November 24th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion, True Stories
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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*
November 14th, 2010 by Davis Liu, M.D. in Better Health Network, News, Opinion, Research
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The Associated Press ran a provocatively-titled piece recently, “Family health history: ‘best kept secret’ in care”, which noted how a geneticist at the Cleveland Clinic discovered that asking about family members and their history of breast, colon, or prostate cancer was better than simply doing genetic blood testing.
Surprising? Hardly. This is what all medical students are taught. Talk to the patient. Get a detailed history and physical. Lab work and imaging studies are merely tools that can help support or refute a diagnosis. They provide a piece of the puzzle, but always must be considered in the full context of a patient. They alone do not provide the truth. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
November 5th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion
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The Sacramento Bee recently ran the following opinion piece of mine below. A couple of additional comments not published follow. Enjoy.
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Viewpoints: Choice of health plan can be a lifesaver
It’s that time of year when most of us pick a health insurance plan based simply on cost. It’s a belief that is often perpetuated by friends, family, and advice dispensed by many articles in magazines and newspapers. As a practicing primary care doctor, I can tell you that the advice is frankly wrong.
Health insurance isn’t a commodity like auto insurance. It’s not just about the price. They aren’t all equally good at keeping you healthy and well. The recent annual report by the National Committee of Quality Assurance, which has been evaluating health plans for twenty years, continues to report tangible differences among health insurance plans across the country as well as in California.
In a ranking of 227 HMO plans nationwide in important areas like immunization rates for children, appropriate use of antibiotics, blood pressure and cholesterol control, cancer screening in adults for breast cancer, cervical cancer, and colon cancer, only two of nine California HMO health insurance plans ranked in the top 15 percent. The remaining seven were in the bottom half. If all health plans across the country performed at the level of the top 10 percent, 186,000 Americans would be alive today. They would have consistently and routinely received the preventive care and medical interventions that have proven to save lives. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
October 20th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion
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The first-year medical students I precept were too young to see Tom Cruise’s alter ego Lieutenant Pete “Maverick” Mitchell grace the big screen in the 1986 blockbuster film “Top Gun.” Yet, the story has a relevant analogy to medicine.
According to the film, during the Vietnam war American pilots were relying too much on technology to bring enemy fighters down. They weren’t as skilled in taking out the opposition. They fired their technologically advanced missiles to try and get the job done. They didn’t think. It didn’t work. They forgot the art of dogfighting.
The military discovered that technology alone wasn’t going to get the job done. The best fighter pilots needed the skills, insight, and wisdom on when to use technology and when not to. As a result, the Navy Fighter Weapons School, known simply as Top Gun, was created to retrain the military pilots on this vital lost skill. The goal of the program was specifically to make the best of the best even better.
Like the military, the country is discovering that the healthcare system enabled with dazzling technology isn’t getting the job done either. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
October 10th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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Unless your doctor is a policy expert, in healthcare administration, a researcher, an author or blogger, I seriously doubt he will be reviewing an important report card that helps you pick the best health insurance plan that keeps you healthy. Published annually by the National Committee for Quality Assurance (NCQA), this year’s report card ranks 227 health plans across the country on their ability to keep you healthy and well, treat you quickly, and how patients feel about their insurance coverage.
Because unlike banking or airlines where there is not much difference in ATM machines or planes, there is a big difference in whether a health insurance plan helps in keeping its enrollees healthy. Do children get their vaccinations? Do healthy mothers get screened for breast cancer or cervical cancer with mammograms and pap smears respectively? Do kids only get antibiotics appropriately for strep throat and not overtreated and unnecessarily when they have a viral illness or cold? Are adults over 50 screened for colon cancer (something Dr. Oz can relate to). Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
