October 22nd, 2010 by John Mandrola, M.D. in Better Health Network, Health Tips, Humor, News, Opinion
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I have an easy solution to a vexing problem in today’s healthcare crisis. A problem so widespread that it’s worth hundreds of words in the Wall Street Journal: Long wait times at the doctor’s office.
But first, before I give my simple, pragmatic, master-of-the-obvious solution, let me say something truthful: I try. I try really hard — to run on time, that is.
I’ve been there myself — a patient in a gown, in a cold room with only big pharma-sponsored propaganda on the walls to stare at.
At the risk of a sounding like a…blogger, let it be said that practicing quality medicine in the current luxury of technology is much more complicated than it used to be. Such complexity devours our most precious treasure: Time with the patient. Read more »
*This blog post was originally published at Dr John M*
October 18th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion
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You can be for freedom. You can be for smaller government that intrudes less. You can be for lower taxes. You can be for most anything, but if you’re interested in improving the sagging health of American citizens, get on Michael Bloomberg’s wheel.
As reported in the Wall Street Journal, NYC mayor, Michael Bloomberg, has asked the U.S. Department of Agriculture to bar city residents from using food stamps to buy sugary soft drinks. It turns out that last year $135 million in food stamp money was used for the consumption of these obesity-fostering beverages in NYC alone.
Mr Bloomberg is morphing into a real-world public health super star. Previously, he was a pioneer in banning smoking in restaurants and bars. They said it could not be done, or that it wouldn’t work. Well, the naysayers were dead wrong. Now public smoking bans our commonplace and, backed by objective data, are accepted as having prevented thousands of heart attacks. Read more »
*This blog post was originally published at Dr John M*
October 9th, 2010 by John Mandrola, M.D. in Better Health Network, Health Tips, Opinion, True Stories
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It’s been a very busy few weeks. Medicine is like that — seldom is “business” steady. Like rainy weeks in the southeast when you think it will never be sunny again, there are weeks when you think everyone’s atria are fibrillating. So there were shocks, and burns, and wires installed. The heart rhythm was rocking, and so were we.
But in all this fury two cases stand out as a reminder that in spite of, not always because of, what we doctors do, the human body can right itself — like it did before their were drugs, procedures, and surgery. (Keep this quiet, though.)
Case 1: A semi-emergent consultation for atrial flutter (AF’s crazy sister) came in. “Something has to be done, Dr. M,” was the message. She was symptomatic and scared (not necessarily in that order), but after a bit of simple doctoring (a pill), the heart rate had slowed and the symptoms abated somewhat. Then after a heavy dose of an AF doctor’s greatest weapon, reassurance and education, we mutually decided on one of my secret treatments for acute AF/AFlutter: A deep breath, a chair, a book, and time. Just in case, though, a cardioversion (shock) was set up for the next morning. I knew that since this was a first episode, that given some time the heart may right itself, without any fury.
Bingo. The text message came the next morning: “Cardioversion cancelled. Patient converted to sinus rhythm right after you saw her yesterday.” (Grin.) Read more »
*This blog post was originally published at Dr John M*
October 3rd, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion
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Could understanding the tacit rules which govern play on a neighborhood playground help us explain why some aspects of implementing healthcare reform are unlikely to succeed? Recent news involving McDonald’s Corporation suggests so.
On the playground, there are some simple precepts — like the fact that older and stronger kids get to make up the game, and the rules. That’s understood and mostly okay. As if these leaders are considered modestly benevolent and the rules are workable, the game is good and all benefit. And all players on the playground know this basic tenet of fairness: That the rules of the game shouldn’t change in the midst of the competition, and, taking it one step further, if the rules have to be changed they weren’t very good in the first place. Soon, if those in power become too controlling, too conflicted, or too self-serving, kids stop showing up, and the games cease.
In enacting this, our government gave us a very complicated game, with oodles of rules. (For the record, the PPACA of 2010 is 475 pages and 393,000 words.) But then, on further consideration of the rules, important players (McDonald’s) decided that they could not play. They were pulling out of the game, and they had many friends (Home Depot, CVS, Staples, etc.) who may not have spoke outwardly, but surely felt the same way. Read more »
*This blog post was originally published at Dr John M*
September 26th, 2010 by John Mandrola, M.D. in Better Health Network, Health Tips, True Stories
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“It was the best of times, it was the worst of times…”
An intermission, the curtain has closed on youth, but the next act awaits.
Caring for hiccups of the heart, like atrial fibrillation for example, often throws me in front of the mirror, of middle age that is, and sadly the reflections show imperfections. Since I am middle aged myself, there are my own experiences. But everyday at work, on my job site, I see the effects of these same middle-age experiences on the atrium of my patients. The results are often profound. So must be the pressures.
I read a passage in the wee hours of the quiet morning, in the dark, with a flickering book light. It grabbed me. It is from Elisabeth Strout’s Pulitzer Prize-winning, Olive Kitteridge. Read more »
*This blog post was originally published at Dr John M*
