I want a T-shirt that says Artificial Intelligence Isn’t. I spent a very long twenty minutes on a Zoom this week with a surgeon-turned-tech-entrepreneur from Stanford, who was trying to persuade me that the new software he’s developing is going to save primary care. Artificial intelligence is better than humans at making diagnoses, he tried to […]
Michael Fine, MD
Michael Fine, MD, is a writer, community organizer, and family physician. He is the chief health strategist for the City of Central Falls, RI, and a former Director of the Rhode Island Department of Health, 2011–2015. He is currently the Board Vice Chair and Co-Founder of the Scituate Health Alliance, and is the recipient of the Barbara Starfield Award, the John Cunningham Award, and the June Rockwell Levy Public Service Award. He is the author of several books, medical, novels and short stories, including On Medicine and Colonialism, Rhode Island Stories, and The Bull and Other Stories, You can learn more about Michael at www.michaelfinemd.com
Posted inColumns
Dr. Michael Fine: What’s crazy about 25,000 people losing their doctors
You may have heard that 25,000 people in Rhode Island are losing their primary care doctors because a large practice called Anchor Medical is closing its doors. Not my problem, you might think. Anchor is in Warwick, Providence and Lincoln. Not in Newport, Middletown, or Portsmouth. Or Jamestown. Or South Kingston. I still have my […]
Posted inColumns
Dr. Michael Fine: What’s crazy about the HHS
Ok, Chicken Little. Is the health care sky falling? Since Secretary Robert F. Kennedy Jr. (RFK Jr) has announced the departure of about 20,000 of the 80,000 U.S. Department of Health and Human Services (HSS) employees, my health professional and policy colleagues are predicting doom and disaster. And it’s not just the HSS employees: hospitals, universities, […]
Posted inColumns
Dr. Michael Fine: What’s crazy about chickens, eggs, and bird flu
So our fearless health care leader, the guy with the worm in his brain, is going around saying that we should let bird flu run rampant, run its course, kill the susceptible chickens and that way we’ll be left with a national chicken flock that is resistant to bird flu. Is this crazy? Or does it make […]
Posted inColumns, Environment & Health, Opinion
Dr. Michael Fine: What’s crazy about Medicaid
Get out the earplugs and blindfolds, Susie, they are at it again. Brothers and sisters, get ready for another round of yelling about Medicaid, which will be all heat and no light. As some of us know, the mean Republicans have committed themselves to cut $880 billion out of the federal budget over the next ten […]
Posted inColumns
Dr. Michael Fine: What’s crazy about hospital galas
So it’s hospital gala time again. You know the drill. Fancy invitation. Black tie optional event. A thousand people in a convention center or hotel ballroom. A high-powered committee on the invite, most of whom have nothing to do with planning the event itself, and sometimes bold-faced names who serve as honorary chairs, whatever that means. Adequate food. Too many self-congratulatory […]
Posted inColumns
Dr. Michael Fine: What’s crazy about saying Covid was a lab accident
So we’ve had regime change, and the new party line is that Covid was a lab accident. The CIA, which may or may not have anybody working there by the time this is published, now says they think the Covid was caused by a lab leak — but that is a “low confidence” determination, which is bureaucratic-speak […]
Posted inColumns
Dr. Michael Fine: What’s crazy about answering the telephone
I’ve now tried twice to make an appointment for a colonoscopy with a gastroenterologist. I also had to call Blue Cross, got put on hold after having to enter a zillion numbers and pressing 2 for this and three for that, and then 25 minutes later got called back by a nice young human! These are the […]
Posted inColumns
Dr. Michael Fine: What’s crazy about killing managed care executives in the street
Full disclosure: I hate United Health Care and have hated them for thirty-five years since they bought out Ocean State Physicians Health Plan and became the second-largest health insurer in Rhode Island in the late 1980s. I think they are predatory and manipulative and leverage market power inappropriately in pursuit of profit, making a critical public […]
Posted inColumns
Dr. Michael Fine: What’s crazy about defunding NIH
So there’s talk that Robert F. Kennedy Jr will defund the NIH. Or something like that. In full disclosure, I am not a fan of the man. But, I also view the hysteria of academics and institutionalists about his nomination to head HHS with a somewhat jaundiced eye. The National Institutes of Health is the nation’s – and […]
Posted inEnvironment & Health
Dr. Michael Fine: What’s crazy about mammogram and colonoscopy rules
Okay. We think women need mammograms if we are going to reduce the number of women dying from breast cancer. (Men also get breast cancer. It’s less common. But it happens. There is no mammography recommendation for men, however.) We think everyone of a certain age needs screening for colon cancer, which is or sometimes leads to colonoscopy, if […]
Posted inColumns
Dr. Michael Fine: What’s crazy about vaccines
So we may or may not have a guy with a worm in his brain running CDC or HHS. Time will tell. But it is clear that, for the moment, we have a guy with a famous last name who appears to be a vaccine skeptic, and who has the ear of the President-elect. What’s up with […]
Posted inBusiness
Dr. Michael Fine: What’s crazy about buying and selling hospitals
Lifespan, which is about to be rebranded as Brown University Health, just bought St. Anne’s Hospital in Fall River and Morton Hospital in Taunton, Massachusetts for $175 million, making it a two-state hospital system. Should Rhode Islanders care? On the face of it, it’s no big deal. A number of Rhode Island hospitals – Landmark in Woonsocket, […]
Posted inColumns
Dr. Michael Fine: What’s crazy about medical debt?
