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Reducing Health Care Spending: When Rationing Resources Goes Too Far

A sure-to-be controversial article appears in the Chicago Tribune earlier this asking the sensitive question of ‘Health care at any age, any cost?:’

“If you want to save all lives, you’re in trouble,” said Callahan, co-founder of The Hastings Center, a bioethics research institute in New York, and a faculty member at Harvard Medical School, in an interview. “And if you want to save all lives at any cost, you’re really in trouble.”

Callahan and co-author Nuland, a retired professor of surgery at Yale School of Medicine who wrote the best-selling “How We Die,” were both 80 when the article was published.

“We need to stop thinking of medicine as an all-out war against death, because death always wins,” said Callahan.

The article goes on the make some bold demands of doctors: Read more »

*This blog post was originally published at Dr. Wes*

Getting The Attention Of Patients In Younger Generations

Surely you’ve read before (perhaps even in our publication) about the challenges of Boomers and younger generations working together. You know the drill– these young’uns are good with computers but they’re all hung up on this idea that they should get to have a life. But Cam Marston, the opening speaker at MGMA put a new spin on the concept– addressing how generational differences can affect the way that you attract, and treat, patients.

A lot of it is pretty obvious. Millennials (those born between 1980 and 2000) like getting information by text, Boomers not so much. Younger patients do a lot more of their own internet research.

But some of the advice on how to act on these generations’ well-known differences was Read more »

*This blog post was originally published at ACP Internist*

When Age Plays A Role In Medical Decision-Making

Missed Diagnosis Lawsuit and the Dynamics of Age Related to Risk

Years ago I had the opportunity to care for Mr Smith, a 101 year old man who presented to the hospital with chest pain and shortness of breath. Besides having  101 year old heart and lungs that tend to follow their own  biological clock,  this man also had a massive chest tumor filling 85% of one side of his thorax.

Whoah really?  What does that mean in a 101 year old man?  Most folks this age have exceeded the normal bell curve distribution of life and disease.  When you reach 101 years old, there isn’t a lot of chronic anything you can catch with the expected time you have left on earth.

Every now and then, however, we find patients who are the exception to the rule, such as the 101 year old guy that present with a new cancer diagnosis.  That’s where being an internist comes in handy. Read more »

*This blog post was originally published at The Happy Hospitalist*

New York Times Piece About Plastic Surgery Gets People Talking

Monday’s New York Times tweeted a headline – “Never Too Old for Plastic Surgery” – about this story.

While I’m very happy for the 83-year old woman in the piece for her happiness over her “new” $8,000 breasts, the piece was framed like an expensive billboard for plastic surgeons – only it didn’t cost them anything. The Times gave away the advertising space.

The story states:

“There are as many reasons for getting plastic surgery as there are older patients, experts say”…and…”some are simply sick of slackened jowls, jiggly underarms and saggy eyelids.”

There are a few other perspectives in the middle of the piece:

“Some critics question whether the benefits are worth the risks, which may be underestimated.”

But it is often how you END a piece that determines readers’ takeaway messages – and it is often also a sign of the message the journalist really wanted to convey. And this one concludes with a Harvard prof’s comment: Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Should Surgery Be Considered For A Persistently Hoarse Voice?

I was informed about this interesting concept on ABC news

With many aging baby boomers tapping into cosmetic surgery in order to look younger, some are taking it a step further to “sound” younger as well with a “voice lift”.

For some, it’s not right to look 10-20 years younger after a facelift but still sound like 70 years old.

A hoarse voice with aging is not unusual, but a surgical “voice-lift” is not necessarily the first step that should be taken.

First things first… Read more »

*This blog post was originally published at Fauquier ENT Blog*

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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