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Insights and diagnosis 27 Aug 2013 | 05:12 pm

Seeing What Others Don’t: The Remarkable Ways We Gain Insights In the past I have written about Gary Klein. He helped create and popularize naturalistic decision making. Rather than explore decision ...

My weight loss project – 5 24 Aug 2013 | 04:51 am

I am doing a lot of smiling.  Over the past few weeks I worried that I might have plateaued.   Then we went on a 1 week vacation to the West Coast.  During that vacation we ate out every meal. I lost...

Strict work hours are not the right solution 21 Aug 2013 | 06:19 pm

Lisa Rosenbaum has described the problem well – WHY DOESN’T MEDICAL CARE GET BETTER WHEN DOCTORS REST MORE? We have a classic conundrum in medical training. We want our trained doctors to care deeply...

Walking, cities, health 18 Aug 2013 | 06:13 pm

We have spent the last 3 days in SF.  Most everyone loves visiting here.  The city is interesting, the food is great, and we got spectacular weather this weekend. As I wrote several years ago, one th...

Teaching medicine requires teaching thinking 16 Aug 2013 | 06:29 pm

Many readers know that I am a founding member of the Society to Improve Diagnosis in Medicine.  This society has staked out the position that we no longer focus enough on the diagnostic process in med...

My weight loss project 4 14 Aug 2013 | 05:18 pm

Slow steady progress continues.  The real key to sustainability in weight loss comes when we have modified behavior permanently.  This past week was a great one for exercise and a good one for eating....

Should we vary co-pays? 12 Aug 2013 | 12:51 am

Today’s NY Times has a provocative article – When a Co-Pay Gets in the Way of Health The problem here is the exact opposite of moral hazard. People are not overusing ineffective drugs; they are under...

Do not blame the RUC, blame RBRVS 9 Aug 2013 | 06:42 pm

Blaming the RUC for everything has become the latest fashion.  Dad-burned RUC is causing climate change.  The entire health care cost problem comes from RUC decisions.  Alex Rodriguez took PEDs becaus...

Catch-22 – a whine about observation status 7 Aug 2013 | 10:01 pm

A patient is admitted (appropriately) to the hospital.  He should not go back home as he is a danger to himself and his caretaker.  Technically, we are told that he does not “meet criteria” for admiss...

Patients, computers, billing requirements and physicians 7 Aug 2013 | 01:37 am

Earlier today I tweeted about Danielle Ofri’s important piece The Doctor Will See Your Electronic Medical Record Now.  I like the piece, and especially like some of the quotes, but still I believe the...

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