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Hospital CEO Is Diagnosed With Cancer While Building A New Cancer Center

Pat Elliott, me and a HUGE cactus at Banner MD Anderson!

I am just back from the Phoenix-metro area. It’s now the 5th largest in the United States and despite home foreclosures, there is still a feeling of growth in many areas. Gilbert, a nearby suburb, has expanded to over 200,000 people and a growing major medical center. I spent several days interviewing patients and staff about the soon-to-open, Banner MD Anderson Cancer Center. The hope is that by bringing MD Anderson’s world-renowned expertise, clinical trials and processes to this new center, cancer care around Phoenix and the southwest will be improved. Look for my video interviews coming soon.

But, in the meantime, one interview stuck out for me; the one with the Banner Health President and CEO, Peter Fine. Peter is in his late 50s and is a health care industry professional who has been guiding Banner Health and its 23 hospitals well for over a decade. For the past several years, Peter has been strategizing the building of a major cancer center on one of his hospital campuses. Peter knew he would need a renowned partner to make it successful and three years ago he chose MD Anderson Cancer Center, in Houston, consistently ranked as the nation’s #1 cancer center (and where I was treated in a leukemia clinical trial).

Even before the partnership contract was inked, a strange thing happened. Peter found a swollen lymph node in his neck and it didn’t go away. Read more »

*This blog post was originally published at Andrew's Blog*

Should Doctors Treat Their Patients Like Customers?

Customer or patient?

I can’t remember; are they patients or our customers?

Are our patients really customers? Are they clients? Does this term, borrowed from the business world, really hold water in the current climate of health care? I believe if you ask most practicing physicians and nurses, other than those in charge of administration of groups and hospitals, they would say that they have patients, not customers, and that the whole idea is driving them batty.

The customer service model is very popular. Entire lectures and conferences exist to enforce this enlightened way to view patient care. I understand the drive, to an extent. The people we see in our hospitals and emergency departments need to feel valued and need to feel we are competent and caring. This matters especially in highly competitive markets because the ones who are happy keep coming back. This also matters because people who feel valued may be less likely to sue us. There is some logic to the customer service world view.

Unfortunately, Read more »

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

Tort Reform Will Not End Defensive Medicine

It’s ever so satisfying to be proven right. Well, maybe “proven” is too strong a word to use, but there is a bit of strong evidence that, as I have said in the past, the practice of defensive medicine is driven by powerful multifactorial incentives and is very unlikely to change even if the most often-asserted motivator, liability, is controlled. Today, Aaron Carroll guest blogs at Ezra Klein’s WaPo digs:

The argument goes that doctors, afraid of being sued, order lots of extra tests and procedures to protect themselves. This is known as defensive medicine. Tort reform assumes that if we put a cap on the damages plaintiffs can win, then filing cases will be less attractive, fewer claims will be made, insurance companies will save money, malpractice premiums will come down, doctors will feel safer and will practice less defensive medicine, and health-care spending will go way down.[...]

Health Affairs in December, estimated that medical liability system costs were about $55.6 billion in 2008 dollars, or about 2.4 percent of all U.S. health-care spending. Some of that was indemnity payments, and some of it was the cost of components like lawyers, judges, etc.; most of this, however, or about $47 billion, was defensive medicine. So yes, that is real money, and it theoretically could be reduced.

The question is, will tort reform do that? Read more »

*This blog post was originally published at Movin' Meat*

Supporting Primary Care Has Become A Partisan Issue

You’d think that ensuring that there will be enough primary care doctors would not become a partisan issue. If you are a Republican congressman from Texas, or a Democratic Senator from California, you’d want your constituents to have access to a primary care doctor, right?
Link

Apparently not: in the hyper-polarized and ideological world in which we now live, even modest steps to support primary care have been caught up in the worst kind of partisanship. The Washington Post reported recently that funding for a new expert commission authorized by the Affordable Care Act (ACA), which was to examine barriers to careers in primary care, has been blocked by Republicans:

“When the government set out to help 32 million more Americans gain health insurance, Congress and the Obama administration acknowledged that steering more people into coverage had a dark underside: If it works, it will aggravate a shortage of family doctors, internists and other kinds of primary care. So Page 519 of the sprawling 2010 law to overhaul the health-care system creates an influential commission to guide the country in matching the supply of health-care workers with the need. But in the eight months since its members were named, the commission has been unable to start any work. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Pregnant Female Prisoners Must Remain In Shackles During C-Section Procedures?

“But for the grace of God go I.” My late aunt drilled that value into my six-year old head and it has never left. An article regarding a New York politician recently caught my attention. When New York State enacted a bill to ban the shackling of pregnant prisoners, a New York State Assemblywoman objected. The article goes on to discuss the case of Jeanna M. Graves, who, in 2002 was arrested on a drug charge and began a three year sentence. Graves was pregnant with twins and while in labor, was handcuffed during her entire C. Section. How utterly ridiculous.

Before a C. Section begins, a patient is usually given either an epidural or spinal anesthesia. On rare occasions, she is put to sleep with general anesthesia if the baby must be delivered emergently. On all accounts, the patient’s legs will either be numb from anesthesia or she will be sleeping. Why then does she need shackles? She’s certainly not in a position to run. Although I addressed this issue last August, it needs to be revisited again. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

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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