Edward Hoffer, MD

Edward Hoffer is an internal medicine physician and author of Prescription for Bankruptcy: A doctor’s perspective on America’s failing health care system and how we can fix it.

The flaws in the new child health report

Edward Hoffer, MD

Physician

November 9, 2025

The Trump administration recently released a long-promised report decrying the sorry state of the health of American children and saying how it planned to change this.

They correctly begin by noting that “Despite outspending peer nations by more than double per capita on health care, the United States ranks last in life expectancy among high-income countries and suffers higher rates of obesity, heart disease, and diabetes.” Unfortunately, they then largely focus …

Unveiling alcohol’s health paradox: heart benefits and detrimental effects

Edward Hoffer, MD

Conditions

August 30, 2023

Tons of ink have been expended on the health effects, both positive and negative, of alcohol consumption. Beneficial effects on the heart were discussed in the 1990s based on the “French paradox.” A paper published in 1995 noted that there was less ischemic heart disease in France compared to the U.S., despite higher saturated fat intakes and a higher prevalence of smoking.

The relatively lower incidence of ischemic heart disease in …

Gun crisis in America: Youth fatalities on the rise

Edward Hoffer, MD

Policy

January 23, 2023

In 2020, firearm fatalities displaced motor vehicle accidents as the leading cause of death of U.S. youth (ages 1 to 19). We long ago dramatically reduced infectious deaths (though vaccine hesitancy threatens to upend this victory), and the “big five” have been auto accidents, firearms, cancer, suffocation, and drug overdose – accidental in the youngest and intentional or accidental in teens.

Between 2000 and 2015, firearm deaths remained steady at about …

One person’s wasteful medical spending is another person’s income

Edward Hoffer, MD

Policy

January 29, 2020

In a New York Times article, “The Huge Waste in the U.S. Health System,” it stated that the estimated waste is at least $760 billion per year: “That’s comparable to government spending on Medicare and exceeds national military spending, as well as total primary and secondary education spending.”

Why is waste so prevalent? There are many sources. The biggest one, and the one that should most concern …

Can rural health care be saved?

Edward Hoffer, MD

Physician

December 4, 2019

There are many disparities in health care. Black mothers have a much higher rate of maternal death than do white women. All women are less likely to get guideline-advised cardiac care than do men. Among the many such examples, perhaps the hardest disparity to solve is that of the poorer access to health care faced by rural communities. People living in rural counties have higher death rates from cancer and …

Read more…

Can rural health care be saved?

How to make the most out of your doctor’s visit

Edward Hoffer, MD

Physician

October 18, 2019

For most of us, going to the doctor is not at the top of our favorite things-to-do list, but it may be one of the most important. Whether the visit is for a scheduled check-up or to deal with a new problem, there are ways you can make the visit less stressful and more useful.

You must remember that things have changed. In the “good old days,” when I started in …

What is low-value care, and why does it matter?

Edward Hoffer, MD

Physician

August 19, 2019

Doctors and policy wonks hear a lot these days about “low-value care.” What exactly is that, and should you care?

The term refers to tests, medications, and procedures that add little to a patient’s health or well-being but which cost them or the system more money than any benefit warranted. Some of the earliest research that looked at this was done at Dartmouth, where they found enormous variations in the cost …

Why patients should read their medical notes

Edward Hoffer, MD

Physician

June 26, 2019

For centuries, doctors felt that their notes were their property, and none of the patients’ business. This attitude slowly shifted, and the Health Insurance Portability and Availability Act (HIPAA) of 1996 put into law the fact that patients must be allowed to review and get copies of their medical records. Despite this, access to records has remained a daunting task for many. A study done in 2017 of 83 hospitals, …

Beware the claims of stem cell clinics

Edward Hoffer, MD

Conditions

June 16, 2019

Earlier in June, the U.S. Food and Drug Administration (FDA) won a major legal victory by getting an injunction to prevent Florida-based US Stem Cell Clinic from offering its treatments. The company claimed to create stem cells from patients’ body fat and use these to treat a variety of serious illnesses, including Parkinson’s disease, ALS, and chronic lung disease. This company is just one of many that have sprung up …

Read more…

Beware the claims of stem cell clinics

When should you be tested for vitamin B12?

