shutterstock_115761625 The Medscape Physician Compensation Report puts primary care physicians at the bottom of the heap, with a median earning of less than $200,000 per year in 2014. What if the largest insurer of older Americans took those numbers to heart and decided to give primary care a pay raise of 25 percent, in recognition of and better support for ...

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shutterstock_144006859 A loyal reader alerted me to news of a lawsuit brought by an obstetrician in South Carolina who is suing a hospital for suspending his privileges. He had performed a cesarean section while sitting on a stool because he had a foot fracture secondary to diabetes. Several witnesses said that the doctor "had been unable to properly view the ...

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shutterstock_213079855 I noticed that my writing and conversations with others convey far less emotion than usual.  My reserve for tolerating stress had reached maximum capacity, which I realized upon my first day back at work from vacation three weeks ago as exhaustion immediately erased any sense of relaxation from my trip.  Perhaps I should have requested two weeks off instead of one?  Either way, ...

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I would think that when physicians decide where to set up practice, there are things that they would want to think about other than how much money they’ll make.  Yet if one reads Medscape’s current list of the best and worst places to practice, it would appear that money trumps everything else (although Medscape said it also considered factors like “cultural attractions”). What Medscape apparently did not consider ...

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Here is a behind-the-scenes peek into an operating room in the midst of Silicon Valley. Here, routinely there is a groundbreaking intersection of technology and medicine that's blurring the lines between what's possible today and what you'll come to expect as routine in the future. Imagine two experienced surgeons working side by side to replace a calcified, stenotic and tired aortic valve within a man's heart without ever having to cut into ...

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shutterstock_282098786 Everyone has an angle. Everyone. Your doctor? Sure. But, he or she isn’t the only one. The pharmaceutical company? Of course. The medical device company? The hospital? The insurance company? You get the point. Everyone has an angle. Everyone has a conflict of interest. Know it. Get over it. It’s time to focus on something else. Like filling up your car with gas. In ...

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shutterstock_124482742 The insurance company insisted that they would be saving money in the end.  So they sent the PA (physician assistant) to my patient's house.  They didn't take into consideration that I was just there a week before.  Or that I made home visits on a regular basis.  In fact, they didn't even inform me about the appointment. My patient later told me ...

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shutterstock_206493670 A new paper in the journal Lancet Oncology evaluates outcomes after vaccination with Cervarix, which is the HPV vaccine that is effective against the 2 most oncogenic (cancer-causing) strains: HPV 16 and 18. The paper is actually a compilation of results from two studies of Cervarix among women ages 15-25 and now has four years of follow-up data on more ...

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shutterstock_253534771 Merriam-Webster defines "value" as follows:

  • The amount of money that something is worth: the price or cost of something
  • Something that can be bought for a low or fair price
  • Usefulness or importance
I find this intuitive, really. The value of something is what it is worth. However, is that something worth the same to me as it is to you? And if I give ...

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shutterstock_145545640 Teleradiology has the same effect on radiologists as Lord Voldemort has on Muggles. It’s the feared end point of the commoditization of imaging, with Rajeev in Bangalore outpricing Rajeev in Chicago for reading follow-up CTs for lung nodules. But despite the fears of U.S. radiologists, their counterparts in India have more pressing things on their mind. “U.S. radiologists think that Indian radiologists are ...

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A continuing series on physician online reputation.  Created in partnership with The Doctors Company as part of their social media resources for physicians Physicians can use online rating sites to establish your online reputation by asking more patients to rate them online. Don't just cherry pick or pressure patients into giving you good ratings. Ask all your patients to do so, in a ...

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shutterstock_140576308 Years ago as a first-year medical student, I wrote a piece titled “Be an Innovator in Medical School.” The content was meant to be a starter guide for medical students interested in creating change at their institution or community. Now, at the tail end of medical school, I reflect on lessons I have learned along the way. 1. Do what moves ...

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shutterstock_73029814 Ask anyone connected with health care these days to provide a definition for patient engagement and you will likely receive as many answers as there are agendas surrounding the discipline. While patient engagement has evolved as a critical strategy in support of the ultimate goal of creating improved health for a total population, you would think that a mandate for a unified ...

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Idioms are expressions everyone understands as something other than what the literal words say.  For example, when I talk about “putting all of my eggs in one basket,” everyone knows I’m not really talking about eggs. We say things like: It’s raining cats and dogs. It was a piece of cake! I heard it straight from the horse’s mouth. We have a few idioms in medicine, too.  If I talk about “hanging crepe” in a ...

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shutterstock_85214245 Below is a letter I have written to parents who are hesitant about giving vaccinations to their children.  I don’t know how many it will convince, but I needed a respectful and informative way to follow up with parents who expressed concerns or declined vaccinations, and this is what I now share with them after such visits.  This is written not ...

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Antibiotic resistance is an alarming and increasing threat to global public health. According to the Centers for Disease Control and Prevention (CDC), two million people a year become infected with bacteria resistant to antibiotics and lead to 23,000 deaths in the United States alone. Simply put, the bugs are getting stronger and smarter, our antibiotic arsenal has not kept pace, and we have overused our antibiotic resources in a manner ...

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shutterstock_57058306 Twitter is a communication platform, and, therefore, it is a neutral medium. It’s not the medium itself, but how you use the medium that makes Twitter "good" or "bad." In my five years of being an anonymous and five months of being a named individual on Twitter, I have come to realize that different people use Twitter for different purposes. In ...

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shutterstock_173798813 My daughter was born, three months premature, during my third year of residency.  Following a harrowing three months in the NICU, we joyfully welcomed her home. After eight blissful but isolating weeks, I was eager to return to the wards. I happily reunited with colleagues and patients, but I also deeply missed being home. During quieter moments, I daydreamed about stroking ...

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shutterstock_228580378 I have written previously about some “aha moments” that I have had as a clinician, when something that I knew was coming seemed to arrive with a thud in my own practice. I had another one of those moments a couple of weeks ago. I was finishing up with a new patient, and had explained to him and his wife my assessment ...

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shutterstock_248807428 Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated during a routine examination. She has very severe COPD with multiple exacerbations. She has dyspnea at all times with decreased exercise capacity. She does not have cough or any change in baseline sputum production. She is adherent to ...

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