At the New York Times’ City Room Blog, Joel Cohen writes:

my wife and I are convinced that all medical students should have to pass Overbooking 101 before they can become doctors.Again and again, we arrive at a doctor’s aptly named waiting room on or before the scheduled time, only to learn that three or four others sitting there have been given the same appointment.

He says doctors need to understand the impact of this on their patients.  I agree, but not just because it’s annoying.

A typical doctor sees thirty patients a day.  Some see even more.

Reflect on that math.  If your doctor sees 30 patients a day, that’s 150 a week, 600 a month, maybe 7,000 a year.

It means that if it’s been even two months since you last saw your doctor, he has probably seen more than a thousand people since your last visit.  It’s why there’s often that moment of disconnect when you see your doctor.  You’re living every day with the fears and anxieties of your medical condition, but your doctor can’t quite place which one of the worried patients you are.  So you have to remind him why he ordered that extra test a few months ago, why you switched medications the last time you were there, how he already ruled out that possibility the last time he saw you.

We all work through these awkward moments- but they are a symptom of a more serious problem.

Doctors who are starved for time in a patient visit are also starved for time to think about their patients, reflect on what is wrong, and find good solutions.  It’s why studies show such alarming rates of incorrect diagnosis and treatment.

But what else can a doctor do?  There’s a room full of patients outside.  Just like there was yesterday, and just like there will be tomorrow.

There’s more than one reason to go see the latest call for submissions for The Benefits Package.

It’s hosted at the Beyond Health Care Reform Blog, so go there to find out how you can submit your post.

But also go there because you’ll find that the blog is hosted by a law firm (Faegre & Benson) that has embraced social media.

It’s not the kind of thing you see every day, and they do a terrific job of making issues of employee benefits suitable for the blogosphere.

Just like the Benefits Package.

Disclosure:  Best Doctors has no business relationship with Faegre & Benson.  Of course, that doesn’t mean you shouldn’t.

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.

How do I know?  Here at Best Doctors, we’ve got a lot of experience and data on what happens to regular people when they get sick.

We get our data from the programs we run.  In our work, members call us when they’re trying to make decisions about their health care.  We do whatever we can to make sure the person knows what’s really wrong and what to do about it.  The people we serve work in factories, behind desks in an executive suite, in retail stores, behind the wheel of a truck – it’s a cross-section of Main Street America.

Our call data is fascinating – and disturbing.

More than one-third (34%) of our calls are from people who haven’t been able to get a diagnosis or have symptoms that aren’t getting better.  They’re trying to figure out what to do, but are finding that the system is failing them, just when they need it to work.

Why does this happen?  I think it’s because health care has become increasingly depersonalized.  Medicine is being turned into something like an assembly line process – 15 minutes per patient, 30 patients a day, please fill out the following form and see the nurse at the front when we’re done. Medicine – the art of listening to patients, thinking about their problems, and offering solutions – is slowly dying under this pressure.  Doctors know this, and they don’t like it.

The trouble for regular people is that you haven’t a clue this is going on until you get sick.

You can’t fix the system, but you can protect yourself from its failings.  Stand up for yourself.  Use every resource available to you to make sure things go right.  Insist that your doctors hear your concerns.  And above all, don’t let anything happen until you’re sure you’re doing the right thing.

When health care reform became law, HR and benefits professionals I spoke with had two reactions: surprise and annoyance.  Surprise, because they thought reform was dead; annoyed, because the law was full of provisions that didn’t make sense to them.

But it was partly their own fault.

Blogs and other social media were buzzing with health care reform talk for more than a year, and were more influential than ever.  But HR and benefits professionals – experts in the topic – were mostly on the sidelines.  They didn’t shape the debate, didn’t point out when people didn’t know what they were talking about, didn’t talk about how what was proposed would affect what they did for a living.

Don’t take my word for it.  A study last year on social media use by HR professionals revealed some striking results:

• Only 13% use RSS feeds, tags and bookmarks
• Only 5% post original content to blogs and website
• Only 4% post ratings and reviews or comments on blogs and on-line forums

Reform shows there are real consequences to this failure to participate in social media.  If you’re not part of the conversation, you’re marginalizing yourself, losing influence within your organization and the world.

