There are over 58 million references to "patient engagement" if one conducts a Google search. The term has been diluted and changed in the past couple of years and has become a buzz phrase, used more from a business than clinical benefit perspective. The Center for Advancing Health defines patient engagement as “actions individuals must take to obtain the greatest benefit from the health care services available to them.” This implies ...

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The past few months I have joined thousands of individuals hoping to match into a residency program in 2014. I have had interviews all over the country and spent way too much time living out of a suitcase. For many students, residency interview season is exciting. For others, it’s stressful and exhausting. But for me, more than anything else, the interview trail was inspiring. I am currently applying to internal medicine-primary care ...

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As an internist (yes, I am a specialist, just not a subspecialist), I do no procedures.  Patients pay me (albeit mostly indirectly) for my cognitive skills.  But we live in a culture that seemingly rewards procedures more that pure cognition.  Now I understand that procedures are not mindless.  Physicians doing procedures must think prior to the procedure, during the procedure and after the procedure.  But cognition without procedures seems undervalued. The ...

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Next in a series. We have a real paradox in American health care. On the one hand we have exceptionally well educated and well trained providers who are committed to our care. We are the envy of the world for our biomedical research prowess, funded largely by the National Institutes of Health and conducted across the county in universities and medical schools. The pharmaceutical and biotechnology industries continuously bring forth ...

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A few months ago, I spent 15 minutes filling out a detailed health data form at the doctor’s office. The paper form contained multiple questions about my health, family history, medications and basic demographic information. I assumed that an administrative specialist would code it into the practice’s electronic medical record (EMR) to be put to use. So it came as a surprise when I spent another 5 minutes reviewing the ...

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During an afternoon seminar on a new paradigm for lung cancer screening in primary care, my phone chirped announcing the latest MedPage Today bit of breaking news: "Medical Homes May Not Be the Answer." A study in JAMA reported that cost per month per patient had actually increased, and only one marker of improved care was found to have improved after thousands of patients were followed in a large group of patient-centered medical ...

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When you go shopping, everything has a price tag. Buying a new car is challenging, but ignoring dealership costs may result in sticker shock when you receive the first payment notice three weeks later. Few of us would ignore costs this way. In actuality, this happens everyday in health care as we interact with medical professionals, have an examination, and are given treatment without knowing the price. Headlines alert us how health ...

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There is a disconcerting myth about single mothers that has been circulating in our society for some time. It was popularized in the Reagan Era as a denunciation of US social welfare policy and resulted in a pointed caricature of a woman on welfare, forever to be known as the “welfare queen” or the entitled single mother. The narrative of such a woman goes something like this: Not only is she ...

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How to save hundreds of dollars on your medical bills Rob got a cat bite. Then a swollen hand. He goes to the ER, gets antibiotics, then develops itching. So he calls me for advice. A few days later, I get this email: “The itching from the antibiotics went away as you said it would. But what is NOT poised to go away is the $624 bill from the ER for talking to ...

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I had a pretty grueling office session yesterday -- one of those days where you're sending someone to the hospital and calling another consultant on the phone and bouncing among three rooms at once.  A typical family medicine day. I was 45 minutes late seeing my last patient.  I was a little surprised that she was still on the schedule -- we had actually resolved her issue over the phone the ...

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