November 9th, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
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With regard to physicians’ support for medical malpractice reform, the times they are a changin’. These iconic words of Bob Dylan, who has now reached the 8th decade of life, apply to the medical liability crisis that traditionally has been a unifying issue for physicians.
The New York Times reported that physicians in Maine are going soft on this issue, but I suspect this conversion is not limited to the Pine Tree State. Heretofore, it was assumed that physicians as a group loathed the medical malpractice system and demanded tort reform. The system, we argued, was unfair, arbitrary, and expensive. It missed most cases of true medical negligence. It lit the fuse that exploded the practice of defensive medicine. Rising premiums drove good doctors out of town or out of practice.
What happened? The medical malpractice system is as unfair as ever. Tort reform proposals are still regarded as experimental by the reigning Democrats in congress and in the White House. The reason that this issue has slipped in priority for physicians is because Read more »
*This blog post was originally published at MD Whistleblower*
October 18th, 2011 by Michael Kirsch, M.D. in Opinion
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The blog, Shots, posted a question primer to prepare patients for medical office visits with their doctors. A reaction to this appeared on Glass Hospital, where John Schumann offered his own wry version of the question list. My less wry, and more dry response appears below.
While I agree with Shots that education is power, a closer look at the question list demonstrates that the intent to educate may obfuscate instead.
First, the post is entitled, Ten Questions to Ask Your Doctor, suggesting that patients arrive at their physician’s office Read more »
*This blog post was originally published at MD Whistleblower*
October 12th, 2011 by Michael Kirsch, M.D. in Opinion
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There’s a new term that has entered the medical lexicon. The word is wellness. Hospitals and medical offices are incorporating this term into their mission statements, corporate names, business cards, medical conferences and other marketing materials. The Cleveland Clinic Foundation has appointed a Chief Wellness Officer, an intriguing fluffy title that does not clearly denote this individual’s role and function. This is deliberate, as the word wellness is designed to communicate a ‘feel good’ emotion, not a specific medical service.
Just a click or two on Google will lead you into the wellness universe. Here’s a sampling:
- Institute of Sleep and Wellness
- Wellness Institute of America
- Naturopathic Wellness
- National Wellness Institute
- Physicians Health and Wellness Center
- Physicians Wellness Group
There’s even a sponsored ad on Google where one can Read more »
*This blog post was originally published at MD Whistleblower*
October 7th, 2011 by Michael Kirsch, M.D. in Opinion
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Physicians are still debating whether prescribing placebos is ethical. Dissenters argue that this is dishonest and would erode trust between patients and their physicians. If the practice were to gain acceptance, then physicians’ credibility would be diminished. Patients would wonder whether the medicines their doctors are recommending are evidenced-based or fraudulent.
Patients can now push their own snake oil right back onto their physicians. I learned that the ‘secret shopper’ mechanism for quality assessment has been introduced into the medical profession. I first read about this in the March/April 2010 issue of the Journal of Medical Practice Management, a periodical that I suspect is not widely read by physicians.
Folks are hired as pretend patients and are dispatched to doctors’ offices and hospitals to document their findings. Their mission is to assess office staff, appointment issues and the waiting room experience. I wonder if Read more »
*This blog post was originally published at MD Whistleblower*
September 28th, 2011 by Michael Kirsch, M.D. in Opinion
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How much are good bedside manners worth? Would you double your copay if you could be guaranteed an extra measure of TLC from your physician? Can we put price on a physician’s warm smile, an understanding nod or a reassuring hand on your shoulder? Do patients have to contract with a concierge medical practice to receive this treatment?
I agree that our bedside manners with patients need some rejuvenation. It’s not fair, however, to isolate this issue out of context. Physicians today are facing crunching pressures from various sources that we cannot always compartmentalize when we are facing our patients – even though we should. Most folks believe that the bedside manners of the prior generation of physicians were superior to ours. Were our predecessors simply more compassionate and caring human beings than we are? I don’t think so. I think the medical profession was a different beast then. I hypothesize that if these wizened physicians entered the profession today, that they would behave differently.
Context is so critical when examining any issue. Read more »
*This blog post was originally published at MD Whistleblower*
With regard to physicians’ support for medical malpractice reform, the times they are a changin’. These iconic words of Bob Dylan, who has now reached the 8th decade of life, apply to the medical liability crisis that traditionally has been a unifying issue for physicians.
