I recently read the New York Times article on the ridiculous amount that insurance company executives and hospital administrators make. So the reason that American health care is so expensive is not because doctors earn too much, or drug companies charge too much or device manufacturers are making ever more expensive devices with ever expanded indications. Except that it is all of that and more. Hospital administrators and insurance company executives do ...

Read more...

I’ve worked at a few VA medical centers, including four years at the Phoenix VA. I’d like to report something missed in the media storm. Before spilling secrets, though, I’ll dispense with the non-secrets. Everyone who has entered a VA hospital knows: 1. The system is overwhelmed. While we might have planned for the increasing needs of aging Vietnam-era vets, I doubt anyone predicted two long wars or the number of ...

Read more...

The very basic definition of a hospital is a place of healing and recovery. Health care is in a tumultuous state of flux at the moment, with the universal drive for quality improvement and the need to reign in costs. These issues, along with the desire to enhance our patients’ satisfaction and overall health care experience, were barely even talked about a decade ago. Now, they are all the buzz ...

Read more...

Recently, I began to think of death as a friend. My grandfather was hospitalized on Mother’s Day, and by the time my parents called me on Monday morning they couldn’t tell me anything more than, “He’s in the ICU with multiple seizures. They’re taking him off ventilation tomorrow.” Reaching for the knowledge I’ve spent all year chipping away at textbooks to acquire, I asked about neurologic exams, autonomic drugs and ...

Read more...

Dr. Arlen Myers, president of the Society of Physician Entrepreneurs, can give you ten good reasons why doctors make great entrepreneurs.  However, in my many years of working with physicians, I have learned when it comes to a business idea, doctors, like most new entrepreneurs, often need help getting the nuances wrestled to the ground. For example, I remember the conversation with an ED medical director about the importance of using “ER” ...

Read more...

Walter White and the narrow networks of Obamacare As we behold the continued wonders of Obamacare, we receive another reminder of the president’s empty promise: “If you like your doctor, you can keep your doctor.”  The New York Times observed, “No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network -- or pay much more for the privilege of going to any provider ...

Read more...

Every player in the medical arena has found itself challenged by conflicts where one’s self-interest competes can skew what should be pure advice.   This issue is not restricted to the medical universe.  Every one of us has to navigate through similar circumstances throughout the journey of life.  If an attorney, for example, is paid by the hour, then there is an incentive for the legal task to take longer than ...

Read more...

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.  He's a gifted storyteller, with many of his articles regularly featured here.  In this dotMED 2013 presentation, Jordan shares powerful stories from medical training that define him as the physician he is today.

For the past couple of years I’ve been working as a traveling physician in 13 states across the U.S. I chose to adopt the locum tenens lifestyle because I enjoy the challenge of working with diverse teams of peers and patient populations. I believe that this kind of work makes me a better doctor, as I am exposed to the widest possible array of technology, specialist experience, and diagnostic ...

Read more...

The doughnut shop I pass on my drive to the hospital isn't the kind of place where you might expect to see outpourings of random kindness. It sits in the shadow of a raised highway, a few doors down from a bail bond business and a block away from a prison complex that resembles a medieval castle. One Sunday before Valentine’s Day, the line to get served there was long, checkered ...

Read more...