When I graduated fellowship in the mid-90’s I opened my own practice. I rented an office, hired a staff and saw children. Everything was fine until one day my office manager came to me and said there wasn’t enough money to pay me. Accounts payable had exceeded accounts received. My son (now 18) was a few months old at the time. I had to walk into my house and tell ... Continue Reading about Cost of Care – Hard Lessons for a Young Doctor
Wakefield in the White House
After the Cleveland Clinic Vaccine kerfuffle I was interviewed by a reporter at the Cleveland Plains Dealer. She wanted to know why there was such a backlash against the comments of The Clinic doctor. It wasn’t an issue of new science, I suggested, but new voices. The doctors finally showed up. Pediatricians, for example, now number in the thousands on ... Continue Reading about Wakefield in the White House
How Do We Make Evidence Care?
Medicine is increasingly about outcomes, data and numbers. But while evidence helps us provide care, how does it apply to individual patients? Victor Montori from The Mayo Clinic addresses this question in a beautiful 19 minute talk from Oxford University. I’ve watched it over an over. What stuck with me: Evidence creates work for patients. Education and ... Continue Reading about How Do We Make Evidence Care?
One Button Medicine
Everyone's looking for the Uber of healthcare. The ideal is a button that makes everything right. Most aspiring health care Ubers amount to a convenience for the worried well positioned as brilliant disruption. Attention and social dialog surrounding such 'innovations' are fueled almost exclusively by fantasy. Sensational solutions are less about real problems ... Continue Reading about One Button Medicine
Write Like No One is Watching
This blog was easier when no one was watching. Let me explain. I started this whole thing for myself. To put my thoughts together. Then I realized that there’s value to sharing ideas before they’re fully baked. While you may enjoy this, it's really for me. You’re a spectator. But I started running into problems when I learned who was watching. I got pulled ... Continue Reading about Write Like No One is Watching
Silicon Valley Has a Health Problem Problem
Silicon Valley has a Problem Problem by Melissa-Riva Tev is the most important thing I've read in a couple of weeks. It seems that what Silicon Valley identifies as a problem typically isn't a problem. This is true when it comes to health. A onesie sensor that texts a parent when a baby rolls over doesn't represent the solution to a problem. Access to drinking ... Continue Reading about Silicon Valley Has a Health Problem Problem