He was here for routine follow-up. He has atrial fibrillation. He is, and has been well controlled on generic, well-tolerated anti-arrhythmic medicine for years. “I feel great, Doc” He is happy, as am I. But he was confused. Why hadn’t he been switched to the “new” AF medicine. Hmm. Uh-oh. Here we go again. He […]
Category: Health Care Reform
Feeling sorry for the big bad insurance companies? Is this even possible? Let me explain. We stayed at a national hotel chain this weekend. I am fairly sure that the free food and sugary drinks they routinely supply, are on-the-whole a profitable venture, but on a microeconomic scale such was not likely the case this […]
Sudden death in a young athlete is surely a tragic event. Sadly, many of the afflicted had an underlying undiagnosed heart anomaly that might have been detected with a screening ECG. On the surface, the idea seems so simple: just add an ECG to the routine pre-sport’s history and physical exam. ECGs are painless, non-invasive […]
“Did you sign those (three) consents?” “This patient needs a short form; your office letter was done 30 days and one hour ago.” (just over the legal limit) “The insurance ‘people’ in area code (***) denied the stress test.” “Mr Smith’s son, an alternative medicine specialist in California wants a phone call to discuss herbal […]
“Ouch! That really hurts!” “You win, please stop torquing my arm behind my back. “Uncle…I said, Uncle!!” Yes, the threshold has been reached. We docs no longer need a tennis court or a Mercedes, our kids are fine in public schools, and we will happily buy our own damn pens. But, please, just give us […]
This morning I am told, “Dr Mandrola, there are two ladies from this company, Boehinger Ingelheim, who need to to give you a secret, sealed envelope.” I wonder whether the department of Health and Human Services knows about this exciting new potential warfarin substitute. Surely they do, as replacing the ubiquitous blood thinner warfarin with […]
The memo is in all caps and a bold font. It rests on my office keyboard, not to be missed. It is from a senior business office staff member who recently attended a two day medicare coding meeting. It said… To: ALL Physicians RE: Medicare Meeting Aug 2010 Just a few things that I learned […]
Will he get to play, or not? Dear Coach, (or administrator, or secretary, or school legal department.) I have seen and examined, Mr. “Joe Teen.” (name changed for HIPPA) He came to me for a school physical because he is deathly embarrassed over the check for inguinal hernias. He is a healthy teen. This I […]
I present interesting cases to colleagues often. Because it is educational and good for patient care, and because I like to. But it has been many years since I was mandated to present a case. It seems that I am not the only doctor exasperated by this pesky new barrier to patient care: “doctors-in-cubicles.” An old […]
I would follow the lead of our country’s first Mom. This is serious folks. We, as an American society, need to solve the obesity crisis. Â Not just for our physical health, but for our country’s financial stability. Reducing the spiraling costs of health care is wanted by all. Â So far, prevention of the diseases which […]
The first link from an email source of medical news reads, “better patient-centered care reduces mortality risk.” It made me think, exactly what do they mean with this new verbiage, “patient-centered care?” And so I learned. Thank goodness, I think my care is indeed patient-centered, even though the terms patient- and family-centered are news to […]