If you have read Michael Lewis’ book, The Blind Side, or seen the popular movie based on it, you know that the title refers to the fact that quarterbacks, who are typically right-handed, can’t see when a 300-pound opponent is charging at them from the left side. Not being able to see the full picture puts the quarterback directly in harm’s way and makes it harder for his team to ...
December 2011
All Stories
The skinny on obesity
There is a fire burning in America over an issue that at times seems hotter to me than the anger against Wall Street: obesity. Time after time when I talk about taking responsibility for our individual health by eating well, maintaining a healthy weight, and exercising more, someone responds in anger.Many would consider me to be a wellness evangelist. They would be right. For nearly a decade I was sick ...
Doctor, Google thyself
Have you ever Googled yourself or your practice? Did you know that you have an ever growing online reputation? Whether you know it or not, doctors have an online presence. When you type your name in a search engine you may be surprised by what you find. Everything you do professionally creates a digital footprint. If you are involved in social media then you are contributing to your online reputation. ...
The difference between a child psychologist and child psychiatrist
What exactly is the difference between a child psychologist and child psychiatrist? The two terms are frequently mistakenly interchanged, but the requirements for the two are considerably different.To become a child psychologist, many programs require that you get an undergraduate degree in psychology, although some graduate programs will only require that you take the prerequisite sciences courses (biology, physical and social sciences, statistics, mathematics, etc.) before applying for the graduate ...
What physicians can learn from the Penn State scandal
The investigations about the Penn State sex abuse scandal are still unfolding. Revealing the truth is up to justicia now. Meanwhile we can learn an important lesson about professionalism.It seems to me as if a few very powerful people put the Penn State brand above children and covered up the raping of young boys within the Penn State facilities. I assume that several people at the top of the Penn ...
How to ease the pain of isolation during the holidays
It’s that time of year. The media is filled with stories about people traveling to be with loved-ones. Holiday decorations and yummy recipes abound. But for many people, the holidays are a difficult time of year. This piece is for those of you who face isolation during the holidays, either because you’re unable to be with others at all due to health or financial limitations (which often go hand in ...
Care about people as people, not just as hosts of disease
I never thought I would call cancer "cool."It was the last day of anatomy lab. Finally, we had dissected through everything: starting with the back, moving through arms and legs, hands and feet, chest cavity with lungs and heart, abdominal cavity with gastrointestinal organs, pelvis, and ending with head and neck.Looking at our cadaver was disorienting. There were insides where outsides should be. Organs completely removed. The head literally sawed ...
Primary care doctors are set to lose more than half of their salary
Fortunately, the 27% reduction in Medicare payments to physicians that is set to take place in a matter of weeks unless congress acts is getting some press. Fox News published a piece recently, as did the Washington Post. Writer Merrill Goozner breaks things down nicely in his article, "Is There a Doctor Fix in the House ... and Senate?"However, one thing that seems to be getting confused in all ...
Length of stay differences in the uninsured is less than you think
There was a bit of excitement on Twitter recently with a number of tweets about a paper published in the Annals of Family Medicine which shows that uninsured patients are being released from hospitals significantly sooner than insured patients. The numbers don’t lie.From the abstract: "Across all hospital types, the mean length of stay … was significantly shorter for individuals without insurance (2.77 days) than for those with either private ...
Technological advances can solve our current healthcare crisis
It can’t be ignored that dramatic transformation in our healthcare system is imminent. The economy, market forces and increasing political demands will soon force physicians and healthcare professionals to change how we take care of our patients. Just as the days of housecalls are gone, so is our current system of delivering care.The rising cost of healthcare now has the government and insurance companies placing more emphasis on controlling costs, ...
Good doctor qualities for your aging parent
As we get older, having a good doctor in our corner becomes incredibly important.And you don’t want just any doctor for your parent. Smarts, signs of basic compassion and a few other things are essential for the relationship to work.Good doctor quality #1: Listening skillsPicture it: Your Mom’s doctor’s office. 10am Tuesday. She reaches into her pocket for her list of three concerning symptoms she plans to mention, if she can ...
What do you say to a person who has cancer?
Well-meaning but clueless person: "Let me know if you need anything." Snarky me: "Really? Thanks! Empty your purse and let's see what you have in there. Wait, is that purse Prada? I need that, I have medical bills to pay and want to look good paying them. Oh, that's a pretty wedding ring, lots of diamonds, can I have that too?"What you should say is absolutely nothing. This is a time ...
