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About Islon Woolf MD
I was born in Johannesburg, South Africa and grew up in Toronto, Canada. I began my undergraduate studies at the University of Toronto in Biology and Physics, and in 1989, gained early acceptance to their highly ranked medical school.
After graduation in 1993, 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 finally a Chief Residency at the Cleveland Clinic where I helped build their new Florida training program. I am board certified in Internal Medicine and a Fellow of the American College of Physicians (FACP).
In 1997, I settled down in Miami Beach to begin practice, and shortly afterwards, in 2002, became one of the first concierge doctors in the city. My practice focuses on helping patients make good medical decisions by applying the tools of critical thinking.
Concierge Medicine
Due to the constraints of insurance, the average appointment with your doctor lasts fewer than fifteen minutes. This is particularly problematic in primary care and internal medicine where we must oversee the entirety of your health. Tasks like coordinating care, promoting prevention, and solving complex medical problems demand far more than fifteen minutes. As a result, primary care is often limited to urgent care, providing just temporary fixes and only scratching the surface of your problems.
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 subsidize the practice allowing the doctor to carry a lighter patient load. My practice, for example, is capped at three hundred patients, and I see fewer than three patients per day.
This extra time leads to several benefits.
5
Benefits of
Concierge Medicine
Caring
1
My small practice gives me the opportunity to connect with every one of my patients. No problem is too big and no problem is too small. I am always there to help.
Access
2
Access to healthcare means timely visits and seamless communication with me, my staff, and the network of specialists I've built over the last 25 years. Improved access leads to early intervention, fewer errors, and better outcomes.
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 health 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 (in or out of the office), or medium (in person or on our devices).
Accuracy
5
With more time to devote to your case and more time to update my medical knowledge, I can achieve greater accuracy in diagnosis and treatment.
Critical Thinking in medicine
While Concierge Medicine - having a doctor with more time - is necessary for good healthcare, it's by no means sufficient. Each practice uses their time differently. It depends on the practice's philosophy, the claims the practice is making, and the standard of evidence the practice uses to justify their claims. Concierge Medicine is merely an amplifier. If the practice philosophy is misguided or they use weak evidence to justify their claims, Concierge Medicine will only make things worse. It is therefore incumbent on you to determine the practice's philosophy before you join.
For example, to entice you, many Concierge practices claim they can enhance the quality of your life or even extend it with an array of extra laboratory tests, scans, drugs, supplements, IV infusions, or specific lifestyle recommendations. These claims, however, are invariably based on weak evidence, and to make them, the practice must lower its evidence standard. A logical dilemma ensues: with a low standard of evidence, any medical claim can be made to look true. The result: no two practices offer the same set of claims, and the claims often contradict one another (eg. meat is good for you, meat is bad for you).
From a bird's-eye view, patients are being offered a multiplicity of contradictory claims about what makes them healthy. Literally, thousands of claims. Which begs the question: How can you determine which of these claims, if any, are true? This is Critical Thinking in medicine, and the central philosophy of my practice: to question medical claims and to help you evaluate them 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 harbor conflicts of interest and are prone to bias. 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 types of evidence, and how reliable or unreliable they are.
Comprehensive
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 know all of your options in order to make informed decisons.
Shared Decision-Making
4
Most decisions in healthcare are not black or white. The evidence is weak and individual patients respond differently to the same treatment. The best medical decisions are made when you and I work together to address these uncertainties and incorporate your values and preferences.
Addressing bias
5
Bias is unavoidable in healthcare: practitioners carry conflicts of interest, specialists favor their own specialty, the media wants more clicks, and patients just want to feel better. My practice aims to reduce bias within, and helps you identify bias in yourself and others.
Lifelong learning
6
For the critical thinker, medical school marks only the beginning. Lifelong learning teaches us that knowledge is often incomplete, becomes quickly outdated, and frequently refuted. It cultivates the critical thinker's most valuable asset: intellectual humility.
Critical Thinking in Medicine
Blog
There are thousands of claims in healthcare. Most are untrue. Your inability to assess these claims for yourself renders you vulnerable. By applying the principles of Critical Thinking, this blog aims to help you evaluate healthcare claims for yourself.
The process is quite simple. Since a claim is only as good as the evidence that supports it, we gather the evidence, find out what type it is, and determine if that type is reliable or not. For example, if a claim is being supported by an anecdote, we ask, "Are anecdotes reliable?", "What is their track record?", "How often do they lead to the truth, and how often do they mislead?". With this, we can determine the likelihood the claim is true, or not.
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