Most of us would agree that health care costs are too high in America.  They must be controlled or else we won’t have a sustainable health care system here.  And we should acknowledge that, on average, all doctors in America are paid higher than their overseas counterparts.  But we should also agree that expenses for doctors to earn a degree, maintain that degree and licensure, and pay their malpractice premiums ...

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I first read Dr. Matthew Moeller’s piece from this past March for the first time this week after a classmate of mine passed it on to me. I’m a first-year medical student -- bright-eyed but sleep-deprived, trailing the smell of the cadaver lab everywhere. I entered medicine fully aware of the long, arduous road ahead, almost exactly as Dr. Moeller described it; with many of my classmates in my ...

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There’s an elephant in the room, one that’s preventing patients from getting the most out of their visits to the doctor -- and the name of that elephant is embarrassment. It’s not unusual to feel uncomfortable about some of the more intimate aspects of your health, but too often this discomfort turns into outright embarrassment.  This embarrassment can lead to omissions, which in turn make it impossible for your doctor to ...

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Everyone agrees that the US healthcare system is too costly.  The challenge of public policy is deliver higher value by improving quality while reducing costs by eliminating waste and increasing efficiency. Historically physician compensation has been tied to productivity, which encourages procedures and over-utilization. How can we motivate physicians to provide preventive, cost effective and quality care without incentive programs? Alfie Kohn in 1993 published ”Incentive Plans Cannot Work.” Clearly, poorly ...

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Doctors are burned out and they don’t enjoy their job as much as they used to.  But looking broadly, physicians are still spared the economic difficulties and loss of autonomy that are present in most other sectors where people are still lucky enough to be employed.  There are issues that doctors rarely face: unemployment, inability to pay their rent and food with their paycheck, and lack of health insurance. These benefits ...

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Norman Rockwell never imagined a world where visiting a doctor could be compared to a trip through a Starbucks drive-thru. The days of shooting the breeze with patients and family members have been relegated to the “Good ole’ days” museum right next to Rockwell’s paintings portraying the doctor as more than just a healer, but a trusted friend. What happened to those days? With challenges like increased patient volumes and ...

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He looked ahead, seeing his feet on the hearth. There was smoke rising from one of the three logs, and he marveled at the small flicker of flame that stretched up and ignited the smoke that swirled above the log, dancing briefly somewhat joyously, then gone again, smoke returning. "You can't say you weren't warned," she said. He sat, reflecting on her words. So much years of work, so much effort, breadwinner, ...

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Before Michael Jackson, most folks didn’t know what propofol was. Now, patients are asking me for it by name. It’s an awesome drug. It provides a beautiful sedation, is extremely safe and rapidly clears after the procedure. Under its effects, colonoscopy has become a sublime experience. We administer it in a different manner than Conrad Murray did. For those who may have just awakened from a 5 year coma, Conrad Murray ...

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I realize that my blog has been littered with depressing musings on healthcare lately, and so I thought I’d offer up one very positive and “actionable” suggestion for all you patients out there. In the midst of a broken system where your doctor is being pressured to spend more time with a computer than listening and examining you, where health insurance rates and co-pays are sky-rocketing, and where 1 ...

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Recently I read an interesting article on leadership published at Inc.com.  Although most of the journal is focused on those in business, many of the pieces on leadership are very applicable to those of us in medicine.  In this article, author Curt Hanke writes about the inspiration and leadership positives found in the three simple words:  “I don’t know.” On first blush, we may think that a leader speaking these words may ...

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