Category Archives: Medicine


I am a physician. I believe that the modern medical care system is broken. It used to be that the patient selected the doctor because of her reputation, and the doctor was motivated for excellence. Now the doctor is apportioned by the insurance system, and the doctor is motivated to be “efficient” (to see more people in less time). 

Coupled with electronics surveillance of doctors, requirement for electronic medical records, the expansion of patients in a doctors practice to quadruple the number it used to be, plus increasingly technological surgery ( I consider search doctors as technicians more than physicians ), a system of payment that favors such surgery,

With the “disease” model of medicine still dominant over the “health” model, it is difficult for the doctor to take patient’s phone calls, inform patients of their laboratory results, counsel them in nutrition,  exercise, sleep, and other health benefits, or even see them the same day as their illness. Thus “go to the emergency room“ is the default advice.

The concierge doctor attempts to remedy some or or most of these deficiencies, which characterize the usual modern medical practice. Concierge medicine  is so different from regular medicine as to draw the interest of Congress in preventing such discriminatory behavior.

Of course, the concierge doctor charges a periodic fee to deliver these services; there in lies it’s “unfairness”. I have even heard of super concierge doctors who meet your injured child at the emergency room with the chief of orthopedics , or fly with you to the Sloan Kettering Institute if you need consultation there. They, of course, charge tens of thousands of dollars annually for such service.

We already have multiple tier medical systems in America. The original concierge Idea modeled the care delivered to professional athletes, who must stay healthy in order to play.

Of course, there are still good doctors out there if you look hard enough and are lucky. Some family practitioners and internists still manage to practice quality medicine. Otherwise, my advice is to find a concierge doctor you can afford.

–Dr. C

Telemedicine: Pediatric Otolaryngology (Video)

Mayo Clinic is happy to offer telemedicine as an option for patients interested in seeking care. Modern technology provides a virtual platform for health care providers and patients to initiate partnership in care in a secure, safe and convenient way.


Vaccines are medicines that train the body to defend itself against future disease, and they have been saving human lives for hundreds of years. Vaccines are medicines that train the body to defend itself against future disease.

Mayo Clinic: ‘When Livers No Longer Function’

In the U.S., it’s estimated that 4.5 million adults are diagnosed with chronic liver disease. It develops over time and may be caused a number of conditions including hepatitis, genetics, alcohol overuse or cancer. Chronic liver disease is different than acute liver disease which can come on quickly and may be the result of an injury or a virus. Regardless of the cause, Dr. Bashar Aqel, a Mayo Clinic transplant hepatologist says when the liver can no longer function, a life-saving transplant may be needed.


Hypertrophic cardiomyopathy is a thickening of the heart muscle, making it more difficult to pump blood. Dr. Steve Ommen is a Mayo Clinic cardiologist who specializes in the disease. He says shortness of breath or chest pain, especially during exercise, are common symptoms. Many people with the disease won’t have any significant health problems. But there are cases that require treatment. If a patient has symptoms that affect quality of life, the disease is treated with medications. Surgery or other procedures also may be necessary in some cases.


The rollout of the Johnson & Johnson vaccine has been paused in the US, Europe and South Africa after reports of rare blood clotting in a very small number of people. Health authorities said they were halting the use of the shot while they investigate the cases — and that they were doing this out of “an abundance of caution.” The Astra Zeneca jab was also recently temporarily suspended in some countries after being linked to rare blood clots. Authorities are calling it a short “pause.” The US’s Johnson and Johnson vaccine has hit the same stumbling block as the UK’s AstraZeneca jab did last month: a likely link to a rare and deadly blood clot. Use of Johnson and Johnson’s Janssen vaccine has now been halted across the US, Europe and South Africa, with health authorities investigating six incidents of clotting in younger women, one of them fatal. The US-developed vaccine uses an adenovirus to trigger immunity – the same mechanism as the UK’s AstraZeneca vaccine. It accounts for roughly 5 percent of vaccines delivered so far in the US. This is a setback to Europe, too. Johnson and Johnson announced it will delay it’s rollout on the continent. The company had already started processing an order from the EU of 200 million doses. The Janssen jab has been partially rolled out in Africa, where a majority of countries don’t have enough vaccines even for their healthcare workers. The African Union signed a deal for 220 million doses this year. But US authorities remain hopeful. They’re saying it could only be a matter of days before the rollout resumes.


A new study by a team from the University of Michigan Institute for Healthcare Policy and Innovation shows that adults over age 50 place more importance on convenience-related factors, rather than reputation, when choosing a doctor.

The study, based on data from IHPI’s National Poll on Healthy Aging supported by AARP and Michigan Medicine, still shows that online ratings and reviews of physicians play an important role, and should receive attention from providers and policymakers.

Dr. Jeffrey Kullgren, a U-M primary care physician and lead author of the study, describes the findings.