Category: primary care

From a neurosurgeon: You need a family doctor

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…

The biggest addiction problem in the U.S.? Health insurance.

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…

The barriers to patients choosing higher-value providers and insurers

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 …

The healing patient-physician analog relationship is in critical condition

In the history of medical care, medical records served one purpose and two masters: to record diagnosis and treatment for physicians to refer to and for patients to use to transfer care when they desired. The medical record was a simple 3 x 5 or ledger…

Why doctors need to be chameleons

Doctors need to be true to themselves, but at the same time, they must be chameleons. A doctor fills certain roles in the lives and stories of patients. It is a two-way relationship that looks different to each person we serve throughout every workday …

Nurturing professional identity and maintaining pass rates: an important goal in medical education

The doctor shortage across the United States is coming and has the potential to be painful to millions of Americans. According to the Association of American Medical Colleges, by 2023, the country may experience a deficit of up to nearly 122,000 physic…

The weight of it: a pediatrician’s thoughts on how words last a lifetime

Start at the origin. Over two, up four. Down three, right six. Left five, up one. Keep connecting the dots. Everything will take shape. I liked graphs. Plotting coordinates — whether it be for a parabola or ellipse — was always calming for me: numbers …

Why physicians should adopt the roles of guides

The family doctor used to be almost the only source of medical information patients had access to. Now, few people need us to bring them the latest news. It’s there for everyone to see. There’s even too much of it. Today, our role is to help make sense…

What rushed patient encounters are doing to patients and physicians

Research shows that as many as 50 percent of physicians report some level of burnout that manifests as depression, dissociation, indifference, and even substance use disorders. Medicine has become focused on monetary gains by large corporations, major …

When physicians are complicit

The other day I asked myself why do I focus my attention on immigrants when there are plenty of other underserved and neglected populations.  When an opioid crisis surrounds me, why do I speak of a crisis at the border?  When structural and overt racis…