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Perspective For All (It’s Free!)


Sometimes perspective is helpful.

Even when given just a little bit of it.

Presidential candidate, Sen. Bernie Sanders, has recently released his “Medicare-for-All” plan. Similar to his make college education free plan, there are a number of things admirable about it. No healthcare deductibles. No co-pays. No fighting with insurance companies. We all get, seemingly for “free,” whatever the government thinks we need.

And, I get it. In 4th-grade, I once ran for student council touting a “No Homework For All! slogan. I’m not even saying this is the same strategy being used by Sen. Sanders. Instead, I’m just trying to imagine the ideal:

A world where all of us have (1) the healthcare we need, (2) when we need it, (3) at the most reasonable cost to all of us, collectively.

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Less-is-More… for Tortillas


There is a single CT scanner in town.

A certain number of scans are done with it each month.

Suddenly, a second scanner is installed at a new location across town.

True or False:

The total number of CT scans being performed will remain the same with two scanners now available.

The answer is false… at least within our current system. Someone has studied it. Adding another scanner increases the utilization of scanning.

Is this a good thing or a bad thing? Careful, now. It’s an entirely different question. The answer, of course, is maybe, or maybe not. You need more information.

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A Friend? Must You Have…


My wife and I had planned a three day trip to celebrate our anniversary. 

Extended family was in town to watch our boys over the long weekend while we were going to be away. And, yes, it’s always challenging getting out the door.

I’m not talking about the often bizarre scenarios that befall my private-practice patients in the hours leading up to any scheduled vacation. I’m really just talking about parenting.

If you’ve been there… you know. You just know.

The school lunch supplies must be lined out and ready to go. Clothes have to be washed. Instructions for this and that must be given for the extended family. I really thought I stressed about these things far less than other parents, until I saw my kitchen completely covered with post’em notes.

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Cancerous Beliefs On Screening


Cancer screening has NEVER been shown to save lives.

That’s the eye-catching title of a recent article emanating from Academic medicine.

I liked it.

I’ve known for some time that we bother too many patients with absolutely no symptoms of disease under the guise of Evidence Based Medicine (EBM). So, of course, I started reading it.

The lead author has been involved with other discombobulating publications of statistical mumbo-jumbo. So, naturally, I wondered what sensible and non-sensible use of statistics I’d encounter.

It didn’t take long for me to find both.

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Just Passing Time


We got the urge to play catch with the football today.

My oldest son is eight.

We weren’t interested in football before this season. But, we recently started watching a few games on television together. We now check the scores of them every day.

I told my son that it’s not like baseball. You have to wait a week between games. But, that doesn’t matter to him, he checks the scores anyway. As if they might change. For Dallas Cowboys’ sake, I’ve been hoping they will.

Rather than watch an entire game, I often encourage that we go outside and play at some point. We usually do. I even suggest a few potential activities–ride a bike, swing a bat, throw a frisbee, you get the point. Playing catch with the football, however, has just never been what he wants to do.

Until today.

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“No WATCHMAN™ For You!”


Healthcare insurance deductibles have increased seven times faster than wages in the last five years.

In case you missed the memo already sent to your pocket book, our system is not designed to help anyone afford quality care.

Few understand it. How it works. Who controls it.

Most of us just accept it.

Maybe, it’s because we’ve led ourselves to believe a world cannot exist without having a Food and Drug Administration (FDA) to protect it. America’s unregulated $37 billion vitamin and supplement industry may speak to the contrary, but yes, we seem to sleep more soundly believing there is a watchdog on our front porch.

It would be ideological suicide to question what’s really there.

And, so we believe. Me included.

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“Stop Running, Dad!”


100 billion neurons are in the brain.

Seemingly, each one makes a minimum of 1,000 to 10,000 connections with other neurons. Something like 100 trillion to 1 quadrillion potential points for data entry. Like having the U.S. Library of Congress up there.

Memories are built from connections.  Basically, a lot of handshakes are going on between neurons. The more frequent or powerful the handshakes, the stronger the connections, and the easier to remember something.

The neuroscience of dreaming is equally fascinating. In fact, I’m not certain that anyone really understands it perfectly.

All I know is that my father has appeared in only one of my dreams since his death exactly one year ago. And, in it, we were arguing.

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More Astrological Proclamations From The New York Times


I made a mistake.

I don’t buy the New York Times. I told you why. But, someone snuck one of their recent articles into my email. And, yes, I read it.

The article was written by a person with well-known hostility toward private practice physicians. That’s fine. He was giving his interpretation of a study.

The study appeared almost one year ago in a medical journal published by the American Medical Association (AMA). The AMA is the same society who last month, in response to increasing prescription medication costs, recommended that we ban all television commercials for pharmaceutical drugs.

Whatever your take is on this one, I don’t really care. I just wasn’t certain opening up more advertising slots for beer commercials and Doritos would be the answer. Of note, the AMA failed to mention any need to ban the dollars they receive from pharmaceutical ads appearing in their own magazines. (Perhaps, that will be a post for another day.)

Regardless, the New York Times article was about a study that evaluated outcomes of heart patients admitted to hospitals during two distinct periods of time: (1) during days of the year when a handful of cardiologists are away from work “learning” at national meetings, and (2) during similar days when they are not.

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To Succeed, You Need More Than Ideas


To laugh often and much

So begins one of my favorite quotes by Ralph Waldo Emerson. One that will have more meaning shortly. I’ll explain.

The American College of Cardiology (ACC), a medical society of which I’m a member, has launched a new website. It claims to be able to help you select the best hospital for your heart condition.

There are often several options to choose from when deciding the best hospitals to receive care for a heart (cardiac) condition… You can make more informed choices.    –From

Since numerous organizations with almost no knowledge about healthcare delivery have decided to release medical scoring systems under the premise that it will help the public in some way, why shouldn’t the ACC get involved? Great idea. Most of ACC’s members are physicians who will know a thing or two about patient care.

So, I quickly navigated to their new website to see what it was all about.

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