So let this be a wake-up call:  Get involved in social media.

Easy to say.  But how do you get started?

Here are three simple steps you can take – today – that will have you in the game right away.

1. Set up an RSS reader. A what?  An RSS reader is a fancy word for a simple web tool that lets you read multiple blogs, news sites, or other web sites all in one place.  Getting started is easy.

Create an account with an RSS reader provider (I use Google – it’s free and you can sign up for here).   Next, enter the address of each of the websites to which you want to subscribe.  Now, every time there’s a new post or article on that site, you see it show up in your reader, sort of like getting an email.  Now, any time you find a cool or interesting website or blog, you can just add it to your reader.

When you start you’re only going to have a few web sites on your reader.  That’s ok.  When you find a blog you like, here’s a tip.  Most bloggers keep a list of their favorite blogs on the lower right hand side of their blog.  It’s called a “blogroll” and if you like a blogger, you’re sure to find interesting blogs that that blogger reads.  Click through to them, and if you find something you like, add it to your reader.  Check out their blogroll, too.

In no time at all you’ll have a lively, interesting set of things to read every day.  You’ll also probably learn that your favorite TV and print media are often a day or two behind blogs in reporting on interesting stories.  You’ll be “in the know.”

2.  Create a Profile on LinkedIn. LinkedIn is one of those “must haves” mostly because it’s so damn practical.  You probably go to lots of conferences and events where you meet interesting people in your industry and get lots of business cards.  But by the time you get home, you’ve completely forgotten whether that Evan Falchuk guy whose business card you have was the fascinating person you met at lunch that you wanted to follow up with, or if he was the guy at the booth who had nothing to say.  Now what?

What I do is go to LinkedIn and search for his name.  Presto, up comes a picture and a basic resume – ah, now I remember who he is.   Now, if you want, you can press a button and add him to your network.  If he accepts (most people who you’ve met will accept your invitation) you get to see much more detail about them, including who they are connected to.  You’ll be surprised at what a small world it is and how much easier it now is to network.

What’s more, you now have some kind of rudimentary relationship with the person.  More serious users of LinkedIn regularly update their profile with news, or post interesting articles or blog posts, so it’s a great way to get to know someone in a completely passive way – all you have to do is read.  Next time you see them, you’ll have more to talk about than trying to remember each others’ names.

Know this, too: if you’re ever looking for a job or trying to hire someone, having an active LinkedIn profile means you have an installed network of people who can help you.

Setting up your profile is very easy, you can do it here.  Share as much or as little about yourself as you want, but whatever you do make a profile.

3. Create a Twitter Account. Twitter gets a really bum rap as a place where people post inane stuff like what they are eating for lunch.  It’s true, there is a lot of that out there, but that’s not my experience with Twitter.  Think of Twitter like a big cocktail party where you get to decide who’s there, where you can overhear every single conversation, where people agree to only talk about subjects you’re interested in, and where you don’t have to say a single word.

Sounds pretty good, right?

It’s true.  I follow more than 1,000 people on Twitter.  Many are doctors, some are HR and benefits professionals, others are business executives, news analysts and other people interested in health care or business.  As you might expect, almost all of the posts I see have something to do with some health care story that’s in the news, or being talked about on someone’s blog.  It’s a real-time view of what people are talking about.

Setting up a Twitter account is very easy (do it here).  Finding people to “follow” (it’s not stalking – people want to be followed!) may take a little bit of work.  Start by following someone interesting (like me!) and then look at who they follow.  You’re likely to find plenty of interesting people in their list.  Like I said, you never have to say a word, so don’t feel any pressure to say anything.  Still, don’t be afraid, if you have something interesting to say, say it!

Like with your RSS reader, you’ll quickly find that when you turn on your computer there’s a lively conversation going on that you can dip into at your leisure.  You’re very likely to learn something interesting, think about something important in a way you’ve never done before, or even get annoyed.

