Categories
Health Care Reform ICD/Pacemaker

A rough day in heart-rhythm news

For some patients it’s a terrible sensation; they are left scared and persistently anxious. For others it’s just a thump in the chest. But for nearly all patients shocked by their ICD (internal cardiac defibrillator), it means they are still alive. Today was a sad day for electrophysiology–a branch of cardiology that has the prevention […]

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Doctoring Health Care Health Care Reform

Kentucky’s back problems

“John…Why are you going out in the cold?” “I need some stuff for work.” “Stuff?” “Pens…those cool felt tip ones that write really dark and bold.”  I like it when the ‘Electrophysiology’ note stands out in the chart—like John Hancock’s signature did. Until a few months ago, a pacemaker company used to give out nifty […]

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Doctoring Health Care Reform inflammation

Friday’s reflections: If I were the surgical secretary…

December is always a busy time in the surgical waiting room.  It’s all about the deductibles. An ice storm only made matters worse.  Nerves were frayed. It was at the busy reception desk where I witnessed an irate family member of a post-op patient accost the friendly secretary.  The patient was waiting in the recovery […]

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Doctoring Health Care Reform

Grand Rounds, December 14th 2010

Hey all. Welcome to another edition of Grand Rounds, a collection of writings from medical bloggers, the world-wide. Here are this week’s posts, collated into four chapters, with just a little commentary and a few selected images. Chapter 1:  Good Doctoring: —From the poetic Examining Room of Dr Charles, comes the imagery of a doctor’s […]

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Doctoring Health Care Health Care Reform

Friday reflections: Friday Conference–A let down

They are gathered around the back of the darkened room, standing too close together, eating hurriedly, non-enjoyably.   A voice crackles over a 1980s-era microphone. The food is in the back, the slide projector in the front.  One Friday a month, the doctor’s lounge is transformed into a lecture room. The retired docs looking for […]

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Atrial fibrillation Health Care Health Care Reform

A good plan denied…

Smart doctors will take help from wherever it lurks. Today, advice on doctoring came from an unlikely and well-camouflaged source. (I always ask: “where are you talking to me from?”) He was advising me from a warm cubicle in Milwaukee, Wisconsin.  It was a paternalistic male voice—another doctor, he said. Obviously, he was savvy, disguising […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Health Care Health Care Reform

A letter to the CEO of Boerhinger Ingelheim–on Pradaxa

I remember in high school, as an assignment, I wrote a letter to a prominent business person.  I will try it again. In 2010, this would be an e-letter. To: J Martin CarrollCEO of Boehringer Ingelheim Corporation: The makers of the recently-released exciting new oral blood-thinner, dabigatran (Pradaxa). Dear Sir, To start off on a positive […]

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Exercise Health Care Health Care Reform ICD/Pacemaker

Benefits of the “Fury of American Medicine.”

I do not consider myself a right-wing healthcare fear-monger.  But if I were, this study would be worthy of amplification. As reported concisely in the NY Times, from the journal Demography (not previously known to me), population researchers reported that even though elderly Americans have more medical problems than their peers in Britain, once they […]

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Doctoring Health Care Health Care Reform

Election 2010: If I were elected…Expert panels

Have you ever thought, “What if I won an election and was put in charge of an administration.” Halloween weekend seems the perfect time for considering the fantasy (or some would arguer horror) of a DrJohnM administration. (Let it be known, I have some leadership experience: I lead local group rides with some success.  A […]

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Doctoring Health Care Health Care Reform

Independent doctors?

In response to my story on how physician consolidation and hospital ownership of doctors is affecting patient referral patterns, I received an email with this attached PDF file.  (Smudges mine) Click to enlarge It is from a cardiac surgeon who doggedly chooses to remain independent. This document appears on his website and also ran in […]

Categories
Health Care Health Care Reform

How healthcare reform changes referral patterns?

As a specialist, one of the saddest truisms about practicing medicine in the private world has always been how little one’s clinical skills determines referrals. Unfortunately, as our present healthcare climate pushes “providers” to consolidate along the lines of major hospital networks this injustice will only worsen. A decade-or-so ago when I started private practice […]