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Health Care Health Care Reform

Is my Doctor worth extra money…my money?

“Hey David put that stone down. Don’t risk enraging the giant.”   So it is in Louisville, where a small band of academic doctors have dared to challenge the multi-billion dollar local beast, Humana. The story, as reported on the front page of the Courier-Journel, describes how a small group of doctors are testing the waters […]

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Health Care ICD/Pacemaker

A new ICD, without a wire in the heart…Less can be better…

“Hey John, I hear there is a new ICD out…without any wires,” came the question in the doctor’s lounge. That’s cool, they are reading the NEJM, I thought. It is true that a very preliminary report on a subcutaneous-only ICD was published in the print version of the NEJM this week.  The print version of anything […]

Categories
AF ablation Doctoring Health Care Health Care Reform Reflection

Where’s my “foundation?”

This week I traveled to a major “arrhythmia institute” in the southern US. For a specialist in a rapidly evolving field, venturing out of the protected cocoon of one’s routine, to see other’s approach, especially those at major referral centers, is immensely helpful.  Although trips like this do not count for CME, they are just […]

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Health Care Health Care Reform

Denied…

When a letter comes from a hospital employee with the title Appeals Coordinator, Patient Management Services, it is not likely to be good news. And it was not. That there is such a cubicle somewhere deep within hospital administration real estate speaks metaphorically to the current health-care delivery quagmire. Keeping the case details turned down low, […]

Categories
AF ablation Atrial fibrillation Health Care Health Care Reform

Comparison shopping for health-care?

Can a consumer (patient) really comparison shop for their health-care needs? It seems there are entrepreneurs who want to help. Check the specifics at this website. It will not take long. In this age of monopoly-money like health care charges, isn’t the notion of comparison shopping a joke? Sure, you might find one doctor charges […]

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General Medicine Health Care Health Care Reform

When American health-care works great…

When does Medicine in America rock? When things like this happens… The call came during one of the earlier cases to see this patient who had complete AV block.  As her BP was normal, the report described her as“stable.” (Note: cardiac output requires an adequate heart rate, so just because one’s BP is stable, does […]

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Health Care Health Care Reform Uncategorized

Baby Teeth follow-up: Some real-life economics at work…

My late grandmother, Nellie, coined the term “chiseler.”   I thought of her today at the oral surgeon’s office. It turns out, my wife, Staci, and I garnered a 50% discount on the removal of the 5 pesky baby teeth. How?  It was a three pronged attack… I came from the hospital in between cases […]

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Health Care Health Care Reform

Baby teeth and health-care reform…

I know a boy with these pesky baby teeth.  They just won’t come out. The orthodontist recommends removal of these five persistent remnants before placing 5000 dollars worth of braces. So the next stop is the oral surgeon’s office. The oral surgeon’s receptionist says it’s cash up front before the procedure. She looks sad as […]

Categories
Doctoring Health Care Health Care Reform

Concierge medicine makes everyday a snow day. Implications for impending health care reform…

The interview, such as it was, happened on the walk in from the doctor’s parking lot.  As early morning approachability of doctors varies widely, one is especially cautious about starting conversations at this time of day. He had recently changed his very busy Internal Medicine practice to a concierge style practice.  Maybe because of this, […]

Categories
Health Care Healthy Living

In heart health, we need more than just education…

Everyone knows that the heart health of Americans is dismal. Obesity, diabetes, and high blood pressure are all on the rise. For now, technological advances in cardiac care continue to maintain, or in some cases, lower the death rate from heart disease. Squishing blockages, ablating abnormal heart tissue, and installing cardiac devices have successfully kept […]

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Health Care

Bald is cool…

The first time my barber saw my shaved head, he smirked, and told me he didn’t think healthy people shaving their heads helped cancer patients. (Conflict of interest does not only involve pharmaceutical and medical device companies.) He’s right and wrong. Sure, my agreeing to have my head shaved by the highest bidder doesn’t help […]