In Brief, Football: The History, The Violence, The Grace/Beauty

Posted on February 5, 2016 by Bernadette Keefe

Bernadette Keefe M.D.

Introduction -The Passion, The Inquiry

The Golden Game, the game that decides the 2016 National Football League (NFL) champion, will be played in Santa Clara, California, on Sunday February 7, before a stadium audience of 68,000 and a U.S. television audience likely surpassing 110 million (private TV sets).

Football is immensely popular in the United States. For many, it is a favorite past time and, is often dubbed America’s sport. Football is also big business, with tentacles reaching into two massive empires: media, through TV networks such as ESPN, and gambling, from Las Vegas back rooms to online Fantasy Football websites such as FanDuel and Draftkings.

Notably, football is a particularly violent game, one in which brute strength is as important as skill. The over-riding mission is to destroy/nullify opposing players who stand in the way of ball possession and goals. Injury is common in the sport, and can be severe.

As a Carolina Panthers fan, but also a physician, the violence in football has always been unnerving. For me, the sport’s allure is in the many graceful, athletic moves, especially the leaping, and reaching. For many others, however, it’s the cold, hard violence that thrills. As a prelude to my larger post on football, to be released later this weekend, I wanted to delve into the roots of the sport, and ask: Was football always so violent?

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Popping Pills: A Drugged Nation

Posted on December 2, 2015 by Bernadette Keefe

Bernadette Keefe MD

Excerpts from ‘Limitless’ The Movie (Trailer)

You (can) access 100 % your brain

A tablet a day and I was limitless

What’s your secret? Medication

A perfect version of ourselves…..power…..

What would you do???

The ‘Limitless” Trailer

Introduction: A pill for every ill.

From teenagers to granny, to the pro-athlete, and everyone in between, the United States is the most drugged nation in the world. A staggering:

70 Million Americans are taking legal mind-altering drugs

Nearly 70% of all Americans are on at least one prescription drug and 20% are on at least five prescription drugs Continue reading →

Falls Prevention Day 2015: Will the real ______________, please stand up!

Posted on September 22, 2015 by Bernadette Keefe

National Falls Prevention Awareness Day ~ September 23, 2015

“Take a Stand to Prevent Falls”

Bernadette Keefe MD

“One of every three older adults falls each year, but less than half talk to their healthcare providers about it.” – Lawrence Z. Rubenstein MD, MPH Chair Geriatrics – U. of Oklahoma Health Sciences Center

Introduction

Tomorrow, September 23, 2015, the U.S. will celebrate the 8^th Annual Falls Prevention Awareness Day. The announcement on the National Council for Aging (NCOA) Falls Prevention Day website reads:

“The 8^th annual Falls Prevention Awareness Day (FPAD) will be observed on September 23, 2015 – the first day of fall. The event seeks to raise awareness about how to prevent fall – related injuries among older adults. The 2015 theme is Take A Stand to Prevent Falls and the official twitter hashtag for this year’s event is #FPAD15 Continue reading →

Our (Cultural) Sugar High

Posted on September 3, 2015 by Bernadette Keefe

Sugar-comparisons HIGH

Bernadette Keefe MD

‘We need to start talking about how our food supply is making many of us sick.”

“Sugar high” is the term used to describe the cascade of responses after eating a sugar load. A high sugar load, especially a pure sugar load, triggers is a rapid release of insulin to counteract the high blood sugar. With that response, glucose is absorbed into cells and the blood sugar plummets. We feel hunger with the low blood sugar and if we consume a sugary snack or meal, the cycle restarts. The taste of sugar is also ‘addictive’ over time. At this time we have a cultural sugar high, a palate tuned to the taste of sugar, across our nation and indeed the world. It has led to unprecedented levels of Type 2 diabetes and obesity. Continue reading →

The Radiologist – Clinician Relationship

Posted on August 21, 2015 by Bernadette Keefe

Quadruple Aim: Care of the Physician

Posted on July 26, 2015 by Bernadette Keefe

By Bernadette Keefe MD and Matthew Katz MD

The classic ‘triple aim’ for healthcare is a framework developed by the Institute for Healthcare Improvement (IHI) that describes an approach to optimizing health system performance. IHI asserts that new designs must be developed to simultaneously pursue three dimensions which we call the ‘Triple Aim’:

Improving the patient experience of care (including quality and satisfaction)
Improving the health of populations, and
Reducing the per capita cost of health care

Numerous publications suggest that the list be expanded to a ‘Quadruple Aim’ to include: Improving the Care of and Experience of The Provider (ie MDs/other HCPs).