Edward Hoffer, MD

Conditions

June 8, 2019

Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, shortness of breath and “brain fog.” She finally researched her symptoms and demanded that she be checked for vitamin B12 deficiency, which turned out to be the cause of her symptoms.

Recently, the …

You can save your baby for $2 million. Can we afford to do this?

Edward Hoffer, MD

Meds

May 31, 2019

You can save your baby for $2 million. Can you afford to do this? If you cannot, should we all pay?

Spinal muscular atrophy (SMA) is a rare genetic disease affecting the part of the nervous system that controls voluntary muscle movement. All types of SMA result from a single known cause, a deficiency of a protein called SMN, for “survival of motor neuron.” When SMA symptoms are present at birth …

Why you should see your doctor in the morning

Edward Hoffer, MD

Physician

May 25, 2019

A recent New York Times piece had the catchy title, “Don’t visit your doctor in the afternoon.” It was prompted by a study published in JAMA Network Open that had the much less catchy title “Association of Primary Care Clinic Appointment Time with Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening.” The study found that the frequency of appropriate ordering of …

Mild memory loss: Is it Alzheimer’s disease?

Edward Hoffer, MD

Conditions

May 18, 2019

As my patients aged along with me, I noticed both the expected increased numbers of people with some form of dementia and even more patients who were worried about this topic. Unless you have been away on a ten-year safari, you are very aware that dementia is a growing problem. Some 5.8 million Americans are living with Alzheimer’s disease, and similar numbers occur in most western countries. The incidence goes …

In a single-payer system, who will be doing the rationing?

Edward Hoffer, MD

Policy

May 9, 2019

One of the arguments made against adopting single-payer health care in this country is that it would “lead to rationing.” This assumes that we lucky people in the U.S. have unlimited access to whatever health care we need and are at risk of losing it.

This argument came to mind when I saw a few recent news items. One was that a federal judge, U.S. District Judge Robert Scola, recused himself …

Many diseases represent an arbitrary number

Edward Hoffer, MD

Conditions

May 4, 2019

A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.”

As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to the way our current medical system behaves.

Part of the problem is that many diseases represent an arbitrary cut-off of a number. Thus, hypertension is defined as a blood pressure above a …

How to choose the right rehab option after a hospital stay

Edward Hoffer, MD

Policy

April 29, 2019

This is the scenario. You (or your mother) were admitted to the hospital with pneumonia. On the third day a cheery continuing care nurse comes in and says, “You don’t have a fever, and the doctors feel you can be discharged to finish your course of antibiotics, but your nurse tells me you are still too weak to go home, so we are going to send you to rehab. Here …

When is a check-up not a check-up?

Edward Hoffer, MD

Conditions

April 26, 2019

Kaiser Health News told the story of a 69-year-old woman who went to a new doctor for her annual check-up, assuming it was covered by Medicare and was happy with the visit until she got a $400 bill.

Most Americans believe in “annual check-ups,” at which your doctor reviews your medical history, gives you a thorough physical and orders lab tests. The actual value of such visits has been questioned, but …

Read more…

When is a check-up not a check-up?

Do not take medical tests as gospel

Edward Hoffer, MD

Conditions

March 31, 2019

During my time in practice, I had at least eight patients who came to me sure they had systemic lupus erythematosus, also commonly called SLE or lupus. This is an autoimmune disease, characterized by joint pain, that can affect almost any organ, including skin, kidneys, brain, and heart, and can even be fatal. In every case, they had been given this diagnosis because of a blood test called an ANA, …

Read more…

Do not take medical tests as gospel

How to help your doctor with diagnosis

Edward Hoffer, MD

Physician

March 5, 2019

To treat any condition, the doctor needs to know what it is. You would not expect to have your sore ankle treated with penicillin or to have an appendectomy recommended for your sore throat. While this may be self-evident, I know of at least one patient who had a normal appendix removed because the surgeon did not notice the few telltale blisters that were warning the careful observer that the …

Read more…

How to help your doctor with diagnosis

How health insurance contributes to our failing system

Edward Hoffer, MD

Policy

October 11, 2018

An excerpt from Prescription for Bankruptcy: A doctor’s perspective on America’s failing health care system and how we can fix it.

Many years ago, while I was involved in developing the pre-hospital emergency medical care system in Massachusetts, I went with a group to meet with the then-president of Blue …

Edward Hoffer, MD

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts