Category: Public Health & Policy

Where have all the doctors gone?

As my husband passed the milestone birthday of 40, he thought it would be a good idea to get a physical exam as it had been several years since he saw a physician. Easy task, right? We soon came to find that the landscape of health care had been changi…

The health effects of structural racism

In the United States, the health of African-Americans lags behind most other racial minority groups.  Compared to whites, black men and women face higher risks of chronic illness, infection, and injuries.  Taken altogether, the average life span for Af…

The cure to our malignant health system

An excerpt from Curing the Cancer in U. S. Healthcare: StatesCare and Market-Based Medicine. Clinical doctors can readily understand the continuing failure of the U.S. health care system. The attending physicians for Patient Healthcare–Washington, both…

Why physicians should start thinking about climate change

Climate change. Global warming. The greenhouse effect. Devastating wildfires, dangerous air quality. Catastrophic weather events and mass human migration. It all sounds like post-apocalyptic fiction except that it’s real. Inside our air-condition…

How we can help our veterans die in peace

The World War II veteran, now in his 90s and receiving hospice for end-of-life care, was playing military anthems on his harmonica for fellow veterans. But the next minute, reliving the horrors of combat, he grew agitated and started to cry.  “Oh, all …

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 …

A solution to reduce defensive medicine

An excerpt from Technology and the Doctor-Patient Relationship. As disturbing as the structure of malpractice insurance is in America, a more significant problem is the defensive style of medical practice it induces. In a large-scale survey done by Jac…

Increasing strictness of gun laws correlates with fewer children killed by guns

Between 2011 and 2015 there were over 21,000 children killed by guns. This recent study in Pediatrics, the journal of the American Academy of Pediatrics, further analyzes the question; it compares pediatric firearm fatality rates among the various stat…

Health coverage really isn’t covering much

I’m a healthy 48-year old, ASA physical class I anesthesiologist. At least I was healthy until an unintentional 20-pound weight loss over the summer, accompanied by an unquenchable thirst, insatiable appetite, blurry vision, and the bathroom freq…

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…