If the rich could hire the poor to die for them, the poor would make a very nice living. Yiddish Proverb Air Care: Thoughts on Health Care from 39,000 Feet. by David J. Elpern I’m sitting in Economy traveling from the City of Angels the Big Apple. Just in front of me is the First Class (FC) section. The cabins are separated by a curtain and I watch a stylish stewardess hovering over a passenger there. The FC passengers get the best attention money can buy. Food, drinks, a table cloth for their meals! Solicitous smiles from the stews. We, in coach, get a small packet of pretzels, soda, juice … Continue reading
Longing to Belong
Nor cast one longing lingering look behind Thomas Gray, Elegy in a Country Churchyard by Richard Ratzan, M.D. Abstract: On the eve of retirement after 45 years as a physician, the author reflects on a lifelong inclusion in medicine, from early childhood days as the son of a medical couple to a career in emergency medicine. He anticipates with dread the day when he will no longer belong in the ranks of those who are unquestionably healers. Keywords: retirement, profession, collegiality, nostalgia, autobiography, clinical medicine, emergency medicine Two years ago I walked out of my emergency department ending 43 years as an employed academic physician. Although I realized at the … Continue reading
My Singing Angel
by Jane E. Babin (This was originally published in Cell 2 Soul in 2006) When I entered Massachusetts General Hospital last April to have a feeding tube placed in my stomach, I was very apprehensive. Don’t get me wrong. I had every confidence in the surgeons and staff at this prominent facility. Also, this procedure is done routinely. My cause for concern was my ALS, aka, Lou Gehrig’s disease. At the time, I had not yet had my tracheotomy. Because ALS is a neuromuscular disease that had begun to affect my diaphragm, I was afraid of any sedation that could compromise my already weakened ability to breathe. Try as they … Continue reading
Health Anxiety: Tables and Appendix
Table 1. Demographic Data Age 0 – 9 5 10 – 14 8 15 — 19 20 20 – 29 41 30 – 39 10 40 – 49 23 50 – 59 28 60 – 69 39 70 – 79 39 80 – 84 12 85 – 89 14 > 90 2 Male = 97 Female = 115 Trans = 1 (87 yo woman with confusion) New Patient 34 Returning Patient 188 Table 2. HA Questions Are you worried a lot about a particular health problem? Y N Do you tend to worry about your health in general? Y N Have you ever … Continue reading
Health Anxiety in a Dermatology Practice
Abstract: Health Anxiety is a common affliction of patients seeking medical attention, yet many physicians are unaware of it. We surveyed 222 consecutive patients in a dermatology practice in Massachusetts and found that upwards of 49% self-reported some level of health anxiety, suggersting that it appears to be pandemic in the dermatology population of patients. Keywords: health anxiety, dermatology, Massachusetts, actinic keratoses, cryotherapy, survey,, Tyrer Introduction Patients see doctors with varying degrees of concern regarding their health. Some, require tests or treatments. A subset of patients have severe health anxiety (HA) and cannot be reassured by tests, procedures or pharmaceuticals but may be helped (at least temporarily) by a sympathetic … Continue reading
It’s Freezing in our County: Medicare Reimbursement in 2012
by David J. Elpern and Mariah L. Ferrara Abstract: We have documented the access to dermatology care in the Berkshire County, Massachusetts. Of the six dermatologists practicing in the area only two accept Medicaid patients and for one of these, the wait for an appointment was over six months. Our data show unequal access to dermatologic care in Western Massachusetts Keywords: dermatology, access to care, Medicaid, dermatologist, medical insurance. Berkshires, Massachusetts, cryotherapy, liquid nitrogen Introduction: It is clear to Medicaid recipients nationwide that they have difficulty in obtaining health care from large numbers of private practitioners There are many reasons for this, but chief among them is that physicians are … Continue reading
Doctorpreneurs
The Business of Medicine: Old paradigm and new I wish I was a young buck looking for my first job. Recently, I received an email promoting a new position: Hi Dr. …, Hope this email finds you well! I’m contacting you regarding a Dermatology Opening in [a scenic rural area] Please see below for details and send CV if interested. Seeking a BE/BC Dermatologist to join its medical staff. Join the most trusted hospital in the area due to its highly trained physician staff and its arms-length affiliation with the University of [X] Hospital in {Y]. The community itself is an attractive university town located in the Foothills of the redacted … Continue reading
Health Anxiety
seen every day in medical offices Health Anxiety: lurking in plain sight All practitioners will learn useful information from this article. Excerpts “Many patients, despite how much they would like to, cannot do what we would like them to do: ‘stop worrying.’” As physicians, we see a few such people every day. Health Anxiety seems to be epidemic (perhaps, endemic) in our communities, yet it is poorly recognized. “People with health anxiety do not ask relief from somatic symptom, but rather only desire freedom from worry about disease. A key component of health anxiety is rumination, so that patients cannot stop thinking about a disease once the thought has come … Continue reading
Person-to-Person Exchanges in El Salvador
by Cailtin Stiglmeier, M.D. mailto:cstiglmeier@gmail.com encuentros breves crean amistades duranderas Cuban proverb Abstract: Every year, seventy-five high school students from Central New York State alight in rural el Salvador for a week-long adventure involving international aid, manual labor, no plumbing, and no Facebook. As a pediatrician, I’ve had the privilege of joining this group three years in a row. What ensues during this week is nothing short of chaotic and miraculous. Keywords: global health, travel, el salvador, young life. The third year for myself. The first time for many. The tenth year of partnership with this rural community in Rancho Grande, El Salvador. Every year another adventure, a week of … Continue reading
What’s in a name? That which we call a rose.
rose-moles all in stipple on trout that swim… G.M. Hopkins, Pied Beauty By Jorge Roman B.S. The vast array of plant life that inhabit this earth has proven to be a great muse for humanity. People have used the ample pool of imagery provided by plants to create gorgeous works of art and what is dermatology if not a visual art? The countless colors, textures, shapes, and sizes displayed by plants have been used by dermatologists as a source of inspiration for describing the skin and its pathology. Arborization is a ubiquitous term used to describe everything from the vessels of a basal cell carcinoma to the dendrites of melanocytes. … Continue reading
