Water cooler talk around the country is now focused on health care reform. While most doctors and health care practitioners agree with politicians that the current system is not sustainable in the long term, very few agree with the ideas being propagated in Washington currently. A video from Mike Magee "Health Reform's Time Has Come" discusses the need for health care reform.
Unfortunately, the reform that is being discussed now is likely to increase cost, and waiting times and decrease the ability of your health care practitioners to make the best decisions for your health. They plan to start a Government Health Plan, which if it anything like the stellar care of the VA system, is sure to be a bomb. They will decrease cost by increasing the wait times, centralizing care, and decreasing reimbursement to doctors and hospitals.
To discuss health care reform, without discussing medical liability reform IS A JOKE!
The cost of defensive medicine in this country has been underestimated for years. The reason for this is the trial lawyer lobby in Washington is very powerful, and they don't want their cash cow of medical malpractice to be lost. The reform that your government officials are telling you is so necessary is not going to help this country in the long term.
Doctors are not completely innocent in the costs of health care. The dirty little secret is that this issue is a double edged sword for physicians. We are concerned about liability, and order too many tests to avoid being accused later that we didn't do enough for the health of "the plaintiff". But, we do make money by performing and interpreting these tests.
True reform must include two basic aspects. The way medical malpractice law functions in the US must be completely overhauled. Most of the discussion usually revolves around tort reform and "caps". In actuality, the way to eliminate most of the lawsuits is with an arbitration board consisting of doctors and lawyers to discuss the merits of a case before a suit can be filed. Since most lawsuits around the country are not real malpractice, such as wrong leg surgery, but are minor variations in the practice of medicine, eliminating most "frivolous" lawsuits is appropriate. Once this is in place, physicians and health care practitioners can make the appropriate decisions for their patients, without fear. The second part of the reform changes the payment from medicare and the insurance companies to a fairly administered capitation system. This systems pays the doctors a fee for taking care of patients on a monthly or yearly basis. So no matter how many times you see a patient or how many tests you order, you still receive the same amount of money. This would have to be done directly, with no middle-men, to avoid corruption. This would allow physicians and health care practitioners to make decisions for their patients, instead of the government or insurance bureaucrats. This should also fairly compensate doctors and health practitioners for their hard work.
Please let us know what you think by uploading your video blog to our community on health care politics.
Thursday, July 16, 2009
Thursday, May 21, 2009
Why can't politicians (and actors) be more like golfers!
The news about Phil Mickelson's wife being diagnosed with breast cancer is sad. It is something that many people have to deal with in their own families. As Tiger Woods press release said, our thoughts and prayers are with them. Phil immediately suspended his golf schedule to be with his wife and family, and help her through the difficult treatment.
This is the appropriate response from a loving husband and strong family man. While I am a huge Tiger fan, I have always had respect for Phil Mickelson. This strongly reaffirms that respect. It makes you feel empathy for him and his family.
Contrast this to the response of John Edwards when his wife found out that her breast cancer progressed. Not only did he vow to spend more time on the road campaigning even harder to advance his personal goals, he also used the cancer as a political tool to try and gain sympathy votes. But that is not the best part. He also decided to have an affair with a younger woman, who has since had a baby (with no father listed on the birth certificate).
When a family member is diagnosed and being treated for any medical problem, it is important to support them, including helping them learn about their problem. VideoMD.com has many videos to help you learn about breast cancer. VideoMD.com is a great tool to help your family learn more about any medical problems that they face. So take the time to support your family and learn more for them on VideoMD.com.
This is the appropriate response from a loving husband and strong family man. While I am a huge Tiger fan, I have always had respect for Phil Mickelson. This strongly reaffirms that respect. It makes you feel empathy for him and his family.
Contrast this to the response of John Edwards when his wife found out that her breast cancer progressed. Not only did he vow to spend more time on the road campaigning even harder to advance his personal goals, he also used the cancer as a political tool to try and gain sympathy votes. But that is not the best part. He also decided to have an affair with a younger woman, who has since had a baby (with no father listed on the birth certificate).
When a family member is diagnosed and being treated for any medical problem, it is important to support them, including helping them learn about their problem. VideoMD.com has many videos to help you learn about breast cancer. VideoMD.com is a great tool to help your family learn more about any medical problems that they face. So take the time to support your family and learn more for them on VideoMD.com.
