Friday, February 22, 2019


The doctor is in ...

Doctors in Congress


When new members of Congress are sworn in this January, there will be a total of 19 doctors in Congress – 3 Senators and 16 Congresspersons. That will be a 27% increase over 2009,from 15 to 19, in doctor members of Congress. These doctors will make up 3.5% of the 535 members of Congress, but will fall far short of the 10.7% who were signers of the Declaration of Independence.

Eighteen of the 19 new members are Republican. This may say something of the mood of America towards health reform, but it may have little effect on whether the health reform bill is repealed or retained in its present form.

Fifteen of the 19 are from the South or West, 5 are Ob-Gyn specialists, and 12 represent specialties who perform surgery. What this means or portends I do not know. Perhaps they will not hesitate to perform surgery on the bloated national budget and cut deficits. I take solace in recent polls, which indicate 77% of the public trust doctors to do right thing vs. 11% who trust Congress.

Here is the list of the 19 doctors in Congress:

Senate Incumbents

  1. Tom Coburn (R, Republican), Oklahoma, family physician and ob-gyn
  2. John Barasso (R, Wyoming), orthopedic surgeon New Senator
  3. Rand Paul, (R, Kentucky), ophthalmologist

HEALTH2.0: Knowledge Prostitution


The powerhouse that is Scott Shreeve, not content with jetting around the US, looking after his newest (and 4th) kid and filling my inbox with amazing stuff, is having a go at prostitutes by comparing them to doctors! Personally I’ve never logically understood the stigma about prostitution, and I like the Heinlein novel where one of the lead characters is a prostitute who charges her son by the hour to see her after he’s 21. After all, they’re providing our society’s most cherished function, and when you pay a high price for great service for anything else in this world it is regarded as a good thing. (And yes I do understand the stigma in this version of the alternate universe).

But I digress….

What Scott’s piece, Knowledge Prostitution, suggests is that for social networking sites to pay members for opinions is not healthy. He particularly looks at Sermo, and he also suggests that the information gained from his inquiry about a rare form of wrist pain is not too helpful.

FD about me and Sermo here. CEO Dan Palestrant bought me dinner to pick my brain (I think I won!), Sermo has paid for advertising for the THCB jobs board, and Sermo is a sponsor of the forthcoming Health2.0 conference—for which Scott is on the advisory board. I like both Daniel and Scott a lot, so it’s good to see a little healthy dispute between MD computer geeks!

How to Replace the AMA


There is nothing more powerful than an idea whose time has come. There is nothing less powerful than an idea whose time has come and gone.

In 1846, and for more than 100 years after that, the American Medical Association as a nationwide organization for all physicians was a powerful idea whose time had come. It worked well for many things and OK for many more.

Then, in the 1970s, 80s, 90s, it came apart and now has the least representation of actual members of a widely diverse base than ever and shows few signs of recuperation. Recently, I advocated that ALL American physicians should become members of the AMA for their entire time in medicine.

Responses, both published and unpublished, were vigorous.

The divide between physicians who think that the AMA should fight for them and those who think that the AMA should fight for the health of the people seems too large to bridge in 2012.

A Prescription For Doctors


Enough about patients: What is a doctor to do?

Picture 42In the past few months, since The Decision Tree book came out, I’ve had the privilege to talk with many doctors about the opportunity and challenge of engaging patients in their own health. Some physicians, not surprisingly, have been suspicious, and even hostile to the idea that patients have a role to play. But thankfully, those have been rare exceptions. Most doctors I’ve spent time with have been eager to hear about new tools that might engage their patients, and they’ve been eager to share well-earned advice on where there’s work to be done. It has been a delight and an education to talk about the potential of healthcare with these physicians who are, after all, doing the hard work of providing medical care every day.

A high point in my continuing education came a couple weeks ago, when I was invited to speak at the Minneapolis Heart Institute Foundation‘s Fall Nursing Conference, where I met a number of nurses who are eager to help patients gain some control over their health. A few days later I gave a lecture on patient engagement at the University of Minnesota Medical Center. The invitation came from Dr. David Rothenberger, an esteemed surgeon who has consistently emphasized the importance of innovative thinking in medicine. Dr. Rothenberger also runs a program for physicians with promising leadership potential, and part of my day involved talking with them about the changing nature of clinical medicine, and the challenge of engaging patients in their healthcare.

These were good doctors, deeply motivated to help their patients, and there was scant resistance to the notion of an empowered patient who might seek to engage in their care and treatment. Indeed, they seemed to relish the opportunity to work with such patients.