August 31st, 2009

I Can’t Jitterbug Anymore

Throughout my more than 62-year career in medicine, I have seen a steady decline in the level of personalized care that physicians give to patients. This is related to the significant advances in medical technology.

The story of my patient John Bongiovanni illustrates this very well. John owned his own food market. Shortly after he retired in his early 60s, he came to see me with chest pain. It came on occasion when he bowled, he said, and “I can’t jitterbug anymore,” he complained. He used to take his wife out dancing weekly.

Office evaluation revealed he had angina pectoris, which is pain in the chest from hardening of the arteries. He improved with medication and a change in diet.

I continued taking care of John, and became familiar with every aspect of his life. He came in regularly for checkups. After four years, John got worse. He had a heart catheterization and heart surgery. After the procedure, he returned to his activities without chest pain.

I took care of John for more than 20 years before I retired from patient care. Read the rest of this entry »

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August 24th, 2009

Universal Personal Care

The concept of universal care is not a panacea, but it may be better for more individuals than what we offer today. Whether it is delivered by the government or by the private sector, however, it will be subject to political manipulation as well as exploitation by commercial enterprises.

One example of political influence that is already happening in government-sponsored care is that the Health Care Regions around the country have different Medicare reimbursement criteria for some of the same services. Much of this is the result of variations in lobbying success among regions.

The British health system often is held up as a model of universal care. Its apparent success in controlling costs since its introduction in 1948 is attributable to three major factors. Read the rest of this entry »

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