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Relationships Are The Key To Healthcare Reform

By Rahul Parikh, MD

There is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.” Worse, the entire focus of reform has centered on spending billions of dollars on technology solutions that will only make marginal changes in the cost and quality of care Americans get.

I want to refocus the debate on what matters most: relationships. Let’s reinvest in the sitting down with, listening to, empathizing with and touching patients. Read more »

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

The House Special

During the past several weeks, I have diagnosed several patients with novel H1N1 influenza infection with my diagnostic opinion occasionally backed by a positive flu swab. When my wife, an ER doctor, fell ill I suggested she had novel H1N1 infection and went on to advise some of my family, friends, and neighbors of the likelihood that they too had H1N1. Yet when it was my turn to suffer with fever, body aches, headache, sore throat, and malaise one word seemed best able to convey how I really felt: swine.

My symptoms began four days after having the H1N1 shot and almost immediately after putting my children to bed following a fun but rainy Halloween night. It would have been nice to blame the rain or the flu shot for my suffering but I knew better. Unable to sleep I found myself ruminating over an aphorism I first heard as a third year medical student, spoken by a man who lives in my heart as my mentor. Read more »

What’s The Most Expensive Medical Condition?

What medical condition costs the U.S. Health system the most in disability and overall costs? If you said heart disease or cancer or pulmonary disease you would be wrong! I would have said one of those myself.

The answer…slow drumroll….is musculoskeletal disease. Yes, 50% of the adult population reported having a disabling musculoskeletal condition in 2008. The expenditures for these problems include the costs of preventive care, the cost of direct care, the cost of care in hospitals, by physicians, therapists and other caregivers. It also includes the loss of productivity. In 2004 it was estimated that the cost of care for musculoskeletal problems was $840 billion. (Hey, isn’t that about equal to the bank bailout?)

What are musculoskeletal conditions? They include that old nemesis: Low back and neck pain. Spine problems are among the most common problems that bring patients for medical care. That’s why the chiropractic industry is booming. Read more »

*This blog post was originally published at EverythingHealth*

Medical Treatment Of Ingrown Toenails: 1908 And 2009

Flipping through the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD I found at an antique store last month, I came across the section on ingrown toenails. The causes of ingrown toenails were much the same as one hundred years.

This is a condition in which the edge of the nail, usually of the great toe, by its too close contact with the flesh beneath causes irritation, ulceration, or suppuration. There has been much discussion as to whether the nail or the flesh is the more at fault. This discussion is without profit. It is much better to study the normal conditions, and see what can be done to restore them. Read more »

*This blog post was originally published at Suture for a Living*

Andrew Weil Sent Warning Letter By FDA For Selling Snake Oil Flu Remedies

Dr. Weil is often seen as the smiling “mainstream” of alternative medicine. He’s a real doctor (unlike, say, Gary Null), and much of what he advocates is standard and uncontroversial nutritional advice. But Weil illustrates the two biggest problems with so-called alternative medicne: once you’ve decided science is dispensible, the door is open to anything, no matter how insane; and no matter how altruistic you may start, sooner or later you start selling snake oil. Most doctors out there are working hard to help their patients prevent and overcome disease use the available evidence.  Others decide that science is too constraining and start practicing at the periphery of knowledge, throwing plausibility and ethics to the wind.

The fact that Weil claims to donate to charity all of his ill-gotten gains does not mitigate the harm he causes. Read more »

*This blog post was originally published at Science-Based Medicine*

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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