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Latest Posts

Is Your Doctor Running Late? Check It Out Online

I just read a Wall Street Journal article about a new web-based service called MedWaitTime that allows patients to check if their doctor is running late before heading to the office for their appointment — kind of like you can check to see if your flight is late before heading to the airport.

Brilliant.

Nothing peeves me more than sitting in a doctor’s office reading 4-month-old tattered magazines on topics I care nothing about (saltwater fishing, seriously?), and not because the doctor had an emergency (when is the last time a dermatologist had to run out to save someone), but because the office staff routinely double books. I can’t count the number of times I walked out (my limit is 30 minutes unless I’m in agony) after giving the front office a targeted piece of my mind. Read more »

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

Games For Health 2010

Games For Health 2010It’s time for the 6th annual Games for Health conference. The conference, in partnership with the Robert Wood Johnson Foundation, provides a forum for experts in the fields of video games, healthcare, and science to come together and share the latest and greatest in health-related video game news and research.

From their promotional pamphlet:

Because digital games can actively engage and challenge people of all ages, they have the ability to help individuals manage chronic illnesses, support physical rehabilitation, pursue wellness goals and contribute to changes in health behaviors. Public health leaders, doctors and nurses, rehabilitation specialists, emergency first responders and other health professionals are also using games and game technologies to advance their skills and enhance how they deliver care and services. Games are even beginning to mine the wisdom of the crowds to forge critical new discoveries in biology and genomics.

The acceptance of games as a valuable health management and training method, the popular success of consoles like the Nintendo Wii, and the growth of smartphone game applications indicate that there is tremendous potential for continuing to move health and behavior change activities beyond clinical settings and the classroom and into consumers’ home, work, social and recreational spaces.

We’ll be reporting throughout the event (May 25-27). Stay tuned for info on the PS3 Move, a Wii laparoscopic trainer, and more.

*This blog post was originally published at Medgadget*

10 Rules For Giving Good Care

The recent discussion of the appropriateness of bringing patients back to the office has really gotten me thinking about my overall philosophy of practice. What are the rules that govern my time in the office with patients? What determines when I see people, what I order, and what I prescribe? What constitutes “good care” in my practice?

So I decided to make some rules that guide what I think a doctor should be doing in the exam room with the patient. They are as much for my patients as they are for me, but I believe that thinking this out will give clarity in the process.

Rule 1: It’s the Patient’s Visit

The visit is for the patient’s health, not the doctor’s income or ego. This means three things:

  1. All medical decisions should be made for what is in their interest, including: when they should come in, what medications they are given, what tests are ordered, and what consults are made.
  2. Patients who request things that are harmful to themselves should be denied.  People who ask for addictive drugs or unnecessary tests should not get them.  Patients who are doing harmful things to themselves should be warned, but only in a way that is helpful, not judgmental.
  3. All tests done on the patient should be reported to them in a way that they can understand.

Rule 2:  Minimize

Many doctors and patients have a “more is better” mentality. This not only costs more money to the system, but it can cause harm to the patient. Read more »

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

Money Isn’t Everything In Primary Care

Much has been recently made about the bureaucratic obstacles that primary care doctors face. With good reason. The impetus was a recent New England Journal of Medicine paper from Richard J. Baron that I mentioned recently.

The New York Times’ Pauline Chen interviewed Dr. Baron, who shared some interesting insights on what needs to be done. He contrasts the inertia in primary care to drug manufacturing.

If you took the resources that went into drug development, for instance, “and put them into a program like this that achieves meaningful levels of behavior change, a lot more patients could be better off.” In other words, research into new primary care models isn’t taking off because the money isn’t there.

But Dr. Baron also notes that money isn’t everything, since “primary care practitioners have been saying that we either already do or would do certain things if you paid us more. It’s true that you can’t do things consistently, reliably and across scales without additional payment. But payment is not enough. People have to change what they are thinking about when they go to work.” Read more »

*This blog post was originally published at KevinMD.com*

Have We Killed Clinical Research?

“…I have always depended on the kindness of strangers.”  — Blanche DuBois in Tennessee Williams’ play A Streetcar Named Desire

Years ago when I began my medical training, I recall enrolling patients for clinical research. In cardiology, there were a myriad of questions that needed to be answered, especially in the area of defining which medications were best to limit the damage caused by a heart attack.

Patients routinely participated in large, multi-center prospective randomized trials to answer these questions. It was routine for them not to charged for participating in the trial — the drug(s) and additional testing would be funded by the company whose drug was being studied. Patients enrolled willingly, eager to help advance science and perhaps, in some small way, their fellow man. It never dawned on me in those early days why hospitals and research centers were so eager to promote research. Read more »

*This blog post was originally published at Dr. Wes*

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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