US healthcare, wait times and the truth…

It’s time for another post on truth and healthcare. (This almost sounds like a good series.) I’ve recently written that the VA healthcare system represents the truth—and that Americans should get over the Pollyanna-view that triage, wait lists, and taking care of increasing numbers of increasingly sick patients can be managed with magic. The truth […]

The danger of digital medicine

Sometimes I worry about where technology is leading the healthcare profession. It is not just the distraction of white screens and electronic health records. These are bad, terrible, in fact. The concern I have runs deeper than just monopolistic EHRs. We, and I mean we as in the caregivers, are losing touch with the basics. […]

Another VA lesson — Healthcare needs to stop being like flying business class

The VA healthcare story has me thinking about the good aspects of delays in medical therapy. Typical American intuitive thinking holds that healthcare waiting lists are a bad thing. The two central tenets of this mindset are that healthcare brings health, and most of medicine is as time sensitive as cardiac arrest or heart attack. […]

The VA healthcare system — Can we handle the truth?

Memorial Day weekend is an apt time to consider the recent accusations of wrongdoing in the VA healthcare system. It’s an opportunity to face the truth. As a free American, I am connected to veterans. It has always been remarkable that young people give their life or health for their country, but now, in this […]

Physician satisfaction: Seeing both sides of the debate

Students of the obvious might consider the topic of physician satisfaction one of mere folly. The “rich doctor” label is an easy one, and the recent Medicare data dump, which revealed hordes of physicians who were doing quite well, thank you, only strengthened it. Yet, when one moves past intuition, into analytical thinking, the contentment […]

Six initial impressions of the Medicare payment disclosure story

What a day it was for medical news. After much legal wrangling, specifically by the Wall Street Journal, the Centers for Medicare and Medicaid Services (CMS) released detailed data on payments to 825,000 US physicians in 2012. It was called a “data dump.” Wow. Was it ever. The story was front page news in US […]

The simple reason the medical-home study failed…

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This week, the Journal of the American Medical Association (JAMA) published a comprehensive study that has major health implications. Major because the negative findings should change how Americans think about health and healthcare. Plus, the findings validate a belief this doctor holds as truth. First my belief, then the study. One blog is enough for […]

Blaming Obamacare is the wrong diagnosis

The Wall Street Journal began the week by publishing a provocative essay in which a young man suggested Obamacare kept his mother from getting appropriate medicine for her cancer. The writer crafted a poignant story about his mother, who sounds like a good person with a bad disease. Mainstream media buzzes with these types of stories. […]

Dronedarone (Multaq), clinical guidelines and patient safety

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(What follows is a brief introduction for a post I wrote over at Medscape/Cardiology. The link is at the bottom of the page.)  It is appropriate to worry about medical errors and patient safety. Here the low-hanging fruit is plentiful: antibiotic stewardship, automated notification of drug interactions and attention to hand washing all join a […]

The truth about early diagnosis — this is more than just a Mammogram story

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The British Medical Journal published a monumental study on screening mammography this week. It’s garnered a ton of media coverage because the findings provocatively question the sacrosanct idea that early detection of breast cancer saves lives. Imagine that…Imagine if the entire pink machine was misguided. Of course, for people who have been willing to squint […]