As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We do have superb medical schools, very well trained providers, superb science and technology but the delivery of medical care is just not what it should be. We spend more for healthcare than any other country does on a per capita basis.And yet when we compare ourselves to other ...
There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers. I have discussed in other articles why patients deserve their data and the benefits derived thereof. There are no substantive arguments against this practice, and I always thought, throughout my 12 years of remotely monitoring patients with these devices, that they not only were entitled to the ...
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over another, typically from a roughly similarly aged peer group. The bullying could be mild such as occasional name calling and having one’s books knocked down when walking in the hallway. This does not mean the effects of the bullying were mild but comparatively speaking, this is generally not ...
From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but the lure of the game has always remained. To my colleagues, it must seem that I can hardly understand the world without the comfort of baseball analogies. I was thrilled when my son Ryan, age 12, saw the ...
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are supposed to be the working partner and I’m supposed to be the consulting partner.My job as the consulting partner is to offer sagely medical advice to the boss (working partner). As a consultant, I’m supposed to help in the making of key decisions, find the appropriate tools to ...
There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place behind closed doors.Privately, they argued about the different approaches. One saw the world in terms of black and white, while the other was steeped in a foggy haze of gray. ...
I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't know the persons I am writing to, but part of their loved one is literally now a part of me.It began with a phone call from my brother. "Jim, what the hell is Fuchs' Dystrophy anyway - do you have it too?"I racked my brain and tried to ...
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand experience of the shortcomings in the healthcare industry, and we know that it’s going to take a concerted effort to upend the system. Those of us who are able to adapt and apply new technology solutions to existing problems will undoubtedly make positive changes.Barriers to entry into entrepreneurship ...
Here are some of the most common questions I encounter regarding vaccines and my answers. I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child.We give so many vaccines now and it seems like we are constantly adding more. Isn’t this too much for my child’s immune system? Isn’t it antigen overload? The immune system is very complex, ...
Peggy was in her early 70s and suffered from a terrible lung disease known as pulmonary hypertension. So bad in fact, that she had a pump infusing a medicine under her skin 24 hours a day to keep the blood supply to her lungs open. Once started, this medicine, treprostinil, was known to improve life in those with pulmonary hypertension. Unfortunately, like all continuous infusion medicines of this type, it ...
Are you a recovering alcoholic?Be honest.How about a recovering nicotine addict, or recovering from an addiction to some illegal drug, or maybe addiction to gambling, or sex, or football, or even your computer screen, or Angry Birds?I have worked in the addiction field most of my professional life. For me, addiction to a chemical includes physical and mental dependence, tolerance, withdrawal, and, of course, drug seeking behavior, despite recognized ...
Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently, breast cancer has certainly gotten a lot of play in the media as of late.Every major news outlet in America covered the breast cancer study released by JAMA which said that nearly half of the women who had second surgeries for breast cancer may not have needed the ...
It is said that "turn around is fair play."So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?If you look closely at "proxy measures" for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.Hello? Hello? ...
This series is brought to you by MedPage Today.1. Follow the Money: Pain, Policy, and Profit. The Federation of State Medical Boards, often develops guidelines that serve as the basis for model policies with the stated goal of improving medical practice -- but after its guideline for the use of opioids to treat chronic pain patients was adopted as a model policy, it asked ...
I was jogging one day while on a business trip in LA and collapsed during the run. Within hours, I was at the hospital at UCLA Medical Center on a gurney headed for a CT scan of my abdominal cavity. I remember telling the ER physicians that I was a doctor and recommending my own course of action. As my advice to the ER doctors went largely ignored, I realized, ...
The lack of evidence supporting the “economy class syndrome” myth in air travel made major news headlines recently. While certainly interesting and accurate, that topic was just one among many topics addressed in the larger framework of the new evidence-based guidelines.The American College of Chest Physicians (ACCP) released the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in its February issue ...
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be. But why? Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics. To explain the complex answer further, we need to ...
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 35-year-old woman is evaluated for a 6-month history of right upper quadrant abdominal pain that has slowly increased in intensity and is worse on deep inspiration. The patient is otherwise well, and her only medication is an oral contraceptive pill that she has taken ...
Would you consider a career as a singer if you had involuntary tics from Tourette Syndrome?Well, it apparently didn’t stop 20-year-old Contemporary Christian musician Jamie Grace.In fact, Grace attributes singing with helping her cope with her disease.And now she is being rewarded with a Grammy nomination for best contemporary Christian music song, Hold Me. The song features TobyMac, who is a Grammy winning Christian recording and hip/hop artist. He ...
"Twenty years ago, I helped save a man's life."So begins this New York Times essay by Peter Bach, MD, where he talks about the inadequacy of resource use at the end of life as a policy metric. Now, I am not very fond of policy metrics, as most of you know. So, imagine my surprise when I found myself disagreeing vehemently with Peter's argument. Well, to be fair, I did ...
Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country...
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but...
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are...
There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He...
I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't...
It is said that "turn around is fair play." So if providers (physicians, hospitals and other health care professionals) expect patients to...
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure...
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We...
Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently,...
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no...
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who...
There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers....
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over...
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand...
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost...
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question, though, is how are you...
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
