Archive for the ‘Doctor Patient Relationship’ Category

A Patient is Not a Shunt

Friday, February 4th, 2011

By Evan Falchuk

Some people may tell you that health care IT will solve many of the quality and cost problems in health care.

I don’t believe them.

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Best Doctors: Fast Company

Thursday, January 20th, 2011

By Evan Falchuk

Kaihan Krippendorff of Fast Company magazine has written two interesting profiles of Best Doctors for Fast Company.

Kaihan is an expert in business strategy, keenly interested in what it takes to build a successful business.   We talked about how the work we do at Best Doctors impacts people’s lives, and how those stories inspire us to make a great company.

One of those stories was the woman I talked about in the article.  She was one of the first cases I learned about when I joined Best Doctors.

She was in her 30s, and over the course of a few months, she started to lose her vision.  Specialists diagnosed her with a brain tumor.   It seemed that a tumor had grown in an area of her brain that was pressing on the optic nerve.  As it grew, her vision got worse.  She was scheduled for surgery to remove the tumor.

She had Best Doctors as a benefit of her job, and called for help, asking the questions many people ask us.  Is this the right treatment for me?  Are there other alternatives?

We reviewed all of her medical information.  It raised some important questions about the original diagnosis, and our team thought it was important to involve an expert in differentiating brain tumors from other kinds of problems.  He agreed something might not be right.

It was possible, he said, that what appeared to be a tumor was actually an inflammatory disease called sarcoidosis.  It’s a chronic illness that can create the kinds of problems the woman was facing.  His recommendation: before taking her into surgery, treat her with anti-inflammatory medication, and see what happens.  If it’s sarcoidosis, the “tumor” will shrink, and her vision will come back.  If not, then, you know the original diagnosis was correct.

We delivered this information to her and to her doctor.  They agreed to follow this recommendation – and in a short time, her sight started to come back.  A follow-up study confirmed the expert’s suspicion – she had sarcoidosis.

Now, she still had a disease needed treatment.  But she avoided an unnecessary surgery, that carried great risks, and a painful recovery.

It’s stories like these that inspire us, and it’s what Kaihn calls building “moral force:”

Stories like this move people. They give your employees a sense of meaning and pull the community to cheer for your success. They also show your clients that you exist for a bigger purpose than making profit.

I will be speaking with Kaihan on a free executive briefing, hosted by Fast Company on Monday, January 24 at noon ET.  Kaihan is a terrifically insightful person, so it promises to be an interesting conversation that you won’t want to miss.  

Click here to register and listen in.

UPDATE: Don’t miss Kaihan’s third piece on Best Doctors, which you can read here.

Wikileaks!!

Monday, November 29th, 2010

By Evan Falchuk

Dr. Wes connects the news of the Wikileaks document dump to the privacy of health care data:

While a single individual’s private health care information may not carry the gravitas of wartime communiqués, each of us deals with famous patients who might not want their diagnosis, HIV status, or drinking history spread far and wide. For them, this private information might be just as personally damaging as anything disclosed by WikiLeaks.

Wes raises a good point. To which I would add a bigger point.

All of the laws and security systems and everything else don’t mean your health information will remain private. No, the extent to which your health information stays private depends on the honor, reliability and trustworthiness of the people who have it.

Almost everyone who touches health information has those morals. But not everyone. And for them, there is no law, no security system that can stop dishonor. What we can do is call this kind of behavior what it is, and root it out. Leaking confidential health information is despicable.

Good on Wes for taking this opportunity to remind us of that.

Stop the Phony Quality Measures, Ctd

Friday, October 15th, 2010

By Evan Falchuk

Who do you think is likely to be a better doctor:

A board certified graduate of one of the top medical schools in America, or a non-certified doctor trained in a foreign country?

If your answer is “I have absolutely no idea,” then you’re probably spending a lot of time looking at the “report cards” that pass for measures of health care quality.  And you’re probably confused.

