I had a 50-year-old patient who had smoke several packs of cigarettes a day for more than 30 years. This had caused her skin to age and she looked more like 70. She would not pay for any pulmonary function tests for her COPD because she was saving all of her money for a face […]

For the past 25 years, the medical profession has battled hypertension and its related illnesses with great success. Significant declines in deaths from stroke and coronary artery disease are the result of effective treatments. So it was a surprise to hear the latest statistics about hypertension-related conditions: They show a rise in severe kidney disease […]

After death and taxes, worry may be the most unavoidable fact of life according to the Menninger Letter. We worry about our personal concerns, our family, all the way to world crises. Worry has always been considered a negative experience. People who worry also tend to make decisions more slowly. In light of these negative […]

Hospital costs have gone off the radar screen. Major efforts have gone into reducing these costs. This has included doing more outpatient surgery and sending the patients home early for post hospital home care. The home care companies, many of which have been bought out by the hospitals, may not have reduced costs. ABC’s 20/20 […]

While filing my 1996 NEJM, I noticed an interesting letter to the editor: “Compensation of Lawyers and Doctors.” Richard G Williams, MD, from Suisun, California, reflects on seeing two lawyers. The first was his own attorney who charges Dr. Williams $185 per hour.. The second attorney was a patient. whose health maintenance organization pays Dr […]

“The Doctor’s Dilemma,” an article featured in a recent issuer of The Economist, discusses the outcome of a fortnight of frenzied debate about the state of the National Health Service (NHS). There are, apparently, two things that “everybody knows.” The first is that Britain spends too little on health; the second is that Prime Minister […]

Driver’s side steering wheel airbags have saved many lives. However the government’s requirement of extending airbags to the front passenger’s side by 1999 in the cause of safety, has proven quite hazardous to children. Of the 23 people killed by passenger side airbags, 22 were children. The lone adult was a frail woman. For years, […]

The new Y2K Medicare Bulletin was received in November. Except for the first page, all subsequent pages listed the year as 1900. The revised Y2K Medicare Bulletin had a special letter inserted stating that this was NOT a Y2K error, but “”a printing oversight.”” Unless the intelligence of a bureaucrat is in the imbecile range, […]

Macon, GA; Jamestown, NY; San Francisco, Santa Clara, and Orange California In a recent issue of the Medical Sentinel devoted to Futility of Care and Duty to Die, Miguel Faria, Jr, MD, cautions us with a history lesson from Germany. Although Hitler issued his first order for euthanasia in Germany on September 1, 1939, the […]

Last week I saw a new patient who changed physicians because of the impersonal treatment from her previous in-house For Profit HMO. This was one of those HMOs that owns the doctor group that work for it. The doctors were allotted 15 minutes per patient, and patients were expected to be seen on time. So […]