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The Limited Potential of Personalized Medicine

March 20, 2011

Have a simple blood test so your healthcare can be personalized. Sounds great, doesn’t it? This is the hope of the supporters of genomics, the emerging science analyzing the DNA structure of humans. Over 80 mutations have been discovered that are associated with obesity and diabetes. Each mutation accounts for no more...
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The Medicaid Mess

March 10, 2011

I’m going to the interim session of the Texas Academy of Family Physicians this weekend. It’s always renewing for me to talk with my colleagues who are committed to caring for their patients in trying times, who come from big towns and small. I’m sure one of the big topics will...
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How Dr. Oz Increases Healthcare Costs – Example 1, Ovarian Cancer Screening

March 6, 2011

In a recent You Docs column in my local newspaper, a woman asked about new ways to detect ovarian cancer. She went on to state, “Each year I ask for an internal pelvic exam and a CA-125 test. My mom died from breast cancer and my sister from ovarian cancer.” The...
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Thoughts on Annual Physicals and God

February 27, 2011

A local reporter pulled another fast and loose assumption on unsuspecting readers recently, though this time I’ll cut her some slack. She was merely conveying a conventional belief shared by many other Americans. The story was very sad. A well-loved perfectly healthy minister, the Rev. Ken Diehm, became suddenly ill and...
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How to Pay Less for Pharmaceuticals – Just Say No

February 20, 2011

A study by the AARP in 2010 found that the cost of brand-name prescription drugs grew 8% in 2009, compared with the overall inflation rate of -0.3%.  Over a 5-year period, retail prices for 207 brand name drugs increased 41.5 percent by December 2009, compared to the general inflation rate of...
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How would you grade your doctor?

February 12, 2011

Do you ever go to a website to see the satisfaction score your doctor or hospital is getting? If their score is below 4.5 would you stop seeing them? Some pundits expect patients to check out websites with quality ratings such as www.healthgrades.com and www.drscore.com to help them shop for doctors...
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How Electronic Medical Records Have Hurt Primary Care

February 5, 2011

Two more recent studies I didn’t mention last week documented how little influence electronic medical records (EMRs) had on outpatient care. One study measured 20 markers of quality between practices with and without EMRs over 255,402 national ambulatory patient visits. 19 of the 20 quality indicators were no different between the...
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Electronic Medical Records – The $100 Billion Boondoggle

January 29, 2011

What are we getting for our national $100 billion investment in electronic medical records (EMRs), or $200 billion, or $300 billion – who knows what the final cost will be? In the primary care ambulatory world, not very much. It’s not that EMRs are useless, they just don’t help very much....
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Medical Malpractice Reform is a Small Contributor to Lower Healthcare Costs

January 22, 2011

Doctors love to talk about tort reform – states passing laws to put limits on awards such as non-economic damages for harms such as pain and suffering, and on the legal process of suing a doctor for malpractice. They speak of defensive medicine – the practice of ordering extra tests, treatments,...
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How Your Are Scared Into Buying Unaffordable Healthcare by Irresponsible Journalism — Example 2, Prostate Cancer Detection

January 15, 2011

I received my Costco Connection magazine in the mail recently and noticed that it contained an article on prostate cancer. The subtitle was “Why your best shot at beating it is early detection.” I knew I was in for a rough ride. The article started with a common story-telling technique. It...
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