Planning ahead for long-term care

The majority of people recognize that aging brings with it the possibility of requiring extra help. There’s no way to know for sure whether you will need long-term care, but according to the Department of Health & Human Services, 70 percent of adults over age 65 have required some kind of long-term care during their lifetime.

Risk factors and red flags

Certain warnings may indicate that you or your...

See Episode 15 of Running Doc Unhinged, and a lecture on the topic, for more information about this blog.

As a difficult flu season grips us, we must grapple with how to treat people who have influenza.  The flu shot this year was not very effective, and the strain of flu is particularly virulent; thus people are getting very ill and even dying of influenza.  So, what can we do?  The CDC and many health organizations and doctors...

The video podcast that I've been working on for many months is finally being RELEASED TODAY. I'd love for you to check it out and subscribe to my channel, as well as to spread the word to as many people you know. The Podcast, called Running Doc Unhinged, is an inside look into the world of healthcare from my perspective as a practicing primary care doctor. As I go for runs through many of the most beautiful locations in my home...

Last week I went to sleep, and when I woke up an additional 30 million people had a diagnosis of hypertension, or high blood pressure.  How did this epidemic occur so quickly?  It turns out that the American College of Cardiology changed its definition of hypertension.  Whereas previously, one had to have a pressure over 140 to be labeled with the disease, now, in their infinite wisdom, the specialist experts decreed that 130 wo...

In July of this year Dr. Shigeaki Hinohara died.  His obituary was given to me recently by one of my patients, which is why I am writing about it now.  There was a telling quote in the obituary: “In the 1970s, he reclassified strokes and heart disorders — commonly perceived as inevitable adult diseases that required treatment — to lifestyle ailments that were often preventable.  Dr. Hinohara insisted that patients be treated as...

On Monday I participated in a Politico event in Washington DC called “The doctor-patient relationship.”  The link to the event is here, and to hear my panel you can forward to the first small video.  The three of us on the panel, all primary care physicians including one Congressman, agreed on virtually everything:  we need to change quality measures so they empower patients and facilitate shared decision making, we need to...

As reformers attempt to fix our health care delivery system, they are dancing around what counts the most:  the cost of health care.  Pundits and “experts,” politicians and physician groups, devise convoluted schemes to expand insurance coverage while lowering premiums, without working to change our low-value health care delivery system.  Our medical system squanders a trillion dollars a year by incentivizing wasteful spending f...

When I recently spoke to a group of seniors about the dangers and risks of hospitalization in the elderly, one of the audience participants was justifiably confused.  She assumed that as her primary care doctor for many years that I would be involved in her hospital care.  I had to tell her that was not the case.  In fact, in our local hospital, Howard County General Hospital, not only are primary care doctors excluded from cari...

“We are losing the battle for the hearts and minds of our patients,” states Dr. Steve Nissen, a noted Cleveland Clinic cardiologist, exasperated that too many patients are listening to the internet instead of their doctors.  But as a primary care physician I perceive his sentiment through a different lens:  too many people are listening to their doctors who feed them deceptive information and who don’t respect their values and w...

Today I published an op-ed in the Baltimore Sun explaining why I am marching with the Right Care Alliance in the Science March this Saturday April 22nd in DC.  We live in a bizarre world in the health care industry:  We are flooded by new medicines and interventions endlessly, we are exposed to tests and procedures that are pushed on us and promoted as life-saving, and yet we cannot have enough time with our doctors, we cannot g...

Recently, not for the first (or I am sure the last) time, I was berated by a cardiologist.  This is what he said after I suggested in a facebook conversation with a friend that cardiology interventions were of low value much of the time and cardiologists were being over-paid to perform such interventions: “Andy Lazris seems like you're really pissed about not making as much money as the specialists. Maybe should've trained more...

In the era of health care reform, two words consistently are employed to describe the strategy being used to cut cost:  quality and value.  What do these words mean?  We have discussed their use many times in these blogs, and have shown that they often diverge sharply from their purpose.  In fact, nothing wastes physician time, and gets in the way of the doctor-physician interaction, more than having to focus on adhering to Medi...

In previous blogs and in my book, we have discussed the value of primary care to the health care delivery system.  Primary care doctors—the lowest paid of all physicians, sometimes earning as much as $200,000 per year less than their more specialized colleagues—provide the highest value of all physicians.  In areas of the country with a higher proportion of primary care doctors to specialized doctors, outcomes are better, costs...

We are at a Rubicon moment in the battleground of health care reform.  The ACA has expanded insurance coverage to millions of Americans, but it has not altered the basic flaws inherent to our health care delivery system.  Now with its elimination hovering over us, we have an opportunity to come together and enact changes in medical care that are universally endorsed and can evade partisan bickering.  Can conservatives develop a...

This week I had an op-ed published in the Washington Times.  In it I argued that sensible reform of our health care system requires more than the cosmetic changes currently being endorsed by the incoming administration and Congress.  The three linchpins of successful medical reform are in fact issues that are never discussed:  an increased focus on primary care, the ability of patients to be treated at home instead of in the hos...