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A Doctor’s Letter To Patients With Chronic Disease

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Dear Patients:

You have it very hard — much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I, too, can’t understand what your lives are like. How do you answer the question, “How do you feel?” when you’ve forgotten what “normal” feels like? How do you deal with all of the people who think you are exaggerating your pain, your emotions, your fatigue? How do you decide when to believe them or when to trust your own body? How do you cope with living a life that won’t let you forget about your frailty, your limits, your mortality?

I can’t imagine.

But I do bring something to the table that you may not know. I do have information that you can’t really understand because of your unique perspective, your battered world. There is something that you need to understand that, while it won’t undo your pain, make your fatigue go away, or lift your emotions, it will help you. It’s information without which you bring yourself more pain than you need suffer. It’s a truth that is a key to getting the help you need much easier than you have in the past. It may not seem important, but trust me — it is. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Do Insurance Companies Help Kill Primary Care?

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Most doctors have a love/hate (and mainly hate) relationship with health insurance companies. We struggle with their confusing and complex coding rules in an effort to be reimbursed for our care of patients. When patients leave the office, they may think that a bill is sent to their insurance company and payment follows. More often than not it rarely happens that way.

I am staring at an explanation of benefits (EOB) from Blue Shield of California for a patient I saw for a physical exam and Pap test. This patient had recently been hospitalized with a life threatening throat infection and abscess and saw me for needed follow up. I spent about 45 minutes with the patient, reviewing the events leading to hospitalization, coordinating the medications, as well as addressing the routine screening and examination of a middle aged woman with some chronic health problems. Read more »

*This blog post was originally published at ACP Internist*

Dr. Val Tells ABC News How To Stave Off Memory Loss

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Did you know that physical activity can reduce your risk for memory loss and dementia? I had the chance to speak to ABC’s Let’s Talk Live team about important lifestyle choices that can keep the mind healthy and active. The good news is that you really can teach an old dog new tricks, and those new tricks can stimulate growth of new brain cells. Watch the video and check out the Alzheimer’s Association website for more information about dementia prevention:

Government Decisions About Avandia And Preventive Services

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An FDA advisory panel has voted that the diabetes drug Avandia (rosiglitazone) can remain on the market, but recommended further warnings associated with its use. The panel was divided, the New York Times reported, with 12 of 33 members saying the drug should be removed from the market, 10 voting to restrict sales and strengthen the warning label, 7 recommending only strengthening the warning label, and 3 voting for no change. One panel member abstained. (New York Times)

The White House yesterday announced which preventive services would be available at no charge to patients under the new healthcare legislation. Adult patients who choose a health plan after September 23 will receive mammograms, diabetes screening, and tobacco cessation counseling, among other services, at no increased cost, but insurers have said patients will eventually pay in the form of higher premiums, the Wall Street Journal reported. (Wall Street Journal)

*This blog post was originally published at ACP Internist*

Cleveland Clinic Targets The “Heart” Of Chicago

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All I can say is, best of luck. From the Chicago Tribune:

In a move likely to shake up the market for heart care in the Chicago area, the well-known Cleveland Clinic’s cardiac surgery program said Thursday that it has signed an affiliation agreement with Central DuPage Hospital in the western Chicago suburbs.

The internationally known Cleveland Clinic draws patients from more than 85 countries around the world for everything from open-heart surgery and valve replacement to heart transplants. Its deal with Central DuPage, in Winfield, is designed to enhance the heart care provided at the 313-bed community hospital and potentially bring Cleveland Clinic patient referrals at a time heart surgeries are less needed than they were a decade ago.

This won’t shake up the market in Chicago. After all, when you have a bunch of Cadillacs in the garage, why go after a Ford? Unless, of course, it costs a whole lot less to buy a Ford.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*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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