Public Health & Policy

Now more than ever, it seems that medicine, politics, social justice, and societal mores have become intertwined. There are so many "lanes" that the 405 to the 10 freeway splits seem like country roads in comparison. Perhaps we have social media to thank for this multitude of lanes. Or maybe it's to blame. When doctors were publicly berated (on social media, primarily) soon after we became outspoken about the issue of ...

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Each year, Medical Economics surveys physician readers to find out what irks them most. Topping the latest list: insurance paperwork, followed closely by electronic health records (EHRs). The reason is the same for both. Insurers and EHRs get between doctors and their patients. When it comes to medicine’s computer problem, the obstacle is literal. Doctors sit behind a screen, focused on the EHR and not the patient. ...

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I worked with someone (not a physician, but that doesn’t really matter here) whose title was “assistant director.” He and I quickly recognized that we worked well together: His head brimmed with big visions and ideas, whereas my head brimmed with plans as to how to make those ideas manifest in the actual world. “He’s like a bunch of balloons,” I quipped to a colleague. “He’s got a ton of ideas ...

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I had the distinct pleasure working with family physician colleagues in Sweden recently. It was a similar experience to a trip I made to Britain about five years ago that I also wrote about. I got to spend some time watching one of my colleagues care for her patients in her surgery (they use the same description of a clinic as the British). I got to spend some time watching ...

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“What About Recovery” is a provocative essay by Yale professor Lenore Buckley, MD, in JAMA. She writes in detail about the death of her 68-year-old brother in a hospital. She felt his doctors did not do enough to help him recover because his nutritional and physical therapy needs were not met. However, there’s more to it. She calls out the system existing in every hospital I’m aware of writing, ...

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Health care is a tough job to work in -- whether you are a doctor, nurse or any other professional. We are dealing with matters of life and death, our patients expect (and deserve) the best from us, and we always have a hundred-and-one things to do at the frontlines of medicine. I remember reading somewhere when I was a teenager that a career in medicine would be a “mentally, ...

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The day of solo practitioners is coming to an end. In its place will be gaggles of gastroenterologists and flocks of physicians. Mega practices are becoming the norm in American medical care.

Here’s a few pictures of this trend, somewhat dated (they only go through 2015) but still quite revealing.

The figure below illustrates the distribution of primary care physicians in the U.S., from June 2013 ...

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The World Health Organization describes universal health coverage -- a system coupling health care access with financial protection for all residents -- as the “single most powerful concept that public health has to offer.” The goal of universal care is to give all people the equal opportunity to enjoy the best health possible. I wholeheartedly endorse universal health care, though not a single-payer system like "Medicare for all" because there is ...

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To help then-candidate Bill Clinton remain focused on the No. 1 voter issue ahead of the 1992 presidential elections, political strategist James Carville coined an unforgettable mantra, which he posted inside Clinton campaign headquarters. It read, “The economy, stupid.” The quote became famous both for its edginess and wisdom, reminding us to separate the big picture from everything else. In health care, it can be hard to define the “big picture” issue when ...

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