Be informed – “The Patient’s Playbook”

the patient's playbookI’ve spent most of the holiday weekend happily engaged in reading through a pile of health care books.

And the one I absolutely have to recommend to everyone is The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love by Leslie D. Michelson.

Michelson is not a physician, but has worked in the health management field for more than 30 years, helping individuals and companies navigate our crazy health care system.

Based on his experience, he has organized his book into three sections. Each chapter ends with a helpful “Quick Guide” of the most crucial … Continue reading

Heads up about Medicare changes

This post if for any of my readers who are Medicare age or about to be Medicare age.

I think it’s important to understand what changes are in the pipeline that will affect your doctors and their ability to be able to treat you.

Some doctors already refuse to see Medicare patients because of government red tape and poor reimbursement.

But starting in 2017 it’s going to get worse, and many physicians are wondering if they should follow their colleagues and drop out of the Medicare game altogether.

I recently read two posts by physicians on the health care blog … Continue reading

Sad but true – CYA medicine works

A few months ago I posted about CYA—Cover Your Ass—medicine being one reason why too many diagnostic tests are ordered and health care costs are high.

CYA medicine is when the doctor or doctors are pretty sure what your problem is, but they order extra scans and x-rays and blood tests anyway because “failure to diagnose” is one of the leading causes of medical malpractice suits. They aren’t going to take any chances, and who can blame them?

Related story from KevinMD: This is why doctors practice cover your ass medicine

Besides, they don’t pay your resulting medical bill, so … Continue reading

Preventing hospital readmissions

I’ve said it many times in this blog: Don’t go to the hospital alone! And don’t let your friends or family members go alone, either.

Having or being a patient advocate during a hospitalization can really improve communication among the patient, the patient’s family and the myriad of health care providers in modern hospitals.

Related story from KevinMD: There are too many cooks in the health care kitchen

Better communication is especially important at discharge time, when the doctor and nurses give you lots of instructions about your follow-up plan: Do you have new medications? Did you stop old medications? … Continue reading

Patients need “Choosing Wisely”

I’ve written several posts about Choosing Wisely, an initiative launched in 2012 by the American Board of Internal Medicine (ABIM) with the mission of decreasing the use of unnecessary health care.

Overuse of diagnostic tests, screening tests, surgeries and drugs is rampant in our health care culture, and it’s costing billions of dollars every year, not to mention that some patients are actually harmed by overtreatment.

It’s a noble goal, but the burden is on the consumer—the patient—to read and use Choosing Wisely’s lists of  inappropriate treatments because a recent analysis shows that physicians are not paying enough attention … Continue reading

Cold or flu? Stay home!

Most doctors will advise you to stay home from work or school if you are sick. Not only do you need the rest, but if you are contagious with a cold or the flu or a stomach bug, you will pass your germs to many more people.

Well, apparently doctors don’t take their own advice!

A recent survey showed that most doctors do go to work when sick, even though they know they could infect their co-workers or patients.

A full 96 percent said they would work if they had symptoms of a cold, 77 percent said they would

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Describe your symptoms more effectively

I think everybody is getting used to (although not liking) the new normal of seeing our doctors for about 5-10 minutes per appointment, maybe even less.

So it’s more important than ever to be ready for your appointment. Have a list of all your current medications, and be prepared to describe your current complaint and symptoms as quickly and effectively as possible.

How can you do that?

I recently read a report from The Society to Improve Diagnosis in Medicine in which they listed the 8 characteristics of symptoms and suggested patients be taught how to use them.

  • Where
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End of life forms – Living Wills, DNR and POLST

Apparently even health care providers don’t understand all the different end-of-life forms that might accompany a patient into the hospital.

I watched a parody video (to Green Day’s “Good Riddance”) on YouTube that seeks to educate and eliminate the misunderstandings.

These end-of-life forms, also known as advance directives or health care directives, are similar but differ slightly in scope and usage.

Certainly physicians and nurses should know the difference (and in my experience, most of them do), but it’s equally helpful for patients and family members to understand them so “medical mistakes” can be avoided.… Continue reading

Sacrificed – On the shoulders of giants

I’ve always been fascinated by the history of medicine and nursing. That’s why I have a degree in medical history as well as nursing.

So I was delighted when the folks at Fusion sent me this YouTube video with an invitation to put in on my blog:

The Doctor Who Jammed a Catheter Into His Heart


In just a couple minutes it tells the interesting tale of Dr. Werner Forssmann, who in 1929 had the crazy idea to thread a catheter through his arm and into his heart (he wasn’t allowed to experiment on … Continue reading

ZDoggMD raps on end of life

I love ZDoggMD’s musical video parodies on health-related topics (by the way, he really is an MD, although how he finds time to make these videos, I don’t know).

His latest offering takes on the huge subject of end of life choices—or non choices, as is sadly often the case.

“Ain’t the Way to Die”


I like the line “Critical care is just hypocritical when it’s so insane.”

At the end of the video, ZDoggMD invites viewers to share their experiences with dying in the comments.

And he promises his next video will be … Continue reading

A physician explains why vaccinations are necessary

Because of the recent outbreaks of preventable diseases such as measles, California passed a law this summer that will severely limit a parent’s ability to opt out of vaccinating their school-aged kids.


But I understand why some parents, especially those with infants and young children, might be fearful when they hear so many (untrue) horror stories about the safety of vaccinations.

One family practice doctor wrote an open letter to parents about vaccinations—why they are necessary and why it’s safer to vaccinate than not—and published it on the health blog KevinMD.

I thought it was very … Continue reading

The physician-patient dilemma

Here’s another video from Healthcare Not Fair(Warning: like their previous video I posted, it contains bad language!)

While I think Dr. Sorry could have gotten his point across without so much swearing, the situation he presents is very real.

Physicians, especially primary care, are routinely seeing 30 patients a day, which averages out to about 15 minutes per patient. But factor in waiting time after you are put into an exam room, and the actual face time with the physician is closer to 5 minutes.

As Dr. Sorry says, “Doctors—they have one eye Continue reading

Cover your a** health care

“Cover-your-ass health care” or “save-my-ass medicine” are terms used to describe all the extra diagnostic tests (blood tests, CT scans, MRIs, etc.) ordered by physicians to rule out possible (but unlikely) life-threatening conditions.

Such as going to the emergency department with a headache and getting a CT scan to rule out an aneurysm or a brain tumor.

Or, as in this video example, being worked up for a heart attack when the most likely diagnosis is a simple case of heartburn. (Warning: video contains some bad language!)

The ER physician in the video is certainly … Continue reading

Antibiotics vs. surgery for appendicitis

I’m very much in the “less is more” camp when it comes to medical care.

So it would seem I would be very interested in the latest research out of Finland that shows, at first glance, antibiotics to be as effective as surgery in treating appendicitis.

Avoiding surgery should be a good thing, right?

This study was published last month in JAMA (the Journal of the American Medical Association). Many news media picked up and reported the story, some even saying antibiotic therapy could become the new normal for treating appendicitis as, they said, it is safer and cheaper.

But … Continue reading

No shortage of bureaucrats

A picture (or a graph) is worth a thousand words.

too many administrators

We might be facing a physician shortage, but apparently not an administrative one. Top-heavy management is another reason health care continues to cost more and more, and physicians feel more crushed by bureaucracy and paperwork.

Related post: ICD-10 and crazy diagnosis codes

The graph is from Physicians for a National Health Program (PNHP), a group that supports a single-payer or “Medicare for all” health care system.

I found it through a post on KevinMD that questions whether a single-payer system will really cut down the amount of administrative … Continue reading