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Latest Posts

The Perils Of Offering A Second Opinion On A Botched Boob Job

A mother called the office today. Her daughter had breast implants placed by a surgeon in another state and the two ladies are not happy. They called for a second opinion.

It is dicey dealing with situation like this as a second opinion consultant. The first question is whether or not the first surgeon did anything wrong. A botched boob job is not any boob job that the patient or mother do not like. “Botched” indicates fault. Sometimes there is fault on the part of the surgeon and sometimes there is not. Sometimes patients ask for surgery on the cheap and decline breast lifting or other associated surgery that might have made things look better. Sometimes the patient choose a surgeon of limited skill or qualifications. Sometimes infection, cigarette smoking or scarring can distort an otherwise good procedure. It is not always clear.

The second question for a consultant is whether or not the patient wants him or her to fix things or just wants to return to the original surgeon. No smart consultant wants to end up embroiled in a patient’s lawsuit with the original doctor. It is a waste of time and time is money.

*This blog post was originally published at Truth in Cosmetic Surgery*

Accountable Care Organizations (ACOs): HMOs With Lipstick?

Thousands of articles have been written about forming ACOs. Millions of dollars have been spent by hospital systems to try to form an ACO. Healthcare policy consultants have discovered a new cash cow.

Hospitals systems are wasting their money. They think the return from owning salaried physicians’ intellectual property will be more than worth the cost.

  1. Thousands of physicians have been confused by the concept of ACO.
  2. Many have felt ACOs are an attack on their freedom to practice medicine the best they can.
  3. Many have rejected the concept because they feel they will have to be salaried by hospital systems.
  4. Many physicians do not trust President Obama or Dr. Don Berwick.
  5. The Stage 2 ACO regulations are not easy to understand. They are more ominous than the stage 1 regulations.

The two core stated objectives for ACOs are:

(1) Reducing healthcare costs.

(2) Preserving and improving quality.

The stated objectives are laudable. The government regulations and controls are confusing. Read more »

*This blog post was originally published at Repairing the Healthcare System*

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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