Add Magic and Music to Medicine

PUBLISHED ON  November 1, 2009

WRITTEN BY  Roni Zeiger

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Last week a special conference called TEDMED happened, which brought together thought leaders in health and technology, as well as leaders from many fields which at first glance might surprise you.

We saw the future of health care in discussions about robotic limbs, over-the-counter DNA testing, and pills with (edible!) computer chips inside them. Equally eye-opening was inspirational poetry, soul-touching live music, and magicians who made us question our assumptions about the impossible. I even learned how to hold my breath for 4 minutes!

At first, I judged these latter sessions to be light entertainment designed simply as a break between the real content of the conference. Now I’m not so sure. Health is a science we still understand only superficially. Surely a century from now we will look back at the state of the art of 2009 and see that medicine was in its infancy. I expect (and hope) that health care also has a long evolution ahead. We — patients, clinicians, caregivers, friends — will learn to take better care of each other as we uncover the mysteries of science and technology.

Perhaps we can also learn about health care by listening to the way music and other art can heal, and the way magic can make us challenge our assumptions about what is possible.

Mission: Transform the Culture of Medicine

PUBLISHED ON  October 20, 2009

WRITTEN BY  Roni Zeiger

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Today I’m proud to share that a special online journal has launched: the Journal of Participatory Medicine. The simple goal is to learn what methods really work for patient-doctor collaboration, and in doing so transform the culture of medicine.

Why is this important? It turns out that doctors can’t do it alone. This isn’t news, and “e-patients” have been at it for years now, improving their own outcomes and the outcomes of others by supplementing and often going beyond what their doctors can alone do for them. Participatory Medicine is a new approach that encourages and expects active patient involvement in all aspects of care.

Have a look at the launch issue: It’s peer reviewed by doctors and patients.

How do you want to participate in your care?

My Doctor Says: Get a Boob Job

PUBLISHED ON  August 18, 2009

WRITTEN BY  Roni Zeiger

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My wife, my children, and I are all patients at the Palo Alto Medical Foundation (PAMF). I am grateful for the world-class care that we all receive there, and I continue to refer many friends and colleagues there.

We recently received a mailer from PAMF, addressed to my wife and personalized with her name showing what they think her summer to do list should include. (I’ve blacked out her name in the photo of the mailer below.) The list ends with: “Do something REALLY special for myself!”

Cute, I thought, and wondered what would be inside. Perhaps some tips on exercise or eating smart, or a reminder to get caught up on important screening tests. My jaw dropped when I opened the pamphlet and saw: “To look and feel your best, you don’t have to look far”, and listed the following services:

– Breast Reshaping
– Tummy Tuck
– Face, Eye, and Neck Lift
– Liposuction
– Rhinoplasty (Nose Reshaping)
– Laser Skin Rejuvination

I think it is entirely appropriate that PAMF offers these services. However, I am deeply concerned that they are advertising them as the way — for a woman in particular — to do something really special for herself and feel her best. Body image issues aside, what does this say about our physicians? PAMF represents my wife’s primary care doctor (and mine), and I suspect many patients see this type of promotion as coming from their doctor. Did she approve this, we wondered? If so, what should we think when she recommends a mammogram or a colonoscopy? It begs the question of whether the primary goal is my health or profit for the health care provider.

I’ve commented previously on Atul Gawande’s eye-opening piece in the New Yorker about McAllen, Texas, a town where health care costs are among the highest in the country, while the quality of care is no better than average. Gawande explains:

About fifteen years ago, it seems, something began to change in McAllen. A few leaders of local institutions took profit growth to be a legitimate ethic in the practice of medicine. Not all the doctors accepted this. But they failed to discourage those who did. So here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers.

Perhaps we are asking too much of physicians. They should have only my well-being in mind, while at the same time their decisions about my care often impact whether they can afford to send their kids to college. In case you’re worried about your own bills, don’t worry — as you see in the screenshot below, for these procedures you can get a FREE private consultation and financing options are available.

Ideally, it won’t be long before we get much better at measuring the quality of care, and physicians will get payed for delivering quality. In the meantime, demand the facts and make informed decisions.

P.S. I originally posted this on Huffington Post. I couldn’t export the comments and there were some great ones, so feel free to read the comments there.