Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Improving Doctor-Patient Communication To Provide Patient-Centered Care

The first experience patients are likely to have with your hospital is not in an ER visit or inpatient stay.  A patient’s first experience will most likely be in one of your primary-care physician offices.  That because a person is 10 times more likely during a year to end up in the physician’s office for a routine visit than they are to require an overnight hospital stay.

As a hospital marketer or patient experience officer this should raise an interesting question. How well do your physicians–particularly your primary-care physicians–represent your brand?

Take “patient-centeredness.” Lots of hospitals these days are promoting themselves as providing patient-centered care.  You know … when the hospital and its staff try where possible to be sensitive to and honor the wishes of patients.   But when it comes to patient-centeredness, “walking the talk” is hard in physician offices and even tougher in the hospital.

The fact is that most physicians, with some exceptions, are Read more »

*This blog post was originally published at Mind The Gap*

Most Americans Don’t Know What Healthy Eating Means

Jessie GrumanOnly one in 10 respondents to a national survey could estimate how many calories they should consume in a day.

Seventy-nine percent make few or no attempts to pay attention to the balance between the calories they consume and expend in a day.

These and other piquant findings from the online 2011 Food and Health Survey fielded by the International Food Information Council Foundation (IFIC) struck home last week as I smacked up against my own ignorance about a healthy diet and the difficulty of changing lifelong eating habits.

The confluence of my failure to gain weight after cancer treatment and a blood test suggesting pre-diabetes meant that as of last Tuesday, I have been on an eat-specific-types-of-food-every-hour-and-write-it-down regimen.  And despite a lifetime of recommending that people change their behavior to become healthier, I am frustrated as I try to follow my own advice. I am bewildered about what I’m supposed to eat.  Finding it, preparing it and then eating it at the right time requires untold contortions and inconvenience. Writing it all down is tedious.  I don’t have time for this – I have a job, obligations. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Can Primary Care Physicians Keep Specialists From Ordering Too Many Tests?

There are many tips to saving money on medical costs like asking your doctor only for generic medications, choosing an insurance plan with a high deductible and lower monthly premiums, going to an urgent care or retail clinic rather than the emergency room, and getting prescriptions mailed rather than go to a pharmacy.

How about getting your old medical records and having them reviewed by a primary care doctor?  It might save you from having an unnecessary test or procedure performed.

Research shows that there is tremendous variability in what doctors do.  Shannon Brownlee’s excellent book, Overtreated – Why Too Much Medicine Is Making Us Sicker and Poorer, provides great background on this as well as work done by the Dr. Jack Wennberg and colleagues on the Dartmouth Atlas. Some have argued that because of the fee for service structure, the more doctors do the more they get paid.   This drives health care costs upwards significantly.  Dr. Atul Gawande noted this phenomenon when comparing two cities in Texas, El Paso and McAllen in the June 2009 New Yorker piece. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

New Doctor Considering Primary Care? Show Me The Money

There are plenty of reasons why medical students aren’t choosing primary care as careers. Lack of role models. Perception of professional dissatisfaction. High burnout rate among generalist doctors. Long, uncontrollable hours.

But what about salary? Until now, the wage disparity between primary care doctors and specialists has only been an assumed reason; the evidence was largely circumstantial. After all, the average medical school debt exceeds $160,000, so why not go into a specialty that pays several times more, with better hours?

Thanks to Robert Centor, there’s a study published in Medscape that shows how money affects career choice among medical students. Here’s what they found:

Sixty-six percent of students did not apply for a primary care residency. Of these, 30 percent would have applied for primary care if they had been given a median bonus of $27,500 before and after residency. Forty-one percent of students would have considered applying for primary care for a median military annual salary after residency of $175,000.

And in conclusion:

U.S. medical students, particularly those considering primary care but selecting controllable lifestyle specialties, are more likely to consider applying for a primary care specialty if provided a financial incentive.

Money matters. There should be no shame for new doctors to admit that. After all, they’re human too, and respond to financial incentives just like anyone else. And when most medical students graduate with mortgage-sized school loans, salary should be a factor when considering a career. Read more »

*This blog post was originally published at*

More Doctors Are Refusing Industry Perks And Gifts

Christmas present by the Italian voice via FlickrPhysicians and particularly primary care doctors are reporting fewer industry ties than five years ago, according to a survey.

While 94% of doctors reported some type of perk from a drug or device maker in 2004, 83.8% did in 2009, researchers reported in the Nov. 8 Archives of Internal Medicine.

Researchers surveyed a stratified random sample of 2,938 primary care physicians (internal medicine, family practice, and pediatrics) and specialists (cardiology, general surgery, psychiatry and anesthesiology) with a 64.4% response rate. Read more »

*This blog post was originally published at ACP Internist*

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »