June 16th, 2010 by SteveSimmonsMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
Tags: DocTalker, Dr. Steve Simmons, Healthcare IT, Healthcare reform, ICD-10, ICD-9 Codes, Meaninful Use, Patient-Doctor Relationship, Primary Care
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I believe that those controlling the purse strings are steering modern medicine towards the practice of seeing patients more as the sum of their medical problems than as individual people. Patients have become streams of data as opposed to real human lives.
Consider the dynamics of a family: a wife may worry about her husband while their child adores a father she instinctively knows to be irreplaceable. Modern medicine, however, may only see a diabetic with hypertension and a cholesterol-level running too high. The computers programmed for those advocating the power of data to revolutionize medicine would boil this man down to his “meaningful” essence — numbers, for the above imaginary man: 250.00, 401.0, and 272.0. Read more »
June 9th, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
Tags: Dan Hart, direct-pay doctor, DocTalker, Graduating Doctors, Healthcare reform, Medical Class Of 2010, Medical School, Medical Students, New Doctors, New Medical Interns, Primary Care, Prospective Physicians
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As a medical student in his last year, I can attest that my classmates and I would like nothing less than a crystal ball. Always a daunting time in a future physician’s career path, the direction we point ourselves as we launch out of medical school this year seems as arbitrary as ever.
As we examine the rolling seas of medicine and try to determine our individual paths, there seem to be more clouds than blue skies, and certainly more shadows than light. This may or may not be a feeling many prospective physicians feel, but for the class of 2010 it comes as a tough pill to swallow. In a profession at the heart of a national policy debate and with a storied history to examine, it’s extremely disconcerting to be faced with so many question marks. Read more »
June 2nd, 2010 by AlanDappenMD in Better Health Network, Opinion, Primary Care Wednesdays, True Stories
Tags: Christian Science, DocTalker Family Medicine, Dr. Alan Dappen, Failing Health, General Medicine, Internal Medicine, Medicine and Religion, My Brother's Keeper, Primary Care, Primary Care Wednesdays, Progressive Pneumonia, Refusing Medical Care, Severe Shortness of Breath, The Science of Medicine
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Today my brother Arthur helped someone stay alive a little bit longer. He wouldn’t be happy with how I used his story, but he’s dead enough to not hear it.
Art had an enormous IQ which helped him dance through school, standardized testing, and academic awards like a hot knife through butter. But life requires many skill sets, genius being just one. My brother’s biography in many ways mirrors that of the Unabomber’s — move for move — until one decisive moment when Jesus walked into Art’s life.
Forever and irrevocably from that moment forward, Art became God’s logic pugilist. Heretofore, all of his training in science and math was used to prove that the truth in the Bible could be found only in literal interpretation. Read more »
May 26th, 2010 by SteveSimmonsMD in Primary Care Wednesdays
Tags: Common Sense, Compulsion, Compulsive Doctors, Compulsive Medicine, DocTalker Family Medicine, Doctokr.com, Dr. Steve Simmons, General Medicine, ICD-9 Codes, Internal Medicine, Lack Of Certainty, Logical Thinking, Medical Profession, Medical Students, Practicing Medicine, Primary Care, Primary Care Provider
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Most experienced physicians expect uncertainty in caring for real people with average everyday problems. Yet those inexperienced or uninitiated in medicine tend to see the practice of medicine as exact or even absolute.
I remember waiting in vain as a medical student and resident for my instructors to illuminate a path towards certitude. Instead, I was given something far more real and lasting: An acceptance of the indeterminate mixed with the drive to be compulsive on behalf of my patients.
During my internal medicine internship, I remember a more-senior resident during our daily morning report bemoaning her uncertainty by saying, “But I just don’t know what’s wrong with my patient.” Although she was visibly upset, our program director’s reaction to her comment bordered on amusement, culminating with, for me, an unforgettable response: “Well, you certainly have chosen the wrong profession.”
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May 19th, 2010 by AlanDappenMD in Primary Care Wednesdays
Tags: DocTalker Family Medicine, Dr. Alan Dappen, Primary Care, Primary Care Wednesdays, Telemedicine
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Last week we examined how, in a typical practitioner’s day, he or she often needs to make adjustments in patients’ care to keep them on the path to getting –- or staying — healthy.
Usually a face-to-face physical exam isn’t necessary to make accurate changes to a patient’s care regiment. Instead, all discussions can be done via a form of telemedicine, such as a phone call, email, or video-conferencing. Unfortunately, it’s become standard that face-to-face time is required between patient and doctor, creating more hassle for the patient while not impacting the quality of the outcome.
I’d like to visit the case of a particular patient, Mrs. EE, and discuss how telemedicine allowed me to make small, ongoing adjustments to her medical regiment quickly and easily, and with very positive outcomes.
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