Home health care is in many ways a fantastic service, especially for those Medicare beneficiaries who are essentially homebound due to frailty or illness. But it often feels surprisingly hard to synergize with home health care. The main problem, as I see it, is that home health care agencies have set themselves up to provide only administratively required communication with the ordering doc. (There are rules governing home health care, you know!) Now, ...

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A woman delivered a baby boy at 30 weeks’ gestation at a Boston hospital.  After birth, the infant required a ventilator for 3 days.  The family visited every day, traveling over 45 miles each way, for the first 2 weeks of their baby’s life.  After her husband went back to work, the mother  visited infrequently because she relied on friends and family members to transport her to the hospital as ...

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As I sit home spending Christmas with my family this year, I look back on the past few years of my practicing medicine and realize how much of a luxury this is. While most jobs allow employees time off for particular holidays, health care is a profession where we are called on numerous occasions to sacrifice our time in order to care for others. Frequent are the calls we make ...

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shutterstock_208236568 I tried to order an echocardiogram yesterday at work.  But it turns out, they only do them on Monday, Wednesday and Friday.  Fair enough.  It’s not an unknown phenomenon.  Some places, surgeons are only available on Tuesdays and Thursdays, cardiologists on the second Wednesday of months with an R. After hours, most hospitals now struggle to have ultrasound at all, unless, of ...

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shutterstock_152411498 Dr. Mehmet Oz, also known by many as America’s doctor, is a very influential face within American medicine.  An accomplished cardiac surgeon and Columbia University faculty member, Dr. Oz has impressive academic credentials. However, in the last year, Dr. Oz has received significant criticism for claims he has made about nontraditional medical treatments on his nationally syndicated television show where he has ...

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In the United States, we train health care providers on poor people. This is no secret -- most medical schools and residencies are in lower income areas. If you have Medicaid or no insurance, you are more likely to find care in an office or hospital where medical students, residents, nursing students, and other trainees rotate; Blue Cross patients don’t let interns watch their childbirth. Even though my residency emphasized ...

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shutterstock_213079828 Question: We are currently in the last year of med school, and I’m wondering; what are some practical, everyday things we can do to keep our marriage strong? Especially with intern year coming up. Answer: Don’t confuse character with situation. When the demands of life become overwhelming, it is easy to attack your spouse’s personality when in reality it is the situation you are angry ...

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I was on call over a holiday weekend and Friday night at 10 o'clock I was paged by the emergency department about a nosebleed. A man in his 30s had a bloody nose Friday morning and over the course of the day had developed red spots all over his legs. The ED checked his blood and his platelet count was near zero. Blood looks red because of the oxygen-carrying red blood cells, ...

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The enormous push continues to reduce readmissions, due in no small part to stiff financial penalties from CMS for the worst performing hospitals. The most commonly cited statistic is that about 1 in 5, or 20 percent, of Medicare patients are readmitted within 30 days. A staggeringly high number when you think about it. Having discharged thousands of patients and seen the characteristics of those patients that are frequently readmitted ...

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A few years ago, the United States Navy launched a new recruiting and marketing campaign using the slogan: “America’s Navy: A global force for good.” The line was apparently a flop, and the Navy threw it overboard for “protecting America the world over,” but I liked it. I thought it captured a deep truth about the Navy, which is that it is undoubtedly a global force and that the force exists for ...

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