A New Therapy for Asthma

I first met Carol* (name and identifying details have been changed) when she came to my clinic after a severe asthma attack had sent her to the Intensive Care Unit.  After a few days, she had been extubated and had acquired a new diagnosis, asthma.  When she saw me in clinic, she felt better than … Continue reading

What I Learned at the ATP Reunion Conference February 2014

I. Capitation is coming Although Brent was careful to stress that despite this being gospel among those who “have drunk the kool-aid” it is not universally accepted. Still, the alternative narrative is just more of the same – more efficient fee for service – or aspirations for competing as one of a handful of fee-for-service … Continue reading

Evidence-Free Pregnancy Advice

I know why the hoopla around Emily Oster‘s new book, Expecting Better, bothers me, it’s because she hasn’t let you in on obstetrics’ big bad secret… and here it is…. from a pulmonologist. What Ms. Oster points out, and where she is absolutely correct, is that the data to support most pregnancy advice, indeed, most … Continue reading

Judging by the Source

“Mom, who made the first people?” he asks me sweetly. It is already nine o’clock and well past his bedtime. Blah, blah, blah, I stumble a bit then build up to “people came from monkeys.” “Nah,” he says and gives me a sly smile as if I’m trying to trick him. My “really, they do!” … Continue reading

Slow Medicine

Time heals all wounds, they say, or, in medicine, if not all, then many.  But with our improved efficiency and throughput of patients, we fail to allow this most magical treatment to work.  The pace and intensity of medicine has increased exponentially over the past several decades.  We see more doctors, have more procedures, take … Continue reading

Genetic Testing

“If you want CVS, you’ll have to decide within the next three days,” the genetic counselor told us. My husband and I were sitting in the upscale office of the maternal fetal medicine (MFM) practice in downtown San Francisco. Our obstetrician had referred us here for genetic testing of our twins in addition to the … Continue reading

What I Learned at the ATP Reunion Conference Feb 2012

Hi all, happy valentine’s day!  I hope you’re all doing well.  It was fun to meet up with some of our class for the reunion conference.  While this conference was not the life-altering event our class was, I still found it useful and thought I’d share some of the things I learned at the conference. … Continue reading

What I learned at the ATP Course Spring 2011

[An email to my fellow classmates at the Advanced Training Program in Healthcare Quality and Delivery run by Brent James, MD at the Intermountain Healthcare Institute for Quality Improvement.] I hope you all arrived home safely.  It has been a real privilege taking this course with you.  After Tommy’s speech on Wednesday, my husband asked me … Continue reading