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Latest Posts

Should A Salaried Physician’s Decreased Efficiency Be A Concern?

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For centuries, physician practices have been small  business enterprises built on the sweat equity of intensive medical training.  It was an economic reward system that often had physicians sacrificing family life for patient care.  It continues today as the  foundation of  fee for service.  We know it as the eat what you kill model of health care.

In the last ten years, physician practices have seen a dramatic shift from independent business practices to hospital owned practices. With that shift has come a titanic move toward the salary vs productivity  compensation model.

Is this a good thing?  Is a salaried physician better than a productivity based physician? That question can’t be answered because good depends on which part of the medical industrial complex you belong to and what you consider good.

As a physician, the answer on whether to become a salaried vs productivity based physician can only be answered after one defines what they value most.  We know, across the board, that physicians who work in a 100% productivity model earn Read more »

*This blog post was originally published at The Happy Hospitalist*

Research Regarding Infant Deaths Linked To Japan’s Fukushima Meets Controversy

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nuclear radiation, reporting on health, fukushima, vicente navarro, michael moyerLast week, I wrote about controversial research linking fallout from Japan’s earthquake-damaged Fukushima nuclear plant to infant deaths in the United States.

The research, which was harshly criticized by Scientific American’s Michael Moyer and others, was published in the peer-reviewed Journal of International Health Services, and I had asked the journal’s editor-in-chief Vicente Navarro for his response to the criticisms.

Navarro, professor of health policy at Johns Hopkins University’s Bloomberg School of Public Health, emailed me this comment today: Read more »

*This blog post was originally published at Reporting on Health - Barbara Feder Ostrov's Health Journalism Blog*

Survey Reveals Just How Stressed Physicians Really Are

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The vast majority of U.S. physicians are moderately to severely stressed or burned out on an average day, with moderate to dramatic increases in the past three years, according to a survey.

Almost 87% of all respondents reported being moderately to severely stressed and/or burned out on an average day using a 10-point Likert scale, and 37.7% specifying severe stress and/or burnout.

Almost 63% of respondents said they were more stressed and/or burned out than three years ago, using a 5-point Likert scale, compared with just 37.1% who reported feeling the same level of stress. The largest number of respondents (34.3%) identified themselves as “much more stressed” than they were three years ago.

The survey of physicians conducted by Physician Wellness Services, a company specializing in employee assistance and intervention services, and Cejka Search, a recruitment firm, was conducted across the U.S., and across all specialties, in September 2011. Respondents Read more »

*This blog post was originally published at ACP Hospitalist*

Research Shows A Large Number Of Women Have Experienced Domestic Violence

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domestic violence, CDC, reporting on healthDomestic Violence: 25 percent of women surveyed by the government say they were violently attacked by their husbands or boyfriends in a finding one federal official called “astounding,” the Associated Press reports.

C-Sections: The number of births by Cesarean section in Calif. has risen 50 percent in the past 10 years, new research shows, but it isn’t because of the health benefits over vaginal delivery. Researchers cite financial incentives for doctors and an “awareness gap” of the procedure’s risks among the explanations, Stephanie O’Neill reports for KPCC public radio.

Health Reform: South Carolina Gov. Nikki Haley predetermined the findings of a state committee working on health reform even before Read more »

*This blog post was originally published at Reporting on Health - The Reporting on Health Daily Briefing*

Survey Asks Doctors And Patients If Doctor’s Notes Should Be In The EHR

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We are fast entering the era of the electronic health record, when it will be possible to call up our medical records on our computers and mobile devices. Medication lists, lab results, appointment schedules—they’ll all be available with clicks of your mouse or taps on the screen of your smartphone or tablet.

But one question that’s far from settled is whether the electronic health record should include the notes that doctors make about them. A doctor’s notes can be straightforward, such as a reminder that an additional test might be needed. But they can also include somewhat speculative observations and hunches about a patient and his or her medical conditions. The Open Notes project is a research program designed to test the consequences of giving patients access to doctors’ notes. Harvard-affiliated Beth Israel Deaconess Medical Center is one of the test sites.

The Open Notes project is far from finished. But results of a survey of the expectations that doctors and patients have for note sharing are being reported in today’s Annals of Internal Medicine.

I don’t think there are any great surprises here.  More than half of the primary care physicians Read more »

*This blog post was originally published at Harvard Health Blog*

Latest Interviews

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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How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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Latest Book Reviews

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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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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