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Should Doctors Work Weekends?

Peter Orszag wants doctors to work weekends. The former director of the White House Office of Management and Budget wrote as much in this past weekend’s New York Times:

Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their industry can no longer afford to protect them from the inevitable. Imagine a drugstore open only five days a week, or a television network that didn’t measure its ratings. Improving the quality of health care and reducing its cost will require that doctors make many changes — but working weekends and consenting to quality management are two clear ones.

And he’s right, to a point.

I’ve pointed to studies showing that mortality rises on the weekends, in part due to skeleton staffs that hospitals employ on Saturday and Sunday. And, since Mr. Orszag is an economist, the cost factor is noted. Tests that get pushed off until Monday cost the health system serious dollars. The problem I have is that Mr. Orszag, like most health reformers, offers doctors little incentive in return. Read more »

*This blog post was originally published at*

When A Vacation’s Not A Vacation

I just got back from extended time off, which brings to mind a post I wrote two years ago:

Here’s an observation: most physicians in private practice don’t take enough vacations. I am often (rightly) accused of this sin. My staff, colleagues, and even patients regularly encourage me to take time off, but still I find it hard.

Why is this? Is it that I love my job so much that I can’t tear myself away from it? Is it that my self-worth is wrapped up in being “the man” for my patients, and being away from this makes me feel insecure? Is work my addiction –- the one place that I have control of my circumstances and positive reinforcement? Perhaps. But I think the reasons are more basic than that. Read more »

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

How Much Does A Heart Attack Cost?

Money HeartHow much would a heart attack cost you? Quite a bit, according to CBS

According to an article from the National Business Group on Health, the average total [editor's note: lifetime] cost of a severe heart attack -– including direct and indirect costs -– is about $1 million. Direct [lifetime] costs include charges for hospitals, doctors and prescription drugs, while indirect costs include lost productivity and time away from work. The average [lifetime] cost of a less-severe heart attack is about $760,000. Amortized over 20 years, that’s $50,000 per year for a severe heart attack and $38,000 per year for a less-severe heart attack.

I’m all for maintaining a healthy lifestyle, but before we get all hot and bothered about performing more testing to “prevent” a heart attack as a means to save healthcare costs going forward, remember the lessons we learned from the Tim Russert fallout. Read more »

*This blog post was originally published at Dr. Wes*

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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