Category: Policy

This isn’t just my lane, it’s my highway

On Wednesday, I did a gunshot-wound autopsy. On Friday, I was going into the morgue to perform another when I checked Twitter and saw this. Doctors across the U.S. and across medical specialties were already responding and sharing photos: their face sh…

Money will be lost in health care. This is true no matter how we describe it.

Does anyone in medicine, particularly emergency medicine, understand why we lose money? Why we have to push those metrics so hard to capture every dime? I mean, we’re constantly reminded that satisfaction scores, and time-stamps and time to door, time …

Here’s what the corporatization of medicine is doing

Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the…

Health care is on a different trajectory from most other businesses. Why is that?

Health care is on a different trajectory from most other businesses today. It’s a little hard to understand why. In business, mass market products and services have always competed on price or perceived quality. Think Walmart or Mercedes-Benz, even the…

The problem with mental health funding and prisons

Moving to the Bay Area from the Midwest was a culture shock in many ways. I was amazed by the diversity, the food, the openness of opinions. And I was struck by the traffic, the stark differences driving from one community to another and the homelessne…

A need for structural change to improve the safety and well-being of LGBTQ people

In a previous post on LGBTQ care, Dr. Carlene MacMillan called attention to the importance of respecting patients’ pronouns. As she points out, discrepancies between patients’ chosen names/pronouns and gender markers on official documents can pose real…

Nurses aren’t commodities

Corporate health care mentality set up nurses up to be inhuman while holding us to superhuman expectations. We’re told to be caring — but not allowed to do it. It’s time to demand that we stop being abandoned and dismissed by dysfunctional leadership. …

5 health care lessons from the mid-term elections

This seems to be the big take-home message from voters the mid-term elections, which bodes well for preserving gains from the Affordable Care Act and expanding coverage.   Health care was the number 1 issue for voters according to several exit polls, b…

Don’t wait to take action on gun control

“Active Shooter in Squirrel Hill.” This was the subject line of an email I received on the morning of the Tree of Life synagogue shooting. It was from my children’s school, which is located less than a mile from the scene of the shooting. “I am working…

Medicine: noble profession or big business?

In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expen…