Toni Brayer is an internal medicine physician.
As I looked around the hot, humid room at the male doctors in their white coats, I couldn’t believe I was actually participating in a medical training mission in Rwanda. After months of planning and securing equipment, I was actually in Africa. I watched as the medical residents listened intently to the lectures United States physician volunteers provided.
Forty-two Rwandan OB/GYN residents came to the University Hospital in Kigali for a …
Imagine my surprise and delight when I saw my dentist this week for a check-up and found the electronic health record (EHR) to be both informative and patient friendly. As I sat in the dental chair, the large monitor screen was swung over in front of me, and my dentist was at my side going over it. The monitor was not a barrier; it was part of my exam. The …
The Centers for Medicare and Medicaid (CMS) sets the rates all physicians get paid and insurance companies base their rates on the same formula. So who creates the formula? Well, it’s the doctors, silly! Or at least some of the doctors. Here’s how it works.
A 31-member committee formed by the American Medical Association is made up of representatives from the various specialty societies. This Relative Value Update Committee (RUC) meets …
The massive confusion about Obamacare (the Affordable Care Act) is much worse than I thought. The Kaiser Family Foundation came out with a poll that shows 42% of Americans don’t even know that Obamacare is the law. Seven percent of people think the Supreme Court struck it down and 12% think Congress repealed it.
I understand that there is confusion about the way it will work and who will be affected. …
The baby boomers are strictly identified as being born between 1946 and 1964. The boom lasted 19 years and delivered 76 million total births. “Leading edge” boomers were between 1946 and 1955. They were the generation that were the wealthiest, most active, and most physically fit generation that had ever lived. They were special and expected to have better lives than their parents.
Well, those leading edge boomers are now middle …
The United States is higher in its use of computed tomography (CT) scans than any other industrialized country. There were about 3 million scans done in the U.S. in 1980. By 2007 that number had risen to 70 million. A number of articles published in medical journals over the past few years have reported that excess radiation delivered by these scans will …
Winter is officially here and we are in the cold and flu season. This is the time that patients get sick with viral illnesses and primary care doctors get even more frustrated as they try to do the right thing for patients. What is the right thing?
First of all we want to relieve suffering. But we also want to do that …
There are an estimated 1,638,910 new cases of the dreadful disease diagnosed in 2012 in the United States, not including non-melanoma skin cancers.
Cancer is not just one disease but is a term that represents more than 100 diseases with different causes. The basic unit of life is cells, and cancer always begins in cells. When the normal process of cell growth and division is altered, these abnormal cells divide without …
Traditionally, the patient chart stayed in the doctors office and rarely did a patient get a glimpse of anything in the record. Photocopying the chart is expensive and no physician would let a chart leave her office because the record must be held safely for a minimum of 7 years. Now more and more offices are doing away with clunky paper charts and electronic medical records are becoming the …
There is do doubt that the way pharmaceutical companies market drugs to both doctors and consumers sways prescribing and drives up health costs. Prescription drug costs have outpaced other health care spending and are predicted to exceed the growth rates for hospital care and physician services going forward from 2010-2019.
Two researchers (Howard Brody, MD, PHD, University of Texas Medical Galveston and Donald Wright, PhD, University of Medicine and Dentistry …
When we think of osteoarthritis (OA), we think of chronic “wear and tear” on a joint that has just plain worn out. Many patients with arthritis become less and less active and that is actually the worst thing for an arthritic joint.
A study published in Arthritis and Rheumatism looked at the functional performance in 2589 adults with knee OA and found that …
Arnold Schwarzenegger’s revelation about his long-term affair with his household employee that involved a child being born is the latest in a string of powerful men with career ending flaws. Add to that the shocking arrest this week of powerful Dominique Strauss-Kahn for allegedly raping a hotel maid and we must ask, “What the heck is going on with these guys?”
I can’t count the number of heartfelt apologies that …
“But doc, my blood pressure is always normal at home.” I wish I had a dollar for every time I have heard that line and I know it is true.
When some patients come to see me, their blood pressure is abnormally high (above 130/90) and this is known as “white coat hypertension.” Although it has been thought to be from anxiety about seeing the doctor, even long established patients who …
Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood autism. It shook the medical community and created an international movement of parents questioning the extensive combination of immunizations that are given to children. Could these immunizations be the cause of the increase in …
I was interested in an article in USA Today about the growing number of physicians, especially primary care doctors, who are boosting their revenues by requiring patients to pay new fees for services that insurance doesn’t cover.
No longer is your insurance payment “all-inclusive”. These fees can include annual administration fees, no-show fees, medical report fees, and extra fees for email or phone consultations. If private practice medicine is going to …
The new reform law which is called the Patient Protection and Affordable Care Act (PPACA) will be a huge disappointment to the millions of previously uninsured people who finally purchase insurance policies when they try to find a doctor.
Primary care physicians are already in short supply and the most popular ones have closed practices or long waits for new patients. Imagine when 2014 hits and all of those patients come …
Health costs are high because the body is complicated and doctors and patients hate ambiguity. The cost is high because a missed diagnosis can lead to death and a large lawsuit. The cost is high because we have many specialists that view the body in tiny pieces and want to feel 100% correct about their piece.
Let me give you a real life example.
My patient, Rick, is a brilliant attorney. He …
I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen.
One insurer even told him (the owner of the business) to just “make the sessions shorter and don’t give as much care.”
Clearly the insurance …
The organizations that rate hospitals and doctors have proliferated as the internet has become mainstream over the past 5 years. I’m sure you have seen some of these: U.S. World & News Report, Consumer Reports Health, Health Grades, Leapfrog, Hospital Compare, Americas Best Doctors and 100 Best Hospitals.
My local magazine lists the “top doctors” along with full page paid ads and promos that are very compelling. The questions is, do …
The newest media doc on the block is Dr. Mehmet Oz. When he was first seen on Oprah, he seemed engaging and answered some interesting questions in a real and professional way. The audience loved his blue scrubs and boyish clean cut open style.
That was then.
Let’s face it . . . the media spotlight seems to corrupt even the best physicians. Dr. Oz now has his own show and …
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