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Can Patients Choose A Good Doctor Online?

The following op-ed was published on October 27th, 2010 in USA Today:

When I ask new patients how they found me, frequently they say on the Internet through search engines such as Google.

Out of curiosity, I recently Googled myself. Numerous ads appeared, promising readers a “detailed background report” or a “profile” of me. Among the search results was information about my practice, whether I was board certified, had any lawsuits against me, and reviews from online doctor rating sites. Thankfully, most were favorable, but some were not.

Can patients reliably choose a good doctor online?

People already choose restaurants, movies, and their college professors based on what they read on the Internet, so it’s inevitable that many will research their doctors on the Web as well. But there are some good reasons consumers should be wary of the information they find online about doctors.

Random information?

An Archives of Internal Medicine study in September found that most publicly available information on individual physicians — such as disciplinary actions, the number of malpractice payments, or years of experience — had little correlation with whether they adhered to the recommended medical guidelines. In other words, there’s no easy way to research how well a doctor manages conditions such as heart disease or diabetes. That kind of relevant performance data are hidden from the public. Read more »

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

What Kind Of Physicians Does The Government Want To See?

Here’s my [recent] commentary at KevinMD.  Let me know what you think. What kind of physicians DO we want for the future?

I was talking with a pre-med student recently. He had completed his very first medical school interview and was, understandably, excited. But he told me the interviewer had asked him what he thought would be the outcome of the current healthcare reform measures.

I laughed to myself. After 17 years in practice, even I don’t know the outcome, though I have my suspicions. It seemed a loaded, almost unfair question. After miring students in biology, physics, chemistry and every known application-padding activity, after expecting volunteerism and activism, I’m not sure why they would expect this young man to have any earthly idea about the reform measures from his current position in the medical biosphere.

But I wondered, since I’m not a medical educator, was there a right answer? And I wondered even more, what do we want in our future physicians? Read more »

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

Infection Control And The Doctor-Patient Relationship

Hospitals have recently been stepping up their infection control procedures, in the wake of news about iatrogenic infections afflicting patients when they are admitted. Doctors are increasingly wearing a variety of protective garb — gowns, gloves, and masks — while seeing patients.

In an interesting New York Times column, Pauline Chen wonders how this affects the doctor-patient relationship. She cites a study from the Annals of Family Medicine, which concluded that,

fear of contagion among physicians, studies have shown, can compromise the quality of care delivered. When compared with patients not in isolation, those individuals on contact precautions have fewer interactions with clinicians, more delays in care, decreased satisfaction and greater incidences of depression and anxiety. These differences translate into more noninfectious complications like falls and pressure ulcers and an increase of as much at 100 percent in the overall incidence of adverse events.

Hospitals are in a no-win situation here. On one hand, they have to do all they can to minimize the risk of healthcare-acquired infections, but on the other, doctors need to strive for a closer bond with patients — which protective garb sometimes can impede. Read more »

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

Medical Malpractice Reform: Would Doctors Accept The Deal?

The bipartisan debt commission appointed by President Obama recently released its recommendations on how to pare the country’s debt.

Of interest to doctors is the suggestion to change the way doctors are paid. Physician lobbies have been advocating for removal of the Sustainable Growth Rate (SGR) formula — the flawed method by which Medicare, and subsequently private insurers, pays doctors. According to this method, physicians are due for a pay cut of more than 20 percent next month.

According to the commission:

The plan proposes eliminating the SGR in 2015 and replacing it with a “modest reduction” for physicians and other providers. The plan doesn’t elaborate on what constitutes a “modest reduction” in Medicare reimbursement.

Meanwhile, the Centers for Medicare and Medicaid Services (CMS) should establish a new payment system — one that rewards doctors for quality, and includes accountable care organizations and bundling payments by episodes of care, the report said.

The commission also said in order to pay for the SGR reform, medical malpractice lawyers should be paid less, there should be a cap on noneconomic damages in medical malpractice cases, and that comprehensive tort reform should be adopted.

There’s little question that associating physician reimbursements with the number of tests and treatments ordered is a major driver of health costs. Removing that incentive, and better valuing the time doctors spend with patients, is a positive step in the right direction. Read more »

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

Health IT And Job Security

Hospitals nationwide are racing against the clock to ensure their health IT systems meet meaningful use guidelines. The incentive? Money, of course. Systems that meet certain criteria make doctors eligible for up to $44,000 in bonus money from the government.

As mentioned on this blog previously, implementing an electronic health system is difficult. The usability of the current generation of electronic health records (EHRs) is still relatively primitive, especially when compared to other industries, and the disruption in workflow is undeniable. Worse, there seems to be a lack of trained IT professionals to do the job.

In a recent piece from American Medical News:

60% of hospital IT executives believe tech staffing shortages, which some estimate to be a shortfall of 50,000 qualified IT professionals, will definitely or possibly affect their chances to achieve meaningful use.

It’s a problem. Read more »

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

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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