I know physicians. They are smart, hard-working and prideful. They do a lot of good in this world. But one thing we have been utterly incapable of doing is organizing together and speaking as one voice. The American Board of Internal Medicine may have changed that. The hubris, overreach, and tone-deafness of ABIM may have […]
Category: Health Care Reform
A report from the WSJ this week detailed the fact that FDA reviewers had significant and undisclosed financial ties to industry. I found this discovery remarkable, especially the undisclosed part. But perhaps more remarkable was the lack of reaction it created. The article has only 39 comments, paltry numbers of Tweets and FB shares and […]
Last week, I attended the American Heart Association (AHA) 2014 Scientific Sessions in Chicago. I was there as both a learner and physician-writer for theHeart.org. Here are a few paragraphs on the meeting. The main purpose of this post is to introduce the five editorials I wrote. The links to the posts are at the […]
There is a lot of talk about rewarding value in US healthcare. Don’t believe any of it. It’s not happening. Not even close. This is a post about the real world–where I practice medicine. In a comment on yesterday’s post, Lisa wondered how I connected the current model of employing doctors and paying them on […]
What follows is a short intro to my latest column on theHeart.org | Medscape Cardiology. —- The title of the piece is Three Concerning Trends in the Electrophysiology Clinic. I worked on the 750-word piece the entire week. It was hard to get the tone just right. This is because the trends do not reflect […]
It was a mistake to send the Liberian national Thomas Eric Duncan home from a Dallas emergency room after he presented with fever and pain, which were early signs of Ebola infection. It would be a larger mistake to miss an important learning opportunity. This case demonstrates what I believe to be a major threat […]
You know the story on US healthcare and the elderly: Our current default is an American tragedy. It’s devoid of truth and candor; it’s inhumane and it’s wasteful. Recent gains in longevity have come by extending the period of disability right before death. Aggressive care treatment is often hoisted onto the frail because caregivers lack […]
The thing about US healthcare that bothers me most is the waste: the nuclear stress tests on demented patients in diapers, the MRIs for every case of back and knee pain, the egregious pre-op tests for low-risk surgeries, the mega-workups for simple cases of AF, the disease mongering in the name of prevention, and most […]
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 […]
This is a very short story about a baby bird, a yoga mom and a hawk. I tell it because it made me think about the disordered way we frame healthcare decisions. **** The neighborhood is one of old brick houses, cracked cement sidewalks and tall trees. What was once a suburb is now a […]
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. […]