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Islon Woolf MD
About
Philosophy
I am an internist who believes that medicine is an intellectual discipline, not a product to be sold. My practice is designed to help patients filter through the noise in healthcare, separating what is true from what we hope is true.
Training
I was born in Johannesburg, South Africa and grew up in Toronto, Canada. My training began at the University of Toronto, where I pursed an undergraduate degree in Biology and Physics, and in 1989, gained an early acceptance to their highly ranked medical school.
Post-Grad Training
After medical school, I moved to the United States to complete my training. This included an Internal Medicine internship at the University of Southern California, an Internal Medicine residency at the Mayo Clinic, and a Chief Residency at the Cleveland Clinic. I am board certified in Internal Medicine and a Fellow of the American College of Physicians (FACP).
25 years of Concierge Medicine Experience
I began practice in 1997, and quickly discovered that I had a passion for working closely with patients and showing them how to apply critical thinking to their health. To free up the time necessary for this style of practice, in 2002, I became one of the first concierge doctors in the city.
Concierge Medicine
About
The 15-Minute Appointment
Due to the constraints of insurance, the average appointment with your doctor lasts fewer than fifteen minutes. This is particularly problematic in primary care where we must oversee the entirety of your health. Tasks like coordinating care, promoting prevention, and solving complex medical problems demand far more time.
Less Patients, More Time
For those wanting more time with their doctor and willing to invest more into their health, concierge medicine offers an effective solution. Essentially, all concierge practices operate under the same principle: patients pay a fee so the doctor sees less patients. My practice, for example, is capped at three hundred patients, and I see fewer than three patients per day.
This extra time leads to better outcomes in five ways
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Concierge Medicine and
Better Outcomes
Access
1
Access to healthcare means timely visits and seamless communications with me, my team, and the network of specialists I've built over the last 25 years. Improved access leads to early intervention, fewer errors, and better outcomes.
Decision-readiness
2
Although decision-making is the cornerstone of medicine, 'decision fatigue' and 'burnout' are well-documented amongst healthcare professionals. With less than three patients per day, our practice is shielded from this. We are always decision-ready.
Continuity of Care
3
Your health is complex and dynamic. Healthcare is fragmented and impersonal. You need a stable, well-established practice to coordinate, document, and ensure follow-through. This is continuity of care, and a major determinant of good outcomes.
Efficiency
4
Primary care doctors create inefficiencies by insisting on office visits, and then due to time constraints, hand off your problems to specialists. My mandate is to solve your problems. Regardless of time, location, or how we communicate.
Accuracy
5
To ensure accuracy in diagnosis and treatment, my team and I follow a two-step process. We gather every detail from your visit and perform a review of the medical literature afterward. With the exponential growth of published studies, this degree of rigor is essential.
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Critical Thinking in medicine
About
Concierge Medicine is an Amplifier
While concierge medicine - having a doctor with more time - is necessary for good healthcare, it's by no means sufficient. Time is simply an amplifier. If a doctor’s philosophy is flawed, more time just gives more room to carry out bad ideas. Before joining a practice, you should determine the doctor's philosophy.
Incentivized to Lower Evidence Standards
Doctors have a powerful incentive to lower evidence standards. By accepting anecdotes or animal studies as proof, they can go ahead and market 'wellness', 'longevity', and even 'miracle cures', without waiting for better evidence like everyone else. This approach does more than build a following for them; it creates a platform to 'upsell' tests, supplements, and procedures.
Any Claim Can be Made to Look True
Lowering evidence standards, however, creates a dilemma: weak evidence can be found for any claim. The result is total confusion. Thousands of claims about what makes you healthy, no two practices making the same set of claims, and claims that just flatly contradict one another - one doctor calls meat a superfood, while another calls it a toxin.
Filtering the Noise
This multitude of contradictory claims begs the question: How do you determine which of these claims, if any, are actually true? This is Critical Thinking in medicine. It is the central philosophy of my practice: to help you filter the noise, question the evidence, and empower you to evaluate medical claims for yourself.
There are Six Key Principles of Critical Thinking in Medicine
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Principles of
Critical Thinking in Medicine
Patient empowerment
1
Patients are unable to assess healthcare for themselves and left to trust experts. Unfortunately, experts are prone to bias and harbor conflicts of interest. As a result, good healthcare is not about MORE healthcare, it's about learning how to evaluate healthcare for yourself.
Evaluation of claims
2
A healthcare claim is only as good as the evidence used to support it. Patients can learn how to evaluate any claim by understanding the different categories of evidence, and how reliable or unreliable they are.
Comprehensive analysis
3
There are many treatment options outside of pharmaceuticals and surgery. There are many philosophies of practice outside of science-based medicine. You need to learn all of your options in order to make informed decisions.
Shared decision-Making
4
Most decisions in healthcare are not black or white: the evidence is weak, each patient responds differently, and each patient has a different risk tolerance. The best medical decisions are made when you and I work together to incorporate these uncertainties and your values and preferences.
Addressing bias
5
Bias in healthcare is unavoidable. Practitioners carry conflicts of interest, specialists favor their own specialty, the media wants more clicks, and patients just want to feel better. My practice is engineered to avoid bias, and to help you identify it in yourself and in others.
Lifelong learning
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For the critical thinker, medical school marks only the beginning. A lifelong of learning teaches us that knowledge is incomplete, becomes quickly outdated, and frequently refuted. It cultivates the critical thinker's most valuable asset: intellectual humility.
Critical Thinking in Medicine
Blog
Patients are Vulnerable to False Claims
Healthcare is filled with thousands of claims; most are untrue. Your inability to assess these claims renders you vulnerable. Our blog aims to equip you with the basic skills necessary to evaluate healthcare claims for yourself.
The Hierarchy of Medical Evidence
Evaluating a claim in healthcare can be simplified once you understand three simple rules:
1. A claim is only as strong as the evidence behind it.
2. Medical evidence falls into only a few distinct categories.
3. Each category is predictably reliable, and can be ranked into a hierarchy.
4. To evaluate a claim, simply identify its evidence and where it falls in the hierarchy.
Use The Hierarchy to Evaluate a Claim
Suppose you believe a treatment works because a friend had a good result, this is anecdotal evidence. It sits near the bottom of the evidence hierarchy. We are easily fooled by anecdotes due to a host of reasons, such as: placebo effects, the natural history of the disease, or concurrent treatments. Unless you have stronger evidence - or a reason why this anecdote is more reliable than the millions that have fooled us before - this treatment is unlikely to work.
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