Who are the best judges of physician quality? In a new Forbes article, David Shaywitz ponders whether patients are the best judges of physician quality. This is a very interesting question, not because the answer is elusive, but because the question itself is rather unusual, and may prove to be the harbinger of a new way of thinking about health care. The question raised by Dr. Shaywitz is not whether patients ...

Read more...

Just the other day I received a somewhat anxious-sounding phone message from a patient of mine, approximately 72 hours after her office visit with me, and about 24 hours after I had already gone over all of her lab results from the visit with her. She sounded quite distressed, and said she'd received a message from someone, but could not really understand what they were saying. She said she was finally ...

Read more...

We were intimate. As intimate as a doctor and patient can become.  He had long outlived his wife and there were no children, no family, just friends.  When he first came to me he was lively and active, but the years took their toll.  Our visits became more regular.  Every six months.  Then every three. His memory started to slip.  Occasionally he would look at me suspiciously when something went wrong.  His ...

Read more...

Dr. Daniela Drake writes an provocative and bold piece on the plight of doctors in America and the impact it has on patient care: "Why Your Doctor Feels Like a ‘Beaten Dog’." Though health care is very bureaucratic with administrative paperwork, huddles, and hassles, her linkage of how patients were neglected as a consequence of the system doctors work in is weak. She talks about Victoria, a teenager, who ...

Read more...

Is your doctor a hammer and you're a nail? Here's some insider advice coaxing patients to be more wary and skeptical of medical advice. Should you trust your doctor? Absolutely. But you need to serve as a spirited advocate for your own health or bring one with you. Ask your physician for the evidence. Sometimes, his medical advice may result more from judgement and experience as there may not be ...

Read more...

Urgent care wont replace primary care. Heres why. About seven years ago, the California Healthcare Roundtable and Health Affairs sat down to prepare a white paper on the emerging phenomenon of urgent care centers, and what it might mean for primary care. At the time the group couldn’t agree that urgent care (UC) was a disruptive innovation, but it seemed clear to all participants that it represented a threat to primary care: ...

Read more...

As every physician already knows full well, health care services delivered to the home rather than in an institutional setting are increasing, a trend destined to expand even faster in the decades ahead. This shift is inevitable, thanks to our rapidly growing elderly population and the corresponding prevalence of chronic illness, along with the nationwide push for higher quality care at lower cost and dramatic advances in medical technology such as ...

Read more...

This is what population health looks like It is a beautiful day here in my little college town. The sun is shining and at 11 a.m. it is about 78 degrees with a barely perceptible breeze. People are out walking on Main Street and riding their bikes. The mountain nearby calls: I can go for a hike today with my dog and still be within 20 minutes or so ...

Read more...

5 health care megatrends to watch for Recently, Cisco chairman and CEO John Chambers told me that U.S. health care is at a tipping point. A positive one, he hopes, but the truth is no one knows for sure which direction the system will tip. At the close of our interview, I asked Chambers what health care topic he’d like me to cover in the future. He asked me to ...

Read more...

The new VA secretary, Robert A. McDonald, speaking to a room-full of reporters, acknowledged for the first time that the department needed to hire "tens of thousands of new doctors, new nurses, new clinicians." It is now accepted that a shortage of employees directly involved in treating patients was a main driver in the waiting-list scandal that rocked the agency this year. The second, and equally important driver, was the artificially created benchmarks, that ...

Read more...

Most Popular