September 18th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion
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I’m trying to get off the topic of fatness, but just when it seems right to move on to something less hopeless, we hear that even doctors can be felled by obesity’s resilience.
To the Physicians Committee for Responsible Medicine, a group of well-meaning doctors who are buying expensive TV ads blaming McDonald’s for heart disease, I have just 5 words: McDonald’s is not the problem! Gosh. It’s maddening to think that such smart people could be that misguided — a whole committee of doctors completely devoid of any master-of-the-obvious is hard to fathom.
Don’t misunderstand — I’m not advocating McDonald’s food as overly nutritional, but blaming MacD’s for our obesity epidemic is like blaming guns for violence (for the record, guns scare me), brew pubs for alcoholism, or religion for war. (Sorry, that last one is a bad example.) Read more »
*This blog post was originally published at Dr John M*
September 10th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion, True Stories
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“Ouch! That really hurts! You win, please stop torquing my arm behind my back. “Uncle! I said, Uncle!!”
Yes, the threshold has been reached. We docs no longer need a tennis court or a Mercedes, our kids are fine in public schools, and we will happily buy our own damn pens.
But, please, just give us some modicum of autonomy. Throw us a measly scrap and let us take care of our patients as we see best. Like Dr. Saul Greenfield so beautifully said today in the Wall Street Journal. The paragraph that stood out the most for me is as follows:
Physician autonomy is a major defense against those who comfortably sit in remote offices and make calculations based on concerns other than an individual patient’s welfare. Uniformity of practice is a nonsensical goal that fails to allow for differing expression of disease states.
Really, it isn’t hyperbole to surmise that the overwhelming majority of doctors would decide, if faced with a choice between less compensation and less autonomy, to choose less compensation.
As a teen my dad told me the best part of being a doctor would be the autonomy. He was right, and that’s what hurts the most these days.
JMM
*This blog post was originally published at Dr John M*
August 28th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion
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Yes, it’s true — most doctors may soon be government employees. No, not the Lasik surgeons, the plastic surgeons, or the dentists — they were clearly more focused on career day. But is it necessarily a bad thing if all of your income comes from federal, state, or local governments?
If your business is caring for the medical needs of the less fortunate, a Medicaid doctor or a VA doctor perhaps, then your luxury box may be something more Thoreau-like, maybe some nice lawn furniture in the backyard. On the other hand, if your business model involves caring for recently-released prisoners or drug addicts, then you are in the financial sweet spot. Read more »
*This blog post was originally published at Dr John M*
August 21st, 2010 by John Mandrola, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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I saw a prescient story that linked antagonistic personality traits and cardiovascular risk. It was simply impossible to ignore. Low hanging fruit, no doubt.
The article highlights an NIH-sponsored study [published in the August 16th journal Hypertension] that looked at the effects of antagonistic traits — agreeableness, per se — on heart health. Yes, you read it right — agreeableness. To quantify agreeableness, the researchers used a personality questionnaire which included six traits: Trust, straightforwardness, altruism, compliance, modesty, and my favorite…tender-mindedness.
Your hypothesis is probably right: People who were distrustful, cynical, manipulative, self-centered, and quick to express anger fared worse. But please don’t dismiss this as just another mundane study proclaiming the risks of an angry personality. The specifics of the findings and their implications really hit hard. Read more »
*This blog post was originally published at Dr John M*
August 17th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, Opinion
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I present interesting cases to colleagues often because it’s educational and good for patient care and because I like to. But it has been many years since I was mandated to present a case.
It seems that I’m not the only doctor exasperated by a pesky new barrier to patient care: Doctors in cubicles.
An old friend and mentor, Dr. Richard Kovacs, now chair of the American College of Cardiology’s Board of Governors (and IU guy), has written about these same pre-certification barriers. Dr. Kovacs, being a professor and distinguished ACC official, kindly terms these obstructionists “radiology benefit managers” (RBMs). Read more »
*This blog post was originally published at Dr John M*
