The Hidden Issues of the Healthcare Debate

We need to abandon the notion that our private third-party-payer system of health care enhances our freedom or protects our income from socialistic taxes.   For starters, business people are shaping the way we deliver health care. The bottom line at the doctor’s office is that what gets paid for happens, and what doesn’t get paid … Continue reading

Primary Care Doctors Need to Redefine Their Roles

We all know that effective, affordable primary health care needs to be the bedrock of our health care system.   Primary care medicine, however,  has evolved  into a very expansive and complex undertaking. Primary care physicians need to embrace this reality and define our roles accordingly, for the sake of effectiveness, affordability, and our own sanity … Continue reading

“The Color of Atmosphere” to be released in Jan 2011 by Chelsea Green Publishing

This memoir follows my story from the early days of my career as a  young pediatrician, through the Navy’s system of universal health coverage, and on into our civilian system of managed care and third-party-payers, describing the  reverence I experienced for medical science, and my relationships with patients, but also the ever-widening gap between what … Continue reading

Privatization of VA Medical Care is a Step Backwards

VA Healthcare:  It’s the Wrong Time to Privatize In this midterm election season of making pledges to America, we should not lose sight of the pledges we have already made. We have promised as a nation to provide our disabled veterans with the best health services that modern medicine has to offer.  We need to … Continue reading

Adolescent depression: A Pediatrician’s dilemma

Adolescent depression is a serious medical condition that deserves expert evaluation and appropriate access to mental health professionals, including those who can prescribe medication when indicated.  As a pediatric resident, I spent four weeks on the child psychiatry service, and this time was mainly focused on talk therapy.  In comparison, I spent six months, and … Continue reading

The Heroic Pediatrician

I understood that the more money the practice made, the more my salary would increase. The key was in finding ways to be more efficient without compromising patient care. How much emphasis a doctor puts on either side of this seesaw shapes her practice as much as her expertise will.

My First Patient

Then, as now, nothing in this world seemed as satisfying as having the puzzle pieces fit together.

To Control Health Care Costs, We Need to Change the System

If we are serious about pursuing excellent primary care medicine, and controlling costs, we need to be honest about the disincentives our current system creates. We need to recognize the stranglehold that third-party payers have on our health care, how these forces make their way into the exam room, into the conversations between doctor and patient, influencing clinical decisions, outcomes, and cost.