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Emergency Contacts In Your Mobile Phone: Let ICE Speak For You When You Can’t

A good friend and fellow physician sent me this notice. This is an important public service announcement.

An individual citizen, not the government, initiated the program.  If adoption of the program becomes a national standard, it will demonstrate people power and individual responsibility.

The key to Repairing the Healthcare System is individual responsibility. This program represents an opportunity for every individual to assume responsibility for themselves and alert everyone they know to be responsible for themselves.

A paramedic conceived ICE.  At the scene of accidents he found cell phones on an unconscious victim but he could not find whom to notify.

He thought it would be a good idea if there was a nationally recognized symbol to find a victim’s contact person In Case of an Emergency in the victims cell phone directory.

The ICE cell phone number could be Read more »

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

Genetics And The Blame Game

Just heard a news story that researchers have identified three genes responsible for about 9 percent of  stuttering. In the story, a woman who stuttered as a child and teenager and who now works with other stutterers was nearly in tears at the news. Her clients, she said, would be so happy to learn that their stuttering “wasn’t their fault.”

I’m happy for the stutterers of the world. But this story made me think about so many other things related to our health that we try to find an “out” for, something that makes it not our “fault.” The more we learn about the contribution of genes to human health, the more stories like the stuttering one we’ll hear. The thing is, our genes do not operate in a vacuum. Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine and Health Care*

Tough Love: When Should Physicians Use This Strategy?

Have you ever stopped bothering to care about a patient?  A doctor sent me his own personal account of the smoking Mr Jones:

Dear Happy.  I read your article on bounce backs with great interest, and was astonished by some of the vitriol it elicited.  I remember having one COPDer bounce back to me three times within a month at the VA when I was a medicine resident.  He would leave, smoke and drink, and then come back and be readmitted to my service with exactly the same course each time.  It was like Groundhog Day.

Finally I had a little talk with him and said: “Mr. Jones, each time you come in, you’re on death’s door.  So I come down to the ER, stay up with you all night and save your life.  But you know, I’m really getting tired of having you come in after drinking and smoking and then working like a dog to save your life.  So let me tell you, if you don’t quit smoking, the next time you do this there’s a good chance that I’m not going to bother.  Why should I?  It doesn’t seem to be doing either of us any good.”

To my complete astonishment, he actually quit smoking and stayed quit for about a year.  Then he fell off the wagon, deteriorated too far before getting to the hospital and died.  I was frankly proud of him for the effort, but somehow suspect that I’d be shot in a drive-by if I ever told that story in public. Read more »

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

Is This A Healthcare Crisis Or A Culture Problem?

I got an email today laying out the reality of our current health care debate.  Is it a crisis of culture or a health care crisis.  I am a firm believer in taking responsibility for one’s actions.  I believe those who chose not to practice healthy lifestyles should pay more for the consequences of their actions than those who do.  I believe the solution to our health care finance quandary lies not in controlling the  cost of treating disease, but rather in upholding the personal responsibility all Americans have to themselves and their country.

What does the distribution of health care dollars look like among the American population?  While we know that 50% of our population spends only 3% of health care dollars, we also  know that 50% of our health care dollars are spent by 5% of our population, a population of chronic disease sufferers who’s diseases  are, by and large,  a direct result of the personal decisions they chose to make on a daily basis.  For the most part, genetics alone is no longer an excuse.  We knew very well that lifestyle directly affects the expression of disease by genes. Read more »

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

You Can Save Our Healthcare System

What we need is health reform, not health insurance reform.  If we do nothing about health care inflation, we are all doomed.  Every last one of us.  Taking care of sick people is expensive. The only way to get rid of health care inflation is to stop spending money.  At some point we will either have to

  1. decrease illness
  2. decrease treatment and/or
  3. decrease the cost of treatment

There are no alternatives.  As an American which action plan would you rather see take hold?  Realize that every cost action has a reaction.  You can decrease disease by prevention.  You can decrease treatment by bundling.  And you can decrease the cost of treatment by making it more efficient or simply paying less until access becomes an issue.    I am certain that  keeping the financial stability of America will require all three.  But the only one you as a patient have control over is #1.  As a country, we can prevent 80% of diabetes, heart disease, stroke and cancer by taking care of ourselves with lifestyle modification. Read more »

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

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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