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The Invisible Hand Slaps Valeant Pharmaceuticals and the Sequoia Fund
Over the years I've been a staunch critic of seeing the health care "industry" as a commodity that should be governed by market forces. But fairness and honesty compel acknowledgement when the...
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Walking Meditation and Health Care Ethics
Health care can be frantic. Emergency rooms, intensive care units, and surgical suites are obviously high paced, but so is "ordinary" hospital and outpatient care. In my busy days of practice I...
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Priests and Physicians who betray their trust
If you’re a moviegoer, don’t miss Spotlight, which opened earlier this month. It tells the story of the Boston Globe investigative team that broke the story about sexual abuse of children by priests....
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How Long Should We Live?
Spending Thanksgiving with my two sons/daughters-in-law and five grandchildren made me more aware than usual about the generations, the passage of time, and mortality. Those musings led me to look at a...
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Taking Action on Sexual Abuse by Physicians
"Why Didn't Anyone Stop Dr. Hardy?" is the featured headline on the front page of today's Boston Globe. It's accompanied by the photo of the back of the head of a woman who complained about Dr. Hardy...
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The Four "As" of Ethics
Here's a mnemonic I've found useful for thinking about the actions health organizations need to take to walk the talk of their values:Analysis ("what is the right thing to do?") This is the activity...
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Informed Consent for Simultaneous Surgeries
Two months ago (here) and again today the Boston Globe Spotlight team wrote about the practice of having one surgeon doing two operations at the same time, moving between two operating rooms and...
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How to Deal with Controversy over Physician Assisted Death
We in the U.S. are not skilled at resolving controversy. We're vulnerable to demonizing those who hold different views on issues that matter a lot to us. Polarizations like "pro life" vs "pro choice"...
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New Massachusetts Regulations on Simultaneous Surgeries
Two weeks ago I posted about the practice of simultaneous surgeries. It had been the focus of a Boston Globe Spotlight series. Two days ago, the Massachusetts Board of Registration in Medicine - the...
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A Surgeon Explains and Defends Simultaneous Surgery
In the continuing discussion sparked by the Boston Globe Spotlight Team's reporting on simultaneous surgery, Dr. Alexander Langerman, a head and neck cancer surgeon from Vanderbilt, wrote an...
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Mindfulness, Clinical Outcomes, and Patient Safety
Two months ago, when I wrote a post about using the walking we clinicians do in the course of the working day as opportunities for meditation, I wondered if it was a harebrained idea or a piece of...
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Boredom as a Health Hazard/Uber as a Cure!
A recent New York Times article featured a photo of Carol Sue Johnson, 73, in her rear view mirror, setting out as a Uber driver. Apparently, an increasing number of older folks are doing gigs for Uber...
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Medical Scribes and the Patient-Doctor Relationship
I'd heard and read about the practice of bringing "scribes" into the exam room to allow the doctor to relate to the patient rather than to the keyboard. But I hadn't experienced the phenomenon until...
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Cooperation vs Competition in Health Care
I've long admired the Cleveland Clinic, so I hope this paragraph from a New York Times article on how drug shortages force rationing decisions, turns out to be incorrect:The Cleveland Clinic has an...
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Dreams of the Dying
A fascinating New York Times article about the dreams of people who are close to death brought to my attention a study of end of life dreams and visions carried out by clinicians at a Cheektowaga (a...
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Accountable Health Communities and Primary Care
Last month CMS announced an "Accountable Health Communities" initiative:The Accountable Health Communities (AHC) model addresses a critical gap between clinical care and community services in the...
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Curing Depression with Light: Let the Sun Shine in
In an elegant Canadian study, light outdid Prozac in a head-to-head comparison as treatment for nonseasonal major depression.The study design is fascinating. Patients were randomly assigned to one of...
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Physicians as "Counsellors"
One of my favorite moments in music is the spectacular chorus in Handel's Messiah:For unto us a child is born, unto us a son is given, and the government shall be upon His shoulder; and His name shall...
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"Facilitated Communication" and the Sentencing of Professor Anna Stubblefield
Anna Stubblefield, former chair of philosophy at Rutgers, has been sentenced to 12 years in prison for rape of D.J., a 31 year old man with severe cerebral palsy who she insisted was mentally competent...
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Sharing our Experience of Illness
In the last couple of month I've developed a problem involving circulation to my toes and foot. The formal name is "acrocyanosis." Colloquially it's called "blue [or purple] toe syndrome." Though the...
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"Guilty mind" and the jailing of Professor Anna Stubblefield
I've had several conversations about the justice or lack thereof in the sentencing of Professor Anna Stubblefield since I posted about her four days ago. One person made a strong case against any jail...
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Viagra and the Political Genius of Mary Lou Marzian
Most readers have probably heard about a bill Kentucky State Representative Mary Lou Marzian proposed in response to Kentucky's most recent intrusion on a woman's right to choose: A health care...
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All Physicians Should be Doing Palliative Care
Here's a condensed version of a recent conversation I had with a family member:My family member: The hospital recommended that X should have palliative care. What is palliative care?Me: Palliative care...
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Either/or Thinking about Opiate Addiction
An article about "Rehab Rooted in Science" in this morning's New York Times provokes me to rant about one of my pet peeves - either/or thinking about complex medical problems and grouping those who...
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Using Social Media for Patient Care and Population Health
I'm very interested in the ways we can use digital technologies to improve clinical care and population health. Over the years I've written a number posts on the topic (if you want to see them, the...
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