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Doctors And Aging: 5 Things To Help Good Doctors Stay Good Longer

I asked my age-matched colleague the other day: “Do you think we’ll know when it happens to us?” He responded: “I know. I worry about that, too…a lot. I’m getting out before it happens to me.”

We were talking about our fears of being labeled as an “old” doctor.  Not just old in years — our children and bifocals remind of us of that — but old in our mindset. We fear becoming one of the dinosaur doctors who get known for their excessive attachment to old dogma, premature dismissiveness of novel new approaches, fear of social media, and of course the tell-tail (pathognomonic) sign of agedness, ranting mindlessly in front of Fox news about healthcare reform in the doctor’s lounge.

This transition can happen fast. One moment a doctor might be in their sweet spot — a period of time where the nearness of training meets with the treasure of experience in a capable mind, body and spirit.  Sadly, and obviously this period is finite. It’s limited by aging. Getting older happens to all of us, but the pertinent fact for medical practice is that, like all humans, doctors age at different velocities. Read more »

*This blog post was originally published at Dr John M*

Cardiovascular Care: Costs Could Triple By 2030

Real total direct medical costs of cardiovascular disease (CVD) could triple, from $273 billion to $818 billion (in 2008 dollars) by 2030. Real indirect costs, such as lost productivity among the employed and unpaid household work, could increase 61 percent, from $172 billion in 2010 to $276 billion.

Results appeared in a policy statement of the American Heart Association.

CVD is the leading cause of mortality and accounts for 17 percent of national health expenditures, according to the statement. How much so? U.S. medical expenditures rose from 10 percent of the Gross Domestic Product in 1985 to 15 percent in 2008. In the past decade, the medical costs of CVD have grown at an average annual rate of 6 percent and have accounted for about 15 percent of the increase in medical spending.

The spending is associated with greater life expectancy, “suggesting that this spending was of value,” the authors wrote. But as the population ages, direct treatment costs are expected to increase substantially, even though lost productivity won’t, since seniors are employed at lower rates.

If current prevention and treatment rates remain steady, CVD prevalence will increase by about 10 percent over the next 20 years. The estimate reflects an aging population, and one that is increasingly Hispanic. To prepare for future cardiovascular care needs, the American Heart Association projected future costs. By 2030, 40.5 percent (116 million) of the population is projected to have some form of CVD. Read more »

*This blog post was originally published at ACP Internist*

The Eroding “Doctor” Label

It came as a Twitter “follow” from @coldfeet65, a self-proclaimed “Nurse Practitioner Hospitalist.” I had never heard this term before. Does it mean a nurse practitioner who cares for hospitalists? Or is it a hospitalist who is a nurse practitioner? Or maybe it’s a nurse practitioner who helps hospitalists? (Honestly, I think I know which one she means, but you get my point.)

Perhaps this is a prescient glimpse to healthcare of the future, where our more typical nurse and doctor labels are supplanted by more and more monikers that serve to confuse, rather than clarify, each of our roles in healthcare delivery. As specialists in cardiology, we’ve seen a similar trend with cardiology hospitalists. But we should be clear what this means to the patients and doctors going forward.

No doubt most people in America still expect to see a doctor when they come to the hospital. Increasingly, it appears that might not be the case. Your doctor might be a robot while a nurse (aka, nurse practitioner) will be the one providing the hands-on care in the inpatient setting. Is that a good thing? Honestly, I’m not sure.

No one argues that the costs in healthcare need to be cut. No doubt the central authority has deemed that doctor salaries will be a big part of that effort. Already, 20 states have cut physician Medicaid payments for fiscal year 2010 and, given the current economic pressure on our states both now and after they start feeling the financial impact of the “Affordable” Care Act in 2019, this trend is not likely to improve anytime soon. As a result, we are seeing that the world is full of “creative solutions” to our healthcare access crisis and the evolution to “nurse practitioner hospitalists” might be one of these. Read more »

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

Fire Department App: “There’s A Hero In All Of Us”

Just admit it: Deep in your heart you’ve always wanted to be an emergency medical technician, if at least for a few moments. If you’re located in San Ramon Valley, California, you can now live that dream: The local fire department has released an iPhone app that will alert you of any emergency activity in the area.

The well thought-out application will send out a push notification to users who have indicated that they are proficient in CPR whenever there is a cardiac emergency nearby. In addition, the closest public-access automated external defibrillator (AED) is located by the app. Current response status of dispatched units are shown and incident locations are pinpointed on an interactive map. There’s even a log of recent incidents including a photo gallery. For the old-school ham and scanner lads, it’s possible to listen in on live emergency radio traffic. The app is available for free.

Homepage: Fire Department…

iTunes link: Fire Department…

*This blog post was originally published at Medgadget*

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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