There's no question that health reform needs to rebuild around primary care medicine.
Doctors give their own suggestions, including aligning generalist salaries comparable to how the UK pays GPs in their nationalized health system, which is approximately "$230,000 a year plus 25% performance bonuses."
Some other more aggressive tactics involve forming a physician union, or joining the Service Employment International Union (SEIU). One doctor has initiated ...
January 2009
All Stories
Jett Travolta’s seizure and death, was Scientology a factor?
Jett Travolta tragically passed away yesterday, after being found unconscious in his hotel room by his caretaker. There is speculation that he had a seizure and hit his head on a bathtub.
Travolta apparently had a long history of medical problems, including Kawasaki disease, which is a vasculitis that primarily affects children. It is one of the most common causes of acquired heart disease in children, and ...
What should a doctor do when he discovers another doctor’s mistake?
An interesting question.
Amy Tuteur asks this question at a dinner party, and it elicits a whole host of responses. If a patient asks directly, the answer is easy. But what if the patient doesn't ask? Is there an ethical requirement to disclose another physician's error?
My first reaction, along with Dr. Tuteur's, would be full disclosure, meaning that the patient should know everything ...
Local television news may be using pre-packaged health stories
Budget cutbacks are forcing some local television stations to use canned health segments that can be tailored to a specific local market.
The result can give "viewers the false impression that the stories were locally produced and the patients and doctors quoted in the stories could be their neighbors," and one nationally syndicated physician is ...
The economy, plastic surgery, and how it’s affecting cash only medicine
It's no secret that difficult economic times have forced many patients to put off cosmetic surgery.
No where is that more apparent than in South Korea, the Asian "mecca" of plastic surgery. Thirty percent of Korean women had cosmetic procedures done last year, and now, scores of luxury clinics either are empty or have gone out of business.
Doctors are always drawn to cosmetic procedures, since ...
How old is too old to continue breast feeding?
A woman continues to breast feed her 6-year old son.
Many find that shocking, but when you consider that "the average age of weaning around the world is 4 years old and there are no studies saying it is harmful," is it really?
While psychologists wonder whether it will impede the ability to "develop the capacity to soothe oneself, the capacity to tolerate frustration," mothers claim a ...
Is health care prohibition in our future?
One scenario envisioned by health reformists is to prohibit doctors from practicing outside a government-run system.
This is the situation in Canada, leading to single-tier health care. Opting out of Medicare and other health insurers remains the last trump card doctors have in negotiations. Removing that option would enslave physicians to the whims of government control. Most health policy wonks would like nothing more than to ...
Are doctors finding the physical exam useless and obsolete?
Many are bemoaning the deterioration of physical exam skills that the current generation of doctors are displaying.
Bob Wachter says it may not be that big a deal. "Even if we could create a new generation of expert physical examiners," he writes, "would it be worth the time and trouble?" He doubts it, saying the time spent to learn and perform a comprehensive physical has to be ...
Health journalists need to be held to a higher standard
I have been critical in the past with the health reporting in some major media publications.
The NEJM has a nice perspective piece (via Gary Schwitzer) on the issue from Susan Dentzer, editor-in-chief of Health Affairs. In today's 24/7 news cycle, health stories provide ample opportunities for "gotcha" headlines. Nothing captures the public's attention like reporting a drug scare, a botched ...
How the general surgeon shortage affects patients
General surgeons are the primary care doctors of proceduralists.
As the current generation of physicians are placing a priority on controlled hours and emphasis on lifestyle, general surgery is taking a hit.
Medical students are gravitating towards specialties like dermatology or radiology, with comparable incomes but less grueling hours, and young surgeons are specializing "in fields such as transplant surgery or plastic surgery, in which they can ...
What’s good about our health care system?
Whenever you read magazines or watch TV, the news on our health care system is never good.
Val Jones convenes a community group to talk health reform, and refreshingly, talks about the positives in our health system.
Some cited examples of what's right include customer service, accommodations for persons with disabilities, access to specialty care, and drug development for rare diseases.
Our health care system certainly ...
Why doctors are reluctant to adopt electronic records
Most of the rewards go to the insurance companies instead of benefiting the physician.
This piece by David Hamilton doesn't break any new ground, and I cited a statistic earlier this year that doctors only realize about 11 percent of each dollar saved with EMRs.
Nonetheless, it's a good overview of the obstacles facing every doctor who's on the fence about going electronic. Office costs in ...
Who loses the most with the drug company gift ban?
The makers and distributors of the promotional products of course.
It's a $19 billion industry, and the ban is going to set these companies back at least $1 billion. Pen makers for instance, often receive orders in excess of one million pens per drug.
Kevin Pho, MD
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Why Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
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Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
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When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
Physician
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Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
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Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
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How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
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His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
Patient
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How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
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What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
Policy
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What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
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Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Tech
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When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
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Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
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The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
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EMR liability needs to go further than just the physician
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
