Exercise General Medicine Health Care Reform Healthy Living

The Case for Opening (some) Pools In COVID19 Pandemic

The COVID crisis has decimated water exercise. Can we rethink pool closures? A significant number of my older patients relied on pools for their fitness. During a pandemic, you can stay active or fit only if you have good legs and joints. Walkers, runners, and cyclists have no problem; they play outside in the Spring […]

Doctoring General Medicine Health Care Reform Knowledge Reflection Social Media/Writing/Blogging

Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions

On Telehealth, an older couple asked me a tough question about COVID19. They asked whether this virus would either be gone or less dangerous in 6 months to a year. It was a curious question. I replied, Why do you ask? Doc, we have a big family with many children and grandchildren, most of whom […]

General Cardiology General Medicine Health Care Health Care Reform Reflection

Missing an Obvious Cause of Medical Overuse

This post introduces my latest column over at Medscape. I hope you go read the full piece.  Medical overuse bothers me. Consuming medical care that does not improve outcomes makes you poorer, and puts you at risk for being harmed.  I think a lot about why Americans consume more healthcare than our peers in other […]

Doctoring General Cardiology Health Care Health Care Reform

Flat-of-the-Curve Cardiology Practices

If you think about it, you can’t get much done. So you don’t think about it. You just shake your head and keep tapping on the computer; the next patient awaits. To avoid moral distress, to remain employed as a doctor, you don’t think about the high cost and waste of cardiac care. Dr. Andrew […]

Doctoring General Ablation General Medicine Health Care Health Care Reform Knowledge

A Corrosive Force in Medical Care

It comes in a large white envelope each month. It’s marked confidential. When I hold it up to the light, I can see through the envelope. I can’t see the details, but the colored graphs give it away. It’s my monthly productivity report. Most employed doctors get these graphs. These “dashboards” of value include your […]

Health Care Health Care Reform Reflection

We get what we tolerate…

Richard Fries, a cycling-safety advocate in Boston, uses the phrase we get what we tolerate to describe the dire situation of drivers killing cyclists and pedestrians. Many humans die from these collisions because we tolerate it. An inattentive driver kills a person on a bike; then nothing changes. The phrase applies well to other dubious […]

Health Care Reform

Medicare for All?

Maybe it’s sampling error, but I am seeing an increasing number of people who are being financially crushed by the US healthcare system. One recent patient had a real rhythm problem, one that could or should be fixed with a procedure. But he could not afford it. He had insurance but could not afford to […]

Doctoring Health Care Health Care Reform Knowledge

Big lessons from my error

I was furiously tapping on the computer when he asked: “Doc, what happens if I don’t have the procedure you are recommending?” Glee spread through my body. I grinned and nearly jumped up from the stool to hug him. I enthusiastically answered. Few patients ask this vital question. I tweeted about the encounter: An older […]

Doctoring General Medicine Health Care Health Care Reform Knowledge

Trust and Medical Science

Concerned citizens will march this weekend to defend science. Standing up for science is a worthy cause. Look at what medical science has accomplished in recent times: serious diseases, HIV, heart attack, many forms of cancer, have been tamed by the advance of science. We need more not less science. It’s nuts to cut funding […]

Health Care Reform

Divergent Views of Healthcare Reform

I want to point you to a rebuttal of my last post on healthcare reform. Dr. Rocky Bilhartz is a thoughtful cardiologist and an excellent writer. In a blog post titled Divergent Visions, he offers a completely different view of right care. Go read it. So what if you don’t agree. Christopher Hitchens said in […]

Health Care Health Care Reform

Fight On Healthcare Reform Misses Core Problems

Politicians and policy makers are fighting over new health reform proposals. This debate misses the core problems in US healthcare. Look at this graph from the Our World In Data website: It shows that Americans pay too much for lousy health outcomes. Fixing the problem on that graph should be the focus of reform. I […]