Sunday, April 12, 2009
Heart Health
I spent spring break with my kids this week at Disney in Orlando. As a cardiologist, it is second nature for me to observe people, and make an evaluation of their health habits. It didn't take an expert to observe some of the bad habits that many of us have adopted. It is well documented, but to see the obesity rates first hand, especially in children, is disturbing. Watching a family of obese kids being pushed around the park in a cart, while feasting on a huge turkey leg, is an image that I can not get out of my brain.
We booked a room in a nice hotel, and as usual, requested a non smoking room. After about 2 hours in the room, which had no windows, we were all slightly nauseous and dizzy from the residual smoke in this "non smoking" room. To think in 2009, after decades of warnings on the health effects of smoking, that in certain segments of the population the smoking rates are increasing, is appalling.
As more studies reveal that we need to treat cholesterol to very low levels, I am afraid that many people are still walking around with cholesterol levels that put them at high risk of heart attack and stroke. The JUPITER trial, which was released late last year, showed that even people with normal cholesterol levels may benefit from medical treatment.
As far as smoking is concerned, nothing more needs to be written about the health effects of this terrible habit. It is linked to more diseases than any other toxic exposure.
I enjoy a good meal as much as the next guy, we had a great dinner at Emeril's restaurant. But the next day, I had a good workout at the gym, and ate just a soup and salad. I tell many of my patients that moderation is the key to good health. Everyone makes choices that may not be the best for their health, but as long as the majority of the time you make the best decision for your health, you will be in good shape.
We booked a room in a nice hotel, and as usual, requested a non smoking room. After about 2 hours in the room, which had no windows, we were all slightly nauseous and dizzy from the residual smoke in this "non smoking" room. To think in 2009, after decades of warnings on the health effects of smoking, that in certain segments of the population the smoking rates are increasing, is appalling.
As more studies reveal that we need to treat cholesterol to very low levels, I am afraid that many people are still walking around with cholesterol levels that put them at high risk of heart attack and stroke. The JUPITER trial, which was released late last year, showed that even people with normal cholesterol levels may benefit from medical treatment.
As far as smoking is concerned, nothing more needs to be written about the health effects of this terrible habit. It is linked to more diseases than any other toxic exposure.
I enjoy a good meal as much as the next guy, we had a great dinner at Emeril's restaurant. But the next day, I had a good workout at the gym, and ate just a soup and salad. I tell many of my patients that moderation is the key to good health. Everyone makes choices that may not be the best for their health, but as long as the majority of the time you make the best decision for your health, you will be in good shape.
Thursday, March 12, 2009
Pregnancy
My nurse practitioner is pregnant with twins. We will miss her while she takes time for the delivery and then the first few months while she is getting used to her new angels. She has been scouring the internet for information about labor and delivery, as well as for all of the new purchases she will need to make to take care of these two new bundles of joy. Our work in taking care of patients will continue, and will be harder with her not available to us, but we know that she is doing the most important work in caring for her children. She has been viewing many of the videos on VideoMD.com to learn about what to expect during labor and delivery and how to have health twins. We welcome all expectant mothers to learn more in our library of pregnancy videos. We wish them all luck.
Sunday, January 4, 2009
Milestone For VideoMD.com: 2500 Patient Education Videos
VideoMD.com is proud to announce the milestone of 2500 patient education videos. All of our videos are reviewed by physicians for medical content, so the health care information consumer can be sure that our video library is up to date, and trustworthy.
We look forward to growing our video library, and we want all physicians and health care institutions to join us in helping to better educate patients.
We want to thank all of the physicians, health care providers, and institutions that helped us to achieve this milestone.
We want to invite anyone with a medical question for themselves, family or friends to visit our video library at www.VideoMD.com. You can also ask your own physicians to upload videos to VideoMD.com, on the issues that you would like more education.
We wish you all a happy and healthy 2009.
We look forward to growing our video library, and we want all physicians and health care institutions to join us in helping to better educate patients.
We want to thank all of the physicians, health care providers, and institutions that helped us to achieve this milestone.
We want to invite anyone with a medical question for themselves, family or friends to visit our video library at www.VideoMD.com. You can also ask your own physicians to upload videos to VideoMD.com, on the issues that you would like more education.
We wish you all a happy and healthy 2009.
