I recently had an interesting conversation with several co-residents about how our health care system should evaluate physician performance. If nothing else, the discussion highlighted how challenging this issue has been for almost all medical specialties, including internal medicine, where the controversy has been punctuated by debates about maintenance of certification (MOC) and licensure. It […]

Medicine is obsessed with numbers.  Or rather, journalists and medical administrators are.  Here are two related examples of how large a grain of salt one must put on numbers. Cardiac surgical procedures, like everything else in medicine, have quality indicators.  One of these is what we doctors call “30-day mortality.”  What this term means is […]

Eonia I Mnimi (Eternal Memory)  – Greek Orthodox Funeral Blessing “Have you ever seen anyone die before?” my cousin asked me, from across the bed. “Sure I have, plenty of times,” I answered. We were flanking her father, my uncle (really, my mother’s cousin, but extended Greek families are complicated; suffice it to say that our […]

As I travel around speaking about preparing for peace at the end of life, I have found that there are three pervasive myths about hospice that might cause you to inadvertently rob yourself or your family of a peace-filled end-of-life experience. So, I am taking on the job of myth-buster to clear the air. Here […]

The preferred route for a hysterectomy is vaginal. This means the entire surgery is done through the vagina with no incisions in the abdomen of any kind. The joke among surgeons is that it is a bit like taking a car apart through the muffler. While doing surgery entirely through the vagina may sound highly […]

The feds are at it again. Medicare is in the cross hairs with an anticipated 0.9 percent cut to Medicare Advantage plan payments in 2016. The final decision is to be made on April 6 of this year. Medicare Advantage plans are an alternative to traditional Medicare. Traditional Medicare consists of Part A (hospital) and […]

One of the cornerstones of the practice of medicine is finding imperfection in things. When the doctor encounters the patient, the latter expects the former to find out what is “wrong.” In fact, I often see a patient and find nothing wrong, and when I voice this out loud the parents often ask, “Are you […]

In the last year and a half, I’ve been able to go to Africa 4 times and Haiti once, for which I give thanks that the world still produces abundant fossil fuels. That much airplane travel does make me feel a bit guilty, even though I’m not actually vacationing. Going to far away places to […]

Medicaid expansion “is one of the biggest milestones in health care reform,” according to the Obamacare Facts website. The goal was to provide insurance coverage to low-income Americans, specifically the uninsured. The major problem with Medicaid is low reimbursement. “Due to low payouts, many doctors don’t take Medicaid, and the quality of care tends to be poor,” […]

Millions of people are diagnosed with irritable bowel syndrome (IBS) every year making it one of the most common gastrointestinal (GI) conditions. Despite its prevalence, there remain many misconceptions about IBS among both patients and doctors. Here we review some basic concepts in hopes of demystifying this nebulous syndrome. What is IBS? Irritable bowel syndrome […]

You should know that medical documentation has gone awry. But you really just have no idea. If you’ve been to the hospital or to the doctor’s office even once this year, I’m willing to bet that at least a portion of your medical information is now found somewhere within an electronic medical record (EMR). An EMR is really just […]

It’s been a long day, and you just want to decompress. My boyfriend tells me about his day. I get to hear about the insane amount of reading he has to do for graduate school, or about the occasional annoying customer he’s had to deal with at his part-time job as a bank teller. When […]

Remember the Latin phrase “Primum non nocere”? It means “First, do no harm.” Most of us physicians committed to it when reciting the Hippocratic Oath, back when we were first embarking on our careers in medicine. Sadly, today’s technology threatens this sacred physician-patient relationship. Electronic health records (EHRs), although much-needed, have created perverse, unintended consequences […]

Some parents who purchase certain computer-based brain-training games — which can cost from a few hundred to more than a thousand dollars — hope the programs will make their child’s learning disabilities less severe.

Some parents who purchase certain computer-based brain-training games — which can cost from a few hundred to more than a thousand dollars — hope the programs will make their child’s learning disabilities less severe.