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Primary Care Crisis: Why The Patient-Centered Medical Home Will Fail

Everyone understands the need for a robust primary care workforce in making healthcare more affordable and accessible while keeping those in our care healthy. With the aging of America and healthcare reform, even more Americans will need primary care doctors at precisely the same time doctors are leaving the specialty in droves and medical students shun the career choice.

As a practicing primary care doctor, I’ve watched with great interest the solutions for the primary care crisis. And I’ve been utterly disappointed.

Patients so far don’t like the patient-centered medical home (PCMH) as noted in Dr. Pauline Chen’s New York Times column. The changes recommended won’t inspire the next generation of doctors to become internists and family doctors. Read more »

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

Dr. Frank Ryan’s Death: What We Can Learn From It

I’ll be honest — I’d never heard of Dr. Frank Ryan, a Hollywood plastic surgeon, until his tragic motor vehicle accident recently. Clients included actress Heidi Montag and boxer Oscar De La Hoya.

Although the California Highway Patrol investigation isn’t complete, rumors have suggested that Dr. Ryan may have been text messaging when driving. If this is true and an intelligent, well-trained doctor can fall prey to the allure of technology, then what does it mean for the rest of us?

First, realize that we can’t multitask. You have one brain. You can focus at one task at a time. Though laws allow hands-free cellphone calls, the issue isn’t trying to dial the phone but rather that the mind is engaged in the conversation and not on the road. Yes, we are all increasingly busy, but we can’t multitask. In fact, researchers have found that it takes more time and effort to refocus when we are distracted from one task to the other. Read more »

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

Water Safety: A Drowning Child Doesn’t Scream

This summer I learned a couple of very important lessons. Drowning kids don’t scream. Mothers have a sixth sense even when it’s not their own child.

On a beautiful warm sunny day in San Diego, my family and our good friends were enjoying a well-deserved vacation. My five-year-old daughter was splashing around with her friends as their father and I observed them from the pool. Though he had to watch three kids, one was already on a swim team and the two younger children had followed their big sister in swim class. He also had some help. His wife was watching the kids from her chair.  The scene was certainly picturesque, serene, and unassuming. Children playing happily in the pool. Adults relaxing and talking. It was a great day to be away from home and work.

Who would realize that nearby a little boy would be in serious trouble? Read more »

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

How To Talk To Your Doctor: 3 Simple Steps

As a practicing primary care doctor, I continue to work incredibly hard on making my bedside manner even better so that patients feel heard. The other reason is because as most doctors learned in medical school 90 percent of getting the right diagnosis comes from taking a good history from a patient.

Unfortunately with shorter doctor office visits and doctors interrupting patients within 23 seconds of starting, you need to know how to get your concerns across. While I don’t believe this is the responsibility of patients, the reality is not everyone has access to doctors with great bedside manner.

How to talk to your doctor is quite easy if you follow three simple steps. Read more »

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

Americans Are Cutting Back On Healthcare

The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer-driven healthcare in the way of higher deductibles and copays. This is very worrisome.

Certainly patients should have some financial responsibility for their care, but skimping on care will only result in Americans not becoming healthier, but sicker. Though the article cited some examples of patients saving money by not seeing their allergist for a refill of medication and simply calling for one and getting an athletic physical at a local urgent care clinic for $40 rather than $90 at the doctor’s office, these tiny behavior changes aren’t going to bend the cost curve in medical care. 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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