SHARED DECISION MAKING IS TRENDING:
SHARED DECISION MAKING is a collaborative process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values and preferences. SHARED DECISION MAKING honors both the provider’s expert knowledge and the patient’s right to be fully informed of all care options […] Read More
THE HISTORY OF HEALTH INSURANCE IN CANADA AND HOW ONE PERSON’S STORY CHANGED HEALTHCARE IN CANADA:
In the 1920’s and 1930’s, the farmers got it right. They organized healthcare cooperatives to finance healthcare in their communities. There was no government involvement. This solution worked well for the community. Unfortunately, healthcare cooperatives did not scale up in Canada. In Spain, healthcare cooperatives started in the 194o’s and 1950’s. They did, however, scale […] Read More
NEW LAB TESTS CONTINUE TO AMAZE:
There are new lab tests that are available that can prove to be very important in ruling cancer in or out. Case Study: T.M. is a 52 year old who presented with a spike in his PSA. It had spiked to about 4. Six months previously it had been about 1.0. After the PSA spiked […] Read More
BE CAREFUL WHEN PICKING A SUBSTITUTE DECISION MAKER!
This is an odd situation, but that is what our day is filled with. Case Study: A 63 year old male was admitted to a locked psychiatric unit with severe mental health problems. He had delirium and psychotic thinking. Previously, he had selected his younger brother to be his substitute decision maker for decisions relating […] Read More
WHEN A SICK TRAVELLER NEEDS A 2ND OPINION:
When you or family member gets sick while travelling, you want the best advice possible. Here’s a case study: Dermot is a 25 year old Dublin native. He was vacationing in the Greek islands when he developed a painful abdomen. He was flown to Athens. The surgeon operated and found a portion of small bowel […] Read More
EVERYONE IS DOING TELEHEALTH. HERE’S WHY!
Tele-health has been around for a long time. In the 1950’s the first doctor-patient tele-health intervention occurred. To accomplish this, two TV studios had to be built for the doctor and for the patient at the cost of millions of dollars. Things have changed. Today, two $30 webcams will do the job. I just attended […] Read More
THE ROLE OF THE FAMILY WHEN A NEW DISEASE IS DISCOVERED:
Case Study Of A New Disease And What A Family Can Do To Help: Bertrand is a 7 year old born with an unknown disease. He had widespread damage to his nervous system. He had odd behaviours such as staring into space, grinding his teeth and wringing his hands. He had many seizures that required […] Read More
DENTAL ADVOCACY AND CASE MANAGEMENT- WHAT’S THAT?
Often when a patient with a complex dental problem gets into trouble, they do not know where to turn for help. That is why we have started to advocate for patients who have no solution available for their dental problems. Here’s a case study: P.J. was a 17 year old teen who was playing field […] Read More
FINDING THE WANDERING PATIENT: TRY LOLA
The wandering patient is a vexatious problem. So when you come across a simple cost effective solution, you want to shout it out. So here goes. Case Study: Stan is 60. He has significant dementia. It started in his mid 50’s. He is at home with his wife. She is an attentive care giver and […] Read More
EMPLOYEE BURNOUT NEEDS TO BE PREVENTED
Just 30% of employees feel engaged at work. And of 72 senior executives who were studied, nearly all showed signs of burnout. No wonder, people hate their work. A large survey by Tony Schwartz (CEO of the Energy Project) and Christine Porath ( associate professor at Georgetown University) showed that employees are vastly more productive […] Read More
IMPROVING THE PATIENT EXPERIENCE WHILE TRAVELLING
When someone gets sick while travelling, it can be very frightening, confusing and disconcerting. The usual resources: parents, siblings, relatives, family doctor and local emergency department are not there. The call to the 800 number on the back of the travel health insurance card does seem to be the logical start. It does initiate a […] Read More
THE HUMAN BODY USES ELECTRICAL IMPULSES TO CREATE DISEASE:
The idea that the nerves conduct electrical impulses that create disease would be considered nonsense if it weren’t for the work of Kevin Tracey a neurosurgeon. Dr Tracey’s experiments on the inflammatory reflex have proven that there is a close and causal connection between nerve connections and the immune system. There are inflammatory diseases caused […] Read More
HEALTHCARE CO-OPERATIVES: BRING BACK THE OLD
About a decade ago, I was at a dinner for various managers of co-operatives. There was an old timer sitting next to me at dinner. He had been a farmer. When he found out that I was a medical doctor, he told me about how he and a group of neighbouring farmers had formed a […] Read More
FOOD PROPAGANDA MAKES US SICK:
Food politics and food propaganda is making us sick. From the early days of margarine in the 1950’s to the paleo diet of today, we are being lead by astray by food propaganda. An article by Margaret Wente (May 17 2014) in the Globe and Mail points out the absurd logic upon which our food […] Read More
A HEALTHCARE SYSTEM GONE AWRY:
Controlling costs is essential for all healthcare systems. How costs are controlled is key. Here is a case study of a healthcare system gone awry in its efforts to control costs. Case Study: Bill is a 69 year old Israeli citizen. Originally from Ohio, he came to work in Israel about 35 years ago. He […] Read More
DOCTORS AS COST GENERATORS: THE POWER OF THE SUB-TOTAL IN OUR EXPERIMENT OF N=1
Last week, I was walking down Howland Avenue in the Annex on a sunny spring day. There on the sidewalk were some books put there for strangers. So I glanced at the titles. One that struck me was ” Doctors’ Decisions and the Cost of Medical Care”. So I took it. The first part that […] Read More
HEALTHCARE’S BIG QUESTION: VALUE OR COST?
There is a revolution occurring in healthcare spending. The focus is on value for healthcare dollars that are spent. Healthcare systems want to pay for value and not for volume. When Professor Michael Porter, strategy professor at Harvard Business School, analyzed healthcare systems about a decade ago, he concluded that competition was highly dysfunctional. He […] Read More
WHISTLER GETS HEALTHCARE SERVICE RIGHT!
When there is an opportunity to deliver focused healthcare services many times, then the customer service can be exceptional. Here is a case study: Mr R.C. is a 52 year old business executive who was skiing near the top of Whistler. He is a very competent skier. Unfortunately, he fell and injured his left shoulder. […] Read More
MEDICAL CODING OF ALL HEALTH PROBLEMS TO CREATE THE MASSIVE ICD-10: The Washington Post- Wonkblog- Feb 14, 2014
With 14,000 medical codes, the old collection of codes – the ICD-9- seems puny by comparison. The new manual for ICD-10 explodes that code set to 68,000 much more granular and detailed terms to define — very exactly what health problems can occur. The ICD-10 manual is thick, about the size of a phone book. […] Read More
INCREASING POPULARITY OF CONCIERGE MEDICINE PROVIDED BY FAMILY OFFICES
The Appeal Of Family Office Services Private Wealth Publication MARCH 21, 2014 • RUSS ALAN PRINCE The number of advisor firms claiming to be multifamily offices or providers of family office services is growing. Moreover, all indications are that the desire among advisors to be providers of family office services is going to intensify. In a survey […] Read More