Doctoring Health Care Health Care Reform

Why is paying a doctor so different?

Doctors going to a cash only system of payment is steadily increasing, and these changes are garnering much attention. Practicing medicine is a skill honed over many years of training and education.  Like any good or service, “doctoring,” has a value.  What this value is, has become a matter of much debate.   The payment […]

Doctoring Health Care Health Care Reform

Measuring quality of medical care. How can a consumer know?

While typing words, the advertisement for yet another hospital is overheard from the TV.  “Ignore it John,” I think to myself, but, it is impossible to not look up and see.  The head shakes with a smirk, like my grandfather did and without words displeasure was easily conveyed. Do people really think the graphical professionalism […]

Knowledge Reflection

A doctor discovers the political process…

He grabs your hand enthusiastically and looks you in the eye and says in the most convincing tone possible, “nice to meet you Doctor.” So it was at the Lincoln Day dinner given by the Republican Party of Jefferson County, (Louisville) KY.   Staci and I were invited guests of the May’s, friends whom we […]

Healthy Living Knowledge

Clues to longevity. More obviousness…

To live long, there are many guidelines and much to avoid.  There is now published data suggesting boredom is a risk for an earlier death. One who is engaged in health reads the litany of things that are detrimental to our existence, and it seems impossible to believe that average lifespans are rising.  There are the obvious […]

Doctoring Health Care ICD/Pacemaker

A note to the professors, from the “real” world, on the use of ICDs in a fee for service community…

The practice of medicine is glorious, and I love it, but cynicism must be overcome. What cynicism?   A far more established and connected blogger, Dr Wes, writes of the way technology strains the doctor-patient relationship.  It involves a piece in the Chicago Tribune in which a study published in a major journal outlined doctors […]

General Medicine Knowledge

The Human Mind…

Remarkable.  The scene is the Brown Theatre, Louisville Ky.  The crowd, primarily women but surprisingly not all with painted eyebrows filters in and there is this sense that others are looking at each other for validation.  I study their faces to determine whether they are believers and then realize many look at me with the […]

Doctoring General Ablation

Balance in life and medicine is often elusive…

Today, after a string of hard but professionally gratifying days in the EP lab, a nurse and friend asks me at dinner time while still working in the lab, “Hey, how’s that reading books and writing thing going?”   Funny how a question lingers in the mind. A discovery is in the midst.  Not huge […]

Atrial fibrillation Knowledge

Day 3 Atrial Fibrillation Symposium: Homeward bound and a discovery…

Last spring in the warmth I finish talking to my friend, a gardener, and he speaks of his engagement with non-cycling endeavors and inability to ride the bike for hours.  Hanging up the phone I am perplexed.  How can this be? But now after the third and final day of the atrial fibrillation symposium I […]

Doctoring General Medicine Health Care Health Care Reform

A maze of 5 digit numbers and a cure for the upcoming doctor shortage…

One of my new tasks in joining a new practice is learning CPT codes for what I do.  Said differently, I am learning how to bill for services rendered.  Never needed to this in the past as my large group had an army of business folks (coders) who did this for me.  They of course […]

Doctoring General Cardiology General Medicine Health Care

Not mastering the obvious is costing us now…

Being married to a palliative care doctor is enlightening in so many ways. As has been noted previously, CMS (government) decided that commonly ordered stress scans and ultrasounds of the heart are much less valuable.  Undoubtedly, there are many reasons for this, but at least one is likely the notion that there are too many […]

Cycling Stuff General Medicine Knowledge Reflection

A discovery: but it is already known or thought of. So what…

In the doctors lunch room… “Hey doc, are you riding your bike in this weather?” “It is the off-season, I am resting my body and exercising the mind.” A look of bewilderment, like what does “off season” mean?  I quickly remember that “normal” people do not do this nonsense that is bike racing.  Three months […]