There are relatively few famous fictional OB/GYNs. Among the most notable is Dr. Wilbur Larch, the hero of John Irving’s great novel, The Cider House Rules. Dr. Larch is based on the life of Irving’s grandfather, who was the physician in chief of the Boston Lying In Hospital at the turn of the 20th century. Dr. Larch’s motto was “I must be of use.”
I truly hope that this website will be “of use” for all of its readers. Women really want to understand the changes that our bodies, indeed our lives undergo as we mature through our reproductive and post-reproductive years. To my sensibilities, a good OB/GYN should be a woman’s health physician, rather than exclusively a reproductive specialist. Female health encompasses all of our body’s organ systems, and we need an integrative appreciation of how these systems interconnect and evolve.
I developed this site with the aim to educate both women and physicians learning how to care for them. One primary focus of the site will be the `madameovary videos`, medium-length discussions focusing in on a single topic. Our initial two topics are menopause and cancer; each of these are discussed in two segments, split naturally by subtopics. Shortly we will be adding new videos on other women’s health issues. I have also provided several flavors of companion written content, in the form of excerpts from my published guides, pdf copies of a few of my academic papers that I think are especially `on point`, and a list of important recent references on the subject matter. Additionally, under the Media pulldown category, there are a number of (video and audio) clips that cover a wide range of related content, presented in both structured and more free-flowing formats.
Finally, I would encourage all of my visitors to look at my Blog. This is co-written and researched with my MIT-educated mathematician husband, and is built upon daily discussions over the last 30 years of the evolution of medicine and health care within our society. The initial set of Posts was developed as a single intertwined unit, introduced and motivated by the first entry, which is entitled `Prologue: Why I Left Electronic Medical Recordkeeping`. We hope that this will provide a clearer understanding of some recent changes to health care, and their potential longer-term implications, and that many more folks “outside of a small circle of friends” will be inspired to act to improve the system in ways large and small. Let us all be of use.
Full EHR interoperability has recently received a lot of attention as a core attribute of a smoothly functioning national health care system. This is appropriate. However, interconnection may be of secondary importance compared to a related topic, namely the extent of a patient’s complete medical history that exists within the electronic record. Much less… Read more »
Moving Out It has become increasingly challenging to stay in business as a private-practice primary-care physician. In recent years, hospitals have purchased large numbers of independent and physician-owned practices. The descent in the numbers is striking. A 2014 Physicians Foundation survey of 20,000 U.S. doctors found that 35% described themselves as independent, down from 49%… Read more »
In the last couple of years, I have seen a substantially increased number of retirements among local physicians, including both senior core academic medical faculty at Yale and `private community` clinicians. Many more of my medical friends and colleagues have told me that they plan to retire shortly, even though until fairly recently, they… Read more »
I’ll start this segment with something that sounds like a sure-fire soporific, guaranteed to put you to sleep. Just hold your eyelids up while you read through the next paragraph – I promise that there is a very important point coming up shortly. While reading some of Nicolas Terry’s more recent work on the effectiveness… Read more »
In the essay `Throw Dr. Kildare from the Train`, I wrote that there has been an acceleration in retirements and in retirement planning among local New Haven-area physicians, including both senior members of the Yale Medical school faculty and doctors from the private community. I know from friends and colleagues across the U.S. that… Read more »
There is a lot of unhappiness with electronic health records (EHRs) among nearly all my medical friends and colleagues, and I have heard all flavors of complaints about them. Many of the anecdotes are compelling, in fact at times bordering on the absurd, and given time and license, I can share many horror stories. But… Read more »
The ability to review and transfer EHRs from one doctor or hospital to another is one of the major selling points for the adoption of EHRs, and until told otherwise, most patients presume that `of course` this capability is already fully in place. In fact, full interconnectivity and interoperability of EHRs is essential to the… Read more »
You Can’t Always Get What You Want The saga of the United Kingdom’s Connecting for Health EHR program, formally called the National Programme for IT or NPfIT, presents an important cautionary tale for the U.S. Within the U.K., major National Health Service (NHS) IT projects have a history that dates to the late 1960’s,… Read more »
In the essays above, I have attempted to identify and discuss a number of primary issues that have accompanied the recent major changes within health care, with a view to the long-term. Here, I would like to propose a few suggestions that could potentially help to resolve several of these concerns, at least in… Read more »
Nearly all of my physician friends and colleagues have entered the EHR world in the past few years, only to report that they just feel as if they are on the short-end of an escalating beat-down. The joy of patient care is being ripped away by increasing administrative demands that are often counterproductive and… Read more »