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The Illusion Of Healthcare Reform

The greatest minds are assembled to discern the answer in healthcare reform. Powerful interest groups are aligned to design solutions to protect their turf. Rubrics, formulas, slogans and taglines get designed, spun, pitched and thrown out. The burden of finding alignment, an answer, a plan that suits everyone seems insurmountable — unless we don’t.

The idea of a fit for all is an illusion. Justice and equity are seen differently. We imagine some public consensus at our own peril. But honesty has been in short supply. To paraphrase Oprah: What do we know for sure?

Some people want a relationship with a trusted doctor who knows them well. They want to pick the doctor, the neighborhood and the hospital they attend. Others want immediate access and have little trust or interest in a personal relationship with a doctor.

Some people want interchangeable access to medical care in the most convenient venue — they care little if it occurs at Walgreens, doc-in-a-box, by a nurse practitioner or by a newly-minted resident — it is about access that fits their lifestyle, which may be at a late hour and may be chosen by shortest waiting time at an ER. To others, this type of medical care is anathema. Read more »

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

Social Media For Doctors: The Pros And Cons

The pros and cons of social media for physicians are nicely reviewed by a number of prominent medbloggers (including yours truly) by Bonnie Ellerin in her recent white paper (pdf). An excerpt:

There is a profound change sweeping the world of medicine. Technology is the driver, but it has nothing to do with a new drug, device or procedure. Rather it is about the change in physician behavior and mindset that technology — the Internet more specifically — has unleashed. Today, physicians of all ages and specialties are online, whether via laptop, desktop, or mobile.

With physicians’ acceptance of technology has come a new type of openness among a small but growing number. In the past, the only doctors who were likely to air views publicly were medical journalists. But, today, there are physicians who blog, tweet, email with patients, post videos, even check-in on Foursquare. If you have any doubt, just look at the “Favorite Blogs” section of a physician blogger or scan the list of followers/following of any doctor on Twitter, and you’ll get a sense of how many of them are getting social. Far more than you thought.

Read more HERE.

-WesMusings of a cardiologist and cardiac electrophysiologist.

h/t: @hjlucks on Twitter via Smartblog On Social Media.

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

Doctors’ Right To Freedom Of Speech

Imagine having a medical device that is being tested in multiple centers, but one doctor thinks the device has problems. He says so at a national conference despite glowing reviews by others. Should the company sue the doctor for liable and remove him from their investigative panel?

Today, it seems that might not be such a good idea. This is, in fact, what NMT Medical did regarding comments made by Peter Wilmshurst, M.D. regarding NMT’s patent foramen ovale (PFO) closure device called Starflex:

NMT sued Dr. Wilmshurst for libel after he criticized its research at a US cardiology conference in 2007. The doctor vowed to take the case to trial in order to defend scientists’ rights to free academic debate.

The company threatened Dr. Wilmshurst with libel a second time for subsequent comments he made about the case on BBC Radio 4’s Today programme. Read more »

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

WikiLeaks: What It Means For Healthcare Privacy

From the official White House statement yesterday regarding WikiLeaks disclosure of diplomatic cables:

“By releasing stolen and classified documents, WikiLeaks has put at risk not only the cause of human rights, but also the lives and work of the individuals. We condemn in strongest terms, the unauthorized disclosure of classified documents and sensitive national security information.”

No matter what people think of WikiLeaks disclosure of approximately 250,000 classified diplomatic cables to the Internet yesterday with the help of the New York Times, The Guardian, Der Spiegel, and Le Monde, the implications to electronic healthcare information security are significant.

Day in and day out, I type huge volumes of information on my patients on a computer and my fellow physicians do the same. As a result, vast healthcare information warehouses are at the disposal of the government, insurers, and major healthcare institutions eager to become more efficient, strategic, or competitive. We are promised the information is private, confidential, and even stripped of its identifiers for group analysis. It is even protected to remain so by law. Read more »

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

Thanksgiving: A Heart Attack For Dessert?

It seems the Washington Post, cloaked under an anonymous author, wants to use scare tactics to keep most of us from enjoying Thanksgiving with their ominously titled article, “And for dessert, a heart attack?” They spew all kinds of garbage with very little data about how eating a high-fat diet might give you a heart attack.

If you want to know more, consider this article* from some pretty smart folks at Harvard. Then eat, drink, and be merry without guilt (courtesy of Dr. Wes). Happy Thanksgiving!

– WesMusings of a cardiologist and cardiac electrophysiologist.

*REFERENCE: Renata, M. and Mozaffarian, D. “Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence.” Lipids, 31 Mar 2010.

[Photo credit: Lambert]

*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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