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a matter of trust

Posted on May 26, 2015 by Bernadette Keefe

Bernadette Keefe MD

Breaking someone’s trust is like crumpling up a piece of paper. You can smooth it over but it’s never going to be the same again ~ anonymous

There is perhaps no more central concept to human communication and relationships than trust: “belief that someone or something is reliable,good,honest,effective”. This holds true for our professional (business-ie financial, insurance, governmental, healthcare etc) as well as our personal interactions. Once established, trust allows unbridled, open and honest discussion and limitless learning. A trusting environment fosters personal growth, self esteem and generosity. Trust allows the deepest love humans can have. Trust leads to peace.

The absence of trust breeds the opposite of the above. Deep and open relationships are not possible. Communication breaks down on all levels and realms. Unfortunately, overtime we have experienced a breakdown of trust between the people and much of society’s organizational structure: business, government, academia, scientific and healthcare communities. Physicians as messengers are swept up in this tide of mistrust. If the messengers/teachers/researchers of science, education and medicine are not trusted their messages,no matter how factual, will not be accepted and advice will not be adhered to. Gone, happily, are the days of “blind trust”, but, the atmosphere of “no trust” is equally untenable.

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A Beautiful Question: Questioning in Healthcare

Posted on May 26, 2015 by Bernadette Keefe

Bernadette Keefe MD

A person skilled in the art of questioning is a person who can prevent questions from being suppressed by the dominant opinion. – Hanz-Georg Gademer

It was just after New Years 2015 when an an article by Warren Berger entitled “Forget Resolutions, Whatʼs Your Beautiful Question” caught my eye. In it, the author (see his book “A More Beautiful Question” 2014) suggests that instead of making New Years resolutions (ie: aspirational statements) we should formulate our own ʻbeautiful questionʼ. With questioning firmly top of mind, I started noticing game-changing endeavors that began with one fresh, simple question.

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the annual physical

Posted on May 26, 2015 by Bernadette Keefe

The Argument: Ditch The Annual

Every year, adults face the issues of is it “time to get a check up”? Do I really want to get my annual physical? Do I need to have a checkup? Well now, even your doctor is saying the same thing! A chorus of physicians have weighed over the past several years (especially after the Cochrane Report was released). The consensus has been, for the most part: ditch the annual physical if you are healthy and have no medical symptoms.

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slow medicine – not can we afford it, but how can we not?

Featured

Posted on May 26, 2015 by Bernadette Keefe

Bernadette Keefe MD

The Unease

Over the past few decades there has been an increasing disquiet among doctors and patients. Prior to the late 1970s (pre CT/MRI era) other than basic blood work and plain xrays, there was little in the way of testing for disease. However physicians were well equipped with a robust heritage of patient bedside history-taking and examination skills. Adept physicians in elucidating a pertinent historical record and performing patient examinations were brilliant diagnosticians. Lavishly written patient narratives and exquisite physical examinations filled voluminous charts.

The late 1970s ushered in organized medicine, HMOs, regulations and abundant technological and medical advances. This potent combination resulted in a tremendous escalation in the volume and pace of healthcare. Physicians, once loved for their bedside manner and comfort (1950’s-1960’s) found, from 1980s-present that they were so rushed and burnt out they had little empathy to spare. Patients picked up on this and, coupled with little time to ask questions and (now) electronic medical records consuming their doctor’s attention, stopped feeling cared for. They stifled their questions and stopped buying into the therapies being proposed for them. (Note: Perceived lack of empathy has been shown to adversely affect clinical outcomes.)

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Introduction: A pill for every ill.

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