Discussing Healthcare

In the News Capital punishment: In Oklahoma last week a prisoner was put to death by way of lethal injection. Unfortunately, there was error in the process and the prisoner didn’t die until 43 minutes after the injection. Since then there has been debate about lethal injection and capital punishment. There should be debate about […]

In the News NBC News reported about an outbreak of gastroenteritis (vomiting and diarrhea) at a conference about food safety.  It is ironic that a food related illness infected a large number of people at a food safety conference.  However, food related illnesses are common and have affected most of us at least once in […]

Kevin Pho, MD operates one of the most respected blogs on the web, KevinMD.com. He is a practicing internal medicine physician who is an expert in social media and physician online reputation. Dr. Pho has dedicated himself to advancing the practice of medicine by utilizing the technologies that most of us use everyday…computers and the […]

David Dastrup is a Licensed Marriage and Family Therapist and a Licensed Independent Substance Abuse Counselor.  He has cared for patients in many settings, including: clinics, emergency departments, and hospitals.  David has worked independently and with psychiatrists.  He has great insight into the state of psychiatric care in our country. Columbine, Sandy Hook, Virginia Tech, […]

David Dastrup is a Licensed Marriage and Family Therapist and a Licensed Independent Substance Abuse Counselor.  He has cared for patients in many settings, including: clinics, emergency departments, and hospitals.  David has worked independently and with psychiatrists.  He has great insight into the state of psychiatric care in our country. Psychiatric illness is very prevalent […]

Gloria Lewis, EdD, MSN, MHA, RN, CCM currently works as a per diem palliative care nurse at the John Muir Medical Center in Walnut Creek, California.  She is also a faculty member at the University of Phoenix where she teaches in the nursing and health science program.  Gloria earned her RN (registered nurse) degree in […]

Gloria Lewis, EdD, MSN, MHA, RN, CCM currently works as a per diem palliative care nurse at the John Muir Medical Center in Walnut Creek, California.  She is also a faculty member at the University of Phoenix where she teaches in the nursing and health science program.  Gloria earned her RN (registered nurse) degree in […]

Flight MH370: Did altitude and cabin pressure play a role in the missing aircraft? The mystery of flight MH370 continues.  First, it is a tragedy that 239 people are missing and their families are left wondering what happened without closure.  My heart goes out to the victims and their families.  But, where is the airplane […]

Shannon Berliner is a mother and wife.  Unfortunately, she is also a breast cancer patient. She was diagnosed with breast cancer over this past holiday season and is now undergoing treatment.  In this episode of the Discussing Healthcare podcast she shares her experiences related to her breast cancer. Shannon is one of over 230,000 women […]

The New York Times published an article titled “New Law’s Demands on Doctors Have Many Seeking a Network.” The article is about 2 primary care physicians and their choice to practice in 2 different environments.  One physician chose to join a hospital network and is now an employee.  His job is less stressful, although he […]

The American Academy of Pediatrics (AAP) has updated a very strong statement about obtaining care at retail-based clinics (RBC - clinics in pharmacies, grocery stores, etc).  They argue that the care can be suboptimal and diminishes the continuity of care that should be established with a child's pediatrician.  It is a very interesting argument and well written.  Here is a copy of the statement: American Association of Pediatrics: Policy Statement - Retail-Based Clinics Mark Sexton, MD sat down with me to discuss an article written in TIME magazine.  The article "My Doctor, the Concierge" was written by Merrill Markoe, an Emmy Award winning writer for David Letterman and an author.  She argues against concierge medicine as only those with money can afford to obtain healthcare.  She also states that the concierge model of medicine is not consistent with the Hippocratic oath.  She makes a very strong statement and is an opinion shared by many people who are in her position, but is her opinion correct?  Well, that is what we discuss today.

Obamacare is back in the news.  This time the government will delay the requirement of businesses with 50-99 employees to comply with the Affordable Care Act until January 1, 2016.  Who cares?  Well we all should.  This is a big deal.  This affects about 8 million Americans and is another reason to ask what the heck is going on with the implementation of this law.  Why does the government keep delaying the compliance of businesses with the Affordable Care Act?  Well, it is likely because the law will place a financial burden on these businesses that will result in suppression of growth of our economy which is already struggling.  Also, there is the mid-term elections in November of 2014 that will absolutely be affected by the healthcare law. Check out this article in the Wall Street Journal to learn more about this delay for businesses of 50-99 employees: Health-Law Mandate Put Off Again   Michael Quirk is a Physician Assistant (PA) who currently practices emergency medicine in Phoenix, Arizona.  He has great insight into the history and role of a PA as his father was one of the first PAs in the country.  The role of a PA is evolving in our current healthcare environment.  They are taking on more responsibility for patient care and filling the gaps (especially in primary care) where we do not have enough of a physician workforce.  The PA education is definitely different from a physician, but many of the PA responsibilities are equal to a physician.  There are laws that regulate what a PA can and cannot do while practicing medicine, but those lines are often blurred.  What role will a PA have in the future?  Well, I don't know for sure, but it will be an important role that is developing everyday across our nation. Physician Assistant is a great career and many people are choosing PA school over medical school.  I will continue to explore the world of a PA, so stay tuned for future episodes.

