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The Cost Of Healthcare With Health Insurance and Without

$2600.
$544.

Look carefully at those two numbers. The first is the sum of three bills I received for my husband’s day-after-Christmas visit to the emergency room for unusual dizziness. A CT and EKG ruled out a stroke or heart attack. Diagnosis? Vertigo.

(Note: both figures will likely be much higher once all the bills come in, but I needed a blog post so I’m going with what I’ve got now).

Now look at the second figure. That’s what I have to pay after the discounts my insurance company has negotiated with the hospital and radiologists. Note: there are no payments from the insurance company in there because we had not yet met our deductible. These are just the discounts. Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine and Health Care*

Domestic Violence: When A Baby Is Shot

A while ago I treated a woman with rhabdomyolysis. You see, her husband beat her so severely that she had enough muscle injured that she ran the risk of kidney damage due to breakdown products. I spent some time chatting to her. I couldn’t understand that this beautiful, intelligent woman could find herself in this sort of situation, especially seeing that the bastard had assaulted her twice before. But actually this post isn’t about her. She had finally realised there is no chance that this sort of person is going to change and that she needs to leave him before he kills her. No, this post is about someone else. Read more »

*This blog post was originally published at other things amanzi*

Failed Weight Loss Measures And The Super Obese

What are some excellent weight loss options?  I’m a true believer in diet and exercise.  When you burn more calories than you consume on a daily basis, the laws of chemistry, physics, and all other natural sciences say that you will lose weight.

There’s also the option for gastric bypass, which is really nothing more than a really expensive way to make you stop eating so much.  If you don’t exercise while you diet,  or don’t continue to exercise after you stop dieting,  your body will eventually slow down its metabolism and weight loss will become harder and harder.   You will gain your weight back.  Some people have literally eaten their way through a gastric bypass procedure and find themselves  right back at square one. Read more »

*This blog post was originally published at Happy Hospitalist*

When A Physician Gives A Patient “The Look”

“He gave me the look,” the patient said to my nurse as he walked out of the exam room.

My nurse laughed and said, “I had a feeling you’d get it today.”

What were they talking about?  ”What look?  I didn’t know I had a look!” I asked my nurse.

The patient tipped his chin down and looked at me over his glasses.  My nurse laughed, pointing at the patient, “That one!  Exactly!  You give that look to me too!”

I was mystified.  I don’t like lecturing people or acting like their parent.  Patients do no harm to me when they gain weight, don’t take their medications, or eat a lot of Little Debbies.  My job is not to get them to do everything I say, it is to give them enough information and motivation to do it for themself.  I am the coach; they are the ones who have to go out on the field and play.  I may be disappointed when they mess up, but it’s not my job to patronize them and wag my finger. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

How Much Does Technology Improve Health?


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Last week’s CDC report, “Health, United States, 2009” confirms that Americans are increasingly turning to medications, scans, and procedures to improve their health. Exercising, eating right, and weight loss: not so much.

Don’t get me wrong. I love technology as much as the next guy. Maybe more. I’m writing this on a laptop while jetting from California to New York. My iPhone, Blackberry, and Kindle are all within ten feet of me. But my inner Luddite is starting to stir. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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