Take 100 patients who are candidates for colorectal screening. We know that a group of them will try to avoid the procedure or postpone it for as long as possible. Evidence of this, for example, would be rescheduling appointments multiple times to late…
My brother and I are both physicians. He is a pediatrician; I am a geriatrician and palliative medicine doctor. We are both getting older. My brother has been a practicing pediatrician for almost 50 years. He had a remarkably successful solo practice i…
I scribbled my signature on a pharmaceutical rep’s iPad today for some samples of Jardiance, a diabetes drug that now has expanded indications, according to the Food and Drug Administration. This drug lowers blood sugar (reduces HbA1c by less than 1 po…
When I graduated from residency, I was too worried about killing my first few patients to examine the meaning of being an attending physician. An early patient, a 97-year-old retired doc, brought it to my attention. “Being an attending physician means …
As we approach Christmas, you only need to go to the nearest mall to witness the frenzied activity in preparation. People scurry around trying to find the perfect gifts for their loved ones and co-workers at the lowest prices. While gift-giving indeed …
So many primary care patients have several multifaceted problems these days, and the more or less unspoken expectation is that we must touch on everything in every visit. I often do the opposite. It’s not that I don’t pack a lot into each visit. I do, …
It’s difficult to imagine a world now without Google and the internet. It’s also strange to think that most people alive right now received the bulk of their education in the pre-internet era. I remember in the United Kingdom, where I went to medical s…
One of my favorite scenes in the recent Apollo 11 IMAX film was a dramatic panning shot of mission control moments before lift-off. Row after row of mission specialists, engineers, astronauts, communications technicians — all looking ahead in silent, u…
Whenever I give a talk about health care, I ask the audience, “What is the worst addiction problem we have in the United States?” The answers are typically the same, and all are good guesses — alcohol, tobacco, opiates, and sugar are most frequently ci…
Next in a series. I have developed a framework, which I call the Healthcare Incentives Framework, that helps me understand health care systems. It outlines the jobs we expect a health care system to do for us and identifies which parties in the health …