Let’s close the chapter on statin safety
There was important news recently on statin drugs. As one of the world’s most effective and commonly used medications, statins provide great writing topics. Lots of people have high cholesterol–including cyclists. Lots of people are interested in avoiding our mostly deadly disease.I’d like to tell you about a recently-published landmark study in the Lancet that should quell safety concerns over statin drugs.The punch line after I tell you the study’s ...
Find a physician, not a general
"Superior doctors prevent the disease. Mediocre doctors treat the disease before evident. Inferior doctors treat the full-blown disease." -Huang Dee Nai-Chan 2600 BC; 1st Chinese Medical Text.Not only does my work in integrative medicine have me on the front lines of big pharma-created "syndromes", like chronic fatigue, fibromyalgia and irritable bowel (these are real for patients, but are not formal syndromes), but I get to see the worst of our sickcare system. I ...
Young doctors don’t see value in primary care careers
In my new role as one of the directors of an internal medicine training program, I help select new interns out of medical school for the three year training stint of residency.At the end of residency, many graduates go on to subspecialty fellowships, another two to four year period of intensive training in fields like cardiology, nephrology, critical care etc.For those that don’t choose a subspecialty, one choice remains: traditional ...
Are doctors given more responsibility than they can handle?
Doctors inevitably come into spotlight, being at the front end of health care delivery. Sometimes seen as guardian angels restoring health and life, other times, greedy minds sucking resources while they carelessly harm and kill patients to fill their wallets. After experiencing, observing, and hearing from others like me, I wonder if doctors are given more responsibility than they can handle, often attributed more aura than they deserve and frequently ...
Government and insurance companies should have little say in death
My colleagues who advocate improvement to our healthcare often say, “It’s a non-issue. We all benefit from better care.” Yet the political vehicle that’s to drive the reform has stirred emotions and controversy at almost every turn, leaving us baffled. Why wouldn’t anyone want better coverage, lower cost, and more evidence-based treatments? These targeted goals improve healthcare, which is why they poll well. When asked for a general impression of the ...
Is there truth to the unintended consequences of hospitalists?
When I first learned that the U.S. was going to develop a new specialty, the hospitalist, I was very pleased.I had long believed from study and direct observation that some of the better healthcare systems in Europe were benefited in a major way by the general separation of office and hospital medical practices and practitioners.In the U.S., historically most patients have been taken care of by physicians practicing medicine in ...
The honor of patient responsibility
"So the patient has been temporarily paralyzed by the drugs, and you're the one keeping them alive by squeezing air into their lungs, but ... no pressure".Gulp.I was holding the mask as tightly against her face as I could, sealing the rubber to her cheeks in the effort to keep highly oxygenated air from leaking out. Looking down at her from the head of the bed I saw the patient from ...
When is it time to break up with your doctor?
"When is it time to break up with your doctor? It can be a tough decision to make. After all, if you don't like your experience at a store, you shop somewhere else next time. If you go for a haircut and hate it, you find someone else.With your doctor, it's a bit different. This is someone who might know some of your deepest, darkest secrets. There is a history ...
Kevin Pho, MD
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
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Doctors: Don’t be ashamed about going bankrupt
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
Physician
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Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
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Diagnosing an illness is an art
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
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Physicians have a natural role as advocates
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
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Our society expends huge sums on futile care
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
Patient
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How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
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Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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Why do doctors delay hospice referrals?
This is a response to Deb Discenza's article requesting a one page informational sheet informing a patient about hospice or palliative care. This would...
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How touch can calm patients
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
Policy
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A lack of incentive for medical schools to train primary care doctors
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
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What should be the stated aim of health care in America?
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
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How Moneyball applies to healthcare
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
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The problem of insurance gaps in cancer patients
Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and...
Tech
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Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
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Why the prognosis of patients is difficult
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
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Innovative technologies can markedly enhance safety
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
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Google knows more about certain diseases than physicians ever will
Professor Gunter Dueck, is a calm and eloquent german mathematician who’s also the CTO of IBM Germany. He studied mathematics and philosophy...
Social Media
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
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Twitter Is my third office location
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
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The impact of social media on a physician assistant
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