So there are now a number of programs and great organizations that buy up and retire medical debt. Which is kind of a cool idea. It turns out that 20 million Americans, or 15 percent of American households, have some medical debt over $250, that Americans owe at least $220 billion to health care clinicians and organizations. […]
Posted inEnvironment & Health
Dr. Michael Fine: What’s crazy about health care and the presidential election
Before I start talking about the current presidential campaign, I thought I’d disclose my biases. I’m an independent with complicated political views: fiscally conservative, small government oriented, socially progressive but not woke. I don’t love our choice this year, which seems to me to be the choice between Julius Adolph PT Trump and Tweedle Dum and […]
Posted inOpinion
Dr. Michael Fine: What’s crazy about living with dementia?
Basically, everything is crazy, for the caretakers of people living with dementia. If you have dementia, it’s hard for you, because you can sense what you don’t know or understand, and sometimes see the apprehension and disappointment in the eyes of the people you love, and feel that but too often don’t understand it, which […]
Posted inOpinion
Dr. Michael Fine: What’s crazy about health care and free food
Last Saturday, I went to try to help some heroic colleagues, who practice in one of Rhode Island’s poorest places, and who had set up a walking program called “Walking with the Doc” and a Saturday immunization clinic so that thirty local kids who had just moved into town could get immunized and start school […]
Posted inColumns
Dr. Michael Fine: What’s crazy about your doctor not coming to see you in the hospital anymore
I met a recently retired Massachusetts pediatrician at the eightieth birthday party of an honored physician-writer, colleague, and friend. The pediatrician, also a writer, and I talked for a few minutes about his practice and his retirement. He’d built a great practice, he told me, that did what great pediatrics practices always do – they saw kids when […]
Posted inCOVID-19
Dr. Michael Fine: What’s crazy is that Covid is back
Sorry to be the bearer of bad news. But like Freddy Kreuger, Covid is back for a midsummer surge. It’s worse out west and in England, but what happens there will spread here before long. So here we go again. You know the drill. Just a cold for most people and almost no risk for […]
Posted inNews
Dr. Michael Fine: What’s crazy about primary care in Rhode Island?
First some good news! The Rhode Island General Assembly passed two bills and created one study commission that helps us start getting better access to primary care in Rhode Island. Bill 2024-S 2716A establishes a primary care training sites program, which has been funded with $2.7 million in the 2025 state budget bill. Bill 2024-S2717A added […]
Posted inElection
Dr. Michael Fine: Will the real Democratic Party please stand up?
In the past week, it has become abundantly clear that the Democratic Party does not have a viable candidate for president, and equally clear that the Democratic Party can’t tell itself the truth and move on for the good of the country. Joe Biden has been a good president. But he’s not re-electable, something everyone else besides […]
Posted inEnvironment & Health
Dr. Michael Fine: What’s crazy about hospitals in Rhode Island this week
Lots of hospital-related news in Rhode Island this week. The Rhode Island Department of Health and the Attorney General approved the sale of Our Lady of Fatima and Roger Williams aka Charter Care, to something called The Centurion Foundation, a Georgia based non-profit, which I don’t know anything about. The seller is Prospect Medical Holdings, but with […]
Posted inColumns
Dr. Michael Fine: What’s crazy about eye ointment
Eye ointment? Yes, eye ointment. You see, in late April, the CDC announced there was a shortage of erythromycin eye ointment, which turned out to be a big deal. What? Isn’t erythromycin one of the oldest antibiotics that exist? Aren’t there a hundred or a thousand other eye ointments? Who cares about one old medicine? In fact, erythromycin was discovered in […]
Posted inColumns
Dr. Michael Fine: What’s not that crazy about making sure pharmacists are part of the primary care team
On these pages, an Op-Ed (Let Rhode Island Pharmacists Close the Primary Care Gap) by a number of trusted colleagues argued that allowing pharmacists to bill insurance directly for clinical services might close the primary care gap. I’m not sure where I stand on letting pharmacists bill insurance directly. On the one hand, pharmacists are critical […]
Posted inColumns
Dr. Michael Fine: What’s crazy about letting business people and lawyers control health care
What I am about to tell you is a true story. One that is happening now in a Rhode Island hospital. An 81-year-old man who still worked ten hours a day and was as strong as a bull was hit by a car as he crossed the street from the restaurant where he worked to his […]