It might just be enough make you take some more advanced social media steps.  I’ll cover those in another post.

Meanwhile, enough – go get an RSS reader, a LinkedIn profile and a Twitter account!

What I read (or wrote) this weekend:

1. CONSPIRACY! Can’t figure out why health care reform isn’t as popular as you think it should be?  Look for the mysterious forces aligning against it.  Or something like that.

2. NEUROSURGERY. Top Red Sox prospect, Ryan Westmoreland, needs serious brain surgery.  He is afflicted with the same kind of problem that struck my brother, Brad Falchuk, co-creator of Glee. I hope Westmoreland’s doctors are as skilled as those who treated my brother.

3. HEALTH CARE FOR ARTISTS, PHOTOGRAPHERS AND WRITERS. Nancy Pelosi says,

Think of an economy where people could be an artist or a photographer or a writer without worrying about keeping their day job in order to have health insurance.

She’s running out of time, but give her credit, she’s doing her best to come up with brand new rationales for whatever reform plan she’s talking about.

4.  ONLY ONE MORE WEEK? The White House says the (some) health care reform plan will be “the law of the land” by this time next week.  Whatever you think of whatever it will be, there is good news for health care bloggers:

“[O]nce it passes, we’re happy to have the 2010 elections be about the achievement of health care reform.  That’s a debate I think we’re obviously comfortable having.”

5.  DAYLIGHT SAVINGS TIME. Not awesome.

To the right of these words you see three icons – one for a service called “digg,” one for Facebook, and one for another called “reddit.”  At the bottom of the post, you can see an icon for “buzz.”

If you don’t know, I wanted to give you a quick explanation of what those are there for and how they work.

DIGG AND REDDIT. Digg and reddit are similar services.  They are ways that people can tell other people that they found something interesting and worth reading.  To use them, all you need to do is set up an account on digg and reddit. Then you can browse around and find out what are the most popular, most controversial, or newest stories or blog posts that people around are talking about.

It takes about a minute to set up you account, and you’ll be very glad you did it.  I go to both sites all the time and find loads of interesting stuff.

Many media people use these services to source stories – I often find that something I see on TV or in a newspaper as “news” is something I read about through digg or reddit many days beforehand.  That’s cool.

I have those links on each of my blog posts so you can let other people know about anything I might write that is interesting.  The number on the digg icon tells you how many people have shared the post on digg.  The number on the reddit icon is a combination of how many people posted it and how many people liked or disliked it.  If you like it you can click the “up” arrow and if you thought it sucked, you can click the “down” arrow.

So PLEASE, if you like something I wrote, click on digg or reddit and let other people know.

BUZZ. This is sort of like Google’s version of digg, although it’s more like a combination of digg and twitter.  If you have a Buzz account, you’ll share whatever you click on with your network of followers.  It’s kind of an emerging network, but it’s Google, so I feel like I have to have it on the blog or someone will come to my house at night and make me put it on there.  Just kidding.  Sort of.

FACEBOOK. If you click there, it will open a new window, and it will automatically help you post what you’ve read here to your Facebook account.  Like the digg icon, the number there tells you how many people have shared the story on Facebook using that icon.  It doesn’t count if you just copy and paste the url, but I’m fine either way!

Thank you very much to all of my readers, it’s a thrill to me to have so many of you here every day.

Please help spread the word about my blog by clicking on those icons whenever you read something you like.

Thank you again!

Yesterday, I was sitting on the floor about two feet away from where I am now.  I was holding our wonderful chocolate lab, Hooper, in my arms as he died.

He had been sick, so it wasn’t a shock.  A short time ago, he was stricken with an aggressive cancer.  He hadn’t suffered much, even though he was declining.  The day before yesterday he was as happy and playful as I have seen him in months.  Maybe he knew something was going to happen.

I went to work but half way through the day my wife called to say I should come home.  I found him lying on the ground, right over there, where I had last seen him in the morning.  His breathing was labored, but he looked at me in the eye when I walked in.  As I went over to him and started to hold him and pet him and talk to him, his breathing started to change.  It was as if he was no longer trying to breathe, but it was just happening, reflexively.  It kept getting shallower and shallower, until, after maybe five minutes it faded away completely.  I couldn’t feel his heart beating anymore.  He was gone.

