My take: MA and the Titanic, second opinions, airplane banter, cheap primary care

1) Boston Globe: “In Massachusetts, the coalition behind the health reform law is holding firm. The plan itself is creative and sound. Who dares call this a failure?”

My take: Sounds like the captain of the Titanic before the iceberg. More people may have health coverage, which in the Globe’s view is the only marker for success. Costs continue to spiral to unsustainable levels, and there is growing evidence that the newly insured cannot see a physician within a reasonable timeframe.

I guess the Globe likes to set the bar real low.

2) NY Times essay: “When I went for a second opinion, my internist got mad. As if I were his lover and had cheated on him.”

My take: I am an internist myself, and in difficult cases, I recommend all my patients obtain a second opinion. There are shades of gray when it comes to complex or controversial treatments. The days of the single, paternalistic doctor are gone, and it is up to the patient to be 100% comfortable with any medical or surgical plan being considered. This often includes seeking opinions elsewhere. If your doctor gets upset over this, perhaps it’s time to change physicians.

3) United Airlines’ pilots are wary of travelers listening to their banter with air traffic control.

My take: This is similar to the controversy about recording live births or surgeries. Like physicians in these situations, it is understandable that the pilots would feel uneasy. Especially when some of these recordings are showing up on YouTube.

4) WSJ: “Most Americans could afford a package that combined $20-per-month primary care, $4 generic pharmacy prescriptions and some catastrophic coverage.”

My take: Kudos to Ben Brewer – wonderful article. Primary care is cheap, provides most of the care you will ever need, and will help address the uninsured. It is a tragedy that it is not valued by the public and politicians alike. Giving the appropriate financial resources to primary care physicians will do significantly more than any of the bloated national health proposals that are currently circulated by the Presidential candidates.

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  • IVF-MD

    Picture this. While his wife is pushing out their first baby, the husband is filming everything with a video camera. If this is that one in a thousand cases that ends up with a very bad outcome, you are at a disadvantage. Anything on that tape which helps prove the doctor not culpable is in the hands of the patient’s lawyer and the truth will never be seen. Anything on that tape that makes the doctor look bad will certainly survive the final editing. Nowhere is this concept more evident than in journalism where sound bites are crafted for maximal effect even if they end up grossly distorting the entire message of the speaker. Frankly, it’s annoying when my medical school lectures are recorded. I have this nightmare that someday I run for political office and some comment I made during a talk will end up taken out of context and plastered over YouTube. Then I wake up and realize that I don’t ever intend to run for any office and I’m at peace again.

  • Anonymous

    I think its good practice to get a second opinion at the drop of the hat. I try to suggest it before my patients do for any case, where I feel they may be uneasy.

  • Anonymous

    Second opinions are gooood!

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