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Why Doctors Should Be Less Like Chuck Yeager And More Like Captain Sullenberger

A recent medical error of a wrong-site surgery that occurred in one of the country’s best hospitals, Massachusetts General, reminded me why doctors need to be less like Chuck Yeager and more like Captain Sullenberger.

Growing up, I always wanted to be a fighter pilot, years before the movie “Top Gun” became a part of the American lexicon. My hero was World War II pilot Chuck Yeager, who later became one of the country’s premier test pilots flying experimental jet and rocket propelled planes in a time when they were dangerous, unpredictable, and unreliable.

Much like the astronauts in the movie “The Right Stuff,” Yeager and his colleagues literally flew by the seat of their pants, made it up as they went along, and never really knew if their maiden flight in a new aircraft might be their last. They were cowboys in the sky wrangling and taming the heavens.

Fast forward to January 2009, when shortly after takeoff, a one-in-a-million chance, a double-bird strike completely disabled a US Airways jetliner. Captain Chesley Sullenberger, with the help of his co-pilot Jeff Skiles, ditches the aircraft in the Hudson River in under four minutes even as the nation surely expected a tragedy. But not on that day. Not with that pilot. Read more »

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

The Patient: The Most Important Member Of The Healthcare Team

Do you feel patients are the most important part of the medical (healthcare) team?

In a recent post on Health in 30, “When Doctors and Nurses Work Together,” I wrote about the team-based approach for caring and treating patients, and it addressed the relationship between nurses, doctors, patients and the importance of a multidisciplinary, team-based approach to patient care.

The healthcare team is comprised of a diverse group of specialized professionals, and the most important part of the medical team is the patient.

Subsequent to publishing this post, I received an email from an author and patient advocate stating that patients are not the most important member of the medical team. I value and respect this comment, however I politely and passionately disagree. As a registered nurse and consumer health advocate, I emphatically say that patients are the most important part of the medical team. Read more »

*This blog post was originally published at Health in 30*

The Seduction Of Primary Care

Hey there, big, smart, good-looking doctor…

Are you tired of being snubbed at all the parties? Are you tired of those mean old specialists having all of the fun?

I have something for you, something that will make you smile. Just come to me and see what I have for you. Embrace me and I will take away all of the bad things in your life. I am what you dream about. I am what you want.  I am yours if you want me…

Seduce: verb [trans.] attract (someone) to a belief or into a course of action that is inadvisable or foolhardy : they should not be seduced into thinking that their success ruled out the possibility of a relapse. See note at “tempt.”

(From the dictionary on my Mac, which I don’t know how to cite.)

If you ever go to a professional meeting for doctors, make sure you spend time on the exhibition floor. What you see there will tell you a lot about our system and why it is in the shape it is. Besides physician recruiters, EMR vendors, and drug company booths, the biggest contingent of booths is that of the ancillary service vendors.

“You can code this as CPT-XYZ and get $200 per procedure!”

“This is billable to Medicare under ICD-ABC.DE and it reimburses $300. That’s a 90 percent margin for you!”

This is an especially strong temptation for primary care doctors, as our main source of income comes from the patient visit — something that is poorly reimbursed. Just draw a few lab tests, do a few scans, do this, do that, and your income goes up dramatically. The salespeople (usually attractive women, ironically) will give a passing nod to the medical rationale for these procedures, but the pitch is made on one thing: Revenue. Read more »

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

Patient Engagement: How Empathy Can Empower Your Patients

In my recent post on KevinMD, “Deeply Connect and Engage Your Patients With Empathy,” I write about how empathy is essential to help empower our patients: “It is with empathy that we can engage and empower our patients.”

Doctors and nurses are leaders in health care.

Being a great leader means having a clear vision, mission or goal. It means being committed, and knowing how to listen and communicate, but it involves much more. It’s about having heart, empathy, and an uplifting spirit.

I value and respect a well written post by Thomas Goetz, author of The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine recently published on KevinMD, “How can doctors successfully engage their patients?” Goetz writes about “Five things they should seek to give every patient, strategies to tap the most underutilized resource in medicine, their patient,” however I feel the most critical ingredient is missing, empathy.


It is with empathy that we can engage and empower our patients. With empathy and heart we can help our patients feel good, valued and respected. Empathy allows us to engage and empower our patients to take charge of their health and well-being. Read more »

*This blog post was originally published at Health in 30*

Misusing Medical Technology And Escalating The Cost Of Healthcare

Guest post by Stephen C. Schimpff, M.D.

We are often told that the reason for the high cost of medical care is all of our new technologies and drugs. There is an element of truth in that but when used correctly, new technologies save lives and improve the quality of patient care and often improve safety. But technologies used inappropriately increase costs while not improving quality and may adversely impact safety.

A patient example

An older woman had been coming to the same primary care physician (PCP) as her daughter for over twenty years. She lived in another city about 30 miles distant but she preferred to visit the doctor with her daughter. She also occasionally saw a doctor near her home if she had an immediate problem.

On nearly every visit she said that she felt “tired.” Repeated history and exam over twenty years revealed no cause nor did logical tests such as those for anemia or hypothyroidism. She then developed syncopal episodes — times when she would black out and fall to the floor, once bruising her head when she fell against the stove, and then waking up in a few minutes. Evaluation by the PCP showed that she had intermittent episodes of bradycardia, or very slow heart rate, resulting in the drop attacks. Read more »

*This blog post was originally published at Health in 30*

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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