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A Physician’s Fantasy World: The Ideal Medical Practice

Medscape has a physician portal and they asked the question: “Where would you like to practice medicine?” The responses from physicians were varied with lots of complaining and joking like “Dubai”, but this reply from a family medicine doctor got my attention. I think he speaks for many physicians.
  • I would like to work in a fantasy world.
  • One where I didn’t have to worry about someones economic status. Read more »

*This blog post was originally published at EverythingHealth*

Oh Baby: Infant Denied Health Coverage Due To Weight

If you still think we don’t need healthcare reform in the U.S., consider this: A 4-month-old baby is being denied health coverage by an insurer in Grand Junction, Colo., because the baby is too fat, the Denver Post reports. Details: The 4-month-old boy is in the 99th percentile for his age in height and weight. He is being exclusively breast fed by his mother and has grown from around 8 pounds 4 ounces at birth to nearly 17 pounds. Four. Months. Old. Pediatrician deemed him healthy. Parents are healthy and relatively fit, and  also have a healthy 2-year-old boy.

And people say the government is going to destroy our healthcare system?

OK, let’s be reasonable: Chances are, once the wildfire of press around this spreads sufficiently the company will rescind its decision and offer this lad coverage. (And, for the record, he could be covered by the family’s prior insurer but the parents decided to shop around because that firm raised the family’s rates by 40 percent after the boy was born.)  And, no, I don’t know of other cases where someone was denied coverage for the “pre-existing condition” of having been born hungry. So in the interest of fostering adult-level debate let’s acknowledge that this is probably a VERY isolated case and does not reflect the ethos of all insurers everywhere.

But still: A fat baby getting denied coverage is beyond ridiculous. Read more »

The Future Of Primary Care: HSAs, Catastrophic Coverage, And Direct Payment For The Basics

gordonmooreI’ve been following the career trajectory of Dr. Gordon Moore since I first became aware of his low-overhead, high-tech model of medical practice. He’s come a long way since the AAFP first interviewed him in 2002. I had the chance to catch up with him at the recent Health 2.0 conference in San Francisco, and we discussed the future of primary care and a practice model that I believe in (I just joined DocTalker Family Medicine myself!) Here’s our peek into our healthcare crystal ball…

Dr. Val: Tell me about what got you interested in creating a new practice model for primary care?

Moore: I came into healthcare with a somewhat Pollyannaish vision of reducing suffering and improving health. Without any docs in my family, I had no understanding of what it meant to actually practice. About 5 years after residency, I realized that there was an increasing disparity between my vision of practicing medicine and its reality. At that time I joined a quality improvement initiative at the University of Rochester, and we looked at increasing efficiency in primary care, including creating the idealized design of clinical office practices. Read more »

What To Do When Your Child Glues Her Eye Shut

This little girl accidentally got Super Glue onto her eyelid. She came to the doctor without pain and she was able to move the eyeball under the lid but could not open it.

Her doctor in Decatur, Ala gently irrigated the eye area with normal saline and applied antibiotic ointment and a gauze patch over the eye area but the lid remained stuck together. The next day he was able to gently pull the lid open.

If you should ever glue parts of your body together with Super Glue (cyanoacrylate), the treatment is easy. Acetone, the ingredient found in nail polish remover will dissolve Super Glue. A Q-tip with acetone, gently applied to the area, will dissolve the bond without damaging the skin. Don’t pull the skin apart, but gently roll or peel it.

If Super Glue gets in the eyeball, the eye protein will disassociate from it over time. A warm sodium bicarbonate solution eyewash will help remove the adhesive.

Photo/story credit: Consultant

*This blog post was originally published at EverythingHealth*

Primary Care Is Being Crushed By A Paper Weight

Ever wonder why your physician only spends 5-10 rushed minutes with you during your office visit? You may think it’s because there are simply too many patients vying for her time, but that’s not the real reason. The root cause is that health insurance companies are stealing time from your visit by requiring excessive documentation from your doctor. She can’t give you the time you need, because doing so would put her out of business.

In a special report on the administrative burden of healthcare, MedPage Today revealed that PCPs spend about one third of their income on documentation required by health insurers. Because they run a business with thin margins, they must increase the volume of patients they treat in order to cover the salaries of the staff required to manage this “paper weight.”

About 49% of all physicians have said that they are considering retiring or quitting medicine in the next two years (the rate is lower for specialists), largely because of increasing documentation requirements and decreasing reimbursement. 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…

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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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