Why I’m Not Burning Out

Physician burnout has been in the news for many years. (I wrote about it eleven years ago.) In the last two decades the practice of medicine has become more difficult and less rewarding for many doctors. Though I know that physician burnout is increasing, I still find it shocking. We’re paid better than most. We’re generally held in high esteem. Why don’t more of us love what we do? This ...
More

LA Magazine Recognizes Top Doctors

  “I want to go to the best orthopedist.” I hear this request, or a version of it, all the time. “I want my daughter to see the best cardiologist,” or breast surgeon, or neurologist. I try to explain to patients that there’s no way to figure out who is the single best doctor in a field, or even what it would mean to be the best. Would it mean the best outcomes? The best patient satisfaction? The best reputation among colleagues? I try to explain that there is a group in every sp...
More

Another Path to Reform

It’s very hard to find a product or service that is both lousy and unaffordable. Such expensive duds are usually quickly replaced by cheaper and better competitors. Yet prior to the Affordable Care Act, healthcare was becoming more expensive every year while simultaneously becoming less convenient, less personal, and less satisfying. In 2009 I wrote a series of four posts explaining how the healthcare marketplace reached su...
More

The Anatomy of a Shortage

“If you think health care is expensive now, wait until you see what it costs when it’s free.” – P.J. O’Rourke

I distinctly remember that in first grade I had an idea of breathtaking wisdom and profundity. Candy should be free. ...
More

Rescuing Primary Care

For almost any category of product or service you can think of, a huge variety of price and quality is available. From clothes to food to transportation we can all think of lousy but inexpensive choices that we wouldn’t like and incredibly luxurious choices that we can’t afford. For almost all of us somewhere in the middle there are choices that are both pleasing and affordable. That doesn’t mean that my choice is the same as yours. You may not be happy with anything less than a BMW, while I’m t...
More

A Pulmonologist Defends Benzonatate

Last month I posted about benzonatate, a cough suppressant also marketed under the brand Tessalon. (See the link below for the original post.) In that post I detailed an FDA warning about the serious potential side effects of benzonatate, especially in accidental overdoses in children. I also passed along the conclusion of the Medical Letter that safer cough suppressants were available. My colleague Dr. Roy Artal, a pulmonolo...
More

More Match Day Misery

… or, If We Beg, Will You Go Into Primary Care? What if tomorrow 30% of the nation’s plumbers disappeared?  Perhaps they vanish due some fantastic science fiction experiment gone horribly wrong.  What would happen?  Would a national plumber group call for making plumbing a more attractive profession?  Would there be a cry for greater federal plumbing subsidies to draw more people from other fields into plumbing? No.  (Or at least, I hope not.)  In the short term, there would be a terrible shor...
More