asco-logoOn April 15, 2013, my kids and I were in Stamford, CT, visiting with my sister, Precy, and her family. I had been reading when an email came up, stating a bomb had gone off at the Boston Marathon. I immediately turned to Twitter where #BostonMarathon had already started trending. There before me, gruesome details emerged, coupled with ...

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“Patient engagement.” What is patient engagement?  It sounds like a season of The Bachelor where a doctor dates hot patients.  It wouldn’t surprise me if it was. After all, patient engagement is hot; it’s the new buzz phrase for health wonks.  There was a even an entire day at the recent HIMSS conference dedicated to patient engagement.  I think the next season of The Bachelor should feature a wonk at HIMSS ...

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choose better er You get a terrible headache. What do you do next? Take ibuprofen and try to sleep it off? Call your primary care physician (PCP) for an appointment? Dial 911 for an ambulance to take you to the emergency department (ED)? What if that headache comes with a cough and shaking chills? Would an ad influence your decision? I came across this image ...

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"What's the most important finding on this chest x-ray?" There he was, standing before 5 ICU residents, each peering at a chest film on displayed on the over-sized computer screen. "Um, the pleural effusion?" whimpered a third-year resident. "No!" barked the attending. The others, standing dumbfounded in front of the computer display, searching for another finding but finding none, stood silently. "Come on, folks!  Look!" And try as they may, no one saw it. "The name, folks, ...

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It had all been so easy when Jim was still around.  Lisa's ex-husband had many shortcomings, but being a critical care specialist sure came in handy.  Any time her mom or dad had a health crisis, he was right there in the middle of it: advocating, interpreting, breaking down the complexities into easily digestible morsels of information.  But then Lisa's father died, and the emotional and physical stress brought the unstable union ...

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Since an iron lung costs quite a few dollars, the prevention of polio cannot make sense. Right? If that one has you scratching your head, with a "say what?" dangling from your lip, we are on the same page. Let's populate it accordingly. Of course prevention can save dollars. But that will only be the case when what we refer to as "prevention" really makes sense. Prevention ...

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New York City’s Health and Hospitals Corporation (HHC), which runs 11 hospitals in four of the five boroughs of New York, is negotiating a new deal with the union representing some 3,300 salaried physicians. The corporation wants to base MD pay raises on 13 quality indicators. The New York Times article that broke the story does not list all of the indicators but mentioned the following: how well patients ...

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The story of the surrogate offered $10,000 to have an abortion by the couple who were paying her to carry their pregnancy has been making the rounds. If you don’t know the details, let me catch you up

  • Woman hired to be a surrogate for the fee of $22,000
  • Couple who are paying have 3 children, but had a lot of pregnancy complications. Two children spend months in the hospital ...

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When the American College of Emergency Physicians (ACEP) decided not to join the Choosing Wisely campaign, I was among those who expressed disappointment with this decision, in part because I have long been a proponent of efforts to encourage more cost-effective care in the ED.   In fact I had already independently done a significant amount of work in the Read more...

This question was what drove me to graduate school for an MPH degree a few years ago.  I was finishing up my family medicine residency at, arguably, one of the top residency programs in the nation.  I had been well trained in both medical science and doctor-patient relationship skills.  Yet my patients still consistently did not adhere to my advice. I was not disappointed in my MPH studies.  It turns out ...

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