On June 10, 1963, the Equal Pay Act was signed into law by President John F. Kennedy, amending the previous Fair Labor Standards Act. Under this law, pay disparities between men and women were clearly prohibited. More than fifty-five years later, women are still fighting to be paid the same as men holding the same […]
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated at a follow-up appointment. He has a 7-year history of heart failure secondary to ischemic cardiomyopathy. Over the past 6 months, he has had three hospitalizations for exacerbations of his heart failure. He currently has exertional […]
I lost a friend this month. She was a surgeon; she was one of us. We lost her. So did her patients. All the ones she helped. The ones she saved. So did her hospital, her nurses, her techs. So did her family. All the love, coming to a screeching halt. Continue reading … Your […]
A relative taught me to drive in a burgundy Lincoln Town Car in an empty Long Island parking lot in the 1980s. After emphasizing the need to practice driving in reverse, he also warned: “A car is a weapon. You can kill someone, or get killed, in an instant.” I am a safer driver (forwards […]
Drivers are distracted klutzes and computers could obviously do better. Self-driving cars will make all of us safer on he road. Doctors have spotty knowledge and keep illegible records. EMRs with decision support will improve the quality of healthcare. The parallels are obvious. And so far the outcomes are disappointing on both fronts of our […]
Physicians are notorious for being bad with money. Today we’re going to assign some blame for that phenomenon. Physician finances have three enemies, and we’re going to expose them today. 1. Financial professionals Enemy number one consists of many members of the financial industry. These “helpers” are often part of the problem. One of the […]
The doctor-patient interaction is the absolute core of clinical medicine. Maybe I’ll go much further: it’s the core of health care in general. I always try to remember, whenever I’m ever feeling frustrated with the system, the crazy bureaucracy — and of course, the debacle of our clunky electronic medical records and their data entry […]
Imagine, if you will, that you’re an anesthesiologist. You’ve been part of a successful practice for over 10 years. You can walk down your neighborhood street and run into mothers whose epidurals you’ve helped place. You’ve established a home, a community, and your children are in a great school system. One uneventful day, say Wednesday, […]
When news broke that Dr. Atul Gawande had been named CEO of the Amazon-Berkshire-JPMorgan Chase health care partnership, industry insiders were quick to raise doubts about his credentials. Some pointed to his limited administrative experience, questioning how someone who has never managed a hospital or health system could oversee the care of some 1 million patient-employees. They […]
I am not a doctor of finance. I’m a medical doctor. So when I enter an elderly patient’s home, I’m not expecting to do a wallet biopsy. Whether they can pay me or not is of little consequence. I do think, however, about whether they will be able to afford the care I prescribe. Will they have […]