Dogs don’t live long enough, and so they bookend parts of your life.  In our case, when Hooper was born 12 years ago my wife and I were single lawyers who wanted to be married non-lawyers.  We did both of those things, and much more.  Hooper showed us that we had a responsibility to make these kinds of choices in our lives.  Choices that would fill our lives with the kind of joy that Hooper experienced every day, just by being alive.

Dogs are such pure beings.  Their love and spirit are uncluttered, unfettered, unconditional. They don’t do the “right” thing or the “wrong” thing, they just do the whatever involves taking care of those they love.  They are so undemanding, so selflessly caring, such….friends, that they bring some of that out of you.  I know with my family, my friends, my work – that if I can do for others even one percent of what Hooper did for us, well, I will have accomplished something meaningful with my life.

And so the truth is this.  Hooper died a few feet from here.  But what is important is not how he, or any of us, die.  What matters is how we live.  The choices we make to be sure our lives are in service of something greater, and more everlasting than our own.

Now, our home, filled as it is with three wonderful children, is strangely empty.  I know that will pass.  We will take Hooper’s ashes and spread them by the ocean near where he and I played fetch.  And I hope that as the pain of his loss fades, the memory of what Hooper means in our lives becomes even stronger.

Rest in peace, my friend.

I’ve lived in Massachusetts almost my entire life.  So, like everyone else, I was surprised by last night’s stunning election results.  To think, in Massachusetts we elected a Republican to serve out the rest of Ted Kennedy’s term.  It’s one of the few times where I would say it’s possible that a dead man is actually rolling in his grave.

The explanations – coming mostly from out-of-staters – are already coming in.  Coakley was a bad candidate.  Brown worked hard and showed he wanted it more.  It’s the economy.  These are all reasonable, and probably true, but I think they miss what the election was really all about.

Here are the three things the Massachusetts election was really all about.

1.  It’s health care, stupid

I’ve been blogging about this for months and months and months and months.  You don’t mess with people health benefits.  Benefits professionals know that if you try to make even minor changes to health benefits, you can generate a whole lot of resistance. You would think people in politics would know this.  But they have made it very clear: they don’t.

Here’s what I mean.  The President keeps saying that if you like your current coverage you can keep it, but he’s also keeps saying we need to transform American health care and finally achieve what presidents since Truman and Teddy Roosevelt tried to do.   Which one is it?  If you see all the backroom dealings and trillion dollar price tags, smart people begin to think something big and important is happening that is going to affect them whether they like it or not.  And they suspect they’re not being told the whole truth.  It makes people very anxious, and anxious people don’t vote for incumbents.

Worse, you would be hard pressed to find anyone other than policy wonks who could coherently explain what the health care reform is.  And yet, Coakley, the Democratic Party, and the President tried to make this election all about this poorly understood and badly explained health care reform.  To the extent they had generated already a huge amount of anxiety around health care, and then told voters it was up to them to seal the deal and make it a reality, well, no one should be surprised this didn’t go well.

As James Carville might put it, it’s health care, stupid.

2.  Massachusetts isn’t an emerging conservative state

Massachusetts remains one of the most progressive states in the country.  There is little or no organized Republican party here, and the constellation of social issues that seem to motivate out-of-state conservatives are extremely unpopular here.  Brown said some dumb things about these social issues over the years (well, to be fair, he’s said dumb things about a lot of issues) but he did not run as anything like a social conservative.  In other states, he would have had to run as a Democrat or Independent.

People who misread this election as suggesting that Massachusetts is turning to the right on social issues are badly mistaken.  I already see Republicans doing this, and they are as out of touch with Massachusetts voters on this point as Coakley was with them on health care.

3.  The Kennedys are gone

There was a time in this state where the Kennedys were almost royalty.  If they wanted something done, it would get done.  But the generation of people who saw the Kennedys in this light is fading from view, and the younger generation doesn’t get what all the fuss is about.

