Author: Carol Levine
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Don’t Hide Behind HIPAA to Avoid Communicating with Caregivers!
In May, Carol Levine posted about how HIPAA (the Health Insurance Portability and Accountability Act) interferes with caregiving for the elderly by leading many health professionals to refuse to communicate with families and others involved in care of the elderly. Carol subsequently interviewed Leon Rodriguez, director of the Office of Civil Rights at the Department…
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Coming Out about Age
When I was growing up, every 12 months I got one year older. But my mother, who turned 39 three months after my 7th birthday, remained 39. That puzzled me. My mother explained that for women, by magic, their age never clicked past 40! The French have long dealt with my mother’s reluctance to come…
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How Not to Become King Lear
“You see me here, you gods, a poor old man, As full of grief as age; wretched in both.” -King Lear, 3.2 The story is one for the ages. Our ages. Shakespeare’s tragedy, King Lear. But it is a story that my wife and I can no longer easily watch or read, for it is…
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Grandma and Her Robot
As early as 1985, in A Robot in Every Home, futurist Mike Higgins predicted that “pet robots” would ultimately provide companionship for the elderly. He was right. “Service robots,” like the vacuum cleaner Roomba (on sale at Costco for $299), perform instrumental tasks. By contrast, “social/emotional robots” target the experiential aspects of our lives. Earlier…
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Avoiding Futile Care and Reducing Medicare Costs
If we in the U.S. ever hope to get a grip on Medicare costs, our society will first have to navigate a steep learning curve. That’s the lesson to take from three recent publications. Despite the fact that Medicare is expected to represent 18% of the federal budget in 2020 (up from 15% in 2010),…
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No Sense, Lots of Dollars
Twenty-five years ago, discussions of medical futility were the rage in bioethics circles. The discussions petered out when it became clear that futility was in the eye of the beholder: physicians and patients often had very different ideas about what futility meant, depending on what they hoped medical treatment would accomplish. In one…
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How Patients Can Assess the Quality of Their Outpatient Care
Even before I launched my geriatric consultation practice, I found myself often poring over another doctor’s outpatient notes, trying to explain to a patient what the other doctor was doing. Not every patient had questions and concerns about what their other healthcare providers were saying, and doing, but a fair number of them did. And…
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Too Old to Drive?
On February 25, 1983, my mother drove out of the parking area behind the apartment building in Florida where she and my father lived. She suffered from gradual cognitive decline and should not have been driving. She didn’t notice an oncoming car and pulled in front of it. There was no initial sign of injury,…
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A Proposal That Just Might Solve the Primary Care Crisis: Meet the 35 Hour Work Week
In March, The Health Care Blog published a truly outstanding commentary by Jeff Goldsmith, on why practice redesign isn’t going to solve the primary care shortage. In the post, Goldsmith explains why a proposed model of high-volume primary care practice — having docs see even more patients per day, and grouping them in pods —…
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Seamus Heaney
Learning, today, of the death of Seamus Heaney, I first thought of his magnificent essay contrasting two views of dying, “Joy or Night: Last Things in the Poetry of W. B. Yeats and Philip Larkin,” in his 1995 volume The Redress of Poetry. Heaney speaks of Larkin’s stark poem “Aubade” as “treating as mystification any…