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Cardiac Stents Don’t Work

Wednesday, September 8th, 2010

By Evan Falchuk

I have a friend who had a blocked cardiac artery.  A couple of years ago he had angioplasty on it, and his doctor inserted stents.  The stents got rid of his chest pain and other symptoms, but didn’t do anything to get at the underlying cause of the blockage, which had to do with an unhappy combination of genetics and a – perfectly admirable – taste for rich, fatty foods.

Like steak.  More on that in a moment.

Before having the procedure, his doctors spent a lot of time with him explaining what the surgery would and wouldn’t do.  In particular, the doctors explained that the stents would do their job, but he had to do his.  He needed to eat better, exercise more, and take his medications.  He’s followed most of that advice, and is doing well.

Unfortunately, his experience is not typical.  A recently-published study found that more than 80% of patients who had gotten angioplasty and stents thought they were, alone, a cure for their problems.

These patients are wrong – so how can it be that they are coming to this strange conclusion?

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From Wall Street to Main Street: Misdiagnosed

Thursday, September 2nd, 2010

By Evan Falchuk

According to news reports actor Michael Douglas, perhaps most famous for his role of Gordon Gekko in Wall Street, is suffering from stage IV throat cancer.

He started complaining about symptoms to doctors earlier this year.  His doctors didn’t find anything to explain the problem until months later, when they discovered a walnut-sized tumor in his throat.  Even though doctors had originally told him they couldn’t find anything wrong, Douglas and his wife, actress Catherine Zeta-Jones were sure something wasn’t right.

Still, after months of feeling the pain creep up on him, of having a dry throat and hoarse voice, the news of his cancer came as little surprise to both Hollywood stars.

“It wasn’t a huge shock. I knew something was up. He knew something was up,” said Zeta-Jones.

It’s an all-too familiar story.  Being a rich and famous celebrity can make you special.  But when it comes to the right care, you’re as ordinary as the next guy.

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Starving Doctors

Wednesday, September 1st, 2010

By Evan Falchuk

If you’re into health care consumerism, and you like, well, me, you will enjoy my guest blog post at CDHC Solutions Magazine.

CDHC Solutions focuses on consumer-driven health plans.  Consumer-driven plans are a form of “high deductible” health coverage that is more popular than ever.

For whatever you want to say about these plans, one thing is clear: they don’t solve the fundamental problem of patients not having enough time with their doctors.

Here’s a taste of what I wrote:

Researchers have been trying to pinpoint the impact of this time starvation on the quality of medical care, and they’re finding disturbing results. A recent study in the Annals of Internal Medicine found that because of time pressures and related factors doctors deliver “error-free” care as rarely as 22% of the time. The researchers called this a “failure to individualize care,” which is a nice way of saying the doctors just weren’t paying enough attention to the needs of their patients.

Read the whole thing here.

Health Business Blog Podcast

Friday, August 13th, 2010

By Evan Falchuk

David Williams, the Charlie Rose of the health care blogosphere, recently interviewed me.

You can listen to the audio of our wide-ranging talk on David’s always-interesting Health Business Blog.

We talked about health care reform, health IT, social media, health care quality, patient navigation, and the role of Best Doctors.

Give it a listen, and visit back to David’s blog regularly.

What’s your opinion on the subjects we talked about?

It’s Your Medical Record, But….

Wednesday, July 28th, 2010

By Evan Falchuk

You have a right to your medical record.

It’s true – the record of every test and procedure you’ve had done, any films or studies, your doctors notes.  It’s all yours if you ask for it.

But it’s not that simple.

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“I was shocked”

Tuesday, July 27th, 2010

By Evan Falchuk

According to the Annals of Internal Medicine, doctors make the wrong medical decisions surprisingly often.

Using a “mystery patient” technique – in which actors pretended to be patients – researchers found that doctors made errors in complicated cases in 60% to 90% of cases.  Sixty to ninety percent. In uncomplicated cases, they made errors in nearly 30% of cases.

As one study participant put it, “I was shocked.”

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  • "Medicine is learned by the bedside and not in the class room. Let not your conception of manifestations of disease come from work heard in the lecture room or read from the book: see and then research, compare and control. But see first."
    - Sir William Osler, MD
    The Father of Modern Medicine
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