In part two of my analysis of David Goldhill’s proposal to fix health care, I promised to blog about his interview with my favorite author, thinker, and fellow Canadian, Malcolm Gladwell. Goldhill, a businessman, lost his father to a hospital acquired infection and witnessed multiple errors during that hospitalization which compelled him to write not only a piece in the September 2009 Atlantic titled How American Health Care Killed My Father, but also a new book titled, Catastrophic Care – How American Health Care Killed My Father — and How We Can Fix It. The question is does his solution offer hope? If it was based purely on his interview with Gladwell, the answer would be no. Goldhill perspective of health care boils down to this: health care suffers from distorted thinking that is different that other industries. His simple solution is that health care should not be treated any special […] Read More »
Author Archives: Davis
Malcolm Gladwell and David Goldhill Interview on Health Care – Disappointing, Dangerous, Frightening
Posted on April 1, 2013
Why This Family Doctor Blogs and Writes – The Thrifty Patient
Posted on March 24, 2013
As a doctor, I am compelled to write because of what I know is occurring with alarming frequency in our country. Americans are skipping needed and recommended care that could save their lives and allow them to live to their fullest. Patients are more distracted, as life is more complicated and busier than ever. Households have both parents working, sometimes two jobs, just to make ends meet. They easily would make the right choice if someone would be willing to explain things in a simple, understandable manner. They would prefer a health care system that was so incredibly simple to use, convenient, and personalized that it would anticipate their needs so they could get the right care and get back to living life. Instead, our health care system offers patients higher co-pays, deductibles, and out-of-pocket medical expenses. It shifts the burden of making the right choices to people who frankly […] Read More »
Is David Goldhill Fix For Health Care Right?
Posted on March 12, 2013
First I believe our health care system must be better so I’m always curious to hear how others might propose to fix it. I recently had the opportunity to listen in two conversations with businessman David Goldhill about how healthcare might be made better. Goldhill lost his father to a hospital acquired infection and witnessed multiple errors during his hospitalization which compelled him to write not only a piece in the September 2009 Atlantic titled How American Health Care Killed My Father, but also a new book titled, Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong (Vintage). The first conversation was with New Yorker writer and best selling author Malcolm Gladwell. The second with Professor Ashish Jha, MD, MPH of Harvard medical school and Harvard School of Public Health. Does his solution offer the right prescription? Maybe. Maybe not. As a practicing primary care doctor passionate […] Read More »
The New Ontario Annual Physical Exam – Is It Choosing Wisely?
Posted on March 5, 2013
Is the Ontario Annual Physical Exam going the way of the dinosaur? That appears to be the case for healthy individuals between the ages of 18 to 64 in the Canadian province of Ontario. Effective in 2013, these patients no longer would have available an annual physical examination, but instead a “personalized health review”. The new personalized health review would only be available to those who were healthy and did not have medical diagnoses of cancer, diabetes, or others, in which those patients could still receive a more thorough examination. Other changes include not allowing routine chest x-rays prior to minor surgery and moving the screening rate for cervical cancer from one to every three years. The plan would save the government of Ontario about half a percent on payment to physicians as the reimbursement is less for these personalized health review. Should people in Ontario be worried that their […] Read More »
Book Review – When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests
Posted on February 5, 2013
The premise of the book When Doctors Don’t Listen is that increasingly doctors are adhering to algorithms and protocols, known as “cookbook medicine”. In the process, doctors are not listening to patients. Instead, doctors are hearing what they want to hear, ignoring the patient’s story, which results in medical evaluations and treatments which are erroneous. The consequence can be delay in care, unnecessary tests and worry, and at times the path taken is so far astray that patients need to fend for themselves. In one anecdote, a patient flees the emergency room after being evaluated for a headache after a hangover and discovers that her treatment is on the pathway to be evaluated for a possible life-threatening (and highly improbable) subarachnoid hemorrhage which includes an invasive lumbar puncture. Too far fetched? Do these problems affect a no name hospital? No. What makes the patient stories most interesting is where they […] Read More »
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