Next in a series. The fundamental problem in health care delivery today is a highly dysfunctional payment system that leads to higher costs, lesser quality and reduced satisfaction. It also means less time between doctor and patient with the loss of “relationship medicine.” The core problem? Price controls and regulations that reduce the trust and core interactions between doctor and patient. The patient is no one’s customer and visit times ...

Read more...

Like many, we followed Apple's recent announcement about its Health app and HealthKit development platform with interest. In many ways, it echoed a vision -- of an ecosystem where personal health data formed a platform upon which many could develop apps that help people live healthy lives -- that we have supported for many years through the Robert Wood Johnson Foundation's Project HealthDesign. We were particularly ...

Read more...

For the better part of the last two decades I have practiced psychiatry in a variety of different American health care systems, and over these years I have, on numerous occasions, heard psychiatric services referred to in manner that imply (often subtly) that such services are not medical care.  These references come not only from patients, but nurses and doctors (including myself) too. “Yes Mr. Jones you need to follow up ...

Read more...

Why you should love your doctor Doctors spend their 20s and 30s studying while most of their friends are at parties and enjoying their youth. Doctors may amass up to $500,000 in debt for the honor of one day caring for you and your family. Doctors delay childbearing and starting their own families so they can care for your family. Doctors miss their own kids’ ballet recitals and baseball games ...

Read more...

A simple trick to remember your doctors recommendations An excerpt from The Thrifty Patient – Vital Insider Tips for Saving Money and Staying Healthy.

You’ve told your story. Your doctor gets it. He has completed the physical exam. He formulates a plan to get you better. The next skill you should master may be as important as being a great storyteller. Your doctor has told you the ...

Read more...

Whenever I talk with groups of medical professionals about job frustration and burnout, there’s a theme that shows up that’s hard to ignore. I call it “the pain of perfection.” Most of us pursued careers in medicine to help others. And if we’re honest, we must admit that we have type A tendencies infused in our bloodstream. Can I see a show of hands, please? That part of us, the one that strives ...

Read more...

Replacing transcriptionists with physicians is a fools bargain My general internal medicine practice is equidistant from the three academic institutions and a Veterans Administration facility, and thus I have patients who receive primary, secondary and tertiary care at each of these institutions. The notes I receive back from one of these organizations are hands down the best of the four institutions. These notes are personal, concise, precise and clear. If ...

Read more...

It is a trade secret among patients of many practices: If you’d like to be seen by your personal physician with no waiting and without an appointment, just ask for a free blood pressure check and then mention to the medical assistant that you are not feeling well at all. They can’t send you home without being seen and they don’t have enough to go on to call an ambulance; ...

Read more...

How do you really know if your doctor, surgeon or hospital is good, bad or somewhere in between? I frequently speak with large audiences, ranging from CEOs to Stanford business school students. I often start by asking participants to raise their hands if they receive excellent health care. Each time I ask, about 90% of the hands in the room shoot up. But all the hands come down when I ask, “How do ...

Read more...

The world is asunder.  Iraq is sinking into a sectarian abyss.  ISIS, a terrorist group, now controls a larger territory than many actual countries.  Russia has swallowed Crimea and has her paw prints all over eastern Ukraine.  China is claiming airspace and territories in Southeast Asia increasing tensions with Japan, Vietnam and the Philippines.  The Israeli-Palestinian peace process is in another deep freeze.  Terrorists in Sudan and Nigeria are kidnapping ...

Read more...