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Disease By Choice

“Why should I take my blood pressure medication,” you ask? The more I do this thing called hospitalist medicine, the more I appreciate the power of lifestyle choices we all make.

Every opportunity I get I give my patients my smoking lecture and charge their insurance  a CPT 99406. Everybody knows that smoking is bad for you and it causes lung cancer. Nobody knows all the other stuff. They’re always shocked.

Maybe it’s time for me to start a blood pressure lecture. I often have  patients who say: “Why should I take my blood pressure medication?” They always answer their own question with the same answer: “I was feeling fine. I didn’t see a reason to take my blood pressure medication.”

You see, these are people with insurance. These are people with the Medicare National Bank. These are people who don’t have to lift a finger or a dime to pay any out-of-pocket expenses for their healthcare. And yet, they still lack the motivation to care for themselves, even with incredible resources out there these days to help them — things like great online blood pressure chart sites for home monitoring.

Whatever the reason — whether it’s ignorance, laziness, lack of motivation, lack of remembering, or selfishness — people just don’t take care of themselves. Read more »

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

“Medical Self-Care” And The Doc Tom Interview

Next in our series of posts about our founder Doc Tom. Previous time capsules: 1980 and 1985.

Come, ye economics buffs and algebra fans: Get out your pencils and solve for x, n, and XX:

Whatever else the year 19XX is remembered for, it will — without a doubt — go down in history as a record year for medical expenses here in the United States. All indications are that before the calendar year is out, Americans will have spent $x (n% of the Gross National Product) on drugs, X-rays, surgery, physicians’ fees, laboratory tests, hospital overhead, health insurance, etc. That’s up from the [$0.3x] ([.7n%] of GNP) just 13 years ago.

Clearly, the medical establishment has become a threat to the average American’s budget (if not his health).

Ready? That was…1978. Check the tiny numbers:

Whatever else 1978 is remembered for, it will—without a doubt—go down in history as a record year for medical expenses here in the United States. All indications are that before the calendar year is out, 216 million Americans will have spent $139 billion (8.6% of the Gross National Product) on drugs, X-rays, surgery, physicians’ fees, laboratory tests, hospital overhead, health insurance, etc. That’s up from the $39 billion (5.9% of GNP) medical care cost in 1965 . . . just 13 years ago.

Tom Ferguson was a medical student, and in the self-reliant era of the Whole Earth Catalog, he saw that patients could help heal healthcare by taking better care of themselves. In 1976 he’d started a magazine called Medical Self-Care. The text above appeared in Mother Earth News in May 1978, as the introduction to an 8,000-word interview with Tom. Read more »

*This blog post was originally published at e-Patients.net*

Latest Interviews

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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

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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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