1) Merrill Goozner notes that when it comes to wellness programs, employees respond better to the carrot than the stick.

My take: The same goes for physicians. Instead of cutting reimbursements, why not reward them instead? P4P is a step in this direction, but the carrot is not nearly big enough.

2) The NEJM recently ran a left-pandering op-ed by the American Prospect's Robert Kuttner.

My take: The NEJM is the premier medical journal today, with unquestioned influence and authority. With great power comes great responsibility I would prefer the Journal to stay out of politics, or at least present a balanced viewpoint to counter Kuttner's article.

Pimping out its name to one side just cheapened the NEJM brand in my eyes.

3) Retail health clinics are a threat to primary care.

My take: Perhaps. The standard argument is that these clinics skim off the "straightforward" cases, leaving the time-consuming, complex patients to the PCP. As it stands, we have a severe primary care shortage, with appointments at a premium. PCPs are in no position to complain, as very few would be able to accommodate the retail health population anyways.

There is also opportunity. The growth of retail clinics has identified a subset of patients who value access and quick visits that are on time. PCPs would be smart to capitalize on this population. Open your own walk-in clinic to preempt those from retailers. Implement a "walk-in" urgent care program in your practice.

Retail clinics have little interest in practicing primary care, so a PCP should partner with existing clinics to provide a base of potential patients.

There is no reason why PCPs can't also benefit from the retail clinic phenomenon.