This is the second half of an interview with John Shufeldt, MD, JD, MBA.  The first half was posted in Episode 012.  We do talk more about medicine, but we also discuss his book "Ingredients of Outliers." The book is a guide to finding greatness within yourself.  Dr. Shufeldt draws from his experiences and adventures that made him a successful physician, attorney, and entrepreneur. A well known issue in today's healthcare environment is malpractice litigation.  As an attorney and physician, Dr. Shufeldt has a unique and interesting perspective on medical malpractice.  In his career he has consulted on malpractice cases which gives him great insight into the reality of the situation.  He and I both agree that medical malpractice has a place in medicine.   Also, he has seen the number of physicians losing malpractice cases decline in the state of Arizona.  Is that a good thing?  I guess that depends on who you ask.  I know as a physician it is more comforting, but as a patient there is a bigger obstacle to consider when filing a lawsuit. Despite the ups and downs of being a physician, Dr. Shufeldt still enjoys his work as an emergency physician and would do it again if given the choice.  This is interesting as more than 50% of all physicians are unhappy with their job in the United States (a topic that deserves great attention). Here are the places you can find Dr. Shufeldt: Twitter - @JohnShufeldt Facebook Book: Ingredients of Outliers (find it on Amazon) MeMD  

Although, the actor Philip Seymour Hoffman has died he left us with an important lesson that we should not forget.  He likely fell victim to heroin.  Heroin is a drug similar to prescription pain medication and often destroys the abuser's life.  We have learned with the death's of Cory Monteith and Mr. Hoffman that drugs can rule the lives of both the rich and famous along with poor and mentally ill.  The deaths of Mr. Monteith and Mr. Hoffman were preventable and wasted the lives of 2 individuals with promising futures.  So, why did they become the victims of these tragic circumstances?  I'm not sure anybody can answer that question. But, today we can try to understand more about heroin and prescription pain medication in a discussion with Frank LoVecchio, DO, a medical toxicologist who is passionate about this topic.  He gives us some insight and understanding to a horrific disease...addiction, as it relates to heroin and prescription pain medication.   Below are documentaries that highlight many of the issues with heroin and prescription pain medication:   Here are some links to additional information: Piecing Together Philip Seymour Hoffman's Final Hours CDC: Prescription drug abusers are turning to less-expensive heroin to stave off "dope sickness" Prescription Pain Killer Overdoses in the US

John Shufeldt, MD, JD, MBA is a practicing Emergency Physician in Phoenix, AZ.  But, he has done much more than just practice medicine.  He has started successful businesses, graduated law school and obtained an MBA all while continuing to practice medicine.  What makes him successful? According to Dr. Shufeldt, he isn't successful.  But, I disagree.  He has accomplished more than the average physician, attorney or business man has accomplished and he strives to do more. Dr. Shufeldt sat down with me in his office to discuss his views on medicine and the things he has accomplished, including his new book "Ingredients of Outliers: A Recipe for Personal Achievement". Here are the places you can find Dr. Shufeldt: Twitter - @JohnShufeldt Facebook Book: Ingredients of Outliers (find it on Amazon) MeMD   CRUISE SHIP ILLNESS The Norovirus is suspected of infecting another cruise ship that pulled into port today in New Jersey.  Almost 700 of the 4200 people on board fell ill during the 10 day cruise.  But, this is not a new phenomenon.  Since 2010, 41 cruise ships have had confirmed cases of Norovirus, according to the CDC. So, why is this virus ravaging cruise ships? Well, the answer is that there is almost a perfect storm of events that occur. First, the virus spreads easily between people that are in close contact.  Obviously, on a cruise you are in contact with the person or people you are traveling with on the ship.  But, you are also in close contact with the employees and other travelers.  Second, the virus is easily spread by contaminated food and water.  Think of a buffet.  Food is there for hours.  Employees and customers are reaching in the food constantly which leads to a perfect environment to spread the virus.  Once you are infected the symptoms will not occur for 12-48 hours.  During that time you can spread the infection by not washing your hands thoroughly and touching door handles, railings, faucets, etc.  You have unknowingly left a trail of virus around the ship for others to acquire.  Before you know it a large number of the people on board are sick and their vacations ruined. Norovirus is generally not a deadly illness.  Like most illnesses it has the worst outcomes in the young (infants) and the elderly.  There are upwards of 800 deaths annually from Norovirus, but most people will get no symptoms or have vomiting, diarrhea and abdominal cramping.  Fever and bodyaches are also common.  Symptoms last 1-3 days and dehydration is the biggest concern.  Norovirus is the most common cause of foodborne illnesses every year and occurs more commonly on land than on a cruise ship. So, if you go on a cruise make sure to practice good sanitation and wash your hands constantly. Here are some links for additional information: CDC - Norovirus CDC - Cruise Ship Traveler info