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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, but quickly realized I enjoyed spending a lot of time with patients helping them with critical thinking and medical decision-making. By 2002, I transitioned to the Concierge Medicine model - one of the first in the city - in order to have time to practice in this style.
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 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.
Beyond 15-Minutes
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 an extra fee so the doctor can spend more time with fewer patients. My practice, for example, is capped at three hundred patients, and I see fewer than three patients per day.
This extra time enhances your outcomes in five ways
5
Enhanced Outcomes
from Concierge Medicine
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
Decision making is the cornerstone of medicine. However, decision fatigue and "burnout" are serious issues plaguing 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
My team and I have the time to investigate the fine details of your case and research the latest medical literature between visits. This level of rigor is necessary to achieve greater accuracy in establishing your diagnosis and planning your treatment.
3
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
Unfortunately, doctors can attract more patients and generate more income by lowering their evidence standards. They can make 'wellness' claims, 'root cause of disease' claims, and even 'longevity' claims simply by allowing a rat study or an anecdote to convince them a claim is true, and then 'upsell' their patients the associated tests, supplements, and procedures.
Any Claim Can be Made to Look True
Lowering evidence standards, however, leads to an inevitable dilemma: weak evidence can be found for any claim. The result is total confusion. Literally, thousands of claims about what makes you healthy. No two practices make the same claims. And claims often 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
6
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 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 categories 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 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 and individual patients respond differently to the same treatment. 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
6
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 for yourself renders you vulnerable. This blog aims to help you evaluate healthcare for yourself by showing you how to apply the principles of Critical Thinking.
The Categories of Evidence
A claim in healthcare is only as good as the evidence that supports it. If the evidence is unreliable the claim is unlikely true. Fortunately, evidence can be divided into a few broad categories; each with its own reliability. Therefore, to evaluate a claim, evaluate the category of the evidence supporting the claim.
"It Worked for my Friend"
Suppose you believe a treatment works because a friend had a positive response. This is an anecdote and belongs to the category: anecdotal evidence. To evaluate this claim, we evaluate the category. Is anecdotal evidence reliable? What is its track record with other claims? How often does it lead to the truth, and how often does it mislead? If anecdotes are unreliable in other contexts, can they be used to support your belief?
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