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The Virtue Of Unnecessary Care

I case you didn’t hear the news, the American healthcare system is in financial crisis. One of the biggest culprits indicted in this crises is “unnecessary care,” with estimates ranging from $500 to $650 billion (total spending estimate is $2.6 trillion) going toward things labeled “unnecessary.” Personally I think this is an underestimate, as it doesn’t take into account the some big-ticket items:

  • Brand name drugs given when generics would do.
  • Antibiotics given for viral infections (and the additional cost due to reactions and resistance).
  • Unproven costly care considered “standard of care” (PSA testing, robotic surgery, coronary stents).
  • The unnecessarily high price of drugs.

One of the main reasons I am an advocate of EMR is to measure and analyze care, eliminating that which is wasteful, futile, or even harmful. The biggest burden on our system is not the fact that we have a hyper-complex payment system that hides the true cost of care. The biggest burden is the wasteful care that this system agrees to pay for. In fact, I suspect that the main reason our system has become hyper-complex and covert in its spending is to hide this waste from prying eyes.

It sounds easy: Just eliminate costly unnecessary care and save the system. While you are at it, why not bring world peace, eliminate poverty, and make a detergent that cleans, softens, and deodorizes all at once? Read more »

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

The Best Social Tool For Doctors And Patients

We all want technology to improve communication between doctors and patients. We fantasize that social tools will open doors and bridge the expanding divide between doctors and patients.

I’m wondering if it’s a case of unicorns and rainbows: Fancy new tools to do the old thing in a less-effective way. I’m guessing that if Facebook was the old platform for doctor-patient dialog and the telephone was invented this year, everyone would be clamoring to use the phone (“Dude, this is amazing…you can hear them talk.”)

I like the telephone. Written copy misses intonation, timing, pitch, and all the other rich elements of human speech. Subtle changes in a parent’s voice tell me if I’ve made my point and exactly how I need to proceed [with caring for their child]. Unspoken words on a screen are so one-dimensional.

Of course, email has a tightly-defined place in patient communication. And real-time social interaction between patient and clinic will evolve to have a clear role in patient care. But for now, the phone remains one of the most effective tools for helping doctor and patient really understand one another.

[Image credit: Cemagraphics]

*This blog post was originally published at 33 Charts*

A Tribute To Hospital Volunteers

Here is a talk I gave last week to our hospital auxiliary association, mostly made up of retired volunteers. They give us so much, and this is my tribute to them.

Capacity, utility and volunteers

Thank you for letting me speak to you tonight. It is an honor. I have today been at two different ends of the medical world . Today at lunch, I spoke to a Christian Medical Student’s association at USC in Columbia, SC. And now, I am honored to speak to you, who do so much to keep the hospital functioning by your gift of volunteerism.

Tonight I want to talk about capacity and functionality. About utility and usefulness. In preparing to do so, I began to think about how I became the way I am, and my mind wandered to ancestry. I suppose that ancestry has much to do with who we are, though I doubt it is the sole determinant. Read more »

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

Patient Engagement: How Empathy Can Empower Your Patients

In my recent post on KevinMD, “Deeply Connect and Engage Your Patients With Empathy,” I write about how empathy is essential to help empower our patients: “It is with empathy that we can engage and empower our patients.”

Doctors and nurses are leaders in health care.

Being a great leader means having a clear vision, mission or goal. It means being committed, and knowing how to listen and communicate, but it involves much more. It’s about having heart, empathy, and an uplifting spirit.

I value and respect a well written post by Thomas Goetz, author of The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine recently published on KevinMD, “How can doctors successfully engage their patients?” Goetz writes about “Five things they should seek to give every patient, strategies to tap the most underutilized resource in medicine, their patient,” however I feel the most critical ingredient is missing, empathy.

Empathy

It is with empathy that we can engage and empower our patients. With empathy and heart we can help our patients feel good, valued and respected. Empathy allows us to engage and empower our patients to take charge of their health and well-being. Read more »

*This blog post was originally published at Health in 30*

“E-Visits” With Patients: For Greedy Doctors Or Not?

Dr. Wes (a cardiology blogger whom all should read) wrote a very compelling post about technology and the bondage it can create for doctors:

The devaluation of doctors’ time continues unabated.

As we move into our new era of health care delivery with millions more needing physician time (and other health care provider’s time, for that matter) –- we’re seeing a powerful force emerge –- a subtle marketing of limitless physician availability facilitated by the advance of the electronic medical record, social media, and smartphones.

Doctors, you see, must be always present, always available, always giving.

These sound like dire words, but the degree to which it has resonated around the Web among doctors is telling. 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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