I haven’t give much thought about gun control, but since the horrific unspeakable tragedy which occurred in Sandy Hook, Connecticut where 20 children and 6 adults were killed, I like many others are. Increasingly, crime scenes are now including movie theaters, malls, and schools, places where people escape reality, find gifts, goods or services for themselves, loved ones, or friends, and ...

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Healthy patients think that they are not at risk for serious medical problems. Though maintaining a healthy weight, exercising regularly, not smoking, and eating plenty of vegetables and fruits while limiting meat, fat, and fast foods does decrease the risk of developing diabetes, high blood pressure, heart disease, and cancer, it doesn’t completely eliminate it. The chance is there, just a ...

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New York Times columnist Nicholas D. Kristof wrote a heartfelt piece "A Possibly Fatal Mistake" about his college roommate Scott Androes, who recently was diagnosed with metastatic prostate cancer. His story illustrates the problem with the current health care system.  It isn't about the lack of health insurance. It's about the obstacles all patients face in making the right decisions and the right treatment. Something that will increasingly be ...

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A recent commentary in the Journal of the American Medical Association titled, "The Iron Triangle of Health Care: Access, Cost, and Quality" reflected that any health care system can only optimize two of the three elements - quality, access, cost.  A health care system which provides the finest quality and best access cannot do so without raising costs to unaffordable levels. An inexpensive health care system available to ...

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I recently viewed health care through the lenses of a technology entrepreneur by attending the Health Innovation Summit hosted by Rock Health in San Francisco. As a practicing primary care doctor, I was inspired to hear from Andy Grove, former CEO of Intel, listen to Thomas Goetz, executive editor of Wired magazine, and Dr. Tom Lee, founder of One Medical Group as well as ePocrates. Not surprising, the most fascinating person, ...

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Recently New Yorker staff writers and best-selling authors Malcolm Gladwell and Atul Gawande addressed the question of whether the problem in health care is that patients are too reliant on doctors and don't have the ability to make decisions. In reading between the lines, is that the reason health care is not affordable and care not commoditized or consumer driven like other industries? At a conference for America's Health Insurance Plans, ...

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Solving the American health care system crisis is among the most complex and important challenges facing this generation. Is it possible to provide high quality care with better access at a more affordable cost? Is this problem solvable or simply to complicated?  Though that answer is not yet clear, what is increasingly apparent is that a new type leadership is needed if there is any hope in achieving this goal. Professor ...

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The American Board of Internal Medicine (ABIM) and nine other professional medical societies announced that doctors should perform 45 tests and procedures less often than currently done because there is no good medical evidence that they add any value. Specifically, a xray or other imaging for low back pain in an otherwise healthy individual or an EKG as part of a routine physical, just add a lot of unnecessary cost ...

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Although my team, the New England Patriots lost Super Bowl XLVI to the New York Giants in one of the most exciting and tense games in recent memory, reviewing both the pre and post game coverage provided even more learning for doctors and healthcare than my prior post. One can demand excellence and still fall short. When one fails to achieve the intended goals, the learnings can be as ...

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As the new year starts, I'm eager for a fresh start and working on improving myself both physically and emotionally. I'm also eager for the NFL playoffs and seeing how my favorite team, the New England Patriots, fares under the leadership of Coach Bill Belichick and quarterback Tom Brady. Doctors and health care can learn much from their examples. Over the past decade, the New England Patriots have been dominant ...

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shutterstock_86216713 I've been reading A Game Plan for Life: The Power of Mentoring written by famed UCLA basketball coach John Wooden.  Wooden spends half of his book thanking the people who had a powerful influence on his life, coaching, philosophy, and outlook on life.  Important people included his father, coaches, President Abraham Lincoln, and Mother Theresa. Yes, President Abraham Lincoln and Mother Theresa. Though ...

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The New York Times recently published an article titled, Finding a Quality Doctor, Dr. Danielle Ofri an internist at NYU, laments how she was unable to perform as well as expected in the areas of patient care as it related to diabetes.  From a New England Journal of Medicine article, Dr. Ofri notes that her report card showed the following - 33% of patients with diabetes have glycated hemoglobin ...

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There are many tips to saving money on medical costs like asking your doctor only for generic medications, choosing an insurance plan with a high deductible and lower monthly premiums, going to an urgent care or retail clinic rather than the emergency room, and getting prescriptions mailed rather than go to a pharmacy. How about getting your old medical records and having them reviewed by a primary care doctor?  It ...

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The creation of consumer-driven health plans (CDHPs), health insurance policies with high deductibles linked to a savings option and with more financial responsibility shouldered by patients and employees and less by employers, was completely inevitable. The American public likes to have everything, whether consumer electronics or other services, as cheap as possible. With escalating health care expenses rising far more rapidly than wages or inflation, it's not surprising employers ...

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A recent blog post in Health Affairs proclaimed The End of Internal Medicine As We Know It.  What the article is really asking is the future of primary care in the world of health care reform and the creation of Accountable Care Organizations (ACOs). While doctors should be naturally concerned about change, I don't completely agree with this ...

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A recent post in the Wall Street Journal's Health Blog noted that a study found electronic medical records don't improve outpatient quality.  The authors of the Archives of Internal Medicine article, Electronic Health Records and Clinical Decision Support Systems, correctly points out that we should be skeptical and "doubt [the] argument that the use of EHRs is a "magic bullet" for health care quality improvement, as some advocates imply." This ...

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I understand the frustration and anger in CNN Senior Medical Correspondent Elizabeth Cohen’s new book, The Empowered Patient.  I agree that all of the horrible patient stories should have never occurred.  As a practicing primary care doctor who has witnessed near misses and bad medical outcomes affect family members, I too wrote a book encouraging patients to be informed and engaged about their care. The problem is that The Empowered ...

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Everyone understands the need for a robust primary care workforce in making healthcare more affordable and accessible while keeping those in our care healthy.   With the aging of America and healthcare reform, even more Americans will need primary care doctors at precisely the same time doctors are leaving the specialty in droves and medical students shun the career choice.  So as a practicing primary care doctor, I've watched with ...

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The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer driven healthcare in the way of higher deductibles and copays. This is very worrisome.  Certainly patients should have some financial responsibility for their care, but skimping on care will only result in Americans not becoming healthier, but sicker.  ...

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