About a year ago, there was a great commercial that depicted the slowing of time as a free-falling, but worry-free, James Franco uses his smartphone to chart a safe landing on the billowy awning of a restaurant dozens of stories below.  There probably isn’t a single person who hasn’t, at one point or another, wished she or he could control time in order to navigate a better outcome.  And doctors ...

Read more...

It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under the trade name Capoten. After making a fortune for the company, captopril went generic in 1996. ...

Read more...

In India, when the first heavy droplets of rain meet dry earth it releases a particular kind of smell: a dampness arising from sizzling soil that in Bengal we call shnoda gondho. It is raining on the second day we go to visit my grandfather in the hospital. He has been readmitted to the hospital, after spending a week recovering at home from a hospitalization for rib fractures and bleeding into his ...

Read more...

shutterstock_84146302 I drank the Kool-Aid early.  We installed our first EHR in 1996 with me doing the lion’s share of pushing and pulling.  While I’d ultimately turn my back on this passion, I had a number of notable accomplishments before walking down my road to Damascus.

  • Within a year of implementation, our practice became one of the top installations for our vendor.
  • Within two years, ...

    Read more...

When I was a resident, I saw a middle-aged man, “Charles,” who came into the hospital after playing a round and a half of golf. When I looked at his right foot, he had an ulcer in the shape of a golf tee. He had played the entire day with a golf tee in his shoe and only noticed when he found drainage on his sock. The story sticks in ...

Read more...

Delivering bad news is part of my job, an important part. It is fashionable nowadays to speak of the doctor-patient relationship as a partnership. In the sense that both doctor and patient have important roles to play for the patient to get good care, that’s very true. But even in the best of times, it’s a very asymmetric partnership. Even in a run-of-the-mill visit for a sinus infection the patient and ...

Read more...

Dear patients, First of all, thank you for calling for an appointment. Seriously. Ever since I’ve gone open access, if the phone doesn’t ring I’m toast. And thank you for your interest in preventive care. The fact that it’s now free (well, no cost to you at time of service: trust me, it’s not “free”) has probably motivated more of you to call. That’s OK. But sometimes it seems that your ...

Read more...

medpagetodayFrom MedPage Today:

  1. Delayed Autism Diagnosis Common in Primary Care. Parents with autistic children were more likely to receive a passive, rather than a proactive response from a provider when raising concerns about their children's development compared with parents whose children exhibited signs of developmental delay.
  2. MOC Watch: ABMS President Rebuts Critics. ...

    Read more...

Forty is the new thirty. Orange is the new black. And failure is the new success. It seems these days that no success story is complete without a failure (or two) along the way: the bankruptcy that gave birth to a successful company; the entrepreneur who lost it all just before hitting the Fortune 500. Entire issues of the Harvard Business Review and the New York Times Magazine have been devoted ...

Read more...

shutterstock_226013521 Aaron Carroll, a pediatrician who blogs at the Incidental Economist, had a piece published a few weeks ago in the New York Times concluding that adolescents and college kids would be better off -- given a choice of illicit substances -- opting for marijuana over alcohol.  Of course, he would prefer that his kids chose neither.  But he is a ...

Read more...

Most Popular