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“Team Care” In The Patient-Centered “Medical Home?”

“Team care” has become a rallying cry for those who think the patient-centered medical home is bad for healthcare reform. Comments on a recent blog post in the New York Times provide a good example of this. When patients get sick, as the argument goes, they want to see their doctor — not some nurse or PA who they don’t know. I agree.

There are a whole bunch of things wrong with all the current focus on team care in the patient-centered medical home. Read more »

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

Connecting With Patients: A Forgotten Piece Of Medicine

I [recently] visited a small town in west Texas to address a local medical society on the emerging role of social media in healthcare.

My presentation involves social media and the evolving relationship that patients share with doctors. I discuss challenges and opportunities -– especially as it relates to transparency, personal boundaries, and even the ethical obligation to participate in the online conversation. I target the disconnected physician and offer education as well as a compelling argument for involvement.

When I arrived at the venue I found that the meeting was attended predominantly by physicians much older than myself.  While waiting to speak, I was concerned that my message of connection and changing relationships would elicit pushback. After all, isn’t it this era of physicians we hold accountable for paternalism and control in dealing with patients? That’s what I’d been lead to believe. Read more »

*This blog post was originally published at 33 Charts*

One More Medical Acronym To Add To The Pile

In medicine, hardly a week passes without the introduction of some new acronym, previously unspoken in the average practice, which then grows to prominence — take HIPAA, PECOS, CPT, ICD, etc. — the list goes on and on.

I believe that after 14 years of practice I’ve earned the right to introduce an acronym of my own: CRAPP. For the last several months, my partner and I have used this term to describe the volumes of denials, pre- and prior- authorizations (is there really a difference?), and faxes that seem to grow like weeds on the fertile planting grounds of our desks.

More specifically, in our office the acronym CRAPP stands for: Continuous Restrictive And Punitive Paperwork. To put it blithely, CRAPP could represent any document you wish someone had put on your partner’s desk instead of yours.

On a more emotional level, this acronym captures the visceral response I have whenever my attention is drawn away from my patients and redirected towards some nonsensical busywork — much like someone yelling at a golfer during their backswing.

Read more »

A Family Medicine Leader: What It Is, What It Takes

What is a leader? What is a family medicine leader? Giving a clear and concise answer to these questions have been a challenge for me as I have taken on different leadership tasks and positions.

I can’t believe that it was 10 years ago when I gave my first speech in seeking national office for my professional organization. I was in the final year of my residency, and my colleagues had to convince me to “just give it a go.”

I had done a bunch of stuff on the state level. But, I didn’t feel my game was ready for “prime time” -– meaning being on a national stage. I remember that speech like it was yesterday. My heart still pounds and my hands still get sweaty thinking about it. At the time, it was the most stressful couple of minutes of my life. Read more »

*This blog post was originally published at Doctor Anonymous*

How To Choose A Great Doctor

As a practicing family doctor, it’s easy for me to figure out how to choose a great doctor. Let me tell you the secrets in finding the best one for you and what I tell my family and friends. Look for the following:

— Board certification
— Report card on quality
— Licensing/public reporting

As a doctor, I know many doctors who have great bedside manner but aren’t particularly reliable in giving the right medical care you deserve, and these traits separate the so-so doctors from the truly excellent ones. Read more »

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

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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