policy

Psychotherapy Use is Declining: How Does That Make You Feel?

I shadowed a psychiatrist, Dr. D, about a year ago. I didn’t know how it was going to work. Trust between patient and psychiatrist seemed central to the whole practice of psychotherapy. I was worried that, even as a ‘shadow’ lurking in the corner, I would breach the insulated environment that likely required multiple sessions to create.     It turns out I didn’t have to worry about this because Dr. D was doing consults that day—which were far from intimate, compared to the psychotherapy sessions I expected to see. It involved us going from bed to bed, as Dr. D asked each patient with a history of psychiatric issues general questions about their mental health. As the day of consults went on, I started to wonder whether or not psychotherapy was as relevant as it used to be. Perhaps the image of a patient lying down on a couch and sharing their feelings with a note-taking psychiatrist was more outdated than I thought. Dr. D confirmed my suspicions. He explained to me that many of today’s psychiatrists do not utilize psychotherapy as a dominant form of treatment. Instead, in addition to performing consults, a modern psychiatrist relies more heavily on prescribing psychotropic medications like Zoloft, an antidepressant, or Chlorpromazine, an antipsychotic.   The numbers support the trend Dr. D described. According to a 2010 study in the American...

HIPAA Compliant Text Messaging for your Smartphone: Would you use it?

In a world where every 1 in 5 people owns a smartphone, it comes as no surprise that healthcare, a commodity that matters to all, is interested in staking their claim in new technology. That being said, there are many concerns that healthcare organizations have surrounding the heavy implementation of technology in their practices, hospitals and especially between physicians and patients. One major concern is security: patient information is extremely sensitive and with the rate of identity theft in healthcare increasing: last year the Identity Theft Resource Center reported that up to 43% of identity theft for 2013 was medical or healthcare theft, outranking other common institutions like banking and education. The market is rife with products that claim to be secure enough for a healthcare organization, but this can be difficult to verify. The companies responsible for creating some of the top notch EMR’s on the market have also piloting projects around “mobile health” but physicians and hospital administration remain wary. One company, though, purports a well-marketed solution: qliqSoft, founded by Krishna Kurapati, is creating mobile applications specifically designed for use in healthcare settings, by physicians and between physicians. Secured text messaging in the form of qliqConnect, is available on mobile phones, tablets and desktops on both Windows and Mac OS and has a HIPAA and HITECH compliant sticker.   The product is designed to create faster communication...

An Explanation of Childhood Obesity: An Infographic

A Rapper Turned Doctor is Remixing Healthcare in the Most Refreshing Way

Being a thought leader ain’t easy. So I’ve chosen to be a thought follower. But every now and then I write down some thoughts, mostly stolen, and someone publishes them. The AAMC Reporter recently published just such a piece. BUT…they edited out all the horrible humorous bits. So I’ve included the unmolested version here. And I’m even gonna throw in Turntable Health Cribs, a quick MTV walkthrough of our clinic, courtesy of Fremont East Studios. Shazaam! Video Source Rebooting Primary Care by ZDoggMD For the better part of a decade, I practiced inpatient hospital medicine at a large academic center (the name isn’t important, but it rhymes with Afghanistan…ford). I used to play a game with the med students and housestaff: let’s estimate how many of our inpatients actually didn’t need hospitalization, had they simply received effective outpatient preventative care. Over the years, our totals were almost never less than 50%. For my fellow math-challenged Americans: that’s ONE HALF! Clearly, if there were actually were any incentives to prevent disease, they sure as heck weren’t working. In a country whose care pyramid is upside down—more specialists than primary care docs, really?—we’re squandering our physical, emotional, and economic health while spending more per capita than anyone else. Four percent of our healthcare dollars go towards primary care, with much of the remaining 95% paying for the failure of primary care. (The missing 1%? Doritos.) Worse still, the...

Re-Picturing Drug Addiction

Paint a picture of a drug addict. Now, step back, and look at what you’ve created. Someone in a dark street corner or maybe alone in a messy, empty room. No job, no money, detached from their surroundings, a lifeless body, shooting up. This picture we’ve created is a masterpiece. Not because of it’s beauty, elegance, or accuracy, but instead due to its ultimate depiction of self-destruction, failure, and death.   In some ways, our depiction of drug addiction is rooted in harsh realities. Drugs devastate both physical and mental health. They consume individual lives and communities and just as easily destroy them. This is all very well-documented—according to the NIH, the number of deaths due to overdose have increased dramatically over the past ten years. More specifically, deaths due to heroin overdose have increased six-fold since 2001.   The effects of drug addiction are real and fatal but, it’s possible that our perception of drug addicts has only made the situation worse. We often think that drug addicts willingly separate themselves from larger, ‘functioning’ society. However, maybe we are the ones who’ve pushed them farther and farther into society’s corners and edges. I mean, think about the anti-drug programs, like D.A.R.E., that many of us go through when we’re in grade school. From what I remember, D.A.R.E scared us straight—the main message they tried to hammer in our...

Are Physicians Ready for a New Generation of Transgender Parents?

In the U.S., 1 out of 3 trans people are parents (1 out of 4 in Canada). It’s an issue that most of us have probably never even considered as a possibility As you’ll see, in addition to the usual trials of parenting, they face some unique challenges. Let’s open up our health care and legal systems so they do a better job of supporting trans people to be the terrific parents they want to be. This  jumps directly into an ongoing conversation among trans people about parenting. It’s a beautiful snapshot of current issues, struggles and strengths of transexual, transgender and gender fluid parents (and parents to be) in North America...

Islamophobia and the Mental Health of Muslim-Americans

  It has become all too clear that Islamophobia is more than a buzzword, but a widespread discriminatory ideology that sees no difference between Muslim and terrorist. Turn on the news, and you’ll see a widely-known, pompous presidential candidate proposing a ban on Muslims, including those escaping violence and political unrest, from entering the country — to make America great again, of course. Turn to another channel, and you’ll see a political correspondent interviewing Americans who vow their support for this ‘much-needed’ proposal. Turn the channel again, and you’ll see that this presidential candidate is leading his opponents by a landslide in the latest polls. Turn the channel one last time, and you’ll see a Muslim woman kicked out of the presidential candidate’s rally after silently protesting Islamophobia.   Like many forms of discrimination, Islamophobia is embedded in our society’s most prominent institutions, including the government and media. Muslim-Americans have undergone intense racial profiling by government agencies, such as the NSA, while the New York Police Department surveilled mosques as “terrorism enterprise investigations” after being pressured by the Justice Department. Popular news outlets have also shared Islamophobic attitudes — Bill O’Reilly once exclaimed “Muslims killed us on 9/11”, failing to differentiate between Muslims and terrorists. The views of these large institutions — government and media — are diffusible, easily consumed by the unsuspecting and fulfilling the starving ignorance of...