Monday, December 8, 2008
Hope
We have chosen the next president for our country. Let us all keep a watchful eye on our government to make sure that our medical system, including the patients and the doctors and caregivers, are well taken care of. There are many issues in health care. With the growth in medical technology, the costs have increased. The cost has also been adversely affected by the cost of defensive medicine, due to the current medical malpractice bonanza that lawyers have enjoyed. A study published in the New England Journal of Medicine showed that the outcome of a medical malpractice case, either by settlement or by trial, was not affected by the presence of true malpractice, as determined by specialists in that field of medicine. Most cases are not a doctor operating on the wrong leg, but small variations in the practice of medicine, with a poor outcome.
Our medical system is also not perfect by a long stretch. Most people are in agreement that health insurance should be more affordable for individuals. No one should have to go bankrupt to pay for their medical bills. There is also too much paperwork, which burdens all caregivers. In addition, with the technology that is available today, we should be able to have a way for different health care workers to be able to communicate about patients in an easier way. Currently, there is far too much duplication of services, which wastes millions of our health care expenditures.
I heard Mr. Obama speak on a number occasions about technology in health care, and how it would play a role in reducing the cost of health care. I agree completely with the president elect on this point. VideoMD is one way for doctors to better educate their patients. Although it is a simple technology, it is one way for doctors to use technology to their advantage in improving the doctor-patient relationship. I urge all doctors to take the leap into the 21st century, and embrace new technology that can help us and our patients.
Our medical system is also not perfect by a long stretch. Most people are in agreement that health insurance should be more affordable for individuals. No one should have to go bankrupt to pay for their medical bills. There is also too much paperwork, which burdens all caregivers. In addition, with the technology that is available today, we should be able to have a way for different health care workers to be able to communicate about patients in an easier way. Currently, there is far too much duplication of services, which wastes millions of our health care expenditures.
I heard Mr. Obama speak on a number occasions about technology in health care, and how it would play a role in reducing the cost of health care. I agree completely with the president elect on this point. VideoMD is one way for doctors to better educate their patients. Although it is a simple technology, it is one way for doctors to use technology to their advantage in improving the doctor-patient relationship. I urge all doctors to take the leap into the 21st century, and embrace new technology that can help us and our patients.
Monday, September 15, 2008
Politics and Healthcare
I was warned to stay away from the subject of politics, so I would not offend anyone and keep them away from VideoMD. But given the election is coming closer, and the angry tone that our two parties generate in the media, it was difficult to avoid.
The main issue that I want to discuss is not who is right and who is wrong, but the divisive nature of the way the issues are presented. While we expect the politicians to play politics as usual, the trend has spread to the mainstream media, the blogoshpere, and even to the water cooler conversations in the office. If you did not see the interview with Matt Damon, the recap is that Matt was terrified at the possibility of Sarah Palin being President of the United States, because of her inexperience. Now for someone to say that they don't want to vote for a candidate because of lack of experience, sure...no problem. But to be terrified at one candidates inexperience, and to turn around and pledge your support for another candidate with marginally more experience is just plain silly. You may say that is also expected from a liberal minded movie star, who will joke about the intelligence of the American people if we don't elect his candidate. But this problem is now ubiquitous, you see it in non political newsletters, in (previously off limits) sporting events, and in the conversations around the water cooler at work. It is like people have chosen a political side, as they would a sports team, and they repeat the talking points of their chosen party.
Obviously, this type of conversation is incredibly damaging. It doesn't work in marriage, in friendship, in business, and it certainly is not working to unite our country to face the issues we need to face. Not only that, it does not reflect the truth about who the American people are. The overwhelming majority of us are not party line liberals, or conservatives. We have our own issues we care about, and some that we are passionate about. None of us really fit into what both parties like to consider their "base". Let's, once again, be strong, independent thinkers, who look at the pros and cons of each candidate, and each party on all of the issues.
Take health care as an example. The democrats have historically been in bed with the trial lawyers. They went as far as putting one on their ticket in 2004. As a practicing cardiologist, I can tell you that doctors blood would boil every time we heard John Edwards tell you he was proud of his law career. That he was fighting for the little guy. In fact, he was suing good North Carolina country doctors. Most of the time with very little evidence of true malpractice, and with plenty of questionable courtroom antics. It is these same trial lawyers, with a huge lobby in Washington, who have made the practice of medicine very difficult and very expensive for the country. Any politician who tells you that the cost of defensive medicine is minimal is just wrong, and has not spent enough time in the trenches with the practitioners of health care. On the other side, the republicans have historically been close allies with big business. One of the most annoying aspects of being a physician is having insurance companies mandate how we treat patients. I have to personally call the medical directors of insurance companies daily to try and get the tests that I order approved. For these insurance companies to deny tests that have reasonable medical indications, in order to post bigger profits is just shameful. This is a simplification of a much more complex issue, but illustrates how both parties contribute to the problem, as is the case for most of the issues that the American people face. To simplify the issues even more, so that one party or the other is the only blame for a given problem, just underestimates the ability of the American people to think through these complex issues. (Note to Nancy Pelosi: When your response to every crisis in America is "Oh, that damn President Bush", we know that there is much more to it. So stop insulting our intelligence, and start working together to move this country forward. That's why we hired you!)
