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Is Lack Of Kindness The Greatest Barrier To Healthcare Reform?

Ancient people couldn’t understand why solar eclipses happened, so they looked for explanations that fit what they saw:

A recurring and pervasive embodiment of the eclipse was a dragon, or a demon, who devours the sun. The ancient Chinese would produce great noise and commotion during an eclipse, banging on pots and drums to frighten away the dragon.

They weren’t crazy, although if we accept their explanation, their solutions seem pretty illogical.  I mean, would a dragon big and powerful enough to eat the sun really be scared away by people banging on pots and drums?

I guess I don’t understand the skittishness of giant sun-devouring dragons.

But this the trouble.  When you come at a problem with a faulty premise — and insist on keeping that premise — it leads you down some very strange paths. Read more »

*This blog post was originally published at See First Blog*

My Take On The Mammogram Issue

I was having an interesting Twitter chat with online friends (Liz Cohen @elizcohencnn, Dr. Chuk Onyeije @chukwumaonyeije; Dr. David Gorski @gorskon; Dr. Marya Zilberberg @murzee; Sherry Reynolds @cascadia; and @speakhealth) about the mammogram debate. They asked me “where I drew the line” on paying for expensive screening tests that may save lives but require unnecessary surgery for countless others. My opinion takes into account human nature and political savvy rather than pure science and statistics on this one.

To me, the bottom line is that the mammogram is a sloppy screening test. It’s expensive, there are lots of false positives and unnecessary surgeries, yet it saves occasional lives (which is dramatic and meaningful). We have to appreciate that women have come to accept the risks/benefits of this test, and have been told for a long time that they should begin screening at age 40.

It’s not emotionally or politically possible to reverse course on this recommendation until a better choice is available. You can trade the mammogram for a better test, but you can’t trade it for doing nothing. The amount of drama associated with the perception of having something potentially life-saving taken away is just not worth the cost savings. It may be a reasonable value judgment based on the data, but it’s not politically feasible so we should mentally take it off the table. Read more »

Dr. Val On Anderson Cooper: A New Model For Primary Care

I was interviewed about my participation in DocTalker Family Medicine, a new type of medical practice that dramatically reduces the administrative burden of healthcare. The solution is easy: transparent fees, low overhead, reliance on technology, and no insurance paperwork. Patients who are tired of waiting to see a doctor, or filling out insurance forms, can get immediate care, generally for under $50. The average patient in our practice spends under $300/year on their primary care – and carries insurance for catastropic events.

Links To Our Story:

Anderson Cooper 360 Blog, Part I

Anderson Cooper 360 Blog, Part II

Kaiser Health News

Primary Care Is Being Crushed By A Paper Weight

Ever wonder why your physician only spends 5-10 rushed minutes with you during your office visit? You may think it’s because there are simply too many patients vying for her time, but that’s not the real reason. The root cause is that health insurance companies are stealing time from your visit by requiring excessive documentation from your doctor. She can’t give you the time you need, because doing so would put her out of business.

In a special report on the administrative burden of healthcare, MedPage Today revealed that PCPs spend about one third of their income on documentation required by health insurers. Because they run a business with thin margins, they must increase the volume of patients they treat in order to cover the salaries of the staff required to manage this “paper weight.”

About 49% of all physicians have said that they are considering retiring or quitting medicine in the next two years (the rate is lower for specialists), largely because of increasing documentation requirements and decreasing reimbursement. Read more »

Larry King Researches Healthcare Reform At Better Health

I was glad to see that my recent interview with Tommy Thompson was referenced by Larry King in his opening remarks on healthcare reform with Elizabeth Edwards. My friend Eric Kuhn at CNN kindly offered me the video to embed here on my blog… The Better Health reference is at minute 1:08. I was also asked to submit a blog post to Larry King’s blog, so stay tuned for that! As I have always maintained – medblogs are upstream of mainstream!

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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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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