A must-read article on the challenges facing primary care today:
No serious proposals to narrow the income gap between primary care physicians and specialists are on the national agenda. Fee-for-service payment rewards quantity rather than quality, fostering the rushed visits that underlie primary care's shortcomings. Pay-for-performance programs appear to be insufficient to make a substantial difference; physicians could increase their income more -— with less additional work -— by ...
Most of the major non-profit Boston hospital CEOs are making in excess of $1 million.
The jury sends a clear message to a PCP in this case of hematuria which turned out to be bladder cancer:
"They realized, in a man over 50 years old who has blood in his urine, it is bladder cancer the majority of the time," said Gregory Patton, Doniger's Santa Ana attorney. "The doctor decided that he knew more than urologists do, and he was going to treat it like ...
Many college students in China are going under the knife during the summer:
Like a growing number of students in China, Pan Ou will spend her university vacation going under the knife in a plastic surgery procedure she hopes will boost her chances of getting a good job after graduation . . .
. . . The EverCare in Beijing is one of thousands of plastic surgery clinics ...
Another medical top 10 list - this time, the most likely misdiagnosed diseases.
According to a recent survey in Florida:
Of the students who considered ob/gyn but decided against it, 32 percent ranked "fear of malpractice" as the first or second deterrent to entering the field, compared to 21 percent who never considered ob/gyn. Nearly 27 percent of students who considered ob/gyn ranked "fear of being sued" as a first or second deterrent compared to 7 percent who never considered the specialty.
He spends a morning a week in clinic:
At the clinic, which is affiliated with the country'Â’s best-known private hospital, Dr. Vazquez wears a white smock with his name embroidered on a pocket. His colleagues, men and women alike, greet him with a kiss on the cheek, as is the custom here, and address him as "Doctor" rather than "Mr. President."
Cutler with a policy piece in the NEJM. Matthew Holt dissents.
More religion-based OB/GYN practices are popping up:
The center is one of a small but growing number of practices around the country that tailor the care they provide to the religious beliefs of their doctors, shunning birth-control and morning-after pills, IUDs and other contraceptive devices, sterilizations, and abortions, as well as in vitro fertilization. Instead, doctors offer "natural family planning" -- teaching couples to monitor a woman's temperature and other ...
Flea must be quite the intimidator to make an ER doc cry.
I'm going to side with the ER doc on this. Over the phone, you can't make an accurate assessment of the patient and thus, it's tough to call the shots on what tests should and shouldn't be ordered. If something happens to the patient, it's the ER physician's responsibility (and liability exposure), not the ...
Can this ever fly here?
The British Fertility Society is recommending women with a body mass index of 36 and over should not be allowed access to fertility treatment.
Underweight women and those classed just as obese (BMI over 29) should be forced to address their weight before starting treatment, the society said.
Many offices are starting to charge for administrative requests in this time of declining reimbursement. Hey, that's what you get in a fee-for-service system:
Doctors - particularly primary care doctors - are increasingly billing for services that patients have long expected to get gratis: prescription refills, photocopies of medical records, phone consultations, family medical leave forms, medical disability forms, waivers of insurance premiums, waivers for handicapped plates.
Automotive ...
The physician/author, Robin Cook, explores this idea in the NY Times:
As it is now, insurance companies "” following Medicare's lead "” pay primary care doctors according to the number of patients they see. Each patient visit is generally reimbursed at a flat rate of slightly more than $50. The payment is the same whether the patient is a healthy, young person with a runny nose or an elderly ...
Fox News explores this question during this interview regarding a physician accused of treating Al Qaeda members.
Reasserting that there are no certainties in medicine:
Montgomery tells us it is important to realize medicine is not a science. We imagine if it's a science, its conclusions and recommendations are certain. They're not, as any honest doctor would tell you.
And curing ourselves of this false quest for an impossible certainty is step one toward having a medicine we can live with and manage.
According to the informed opinions of physicians interviewed in Boston.
Many physicians fudge their CME requirements. However, they're not running for president:
Senate Majority Leader Bill Frist did not meet all the requirements needed to keep his medical license active - even though he gave paperwork to Tennessee officials indicating that he had, his office acknowledged Tuesday.
Tennessee requires its licensed physicians to complete 40 hours of continuing medical education every two years. Frist, a heart-lung surgeon ...
An academic thinks the proliferation of portable devices will lead to lawsuits:
Keeping employees on electronic leashes such as laptops, BlackBerries and other devices that allow them to be constantly connected to the office could soon lead to lawsuits by those who grow addicted to the technology, a U.S. academic warns.(via digg)
Their EMR is a major reason. Although I don't think it works this well:
Most private hospitals can only dream of the futuristic medicine Dr. Divya Shroff practices today. Outside an elderly patient's room, the attending physician gathers her residents around a wireless laptop propped on a mobile cart. Shroff accesses the patient's entire medical history--a stack of paper in most private hospitals. And instead of trekking to ...
Apparently some doctors "have to be prompted" to test:
Lisa, who declined to give her last name for privacy reasons, said her physician thought her symptoms were typical of the virus that causes mononucleosis, and only tested for West Nile when she prompted him to do so.
Dr. Henry Lim, who operates a family practice on the Mountain, said he did not initially recognize the symptoms despite having seen ...
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case...
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC...
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
