible, MD | PhysicianA patient is angry with her emergency care bill. But here’s what she really got.
WhiteCoat, MD | PhysicianHeart-wrenching photo of a doctor crying goes viral. Here’s why.
Pamela Wible, MD | PhysicianCan doctors afford to ignore the changes in medical practice?
Tommy Prewitt, MD | Policy