Let's start having balanced discussions, recognizing that the candidate you are rooting for ( as well as the other candidate), has opinions you agree with and some that you do not. That way, no matter who is elected into office come November, you will know what their position is on each issue, and can speak out if you don't agree with their position on that issue. I feel passionately about improving the physician-patient relationship. We built VideoMD.com to help physicians use technology to improve this relationship. I plan to watch the next president closely, whether it is President Obama, or President McCain, to make sure that they take steps to improve the most important relationship in medicine, that between a doctor and his/her patients.
The main issue that I want to discuss is not who is right and who is wrong, but the divisive nature of the way the issues are presented. While we expect the politicians to play politics as usual, the trend has spread to the mainstream media, the blogoshpere, and even to the water cooler conversations in the office. If you did not see the interview with Matt Damon, the recap is that Matt was terrified at the possibility of Sarah Palin being President of the United States, because of her inexperience. Now for someone to say that they don't want to vote for a candidate because of lack of experience, sure...no problem. But to be terrified at one candidates inexperience, and to turn around and pledge your support for another candidate with marginally more experience is just plain silly. You may say that is also expected from a liberal minded movie star, who will joke about the intelligence of the American people if we don't elect his candidate. But this problem is now ubiquitous, you see it in non political newsletters, in (previously off limits) sporting events, and in the conversations around the water cooler at work. It is like people have chosen a political side, as they would a sports team, and they repeat the talking points of their chosen party.
Obviously, this type of conversation is incredibly damaging. It doesn't work in marriage, in friendship, in business, and it certainly is not working to unite our country to face the issues we need to face. Not only that, it does not reflect the truth about who the American people are. The overwhelming majority of us are not party line liberals, or conservatives. We have our own issues we care about, and some that we are passionate about. None of us really fit into what both parties like to consider their "base". Let's, once again, be strong, independent thinkers, who look at the pros and cons of each candidate, and each party on all of the issues.
Take health care as an example. The democrats have historically been in bed with the trial lawyers. They went as far as putting one on their ticket in 2004. As a practicing cardiologist, I can tell you that doctors blood would boil every time we heard John Edwards tell you he was proud of his law career. That he was fighting for the little guy. In fact, he was suing good North Carolina country doctors. Most of the time with very little evidence of true malpractice, and with plenty of questionable courtroom antics. It is these same trial lawyers, with a huge lobby in Washington, who have made the practice of medicine very difficult and very expensive for the country. Any politician who tells you that the cost of defensive medicine is minimal is just wrong, and has not spent enough time in the trenches with the practitioners of health care. On the other side, the republicans have historically been close allies with big business. One of the most annoying aspects of being a physician is having insurance companies mandate how we treat patients. I have to personally call the medical directors of insurance companies daily to try and get the tests that I order approved. For these insurance companies to deny tests that have reasonable medical indications, in order to post bigger profits is just shameful. This is a simplification of a much more complex issue, but illustrates how both parties contribute to the problem, as is the case for most of the issues that the American people face. To simplify the issues even more, so that one party or the other is the only blame for a given problem, just underestimates the ability of the American people to think through these complex issues. (Note to Nancy Pelosi: When your response to every crisis in America is "Oh, that damn President Bush", we know that there is much more to it. So stop insulting our intelligence, and start working together to move this country forward. That's why we hired you!)
Let's start having balanced discussions, recognizing that the candidate you are rooting for ( as well as the other candidate), has opinions you agree with and some that you do not. That way, no matter who is elected into office come November, you will know what their position is on each issue, and can speak out if you don't agree with their position on that issue. I feel passionately about improving the physician-patient relationship. We built VideoMD.com to help physicians use technology to improve this relationship. I plan to watch the next president closely, whether it is President Obama, or President McCain, to make sure that they take steps to improve the most important relationship in medicine, that between a doctor and his/her patients.
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