Categories
Health Care Reform

Difficult days to be an inpatient: Joint Commission Day or July 1?

There was just something about the voice that peaked my interest. Normally, announcements in a hospital are muted, measured and perhaps even staid. But this one was not any of these. The voice over the intercom robustly and frankly welcomed the staff of the Joint Commission. Reflexively, I thought: “how nice of us to warmly […]

Categories
Doctoring Health Care Reform Hospice/Palliative Care

Let’s stop being ashamed of (discussing) death

I recently wrote a post about what happens when the elderly get sick. It was meant to accelerate the conversation about how modern medicine can’t make us immortal. I meant to say that doctors need to learn to be less ashamed of death. And that patients should at least hear about the risks of life-prolonging […]

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Doctoring Health Care Health Care Reform

When the elderly get sick…

There are important medical studies, and then there are landmark studies–the kind of science that disrupts the entire medical community. The most recent game-changer was published yesterday (online) in the British equivalent of the New England Journal of Medicine, The Lancet. Well known surgeon and author, Dr Atul Gawande and colleagues published this important look-back […]

Categories
Cycling Wed Exercise Health Care Reform Healthy Living

CW: Can Government Prevent a Million Heart Attacks?

Imagine if there was an emerging epidemic of slow cyclists. It wasn’t always like this. Despite their lack of feather-light bikes, carbon-soled shoes, wind-cheating lycra, people used to go really fast on their bikes. Are you still imagining? Imagine if people spent more money on “things” that might make them faster: they buy better equipment, […]

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Doctoring Health Care Reform Reflection

57 minutes…Inspiring

There’s a lot about health care news that can get you down. There’s the un-insured. The obesity crisis. Stifling regulation.  Adverse effects from drugs and devices.  Mistakes even. Today, though, I would like to tell you about an inspiring success story here at my little hospital–a cabin in the woods of sorts. Our motto is […]

Categories
Doctoring Health Care Reform Hospice/Palliative Care

When will Palliative Care and Hospice discussions be considered normal?

The patient greeted me with a smile that belied his horrible luck. He was my age, but looked far older. It was a slowly progressive neurological disorder that left his mind intact while his body stopped working. He was now imprisoned in a bed. Various family members fed him, changed his diaper, and freshened the […]

Categories
Doctoring Health Care Reform

Is the AMA on the right track?

Doctors are suffocating under a fume of regulation. Our relationships with patients poked at incessantly. Our autonomy, and ability to use nuance hang by a thread. Our patients consume more care, but get sicker still. The health of the citizenry grows so woeful that it endangers our economy, and even our Armed Forces. But there […]

Categories
Health Care Reform ICD/Pacemaker

CRT: More controversry in medical devices

Heart rhythm doctoring made news again. This time it was a WSJ report on CRT—cardiac resynchronization therapy. What is CRT? (Briefly) CRT devices, formerly known as bi-ventricular devices, involve placing an extra lead in a vein branch of the left ventricle at the time of pacemaker or ICD implantation. The extra lead allows the right […]

Categories
Doctoring Health Care Reform

More inflammation will not solve the doctor shortage

There is a lot about young people that I don’t understand. Tattoos, body piercing, rap music and a complete lack of desire to detach from smart-phones are a few likes that make little sense to me. But one of the new generation’s basic tenets that I find highly enviable is their desire for balance between […]

Categories
Doctoring Health Care Reform Reflection

Doctoring isn’t always blissful

My quest for low inflammation hit a speed bump recently. Usually patients uplift me. But… How would you have reacted if a patient asked you to write a prescription for aspirin? You might answer as I did: aspirin is available over the counter, and at very low cost. …“But if you write a prescription the […]

Categories
Atrial fibrillation Health Care Reform Healthy Living Uncategorized

A Kentucky Doc goes to Europe

I have been in Hamburg, Germany for the past five days. I enjoyed an amazing opportunity to visit one of the world’s most respected heart rhythm labs. Among other things, the main purpose was to learn a new way to ablate atrial fibrillation. It was an incredible learning experience, one for which I owe an […]