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Doctors, Hospitals, And The Yankees

Joe Boyd hated the Yankees. “Those damn Yankees. Why can’t we beat ‘em?” Then he got the opportunity to save his beloved Washington Senators by making a deal with the devil — giving up his soul in exchange for being transformed into “Shoeless Joe” to propel his team to win the World Series.

Interesting. I think a lot of doctors are making their deal with the devil. They are looking for a small gain in comparison to a long-term of misery. True — Joe Boyd made out in the end, but that will only happen if someone from Hollywood writes our script.

Here’s the problem: At the core of our problems with healthcare is the total lack of cohesive communication. Doctors have no idea what other doctors have done with a patient. Tests get ordered, medications get changed, procedures, hospitalizations, even surgeries are done without communication to other doctors who would benefit from this information. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Patient “Customer Service” Is Good Care

Gosh, a whole lot of huffing over a little word! “Customer.” Okay, now grab a paper bag and breathe slowly and steadily into it. I know it’s hard to hear that word. I am sorry to have caused such trouble.

Some folks misunderstood my last post, thinking that I thought patients should only be considered customers, or that they should be referred to as customers. I never said that, nor did I imply it. I simply said that patients are customers. They are. Medical care is not free, and it is being paid for by the patient (directly or indirectly). Medicine is a business that has been so mismanaged that we are now in a crisis over its financial side. The trouble is the cost of care. Cost implies money is used, and trading money for services or goods is what business is about.

We’ve been spending our dollars on healthcare like a person irresponsibly running up a credit card bill they can’t pay back. The pain doesn’t happen now, it happens down the road when the collectors knock. We can’t order whatever tests we want or prescribe gazillion dollar drugs without remembering somebody will have to pay the bill. Ignoring the business of medicine has gotten us into deep doo-doo. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

What Is A Patient? A Doctor’s Perspective

What is a patient? What do they do? What’s their role in the doctor’s office?  Are they chassis on a conveyor belt? Are they puzzles for doctors to solve? Are they diseases? Are they demographics? Are they a repository for applied science?

Or are they consumers? Are they paying customers? Are they the ones in charge? Are they employing physicians for their own needs?

It depends. It depends on the situation. It depends on perspective.

Some physicians are very offended when the “consumer” and “customer”  labels are applied to patients. They see this as the industrialization of healthcare. We are no longer professionals, we are made into “providers” — sort of smart vending-machine made out of flesh.

Patients, on the other hand, get offended when doctors forget who pays the bill. They see the exam room as a right, not a privilege. They think they should be the most important person in the exam room, being treated with respect rather than having to bow at the altar of doctor knowledge.

Who’s right? It depends. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Top Gripes About Drugs And What They Cost

I used to defend pharmaceutical companies. ”What companies out there have contributed more good? Should care manufacturers make more when all they do is make transportation that breaks after a few years?”

It made sense to me that you should put a pot of gold at the end of the rainbow so that companies are motivated to invent more drugs and innovate. We throw a lot of money to athletes and movie stars who simply entertain us, shouldn’t we do better to those who heal us? I used to say that. I don’t anymore.

No, I don’t think the drug companies are “evil.” People who say that are thinking way to simplistic. These companies are doing exactly what their shareholders want them to do: make as much money as possible for as long as possible. That’s what all companies do, right? They are simply working within the system as it is and trying to accomplish the goal of making money. To say that they should “sacrifice” is foolish. They are simply playing by the rules that have been set out there. Those rules are the thing that has to change. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Medicare Reimbursement: A 23 Percent Cut Soon To Come?

 

“It will never happen.”

“They know better than to do it.”

“They realize the disaster it would be if they let it pass.”

That’s what I hear. I hear that the upcoming SGR adjustment, the one that will cut Medicare reimbursement by 23 percent, won’t go through.

In case you missed it, the SGR is a formula coming from the Balanced Budget Act of 1997 that does automatic cuts to Medicare reimbursement. This year we witnessed a legislative game of chicken in congress, with both sides agreeing that it was a bad idea to screw physicians in a time that they are trying to fix healthcare. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

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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