And yet, Coakley ran as Kennedy 2.0.  She had the overt blessing of the Kennedy family, including having Ted’s widow run TV ads for her.  National Democrats, including the President, said her election was about realizing Ted Kennedy’s life’s work.  Coakley even looks, vaguely, like a Kennedy.  She talks with the strange accent no one from Massachusetts not named Kennedy actually has.

But it didn’t mean much to voters.  In fact, it probably had the opposite effect.  One of Coakley’s problems in the campaign is that she seemed to be acting as if she were entitled to be elected.  Wrapping herself in the Kennedy mantle was, if anything, confirmation of that suspicion.  The age of the Kennedys in Massachusetts is over.

And so, the bottom line is this.  Massachusetts remains a one-party state that just had a one-issue election, health care.  Read more into it at your peril.

One late afternoon, some summers ago, I was at the beach.

I was with our dog, a Labrador retreiver.  He was playing fetch with a stick I was throwing into the ocean.  Every time I threw it, he darted into the ocean to find it.  Swimming through the waves, he would get the stick and carry it back proudly to shore.  He would drop it in front of me, shake off some of the water soaking his coat, and stare at me, heaving, begging me to throw it in again.

We did this for a while, and it was always the same.  He was joyous.  Eventually I had to stop, even though I loved seeing him that way.  He would have kept doing it until he drowned.

I realized something else as I was watching him.

He was so happy because jumping into the North Atlantic to retrieve things is what he was born to do.

Now, people are much more complicated than dogs.  Figuring out what we’re each born to do is elusive.  Among the many, many things that make it so hard is that human lives are the accumulation of lots and lots different choices, some of which we don’t even make ourselves.  Some of those choices take us closer to what makes us happy, others further away.  But it’s hard to tell in advance which kind of choice you’re making.  Will it be one that, years later, you say, thank goodness I did this?  Or will it be one that later makes you say “what was I thinking”?  Or will it be one that seems important in the moment, but which ends up being meaningless?

Oh, the bliss of chasing a stick.

But it’s not all bad.  As people we are blessed with an ability to reflect on our choices.  We can think about ourselves, understand our problems, and try to make changes.  I’m not talking about big, dramatic changes, although that might be what’s needed sometimes.  I’m mostly talking about small things, little risks and choices that lead to new opportunities, new avenues for fortune to play a happy role in your life.

A wise man once said, on a long enough time line the survival rate for everyone drops to zero.  Well, none of us know how long our own time line is.  All we know for sure is that each day that passes leaves us with one less day to live.  To really live.

So the real question is this:

Today, what risk did you take, what choice did you make, to make your life better?

Some good links from around the web:

1.  Dr. Bob Centor wants to Keep Politics Out of Medical Decision-Making.  I agree – but is the cat already out of the bag?

2.  The Happy Hospitalists links to someone selling stuffed animals shaped like the H1N1 virus.  They look like pink tribbles.

3.  Mark Boles continues to insist that in marketing – like in any line of work – you absolutely must know your customer.

4.  A colleague, who is a health care media expert, asked me if I could explain the recent poll showing a sharp rise in consumer confidence in health care in October.  Looking at the details of the poll, which seemed to give contradictory answers, I told him I couldn’t explain it either.  Dan Drezner makes a similar observation about polling on foreign policy.

5.  David Harlow at HealthBlawg talks about how ten years after the landmark report that showed 98,000 Americans dying each year from medical errors, things haven’t gotten much better.  Bonus points to David for working in a reference to the band Ten Years After.

6.  And, on a personal note, here’s an article about my mother’s work as the President of Hadassah – Madoff: One Year Later.  And here’s one about my brother, co-creator of Fox’s Glee, who signed a new deal with 20th TV.

UPDATE: Welcome, Wired readers.

For those who are here from other sources, check out Curtis Silver’s interview with my brother (and Best Doctors success story) about his show Glee. Curtis previously interviewed me for his terrific blog, Geek Dad.