Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

ER Overuse: Is It A Myth?

No Comments »

Overuse of the emergency department is commonly discussed during the healthcare conversation, especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER. But is this a myth? That’s what two emergency physicians contend in a piece from Slate.

The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits cost far more than primary care, but even this is disputable. In fact, the marginal cost of treating less acute patients in the ER is lower than paying off-hours primary care doctors, as ERs are already open 24/7 to handle life-threatening emergencies.” Read more »

*This blog post was originally published at KevinMD.com*

The New-Patient Fallout: How It Might Affect Primary Care

No Comments »

Sunset on Hanalei Bay by Alaska Dude via FlickrWith the prospect of 32 million new patients clamoring for care comes sorting out who will see them all. New medical schools are opening and students say they relish the idea of entering a market that will demand their services. American College of Physicians member Manoj Jain, M.D., offers a more tempered view of how the fallout might affect primary care. (AP, American Medical News, Fort Worth Star-Telegram, Memphis Commercial Appeal)

Even Hawaii has a shortage, especially in primary care, but also cardiology and orthopedic surgery. It’s hard to believe recruiters couldn’t sell Hawaii as a destination. (Honolulu Advertiser)

*This blog post was originally published at ACP Internist*

Medicine Is A Human Thing

No Comments »

If there is a central theme to this blog, it is this: Medicine is a human thing.

On the Facebook page of my podcast, I recently asked for readers to tell me some of the “war stories” they have from the doctor’s office. What are some of the bad things doctors do wrong? I quickly followed this with the flip side, asking readers to comment on the best interactions that they’ve had with their doctors.

The response was overwhelming, and equally quick to both rant and rave. They told stories about doctors who didn’t listen, explain, or even talk with them. They told about arrogance and disconnectedness from the people from whom they were seeking help. They also told about doctors who took extra effort to listen and to reach out in communication. They talked about doctors who genuinely seemed to value them as humans. Read more »

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

We Need More Linchpin Doctors

No Comments »

Images-1I just finished Seth Godin’s Linchpin. Seth makes the case that in a hypercompetitive world the stakes are higher than ever to make an indispensible contribution to something you care about. The linchpin is the essential element, the piece of a wheel or organization that is absolutely irreplaceable.

Seth references business, but he might as well have been talking about obstetricians or internists. We need more linchpin doctors.

Modern patient care is progressively marginalizing physicians. Care that is increasingly “managed” and dependent upon automated diagnostics is leaving physicians as powerless cogs in a system of mechanical patient care.  Patients have become naturally detached as they search for solutions of their own.

Physicians have to be remarkable to remain relevant. Physicians have to offer something not available anywhere else. Physicians need to make a difference and in their own way and serve as real leaders and innovators in their relationships with patients and their communities. Physicians have to be linchpins. Read more »

*This blog post was originally published at 33 Charts*

Diagnosis And Care: Just A Phone Call Away

No Comments »

In my medical practice, I have a simple yet revolutionary idea: I get paid to answer the phone. Every one of my 3,000+ patients has my cell phone and email address so that they can reach me the instant they need help, which is no different than any of my friends or family who may be trying to reach me. Our practice motto: “Talk to your doctor anytime, anyway, anywhere.”

It’s not that I’m trying to not see you, or want to be impersonal or to practice risky healthcare. In fact, each of these common assumptions is pointedly wrong. By answering my phone, I can know my diagnosis and treatment worked (or not), or I can help someone avoid an ER visit or unnecessary office visit. My patients call me when they’re traveling, or at work, or from their car, at night and on weekends. There’ve been occasions that I need to see a patient NOW and I’ve come to the office a 2AM to keep someone out of an ER. No matter what, by picking up the phone to talk to my patients, I’m the first person in the healthcare system to know something is wrong, not the last.

Although good examples supporting the power of a doctor answering a phone occur daily, I have one I want to share with you. Read more »

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »