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What Can History Tell Us About Healthcare In America?

Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity…The poor have more sickness, but they get less medical care. People who live in rural areas do not get the same amount or quality of medical attention as those who live in our cities.

The above quote wasn’t taken from an Obama administration policy proposal. These words are from a 1945 speech by President Harry Truman. It is astonishing that over 60 years later, the health care crisis is not only still with us, but is slowly smothering us. How many years of oxygen do we have left until health care in America is entirely asphyxiated? Each year, the challenges deepen and multiply, which pushes necessary solutions and reform further out of reach. The financial costs of simply maintaining the current system are sailing beyond the stratosphere. The ‘reform’ strategies in my adult lifetime have been to promise, procrastinate and pray, methods which provide politicians with short term gains at our long term expense.

As I write this, Read more »

*This blog post was originally published at MD Whistleblower*

Top Health Quotes of the Week

The combined profits of the Fortune 500 increased by 81% this year, the third largest gain in history. Compare that to the unemployment rate, which fell by just 8% over the past 12 months.” Ezra Klein, while analyzing last week’s jobs report by the Federal Government.

erictopol Top Quotes of the WeekWhy would I listen to ‘lub dub’ when I can see everything?” Eric Topol, a cardiologist in San Diego who carries a portable ultrasound device with him in lieu of a stethoscope. The device lets him and his patient see the heart muscle and valves, and blood flow into and out of the organ.

There probably is not a whole lot that we can do at the pipeline level to dramatically improve the number of students choosing primary care. Where the money is, is where the money is.” Mark Schwartz, an associate professor at the NYU School of Medicine, discussing a study showing that high medical school debt and low compensation are driving people away from General Internal Medicine.

It sounds like a new Apple product.” Bara Vada, describing IPAB, the Independent Payment Advisory Board, a controversial panel tasked by the Affordable Care Act to make binding recommendations to reduce Medicare spending. Read more »

*This blog post was originally published at Pizaazz*

Finding Meaning In Illness: Lemons And The Demand for Lemonade

Jessie GrumanLife gives you lemons and you make lemonade…your response to all those cancer diagnoses is so positive, such a contribution!” “Your work demonstrates that illness is a great teacher.” ”Your illness has been a blessing in disguise.”

Well-meaning, thoughtful people have said things like this to me since I started writing about the experience of being seriously ill and describing what I had to do to make my health care work for me.  I generally hear in such comments polite appreciation of my efforts, which is nice because I know that people often struggle to know just what to say when confronted by others’ hardships.

But beneath that appreciation I detect a common belief about the nature of suffering from illness in particular, that in its inaccuracy can inadvertently hurt sick people and those who love them.

The belief is that sickness ennobles us; that there is good to be found in the experience of illness; while diseases are bad, they teach life lessons that are good. Read more »

*This blog post was originally published at CFAH PPF Blog*

AHRQ: Healthcare Access And Racial Disparities Not Improving

According to American Medical News, the U.S. health system is demonstrating better performance on most measures of health care quality, but it’s failing to improve access to care or cut racial and ethnic health disparities, according to two reports released in February by the Agency for Healthcare Research and Quality.  “Quality of care continues to improve, but at a slow rate,” said Ernest Moy, MD, leader of the team at AHRQ that produced the reports.  ”In contrast to that, focusing on issues of access to care, not much has changed.  Focusing on disparities in care, not much changed…Those are bigger problem areas than overall quality of care.”  Measures related to hospital quality are showing the most improvement.  For example, in 2005, just 42% of patients with heart attacks received angioplasties within the recommended 90 minutes of arriving at the hospital.  That figure improved to 81% by 2008.

While the quality improvement indicators are encouraging, the disappointing access and disparities numbers are not very surprising.

The US health care system is still largely focused on acute hospital based care.  It says we are doing better at what we are doing. Read more »

*This blog post was originally published at CFAH PPF Blog*

Medical Terminology Reasoning (Or Lack Thereof)

SpitballIt’s been a very long time since I did an “Ask Dr. Rob” post. It’s also been a long time since I shot a spitball out of a straw and hit someone behind the ear during social studies class. I realize that just because it’s been a long time since I’ve done something, it doesn’t mean the world is better off with me doing it again.

Still, there have been some interesting questions that have come up and I think it’s time they should be answered. They’re both along the same line:

Question 1: What’s the difference between health care and healthcare? I see that you contribute to the Health Care Blog, but you write about healthcare all of the time. What’s the deal?

Question 2: What’s the difference between EMR and EHR?  It seems that some people feel that it’s vile and uncouth to call it “EMR,” only accepting people who call it “EHR” into their secret societies of people who are smarter than everyone else. What’s the deal? Read more »

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

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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